Ventilatory and metabolic adaptations to walking  and cycling in patients with COPD

Palange, Paolo; Forte, Silvia; Onorati, Paolo; Manfredi, Felice; Serra, Pietro; Carlone, Stefano

doi:10.1152/jappl.2000.88.5.1715

Cited by 173 publications

(140 citation statements)

References 16 publications

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“…This is probably due to the differences between these two exercise modalities. In comparison with cycling, walking has been shown to be less fatiguing and to produce less lactate at similar V9O 2 levels [19][20][21]. Hence, patients are able to exercise for longer periods.…”

Section: Discussionmentioning

confidence: 99%

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Cardiopulmonary stress during exercise training in patients with COPD

Probst¹

2006

Eur Respir J

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Exercise training is an essential component of pulmonary rehabilitation. However, the cardiopulmonary stress imposed during different modalities of exercise training is not yet known.In the present study, the cardiopulmonary stress of a 12-week exercise training programme in 11 chronic obstructive pulmonary disease (COPD) patients (forced expiratory volume in one second 42¡12%pred, age 69¡6 yrs) was measured. Pulmonary gas exchange and cardiac frequency (fC) of three training sessions were measured with a portable metabolic system at the beginning, mid-term and end of the programme. Symptoms were assessed with Borg scores.The exercise intensity was compared with the recommendations for exercise training by the American College of Sports Medicine (ACSM). Training effects were significant (maximum change in work: 14¡11 Watts, 6-min walk test: 44¡36 m). Whole body exercises (cycling, walking and stair climbing) consistently resulted in higher cardiopulmonary stress (oxygen uptake (V9O 2 ), minute ventilation and fC) than arm cranking and resistance training. Dyspnoea was higher during cycling than resistance training. Patients exercised for .70% (.20 min) of the total exercise time at .40% of the V9O 2 reserve and fC reserve (''moderate'' intensity according to the ACSM) throughout the programme.The cardiopulmonary stress resistance training is lower than during whole-body exercise and results in fewer symptoms. In addition, exercise testing based on guidelines using a fixed percentage of baseline peak performance and symptom scores achieves and sustains training intensities recommended according to the American College of Sports Medicine.

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Section: Discussionmentioning

confidence: 99%

“…In addition, other differences during cycling and walking, such as more hypoxaemia [21,22] and increased dead space [21], may also have influenced the performance of these exercises.…”

Section: Discussionmentioning

confidence: 99%

Cardiopulmonary stress during exercise training in patients with COPD

Probst¹

2006

Eur Respir J

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“…The mode of exercise testing may be important. It appears that walking induces a greater degree of arterial desaturation than cycling [54,86,88,286]. The 6-MWT has previously been shown to be sensitive to the administration of supplemental oxygen [287,288].…”

Section: Walking Testsmentioning

confidence: 97%

“…While desaturation may occur with any type of intense leg exercise, walking either on a treadmill or freely along the ground elicits more hypoxaemia than cycleergometry [54,[86][87][88]. Any of the standardised walk tests is suitable for diagnosing desaturation [11].…”

Section: Arterial Oxygen Desaturation During Exercisementioning

confidence: 99%

Recommendations on the use of exercise testing in clinical practice

Palange¹,

Ward²,

Carlsen³

et al. 2006

Eur Respir J

562

390

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Evidence-based recommendations on the clinical use of cardiopulmonary exercise testing (CPET) in lung and heart disease are presented, with reference to the assessment of exercise intolerance, prognostic assessment and the evaluation of therapeutic interventions (e.g. drugs, supplemental oxygen, exercise training). A commonly used grading system for recommendations in evidence-based guidelines was applied, with the grade of recommendation ranging from A, the highest, to D, the lowest.For symptom-limited incremental exercise, CPET indices, such as peak O 2 uptake (V9O 2 ), V9O 2 at lactate threshold, the slope of the ventilation-CO 2 output relationship and the presence of arterial O 2 desaturation, have all been shown to have power in prognostic evaluation. In addition, for assessment of interventions, the tolerable duration of symptom-limited high-intensity constant-load exercise often provides greater sensitivity to discriminate change than the classical incremental test. Field-testing paradigms (e.g. timed and shuttle walking tests) also prove valuable.In turn, these considerations allow the resolution of practical questions that often confront the clinician, such as: 1) ''When should an evaluation of exercise intolerance be sought?''; 2) ''Which particular form of test should be asked for?''; and 3) ''What cluster of variables should be selected when evaluating prognosis for a particular disease or the effect of a particular intervention?''

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“…Artan hızda mekik yürüme testi ile KPET'in arasında iyi bir korelasyon bulunmaktadır. KOAH'lı hastalarda yapılan çalışmada iki test arasında süre, kalp hızı, solunum sayısı, pik VO 2 ve dakika ventilasyonu yanıtlarının benzer olduğu gösterilmiştir (12,14) .…”

Section: Altı Dakika Yürüme Testiunclassified

Egzersi̇z Fi̇zyoloji̇si̇ Ve Egzersi̇z Testleri̇

Şen¹

2017

Bulletin of Thoracic Surgery

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During exercise, metabolic demand of skeletal muscles need to be required by the changes of ventilation, cardiac output, pulmonary and systemic circulation in order to provide oxygenation and to prevent the acid-base status of the body. Exercise tests are used to determine the functional exercise capacity, predict the prognosis, evaluate the clinical study results and assess the treatment response in chronic lung diseases. Cardiopulmonary exercise testing and field tests (incremental shuttle walking test, endurance shuttle walking test, six minute walking test) are currently used. Among them, the most common used exercise test is the six minute walking test. Stair climbing test, incremental shuttle walking test and cardiopulmonary exercise testing are recommended to assess the lung cancer patients who are candidates for lung resection. A cardiopulmonary exercise test is indicated when the postoperative predicted (ppo) FEV 1 or ppo DL CO (or both) are < 30% or when the performance of the stair-climbing test or the shuttle walk test is not satisfactory. A peak oxygen consumption (VO 2 peak) < 10 mL/kg/min or 35% predicted indicates a high risk of mortality and long-term disability for major anatomic resection. Conversely, a VO 2 peak > 20 mL/kg/min or 75% predicted indicates a low risk. Six minute walking test can not be recommended as a standart exercise testing tool since there is a lack of data in the preoperative assessment for lung resection.

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Ventilatory and metabolic adaptations to walking and cycling in patients with COPD

Cited by 173 publications

References 16 publications

Cardiopulmonary stress during exercise training in patients with COPD

Cardiopulmonary stress during exercise training in patients with COPD

Recommendations on the use of exercise testing in clinical practice

Egzersi̇z Fi̇zyoloji̇si̇ Ve Egzersi̇z Testleri̇

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