The Responsiveness of Exercise Tests in COPD: A Randomized Controlled Trial.
| Autor: | Harvey-Dunstan TC; Institute for Lung Health, Leicester NIHR Biomedical Research Centre - Respiratory, Leicester, England., Baldwin MM; Institute for Lung Health, Leicester NIHR Biomedical Research Centre - Respiratory, Leicester, England; Department of Respiratory Sciences, College of Life Sciences, University of Leicester, Leicester, England., Tal-Singer R; GlaxoSmithKline, Philadelphia, PA., Allinder M; GlaxoSmithKline, Philadelphia, PA., Polkey MI; Respiratory Medicine, Royal Brompton & Harefield NHS Foundation Trust, London, England; National Heart and Lung Institute, Imperial College London, London, England., Hamilton A; Boehringer Ingelheim (Canada) Ltd., Burlington, ON, Canada., Richardson M; Institute for Lung Health, Leicester NIHR Biomedical Research Centre - Respiratory, Leicester, England., Edwards SA; Institute for Lung Health, Leicester NIHR Biomedical Research Centre - Respiratory, Leicester, England., Steiner MC; Institute for Lung Health, Leicester NIHR Biomedical Research Centre - Respiratory, Leicester, England; Department of Respiratory Sciences, College of Life Sciences, University of Leicester, Leicester, England., Morgan MD; Institute for Lung Health, Leicester NIHR Biomedical Research Centre - Respiratory, Leicester, England; Department of Respiratory Sciences, College of Life Sciences, University of Leicester, Leicester, England., Singh SJ; Institute for Lung Health, Leicester NIHR Biomedical Research Centre - Respiratory, Leicester, England; Department of Respiratory Sciences, College of Life Sciences, University of Leicester, Leicester, England. Electronic address: ss1119@le.ac.uk. |
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| Jazyk: | angličtina |
| Zdroj: | Chest [Chest] 2024 Aug 21. Date of Electronic Publication: 2024 Aug 21. |
| DOI: | 10.1016/j.chest.2024.05.051 |
| Abstrakt: | Background: COPD is characterized by reduced exercise tolerance, and improving physical performance is an important therapeutic goal. A variety of exercise tests are commonly used to assess exercise tolerance, including laboratory and field-based tests. The responsiveness of these various tests to common COPD interventions is yet to be compared, but the results may inform test selection in clinical and research settings. Research Question: What exercise test possesses the greatest sensitivity to change from before to after intervention in patients with COPD? Study Design and Methods: One hundred fifty-four patients with symptomatic COPD were recruited and randomized (2:1:1) to 6 weeks of long-acting muscarinic antagonist (LAMA), pulmonary rehabilitation (PR), or usual care. Before and after intervention, participants performed an incremental cycle exercise test (ICET) and constant work rate cycle test (CWRCT), incremental shuttle walk test (ISWT) and endurance shuttle walk test (ESWT), 6-minute walk test (6MWT), and 4-m gait speed test. Results: One hundred three participants (mean ± SD age, 67 ± 8 years; 75 male participants [73%]; FEV Interpretation: The ESWT and CWRCT seemed to be the most responsive exercise test protocols to LAMA and PR therapy. The magnitude of change was much greater after a program of rehabilitation compared with bronchodilator therapy. Clinical Trial Registry: International Standard Randomised Controlled Trial Number (ISRCTN): No. 64759523; URL: https://www.isrctn.com/ISRCTN64759523. Competing Interests: Financial/Nonfinancial Disclosures The authors have reported to CHEST the following: R. T.-S. is a retiree and shareholder of GlaxoSmithKline since 2019. M. A. is a former employee of GlaxoSmithKline. A.H is a former employee of Boehringer Ingelheim (Canada) Ltd. M. C. S reports personal fees and non-financial support from Boehringer Ingelheim and GlaxoSmithKline, outside the submitted work. None declared (T. C.H.-D., M. M. B, M. I. P, M. R, S. A. E, M. D. M, S. J. S). (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.) |
| Databáze: | MEDLINE |
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