Influence of Disease Severity and Exercise Limitation on Exercise Training Intensity and Load and Health Benefits From Pulmonary Rehabilitation in Patients With COPD: AN EXPLORATORY STUDY
| Autor: | Bradley W. Byers, Anne-Marie Selzler, Desi P Fuhr, Virginia C Huynh, Linn E. Moore, Michael K. Stickland |
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| Rok vydání: | 2018 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty medicine.medical_treatment Physical Exertion Walk Test macromolecular substances Severity of Illness Index Inspiratory Capacity 03 medical and health sciences Pulmonary Disease Chronic Obstructive 0302 clinical medicine Forced Expiratory Volume Surveys and Questionnaires Severity of illness medicine Humans Pulmonary rehabilitation Expiration Exercise physiology Exercise Aged COPD business.industry Rehabilitation 030229 sport sciences Middle Aged medicine.disease Obstructive lung disease Exercise Therapy 030228 respiratory system Exercise intensity Physical therapy Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of cardiopulmonary rehabilitation and prevention. 38(5) |
| ISSN: | 1932-751X |
| Popis: | Purpose Some patients with chronic obstructive pulmonary disease (COPD) fail to achieve health benefits with pulmonary rehabilitation (PR). Exercise intensity and load represent stimulus for adaptation but it is unclear whether inappropriate exercise intensity and/or load are affected by severity of COPD, which may affect health benefits. The purpose was to determine whether COPD severity and/or the severity of pulmonary limitation to exercise (PLE) impacted exercising intensity or load and whether resultant intensity/load affected health outcomes derived from PR. Methods Patients with COPD (n = 58, age = 67 ± 7 y, forced expiratory volume in the first second of expiration [FEV1] % predicted = 52 ± 21%) were recruited upon referral to PR. Primary health outcomes evaluated were 6-min walk distance and St George's Respiratory Questionnaire. Patients were stratified for disease severity using Global Initiative for Obstructive Lung Disease (GOLD) staging and PLE severity by change in inspiratory capacity during exercise. Exercise intensity and load were calculated from daily exercise records. Results Participants achieved comparable training duration and load regardless of GOLD severity. Patients with more severe PLE achieved greater training duration (more severe: 546 ± 143 min., less severe: 451 ± 109 min., P = .036), and relative training load (more severe: 2200.8 ± 595.3 kcal, less severe: 1648.3 ± 597.8 kcal, P = .007). Greater overall training load was associated with greater improvements in 6-min walk distance (r = 0.24, P = .035). No significant relationships were observed between PLE, GOLD severity, training parameters, and St George's Respiratory Questionnaire response. Conclusions Improvements in exercise tolerance can be explained by achieving greater training loads, demonstrating the importance of appropriate training load to maximize health outcomes in PR. |
| Databáze: | OpenAIRE |
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