TY - JOUR
T1 - Greater exercise tolerance in COPD during acute intermittent compared to continuous shuttle walking protocols
T2 - a proof-of-concept study
AU - Alexiou, Charikleia
AU - Chambers, Francesca
AU - Megaritis, Dimitrios
AU - Wakenshaw, Lynsey
AU - Echevarria, Carlos
AU - Vogiatzis, Ioannis
N1 - Funding information: Charikleia Alexiou acknowledges the Greek Foundation ‘Klirodotima Sofokleous Axillopoulou’ for providing their valuable financial support for the fulfilment of this study as part of her PhD degree.
PY - 2022
Y1 - 2022
N2 - Objectives: Ground-based walking is a simple training modality which would suit pulmonary rehabilitation (PR) settings with limited access to specialist equipment. Patients with COPD are, however, unable to walk uninterruptedly at a relatively fast walking pace to optimise training benefits. We compared an intermittent (IntSW) to a continuous (CSW) shuttle walking protocol. Methods: In 14 COPD patients (mean ± SD. FEV
1: 45 ± 21% predicted) we measured walking distance, cardiac output (CO), arterial oxygen saturation (SpO
2), and symptoms during (a) an IntSW protocol, consisting of 1-min walking alternating with 1-min rest, and (b) a CSW protocol, both sustained at 85% of predicted VO
2 peak to the limit of tolerance (Tlim). Results: Median (IQR) distance was greater (p = 0.001) during the IntSW protocol (735 (375–1107) m) than the CSW protocol (190 (117–360) m). At iso-distance (distance at Tlim during CSW) the IntSW compared to the CSW protocol was associated with lower CO (8.6 ± 2.6 vs 10.3 ± 3.7 L/min; p = 0.013), greater SpO
2 (92 ± 6% versus 90 ± 7%; p = 0.002), and lower symptoms of dyspnoea (2.8 ± 1.3 vs 4.9 ± 1.4; p = 0.001) and leg discomfort (2.3 ± 1.7 vs 4.2 ± 2.2; p = 0.001). At Tlim symptoms of dyspnoea and leg discomfort did not differ between the IntSW (4.4 ± 1.9 and 3.6 ± 2.1, respectively) and the CSW protocol. Conclusions: The IntSW protocol may provide important clinical benefits during exercise training in the PR settings because it allows greater work outputs compared to the CSW.
AB - Objectives: Ground-based walking is a simple training modality which would suit pulmonary rehabilitation (PR) settings with limited access to specialist equipment. Patients with COPD are, however, unable to walk uninterruptedly at a relatively fast walking pace to optimise training benefits. We compared an intermittent (IntSW) to a continuous (CSW) shuttle walking protocol. Methods: In 14 COPD patients (mean ± SD. FEV
1: 45 ± 21% predicted) we measured walking distance, cardiac output (CO), arterial oxygen saturation (SpO
2), and symptoms during (a) an IntSW protocol, consisting of 1-min walking alternating with 1-min rest, and (b) a CSW protocol, both sustained at 85% of predicted VO
2 peak to the limit of tolerance (Tlim). Results: Median (IQR) distance was greater (p = 0.001) during the IntSW protocol (735 (375–1107) m) than the CSW protocol (190 (117–360) m). At iso-distance (distance at Tlim during CSW) the IntSW compared to the CSW protocol was associated with lower CO (8.6 ± 2.6 vs 10.3 ± 3.7 L/min; p = 0.013), greater SpO
2 (92 ± 6% versus 90 ± 7%; p = 0.002), and lower symptoms of dyspnoea (2.8 ± 1.3 vs 4.9 ± 1.4; p = 0.001) and leg discomfort (2.3 ± 1.7 vs 4.2 ± 2.2; p = 0.001). At Tlim symptoms of dyspnoea and leg discomfort did not differ between the IntSW (4.4 ± 1.9 and 3.6 ± 2.1, respectively) and the CSW protocol. Conclusions: The IntSW protocol may provide important clinical benefits during exercise training in the PR settings because it allows greater work outputs compared to the CSW.
KW - COPD
KW - Intermittent exercise
KW - cardiac output
KW - symptoms
UR - http://www.scopus.com/inward/record.url?scp=85144492926&partnerID=8YFLogxK
U2 - 10.1177/14799731221142023
DO - 10.1177/14799731221142023
M3 - Article
C2 - 36548147
SN - 1479-9723
VL - 19
SP - 1
EP - 11
JO - Chronic Respiratory Disease
JF - Chronic Respiratory Disease
M1 - 147997312211420
ER -