Greater exercise tolerance in COPD during acute intermittent compared to continuous shuttle walking protocols: a proof-of-concept study

Charikleia Alexiou*, Francesca Chambers, Dimitrios Megaritis, Lynsey Wakenshaw, Carlos Echevarria, Ioannis Vogiatzis

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

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 FEV1: 4521% predicted) we measured walking distance, cardiac output (CO), arterial oxygen saturation (SpO2), 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 VO2 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 versus 10.33.7 L/min; p=0.013), greater SpO2 (926% versus 907%; p=0.002), and lower symptoms of dyspnoea (2.81.3 versus 4.91.4; p=0.001) and leg discomfort (2.31.7 versus 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 setting because it allows greater work outputs compared to the CSW.
Original languageEnglish
JournalChronic Respiratory Disease
DOIs
Publication statusAccepted/In press - 3 Nov 2022

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