Upper-limb interval versus constant-load exercise in patients with COPD: a physiological crossover study

Mara Paneroni*, Ioannis Vogiatzis, Alessandro Cavicchia, Beatrice Salvi, Laura Bertacchini, Massimo Venturelli, Michele Vitacca

*Corresponding author for this work

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Objective: Upper limb exercise is recommended for patients with COPD, albeit there is limited data concerning the optimal modality to implement. We compared interval (INT-EX) to continuous (CONT-EX) upper limb exercise in terms of exercise tolerance, ventilatory, and metabolic responses when both conditions were sustained at an equivalent work rate.

Methods: Twenty-six stable COPD patients undertook three upper limb exercise sessions to initially establish peak work rate (PWR) via an incremental exercise test and subsequently two equivalent work rate tests to the limit tolerance in balanced order: a) INT-EX consisting of 30-second work at 100% PWR interspersed with 30-second work at 40% of PWR, and b) CONT-EX at 70% PWR.

Results: Twenty patients (76.9%) had longer tolerance during INT-EX, whilst 6/26 (23.1%) exhibited longer tolerance during CONT-EX. The average endurance time was 434.1±184.7 and 315.7±128.7 seconds for INT-EX and CONT-EX, respectively. During INT-EX at iso-time (i.e. when work completed was the same between INT-EX and CONT-EX), the majority of patients manifested lower oxygen uptake, minute ventilation, pulmonary hyperinflation, heart rate, symptoms, and higher CO2 blood concentration. Patients with longer INT-EX had a lower comorbidity score (CIRS: 1.58±0.30 vs 1.88±0.29, p= 0.0395) and better-preserved lung function (FVC% 84.7±15.31% vs 67.67±20.56%, p=0.0367; FEV1% 57.15±14.59 vs 44.67±12.99%, p=0.0725) compared to patients with longer CONT-EX.

Conclusion: INT-EX is more sustainable than CONT-EX for the majority of COPD patients withmoderate obstruction, leading to lower dynamic hyperinflation and symptoms at iso-time. Further studies need to define the benefits of its application during pulmonary rehabilitation
Original languageEnglish
Article number00779
Number of pages38
JournalERJ Open Research
Issue number1
Publication statusPublished - 1 Feb 2024

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