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Physiological Response to Moderate Exercise Workloads in a Pulmonary Rehabilitation Program in Patients With Varying Degrees of Airflow Obstruction^*

^* From the School of Health Sciences (Dr. Vogiatzis and Mr. Williamson), University of Sunderland, and the Departments of Physiotherapy (Ms. Miles) and Respiratory Medicine (Dr. Taylor), Sunderland Royal Hospital, Sunderland, UK.

Correspondence to: Ioannis Vogiatzis, PhD, University of Athens Medical School, Department of Pulmonary and Critical Care Medicine, Eugenidion Hospital, 2nd Floor, 20 Papandiamantopoulou Str 115–28, Ilisia, Athens, Greece; e-mail: vogiatzis{at}hotmail.com

Study objectives: To investigate whether a 12-week pulmonary rehabilitation program that includes moderately intensive exercise training performed twice weekly can induce a training effect in patients with a wide variation of airflow limitation.

Participants: Sixty patients with COPD (38 men) with a mean ± SD FEV₁ % predicted of 55.1 ± 19.8 (range, 0.51 to 2.99). All patients performed identical incremental symptom-limited cycle ergometer testing before and after a 12-week study period.

Measurements and results: After 12 weeks, the patients demonstrated a significant (p < 0.05) increase in the peak values for work rate (WR; 77 ± 30 vs 91 ± 36 W) and oxygen uptake (1.14 ± 0.45 vs 1.20 ± 0.52 L/min). Furthermore, at a given WR during incremental symptom-limited cycle ergometer testing, there were significant (p < 0.05) reductions in minute ventilation (42.4 ± 16.1 vs 37.0 ± 13.6 L/min), carbon dioxide output (1.13 ± 0.49 vs 1.03 ± 0.42 L/min), ventilatory equivalent for oxygen (37.6 ± 8.1 vs 36.0 ± 6.3), and heart rate (135 ± 15 vs 128 ± 16 beats/min). None of the observed physiologic changes correlated with FEV₁ % predicted.

Conclusions: A pulmonary rehabilitation program performed twice weekly with moderate exercise workloads can lead to a physiologic training response irrespective of the degree of airflow limitation.

Key Words: COPD • exercise training • pulmonary rehabilitation

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