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Effects of a Walking Aid in COPD Patients Receiving Oxygen Therapy^*

^* From Departments of Pulmonary Rehabilitation (Drs. Crisafulli and Clini, and Ms. Eutropio) and Oncology, Haematology, and Pneumology (Dr. Fabbri and Ms. Costi), University of Modena; Clinic Center Private Hospital (Dr. De Blasio and Mr. Penza), Pulmonary Rehabilitation Unit, Napoli; and Department of Pulmonary Rehabilitation (Drs. Biscione, Pasqua, and Ms. Americi), IRCCS San Raffaele, Velletri, Rome, Italy.

Correspondence to: Enrico M. Clini, MD, FCCP, University of Modena-Reggio Emilia, Department of Pulmonary Rehabilitation, Ospedale Villa Pineta, Italy, Via Gaiato 127, 41026 Pavullo n/F (MO); e-mail: clini.enrico{at}unimore.it

Abstract

Study objectives: To elucidate whether a simple walking aid may improve physical performance in COPD patients with chronic respiratory insufficiency who usually carry their own heavy oxygen canister.

Design: Randomized crossover trial.

Setting: Physiopathology laboratory of three rehabilitation centers.

Patients and interventions: We studied 60 stable COPD patients (mean age, 70.6 ± 7.9 years; FEV₁, 44.8 ± 14.3% of predicted [± SD]) with chronic respiratory insufficiency who randomly performed, on 2 consecutive days, a standardized 6-min walking test using two different modalities: a full-weight oxygen canister transported using a small wheeled cart and pulled by the patient (Aid modality) or full-weight oxygen canister carried on the patient’s shoulder (No-Aid modality).

Measurements and results: The distance walked, peak effort dyspnea, and leg fatigue scores as primary outcomes, and other cardiorespiratory parameters as secondary outcomes were recorded during both tests. A significant difference (p < 0.05) between the two tests occurred for all the measured outcomes in favor of the Aid modality. Most importantly, significant changes for distance (+ 43 m, p < 0.001), peak effort dyspnea (– 2.0 points, p < 0.001), leg fatigue (– 1.4 points, p < 0.001), as well as for mean and nadir oxygen saturation and heart rate with the Aid modality (but not with the No-Aid modality) were recorded in the subgroup of patients walking < 300 m at baseline.

Conclusions: This study suggests that a simple walking aid may be helpful in COPD patients receiving long-term oxygen therapy, particularly in those with lower residual exercise capacity.

Key Words: exercise • 6-min walking test • symptoms • wheeled cart