Upper-limb interval versus constant-load exercise in patients with COPD: a physiological crossover study
Objective Upper-limb exercise is recommended for patients with COPD, albeit there are 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 con...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
European Respiratory Society
2024-02-01
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| Series: | ERJ Open Research |
| Online Access: | http://openres.ersjournals.com/content/10/1/00779-2023.full |
| _version_ | 1827330643545030656 |
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| author | Mara Paneroni Ioannis Vogiatzis Alessandro Cavicchia Beatrice Salvi Laura Bertacchini Massimo Venturelli Michele Vitacca |
| author_facet | Mara Paneroni Ioannis Vogiatzis Alessandro Cavicchia Beatrice Salvi Laura Bertacchini Massimo Venturelli Michele Vitacca |
| author_sort | Mara Paneroni |
| collection | DOAJ |
| description | Objective
Upper-limb exercise is recommended for patients with COPD, albeit there are 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
26 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: 1) INT-EX consisting of 30-s work at 100% PWR interspersed with 30-s work at 40% of PWR; and 2) CONT-EX at 70% PWR.
Results
20 patients (76.9%) had longer tolerance during INT-EX, while six out of 26 (23.1%) exhibited longer tolerance during CONT-EX. The average endurance time was 434.1±184.7 and 315.7±128.7 s for INT-EX and CONT-EX, respectively. During INT-EX at isotime (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 (Cumulative Illness Rating Scale: 1.58±0.30 versus 1.88±0.29, p=0.0395) and better-preserved lung function (forced vital capacity 84.7±15.31% versus 67.67±20.56%, p=0.0367; forced expiratory volume in 1 s 57.15±14.59 versus 44.67±12.99% predicted, 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 with moderate obstruction, leading to lower dynamic hyperinflation and symptoms at isotime. Further studies need to define the benefits of its application during pulmonary rehabilitation. |
| first_indexed | 2024-03-07T16:15:24Z |
| format | Article |
| id | doaj.art-e847493900764d1d832bd74c967d1892 |
| institution | Directory Open Access Journal |
| issn | 2312-0541 |
| language | English |
| last_indexed | 2024-03-07T16:15:24Z |
| publishDate | 2024-02-01 |
| publisher | European Respiratory Society |
| record_format | Article |
| series | ERJ Open Research |
| spelling | doaj.art-e847493900764d1d832bd74c967d18922024-03-04T11:30:00ZengEuropean Respiratory SocietyERJ Open Research2312-05412024-02-0110110.1183/23120541.00779-202300779-2023Upper-limb interval versus constant-load exercise in patients with COPD: a physiological crossover studyMara Paneroni0Ioannis Vogiatzis1Alessandro Cavicchia2Beatrice Salvi3Laura Bertacchini4Massimo Venturelli5Michele Vitacca6 Istituti Clinici Scientifici Maugeri IRCCS, Respiratory Rehabilitation of the Institute of Lumezzane, Brescia, Italy Northumbria University, Faculty of Health and Life Sciences, Department of Sport, Exercise and Rehabilitation, Newcastle, UK University of Verona, Department of Neurosciences Biomedicine and Movement Sciences, Verona, Italy Istituti Clinici Scientifici Maugeri IRCCS, Respiratory Rehabilitation of the Institute of Lumezzane, Brescia, Italy Istituti Clinici Scientifici Maugeri IRCCS, Respiratory Rehabilitation of the Institute of Lumezzane, Brescia, Italy University of Verona, Department of Neurosciences Biomedicine and Movement Sciences, Verona, Italy Istituti Clinici Scientifici Maugeri IRCCS, Respiratory Rehabilitation of the Institute of Lumezzane, Brescia, Italy Objective Upper-limb exercise is recommended for patients with COPD, albeit there are 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 26 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: 1) INT-EX consisting of 30-s work at 100% PWR interspersed with 30-s work at 40% of PWR; and 2) CONT-EX at 70% PWR. Results 20 patients (76.9%) had longer tolerance during INT-EX, while six out of 26 (23.1%) exhibited longer tolerance during CONT-EX. The average endurance time was 434.1±184.7 and 315.7±128.7 s for INT-EX and CONT-EX, respectively. During INT-EX at isotime (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 (Cumulative Illness Rating Scale: 1.58±0.30 versus 1.88±0.29, p=0.0395) and better-preserved lung function (forced vital capacity 84.7±15.31% versus 67.67±20.56%, p=0.0367; forced expiratory volume in 1 s 57.15±14.59 versus 44.67±12.99% predicted, 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 with moderate obstruction, leading to lower dynamic hyperinflation and symptoms at isotime. Further studies need to define the benefits of its application during pulmonary rehabilitation.http://openres.ersjournals.com/content/10/1/00779-2023.full |
| spellingShingle | Mara Paneroni Ioannis Vogiatzis Alessandro Cavicchia Beatrice Salvi Laura Bertacchini Massimo Venturelli Michele Vitacca Upper-limb interval versus constant-load exercise in patients with COPD: a physiological crossover study ERJ Open Research |
| title | Upper-limb interval versus constant-load exercise in patients with COPD: a physiological crossover study |
| title_full | Upper-limb interval versus constant-load exercise in patients with COPD: a physiological crossover study |
| title_fullStr | Upper-limb interval versus constant-load exercise in patients with COPD: a physiological crossover study |
| title_full_unstemmed | Upper-limb interval versus constant-load exercise in patients with COPD: a physiological crossover study |
| title_short | Upper-limb interval versus constant-load exercise in patients with COPD: a physiological crossover study |
| title_sort | upper limb interval versus constant load exercise in patients with copd a physiological crossover study |
| url | http://openres.ersjournals.com/content/10/1/00779-2023.full |
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