Article

OBJECTIVES: To compare conventional exercise-based assessment of pulmonary
rehabilitation (PR) with improvement in training exercises employed during a PR
program, and to describe the cardiopulmonary response of different training
exercises during PR of patients with chronic obstructive pulmonary disease
(COPD). DESIGN: Observational study. SETTING: Inpatient PR. PARTICIPANTS:
Patients with moderate to very severe COPD (N=18). INTERVENTIONS: Not applicable.
MAIN OUTCOME MEASURES: Cardiopulmonary responses to interval cycling, arm
exercise, and a test of functional activities of daily living (ADLs) were
evaluated during the PR training program using a mobile telemetric
breath-by-breath system. The effects of PR were evaluated by comparing pre-PR and
post-PR training activities, incremental and constant work-rate cycling, and a
6-minute walk test. RESULTS: Interval cycling and the ADLs test were
moderate-intensity to heavy-intensity exercises (70%-80% of maximal oxygen
consumption), while the arm exercise was a low-intensity activity (40% of maximal
oxygen consumption). After 12 weeks of PR, cycle load, arm weights, and walking
distances during training activities had increased alongside increased muscle
mass. At iso-intensities, no cardiopulmonary changes in the training exercises
were observed. Exercise duration of constant work-rate cycling and 6-minute walk
distance increased by 160% and 14%, respectively, after PR, with concurrent
right-shifts of anaerobic threshold and a decrease in heart rate. CONCLUSIONS:
Supervised increases in weight, load, and walking distance during training
activities were useful clinical outcomes for patients, demonstrating the
beneficial effects of progressive training on physical performance. However, for
physiologic evaluation of PR, conventional tests, such as maximal incremental
cycling, endurance cycling, and a 6-minute walk test, had greater validity.
Physiologic evaluation of the training exercises showed that the training program
complied with the training recommendations for PR.
CI - Copyright (c) 2011 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS