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A Simplified Approach to Select Exercise Endurance Intensity for Interventional Studies in COPD.
Degani-Costa, Luiza H; O'Donnell, Denis E; Webb, Katherine; Aranda, Liliane C; Carlstron, Júlio P; Cesar, Tamires da Silva; Plachi, Franciele; Berton, Danilo C; Neder, J Alberto; Nery, Luiz E.
Afiliação
  • Degani-Costa LH; a Respiratory Division, Department of Medicine, Sao Paulo School of Medicine , Federal University of Sao Paulo , Sao Paulo , SP , Brazil.
  • O'Donnell DE; b Respiratory Investigation Unit, Division of Respiratory and Critical Care Medicine, Department of Medicine , Queen's University , Kingston , ON , Canada.
  • Webb K; b Respiratory Investigation Unit, Division of Respiratory and Critical Care Medicine, Department of Medicine , Queen's University , Kingston , ON , Canada.
  • Aranda LC; a Respiratory Division, Department of Medicine, Sao Paulo School of Medicine , Federal University of Sao Paulo , Sao Paulo , SP , Brazil.
  • Carlstron JP; a Respiratory Division, Department of Medicine, Sao Paulo School of Medicine , Federal University of Sao Paulo , Sao Paulo , SP , Brazil.
  • Cesar TDS; a Respiratory Division, Department of Medicine, Sao Paulo School of Medicine , Federal University of Sao Paulo , Sao Paulo , SP , Brazil.
  • Plachi F; c Division of Respirology , Federal University of Rio Grande do Sul , Porto Alegre , Brazil.
  • Berton DC; b Respiratory Investigation Unit, Division of Respiratory and Critical Care Medicine, Department of Medicine , Queen's University , Kingston , ON , Canada.
  • Neder JA; c Division of Respirology , Federal University of Rio Grande do Sul , Porto Alegre , Brazil.
  • Nery LE; b Respiratory Investigation Unit, Division of Respiratory and Critical Care Medicine, Department of Medicine , Queen's University , Kingston , ON , Canada.
COPD ; 15(2): 139-147, 2018 04.
Article em En | MEDLINE | ID: mdl-29485343
Time to exercise limitation (Tlim) in response to constant work rate (CWR) is sensitive to interventions in chronic obstructive pulmonary disease (COPD). This is particularly true when the pre-intervention test lasts between 3 and 8 min (Tlim3'-8'). There is, however, no simple method to select a work rate which is consistently associated with Tlim3'-8' across the spectrum of COPD severity. We assessed 59 GOLD stages II-IV patients who initially cycled to Tlim at 75% peak. In case of short (<3 min, low-endurance) or long (>8 min, high-endurance) tests, patients exercised after 60 min at 50% or 90%, respectively (CWR50%⇐75%⇒90%). Critical mechanical constraints and limiting dyspnea at 75% were reached within the desired timeframe in 27 "mid-endurance" patients (46%). Increasing work rate intensity to 90% hastened the mechanical-ventilatory responses leading to Tlim3'-8' in 23/26 (88%) "high-endurance" patients; conversely, decreasing exercise intensity to 50% slowed those responses leading to Tlim3'-8' in 5/6 (83%) "high-endurance" patients. Repeating the tests at higher (60%) or lower (80%) intensities fail to consistently produce Tlim3'-8' in "low-" and "high-endurance", respectively (p > 0.05). Compared to a fixed work rate at 75%, CWR50%⇐75%⇒90% significantly decreased Tlim's coefficient of variation; consequently, the required N to detect 100 s or 33% improvement in Tlim decreased from 82 to 26 and 41 to 14, respectively. This simplified approach to individualized work rate adjustment (CWR50%⇐75%⇒90%) might allow greater sensitivity in evaluating interventional efficacy in improving respiratory mechanics and exercise tolerance while simultaneously reducing sample size requirements in patients with COPD.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Resistência Física / Doença Pulmonar Obstrutiva Crônica / Dispneia / Teste de Esforço Tipo de estudo: Etiology_studies Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: COPD Ano de publicação: 2018 Tipo de documento: Article País de afiliação: Brasil País de publicação: Reino Unido
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Resistência Física / Doença Pulmonar Obstrutiva Crônica / Dispneia / Teste de Esforço Tipo de estudo: Etiology_studies Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: COPD Ano de publicação: 2018 Tipo de documento: Article País de afiliação: Brasil País de publicação: Reino Unido