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Dynamic hyperinflation and tolerance to interval exercise in patients with advanced COPD

¹ Dept of Pulmonary and Critical Care Medicine, Cardiopulmonary Rehabilitation Centre, Eugenidion Hospital, ² Dept of Physical Education and Sport Science, National and Kapodistrian University of Athens and, ³ Third Pulmonary Dept, Seismanoglion Hospital, Athens, Greece

CORRESPONDENCE: I. Vogiatzis, National and Kapodistrian University of Athens Medical School, Dept of Pulmonary and Critical Care Medicine, Eugenidion Hospital 2nd Floor, 20 Papandiamantopoulou Str 115-28 Ilisia, Athens, Greece. Fax: 30 2107242785. E-mail: gianvog@phed.uoa.gr

Keywords: Chronic obstructive pulmonary disease, dynamic hyperinflation, dyspnoea, interval exercise

Received: November 19, 2003
Accepted May 10, 2004

This work was supported in part by theEuropean Community. Project title: Computer Aided Rehabilitation of Respiratory Disabilities (CARED) FP5 (contract no. QLG5-CT-2002-0893).

Dynamic hyperinflation (DH) contributes importantly to the limitation of constant-load exercise (CLE) in patients with chronic obstructive pulmonary disease (COPD). However, its role in the limitation of interval exercise (IE) remains to be explored.

The change () in inspiratory capacity (IC) was measured to reflect changes in DH in 27 COPD patients (forced expiratory volume in one second mean±SEM % predicted: 40±3) at the end of a symptom-limited CLE test at 80% of peak work capacity (WR_max) and an IE test at 100% WR_max (30 s of work, alternated with 30 s of unloaded pedalling).

At the limit of tolerance in both IE and CLE, patients exhibited similar DH (IC: 0.39±0.05 L and 0.45±0.05 L, respectively). However, exercise endurance time (t_end) for IE (32.7±3.0 min) was significantly greater than for CLE (10.3±1.6 min). The IE t_end correlated with resting IC, expressed as % pred normal. At 30 and 90% of total IE t_end, IC (0.43±0.06 and 0.39±0.05 L, respectively) and minute ventilation (31.1±1.6 and 32.7±2.2 L·min^–1, respectively) were not significantly different.

Resting hyperinflation helps to explain the limitation of interval exercise. Implementation of interval exercise for rehabilitation should provide important clinical benefits because it prolongs exercise endurance time and allows sustaining higher stable ventilation.

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