Abstract
Almost half the patients referred to pulmonary rehabilitation with chronic obstructive pulmonary disease (COPD) desaturate during exercise. Although oxygen supplementation may ameliorate oxygen desaturation, the effects on outcomes of exercise training have not been rigorously evaluated. The study aimed to determine whether supplemental oxygen during exercise training was more effective than medical air in improving exercise capacity and health-related quality of life in people with COPD.
People with COPD who demonstrated oxygen desaturation <90% during the six-minute walk test were recruited to this multi-centre trial with randomisation (independent, concealed allocation) to either an Oxygen Group or Air Group, blinding (participants, exercise trainers and European Respiratory Journal assessors) and intention-to-treat analysis. Both groups received the respective gas from concentrators via nasal prongs at five litres/min during exercise training consisting of treadmill and cycle exercise, three times/week for eight weeks. Primary outcomes were the endurance shuttle walk test (ESWT) and Chronic Respiratory Disease Questionnaire total score (CRQ-Total).
111 participants (60 males), mean (sd) age 69 (7) years, with moderate to severe COPD were recruited and 97 completed (Oxygen Group n=52; Air Group n=45). At the end of the 8-week training there were no between-group differences in change in ESWT (mean difference [95% Confidence Interval] 15 s [−106–136] or change in CRQ-Total (0.0 points [−0.3–0.3]). Within-group changes at end-training were significant for ESWT and CRQ-Total (all p<0.01).
Exercise capacity and health-related quality of life improved in both groups, with no greater benefit from training with supplemental oxygen than medical air.
Footnotes
This manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.
Conflict of interest: Dr. Morris reports grants from National Health and Medical Resaerch Council, Australia, during the conduct of the study.
Conflict of interest: Dr. Jenkins reports grants from National Health & Medical Research Council, Australia, during the conduct of the study.
Conflict of interest: Dr. McKeough reports grants from National Health & Medical Research Council, Australia, during the conduct of the study.
Conflict of interest: Dr. Cecins reports grants from National Health & Medical Research Council, Australia, during the conduct of the study.
Conflict of interest: Dr. Hill reports grants from National Health & Medical Research Council, Australia, during the conduct of the study.
Conflict of interest: Dr. Hill reports grants from NHMRC Australia, during the conduct of the study; personal fees from Menarini Australia, personal fees from Journal of Physiotherapy, grants from Better Breathing Foundation, personal fees from SLACK publishing, outside the submitted work.
Conflict of interest: Dr. McDonald reports personal fees from Pfizer, personal fees from GSK, personal fees from Novartis, other from Menarini, outside the submitted work.
Conflict of interest: Dr. Seale reports grants from National Health & Medical Research Council, Australia, during the conduct of the study.
Conflict of interest: Dr. Alison reports grants from National Health & Medical Research Council, Australia, during the conduct of the study.
Conflict of interest: Dr. Leung reports grants and personal fees from National Health and Medical Research Council, Australia, during the conduct of the study.
Conflict of interest: Dr. Lee reports grants from National Health and Medical Resaerch Council, Australia, during the conduct of the study.
Conflict of interest: Dr. Spencer reports grants from National Health & Medical Research Council, Australia, during the conduct of the study.
Conflict of interest: Dr. Holland reports grants from National Health & Medical Research Council, Australia, during the conduct of the study.
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