Greater exercise tolerance in COPD during acute intermittent compared to continuous shuttle walking protocols: A proof-of-concept study

Author:

Alexiou Charikleia1ORCID,Chambers Francesca2,Megaritis Dimitrios1,Wakenshaw Lynsey2,Echevarria Carlos3,Vogiatzis Ioannis1

Affiliation:

1. Faculty of Health and Life Sciences, Department of Sport, Exercise and Rehabilitation, Northumbria University Newcastle, Newcastle upon Tyne, UK

2. Pulmonary Rehabilitation Services, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK

3. Department of Respiratory Medicine, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK

Abstract

Objectives: Ground-based walking is a simple training modality which would suit pulmonary rehabilitation (PR) settings with limited access to specialist equipment. Patients with COPD are, however, unable to walk uninterruptedly at a relatively fast walking pace to optimise training benefits. We compared an intermittent (IntSW) to a continuous (CSW) shuttle walking protocol. Methods: In 14 COPD patients (mean ± SD. FEV1: 45 ± 21% predicted) we measured walking distance, cardiac output (CO), arterial oxygen saturation (SpO2), and symptoms during (a) an IntSW protocol, consisting of 1-min walking alternating with 1-min rest, and (b) a CSW protocol, both sustained at 85% of predicted VO2 peak to the limit of tolerance (Tlim). Results: Median (IQR) distance was greater ( p = 0.001) during the IntSW protocol (735 (375–1107) m) than the CSW protocol (190 (117–360) m). At iso-distance (distance at Tlim during CSW) the IntSW compared to the CSW protocol was associated with lower CO (8.6 ± 2.6 vs 10.3 ± 3.7 L/min; p = 0.013), greater SpO2 (92 ± 6% versus 90 ± 7%; p = 0.002), and lower symptoms of dyspnoea (2.8 ± 1.3 vs 4.9 ± 1.4; p = 0.001) and leg discomfort (2.3 ± 1.7 vs 4.2 ± 2.2; p = 0.001). At Tlim symptoms of dyspnoea and leg discomfort did not differ between the IntSW (4.4 ± 1.9 and 3.6 ± 2.1, respectively) and the CSW protocol. Conclusions: The IntSW protocol may provide important clinical benefits during exercise training in the PR settings because it allows greater work outputs compared to the CSW.

Publisher

SAGE Publications

Subject

Pulmonary and Respiratory Medicine

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