Validation of Constant Work Rate Cycling Endurance Time for Use in Chronic Obstructive Pulmonary Disease Clinical Trials.

A COPD Foundation working group sought to identify measures of exercise endurance, a meaningful aspect of physical functioning in everyday life among patients with chronic obstructive pulmonary disease (COPD) that is not fully accepted in regulatory decision making, hampering drug development. To demonstrate, as we previously asserted (Casaburi 2022;9:252), that constant work rate cycling endurance time is an appropriate exercise endurance measure in patients with COPD. To validate this assertion, we assembled an integrated database of endurance time responses, including 8 bronchodilator (2,166 subjects) and 15 exercise training (3,488 subjects) studies (Casaburi 2022;9:520).

Understanding the effectiveness of different exercise training programme designs on V̇O in COPD: a component network meta-analysis.

Pulmonary rehabilitation programmes including aerobic training improve cardiorespiratory fitness in patients with COPD, but the optimal programme design is unclear. We used random effects additive component network meta-analysis to investigate the relative effectiveness of different programme components on fitness measured by V̇O in COPD. The included 59 studies involving 2191 participants demonstrated that V̇O increased after aerobic training of at least moderate intensity with the greatest improvement seen following high intensity training.

Endurance Time During Constant Work Rate Cycle Ergometry in COPD: Development of an Integrated Database From Interventional Studies.

Introduction: The COPD Biomarkers Qualification Consortium (CBQC) was formed under COPD Foundation management, with the goal of qualifying biomarkers and clinical outcome assessments through established regulatory processes for chronic obstructive pulmonary disease (COPD). Within CBQC, a working group evaluated opportunities for qualification of an exercise endurance measure. In a recent publication ( 2022; 9[2]:252-265), we described a conceptual framework establishing exercise endurance's direct relationship to an individual with COPD's experience of physical functioning in daily life, and that increase in exercise endurance is a patient-centered, meaningful treatment benefit.

Change in V˙O in Response to Aerobic Exercise Training and the Relationship With Exercise Prescription in People With COPD: A Systematic Review and Meta-analysis.

Background: Despite the wide-ranging benefits of pulmonary rehabilitation, conflicting results remain regarding whether people with COPD can improve their peak oxygen uptake (V˙O with aerobic training.

Research Question: The goal of this study was to investigate the effect of aerobic training and exercise prescription on V˙O in COPD.

Study Design And Methods: A systematic review was performed by using MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature, and Cochrane databases for all studies measuring V˙O prior to and following supervised lower-limb aerobic training in COPD.

Neuromuscular electrostimulation for adults with chronic obstructive pulmonary disease.

Background: In people with chronic obstructive pulmonary disease (COPD), the use of neuromuscular electrostimulation (NMES) either alone, or together with conventional exercise training, might improve the condition of the peripheral muscles, increase exercise capacity and functional performance, reduce symptoms and improve health-related quality of life (HRQoL).

Objectives: To determine the effects of NMES, applied in isolation or concurrently with conventional exercise training to one or more peripheral muscles, on peripheral muscle force and endurance, muscle size, exercise capacity, functional performance, symptoms, HRQoL and adverse events in people with COPD.

Search Methods: We searched the Cochrane Airways Group Specialised Register, the Physiotherapy Evidence Database, clinical trial registries and conference abstracts on 14 March 2018.

The Impact of Listening to Music During a High-Intensity Exercise Endurance Test in People With COPD.

Background: In people with COPD, dyspnea is the primary symptom limiting exercise tolerance. One approach to reducing dyspnea during exercise is through music listening. A constant speed endurance test reflects a high-intensity aerobic exercise training session, but whether listening to music affects endurance time is unknown.

Gait Speed: Validity of Measurement in Patients With Severe Chronic Lung Disease, Including Prognostic and Practical Implications.

Gait speed is used increasingly to predict function and future well-being among healthy elderly people as well as for those with long-term medical conditions. When selecting outcome measures such as walking speed, it is important to include the circumstances under which the measurement is made to avoid bias and ensure accurate recommendations. We completed a retrospective chart review of walking test results from patients with chronic lung disease to demonstrate the practical implications of reporting gait speed from either a standing or walking start.

The effects of exercise modality and intensity on energy expenditure and cardiorespiratory response in adults with obesity and treated obstructive sleep apnoea.

To inform recommendations for the exercise component of a healthy lifestyle intervention for adults with obesity and treated obstructive sleep apnoea (OSA), we investigated the total energy expenditure (EE) and cardiorespiratory response to weight-supported (cycling) and unsupported (walking) exercise. Individuals with treated OSA and a body mass index (BMI) > 30 kg/m performed an incremental cardiopulmonary exercise test on a cycle ergometer and a treadmill to determine the peak oxygen uptake [Formula: see text]. Participants subsequently completed two endurance tests on each modality, matched at 80% and 60% of the highest [Formula: see text] determined by the incremental tests, to intolerance.

One-Legged Cycle Training for Chronic Obstructive Pulmonary Disease. A Pragmatic Study of Implementation to Pulmonary Rehabilitation.

Rationale: In patients with chronic obstructive pulmonary disease (COPD), partitioned exercise training using one-legged cycling leads to greater improvements in peak oxygen uptake than conventional two-legged cycling.

Objectives: We evaluated the feasibility of incorporating one-legged cycling as the principal aerobic training modality for pulmonary rehabilitation in COPD.

Methods: Physiotherapists underwent four teaching sessions about the principles and practical implementation of one-legged cycling training.

Is quadriceps endurance reduced in COPD?: a systematic review.

Background: Although the aerobic profile of the quadriceps muscle is reduced in COPD, there is conflicting evidence regarding whether this leads to reduced quadriceps muscle endurance. We, therefore, performed a systematic review of studies comparing quadriceps endurance in individuals with COPD with that in healthy control subjects.

Methods: Relevant studies were identified by searching six electronic databases (1946-2011).

Saving Time for Patients with Moderate to Severe COPD: Endurance Test Speed Set Using Usual and Fast Walk Speeds.

: For assessing the effects of interventions on exercise tolerance, the tolerable duration (t) of a high-intensity constant-speed endurance test is recommended. The test intensity is determined by the test speed () which should be individualized to target a t of 3 to 15 minutes. We determined the accuracy of setting the to achieve a targeted t of 3 to 15 minutes using the participant's easily measured and non-fatiguing usual () and fast () walk speeds.

Repeatability of usual and fast walking speeds in patients with chronic obstructive pulmonary disease.

Rationale: Evaluation of the role of walking speeds in chronic obstructive pulmonary disease (COPD) should be preceded by an assessment of its repeatability. This study aimed to establish the repeatability of the usual (susual) and fast (sfast) walking speeds among patients with stable COPD and determine the accuracy of manual measurement.

Methods: Participants demonstrated their susual and sfast over 10 m with speed calculated using a stopwatch; the accuracy was confirmed with optical sensors.

Do field walking tests produce similar cardiopulmonary demands to an incremental treadmill test in obese individuals with treated OSA?

Background: Cardiorespiratory fitness, assessed during cardiopulmonary exercise tests by peak oxygen uptake (Vo2pk), is an independent predictor of mortality in obesity. We investigated whether Vo2pk and systemic responses measured during field walking tests were similar to those measured during an incremental treadmill test (ITMT) in obese individuals with treated OSA.

Methods: Individuals with treated OSA and a BMI > 30 kg/m2 were recruited.

Breathing helium-hyperoxia and tolerance of partitioned exercise in patients with COPD.

Purpose: Partitioning exercise by 1-legged cycling is more effective than conventional training in patients with chronic obstructive pulmonary disease. Similarly, inhaling helium-hyperoxia can extend conventional exercise tolerance. This study aimed to determine whether breathing helium-hyperoxia could increase the tolerance of a high-intensity exercise session achieved by 1-legged cycling.

Cardiorespiratory responses during the 6-minute walk and ramp cycle ergometer tests and their relationship to physical activity in stroke.

Background And Objectives: The 6-minute walk test (6MWT) is used to measure exercise capacity after stroke. We sought to compare cardiorespiratory responses during the 6MWT with responses to a ramp cycle ergometer test (CET) in community-dwelling individuals with stroke. A secondary objective was to determine the relationship between cardiorespiratory responses during each test and daily physical activity.

Defining hyperinflation as 'dynamic': moving toward the slope.

Measuring the severity of dynamic hyperinflation is a useful clinical approach to assess the effect of therapeutic interventions and explain their impact on exercise tolerance. Dynamic hyperinflation is typically quantified by the change in end expiratory lung volume from rest to the end of exercise. The result may be inconsistent with disease severity and does not clearly explain how exercise tolerance improves with therapy.

Arm elevation and coordinated breathing strategies in patients with COPD.

Background: Hyperinflated patients with COPD breathe against an increased elastic load during physical activity. Arm activities are especially demanding. Some pulmonary rehabilitation programs instruct patients to inhale while raising their arms, whereas others recommend the opposite.

A simple method to derive speed for the endurance shuttle walk test.

Background: The original method for determining endurance shuttle walk test (ESWT) speed involves components that are time consuming for clinicians. We sought to determine: (i) whether components described in the original method for determining ESWT speed held true and; (ii) the agreement between speeds derived using the original method and that equivalent to 85% of the peak speed achieved during the incremental shuttle walk test (ISWT).

Methods: Patients with chronic obstructive pulmonary disease (COPD) performed two ISWTs and one ESWT on separate days, wearing a calibrated portable gas analysis unit.

Pulmonary rehabilitation: a review of the recent literature.

Pulmonary rehabilitation (PR) is an evidence-based, multidisciplinary, comprehensive intervention that can be integrated into the management of individuals with chronic lung disease. It aims to reduce symptoms, optimize function, increase participation in daily life, and reduce health-care resource utilization. In this review, we summarize the new developments in PR over the past 5 years.

Chronic obstructive pulmonary disease and socioeconomic status: a systematic review.

Background: Along with age and sex, socioeconomic status is one of the most powerful determinants of health. We conducted a systematic review to examine the consistency and magnitude of the association between socioeconomic status and COPD health outcomes to determine the potential impact of SES disparity on the COPD population.

Methods: Electronic databases to October 2011 were searched for studies of adults who had or were at risk for COPD that quantified an association between a measure of socioeconomic status and at least one COPD health outcome.

Rollator use does not consistently change the metabolic cost of walking in people with chronic obstructive pulmonary disease.

Objectives: To (1) evaluate whether the use of a rollator changed metabolic cost during a controlled walking task, and (2) explore relationships between the difference in dyspnea and metabolic cost associated with rollator use.

Design: Single-group interventional study in which patients completed 2 corridor walks: 1 without and 1 with a rollator, at the same individualized constant speed.

Setting: Rehabilitation hospital.