Am. J. Respir. Crit. Care Med., Volume 157, Number 5, May 1998, 1489-1497

General Exercise Training Improves Ventilatory and Peripheral Muscle Strength and Endurance in Chronic Airflow Limitation

DENIS E. O'DONNELL, MAUREEN MCGUIRE, LORELEI SAMIS, and KATHERINE A. WEBB

Respiratory Investigation Unit, Department of Medicine, Queen's University and Department of Physiotherapy, St. Mary's of the Lake Hospital, Kingston, Ontario, Canada

We studied the impact of a 6-wk supervised, multimodality endurance exercise training program (EXT) on strength and endurance of ventilatory and peripheral muscles in patients with chronic airflow limitation (CAL), and determined whether potential improvements contributed to relief of exertional breathlessness (B) and perceived leg effort/discomfort (LE), respectively. Twenty breathless patients with stable CAL (FEV₁ = 41 ± 3% predicted; mean ± SEM) were tested at 6-wk intervals at baseline, after a nonintervention control period (pre-EXT), and post-EXT. Measurements included: pulmonary function tests (PFTs), maximal inspiratory/expiratory pressures (MIP, MEP), inspiratory muscle endurance (V_LIM), quadriceps strength and endurance, exercise endurance, and submaximal cycle exercise with cardioventilatory and symptom responses. Measurements at baseline and pre-EXT were identical. Post-EXT, PFTs did not change; exercise endurance measured on the treadmill, cycle ergometer, arm ergometer, and by 6-min walk distance increased 40 ± 8%, 43 ± 10%, 12 ± 5%, and 34 ± 9%, respectively (p < 0.05); quadriceps strength increased 21 ± 5% (p < 0.01); MIP and MEP increased 29 ± 11% and 27 ± 11%, respectively (p < 0.05); V_LIM increased almost threefold (p < 0.05). At isotime near end-exercise, B, LE, carbon dioxide production ( CO₂), oxygen consumption ( O₂), ventilation, and breathing frequency (F) all fell after EXT (p < 0.05): B correlated with F (r = 0.58, p < 0.01). Increased MIP and V_LIM did not correlate with improved breathlessness or exercise endurance. Similarly, changes in quadriceps strength and endurance did not correlate with changes in LE or exercise endurance. In conclusion, general nonspecific EXT improved ventilatory and peripheral muscle function in severe CAL, but such improvements did not appear to contribute significantly to reduced exertional symptoms and enhanced exercise performance. O'Donnell DE, McGuire M, Samis L, Webb KA. General exercise training improves ventilatory and peripheral muscle strength and endurance in chronic airflow limitation.

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