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Am. J. Respir. Crit. Care Med., Volume 158, Number 5, November 1998, 1557-1565

Measurement of Symptoms, Lung Hyperinflation, and Endurance during Exercise in Chronic Obstructive Pulmonary Disease

DENIS E. O'DONNELL, MIU LAM, and KATHERINE A. WEBB

Respiratory Investigation Unit, Departments of Medicine, and Community Health and Epidemiology, Queen's University, Kingston, Ontario, Canada

Changes in lung hyperinflation, dyspnea, and exercise endurance are important outcomes in assessing therapeutic responses in chronic obstructive pulmonary disease (COPD). Therefore, we studied the reproducibility of Borg dyspnea ratings, inspiratory capacity (IC; to monitor lung hyperinflation), and endurance time during constant-load symptom-limited cycle exercise in 29 patients with COPD (FEV1 = 40 ± 2% predicted; mean ± SEM). Responsiveness was also studied by determining the acute effects of nebulized 500 µg ipratropium bromide (IB) or saline placebo (P) on these measurements. During each of four visits conducted over an 8-wk period, spirometry and exercise testing were performed before and 1 h after receiving IB or P (randomized, double-blinded). Highly reproducible measurements included: endurance time (intraclass correlation R = 0.77, p < 0.0001); Borg ratings and IC at rest, at a standardized exercise time (STD), and at peak exercise (R > 0.6, p < 0.0001); and slopes of Borg ratings over time, oxygen consumption (V O2), and ventilation (R > 0.6, p < 0.0001). Responsiveness was confirmed by finding a significant drug effect for: change (Delta ) in endurance time (p = 0.0001); Delta BorgSTD and Delta Borg-time slopes (p < 0.05); and Delta IC at rest, at STD, and at peak exercise (p = 0.0001). With all completed visits, Delta BorgSTD correlated better with Delta ICSTD than any other resting or exercise parameter (n = 115, r = -0.35, p < 0.001). We concluded that Borg dyspnea ratings, and measurements of IC and endurance time during submaximal cycle exercise testing are highly reproducible and responsive to change in severe COPD.




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[Abstract] [Full Text] [PDF]


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Eur Respir JHome page
D.E. O'Donnell, L. Forkert, and K.A. Webb
Evaluation of bronchodilator responses in patients with "irreversible" emphysema
Eur. Respir. J., December 1, 2001; 18(6): 914 - 920.
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Am. J. Respir. Crit. Care Med.Home page
D. E. O'DONNELL, S. M. REVILL, and K. A. WEBB
Dynamic Hyperinflation and Exercise Intolerance in Chronic Obstructive Pulmonary Disease
Am. J. Respir. Crit. Care Med., September 1, 2001; 164(5): 770 - 777.
[Abstract] [Full Text] [PDF]


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Eur Respir JHome page
M.L. Ayers, R. Mejia, J. Ward, T. Lentine, and D.A. Mahler
Effectiveness of salmeterol versus ipratropium bromide on exertional dyspnoea in COPD
Eur. Respir. J., June 1, 2001; 17(6): 1132 - 1137.
[Abstract] [Full Text] [PDF]


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ChestHome page
B. Schonhofer, S. Wallstein, C. Wiese, and D. Kohler
Noninvasive Mechanical Ventilation Improves Endurance Performance in Patients With Chronic Respiratory Failure Due to Thoracic Restriction
Chest, May 1, 2001; 119(5): 1371 - 1378.
[Abstract] [Full Text] [PDF]


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Am. J. Respir. Crit. Care Med.Home page
J. M. MARIN, S. J. CARRIZO, M. GASCON, A. SANCHEZ, B. GALLEGO, and B. R. CELLI
Inspiratory Capacity, Dynamic Hyperinflation, Breathlessness, and Exercise Performance during the 6-Minute-Walk Test in Chronic Obstructive Pulmonary Disease
Am. J. Respir. Crit. Care Med., May 1, 2001; 163(6): 1395 - 1399.
[Abstract] [Full Text]


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Am. J. Respir. Crit. Care Med.Home page
D. E. O'DONNELL, C. D'ARSIGNY, and K. A. WEBB
Effects of Hyperoxia on Ventilatory Limitation During Exercise in Advanced Chronic Obstructive Pulmonary Disease
Am. J. Respir. Crit. Care Med., March 15, 2001; 163(4): 892 - 898.
[Abstract] [Full Text]


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NEJMHome page
P. J. Barnes
Chronic Obstructive Pulmonary Disease
N. Engl. J. Med., July 27, 2000; 343(4): 269 - 280.
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Am. J. Respir. Crit. Care Med.Home page
C. TAUBE, B. LEHNIGK, K. PAASCH, D. K. KIRSTEN, R. A. JÖRRES, and H. MAGNUSSEN
Factor Analysis of Changes in Dyspnea and Lung Function Parameters after Bronchodilation in Chronic Obstructive Pulmonary Disease
Am. J. Respir. Crit. Care Med., July 1, 2000; 162(1): 216 - 220.
[Abstract] [Full Text]


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ThoraxHome page
P M A CALVERLEY
Supplementary oxygen therapy in COPD: is it really useful?
Thorax, July 1, 2000; 55(7): 537 - 538.
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Am. J. Respir. Crit. Care Med.Home page
T. OGA, K. NISHIMURA, M. TSUKINO, T. HAJIRO, A. IKEDA, and T. IZUMI
The Effects of Oxitropium Bromide on Exercise Performance in Patients with Stable Chronic Obstructive Pulmonary Disease . A Comparison of Three Different Exercise Tests
Am. J. Respir. Crit. Care Med., June 1, 2000; 161(6): 1897 - 1901.
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ChestHome page
D. E. O'Donnell
Assessment of Bronchodilator Efficacy in Symptomatic COPD : Is Spirometry Useful?
Chest, February 1, 2000; 117(2_suppl): 42S - 47S.
[Abstract] [Full Text] [PDF]


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Am. J. Respir. Crit. Care Med.Home page
D. E. O'DONNELL, C. D'ARSIGNY, S. RAJ, H. ABDOLLAH, and K. A. WEBB
Ventilatory Assistance Improves Exercise Endurance in Stable Congestive Heart Failure
Am. J. Respir. Crit. Care Med., December 1, 1999; 160(6): 1804 - 1811.
[Abstract] [Full Text]


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Am. J. Respir. Crit. Care Med.Home page
U. Hatipoglu, F. LAGHI, and M. J. TOBIN
Does Inhaled Albuterol Improve Diaphragmatic Contractility in Patients with Chronic Obstructive Pulmonary Disease?
Am. J. Respir. Crit. Care Med., December 1, 1999; 160(6): 1916 - 1921.
[Abstract] [Full Text]


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ChestHome page
B. D. Johnson, K. C. Beck, R. J. Zeballos, and I. M. Weisman
Advances in Pulmonary Laboratory Testing
Chest, November 1, 1999; 116(5): 1377 - 1387.
[Abstract] [Full Text] [PDF]


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Am. J. Respir. Crit. Care Med.Home page
F. E. HARGREAVE and R. LEIGH
Induced Sputum, Eosinophilic Bronchitis, and Chronic Obstructive Pulmonary Disease
Am. J. Respir. Crit. Care Med., November 1, 1999; 160(5): S53 - 57.
[Abstract] [Full Text] [PDF]


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Am. J. Respir. Crit. Care Med.Home page
D. E. O'DONNELL, M. LAM, and K. A. WEBB
Spirometric Correlates of Improvement in Exercise Performance after Anticholinergic Therapy in Chronic Obstructive Pulmonary Disease
Am. J. Respir. Crit. Care Med., August 1, 1999; 160(2): 542 - 549.
[Abstract] [Full Text]


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ChestHome page
M. Newton, K. A. Webb, D. E. O'Donnell, C. Murariu, H. Ghezzo, J. Milic-Emili, and H. Gauthier
Pulmonary embolism--treatment vs nontreatment.
Chest, June 1, 1999; 115(6): 1755 - 1755.
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J. Appl. Physiol.Home page
I. Iandelli, A. Aliverti, B. Kayser, R. Dellaca, S. J. Cala, R. Duranti, S. Kelly, G. Scano, P. Sliwinski, S. Yan, et al.
Determinants of exercise performance in normal men with externally imposed expiratory flow limitation
J Appl Physiol, May 1, 2002; 92(5): 1943 - 1952.
[Abstract] [Full Text] [PDF]




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