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Published ahead of print on September 15, 2005, doi:10.1164/rccm.200507-1037OC
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American Journal of Respiratory and Critical Care Medicine Vol 172. pp. 1517-1522, (2005)
© 2005 American Thoracic Society
doi: 10.1164/rccm.200507-1037OC

Original Article

Walking versus Cycling

Sensitivity to Bronchodilation in Chronic Obstructive Pulmonary Disease

Véronique Pepin, Didier Saey, Francçois Whittom, Pierre LeBlanc and Francçois Maltais

Centre de Recherche, Hôpital Laval, Institut Universitaire de Cardiologie et de Pneumologie de l'Université Laval, Ste-Foy, Quebec, Canada

Correspondence and requests for reprints should be addressed to Francçois Maltais, M.D., Centre de Pneumologie, Hôpital Laval, 2725 Chemin Ste-Foy, Ste-Foy, PQ, G1V 4G5 Canada. E-mail: francois.maltais{at}med.ulaval.ca

Rationale: There is no consensus regarding which exercise test to use to evaluate the functional impact of bronchodilators in patients with chronic obstructive pulmonary disease.

Objective and Methods: Bronchodilator-induced changes in endurance time were evaluated during cycling and walking in 17 patients with chronic obstructive pulmonary disease who completed two cycle endurance tests and two endurance shuttle walks at 80% of peak capacity. Each endurance test was preceded by the nebulization of a placebo or 500 µg of ipratropium bromide using a randomized, double-blind, crossover design. Quadriceps twitch force was measured with magnetic stimulation of the femoral nerve before and after each endurance test.

Results: Cycling endurance time did not improve significantly after bronchodilation despite a significant increase in FEV1 ({Delta}endurance time ipratropium bromide – placebo: 51 ± 255 s, p = 0.42). A similar change in FEV1 was associated with a significant improvement in walking endurance time ({Delta}endurance time ipratropium bromide – placebo: 164 ± 177 s, p < 0.01). A 22 ± 17% fall in quadriceps twitch force was observed after cycling, whereas no significant change was seen after walking.

Conclusion: The endurance shuttle walk is a sensitive test to detect changes in exercise tolerance after bronchodilation. Differences in the occurrence of quadriceps muscle fatigue may explain, in part, the different responsiveness to change between cycling and walking.

Key Words: bronchodilation • chronic obstructive pulmonary disease • cycling • exercise test • muscle fatigue • shuttle walk




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