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Published ahead of print on September 15, 2005, doi:10.1164/rccm.200507-1037OC

Am. J. Respir. Crit. Care Med., Volume 172, Number 12, December 2005, 1517-1522

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Submitted on July 5, 2005
Accepted on September 12, 2005

Walking Versus Cycling: Sensitivity to Bronchodilation in Chronic Obstructive Pulmonary Disease

Veronique Pepin1, Didier Saey1, Francois Whittom1, Pierre LeBlanc1, and Francois Maltais1*

1 Centre de recherche, Hopital Laval, Institut Universitaire de Cardiologie et de Pneumologie de l'Universite Laval, Quebec, Canada

* To whom correspondence should be addressed. 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 seventeen 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, and 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 seconds, 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 seconds, p < 0.01). A 22 ± 17% fall in quadriceps twitch force was observed after cycling, while no significant change was seen after walking. Conclusion: The endurance shuttle walk is a sensitive test to detect changes in exercise tolerance following bronchodilation. Differences in the occurrence of quadriceps muscle fatigue may explain, in part, the different responsiveness to change between cycling and walking.
Key words: COPD, exercise test, cycling, shuttle walk, bronchodilation, muscle fatigue




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