Effect of endurance training on expiratory flow limitation and dynamic hyperinflation in patients with stable chronic obstructive pulmonary disease.

Expiratory flow limitation (EFL) is the primary pathophysiological hallmark of chronic obstructive pulmonary disease (COPD). However, the effect of lower-extremity endurance training alone on EFL in patients with COPD remains largely unknown. This study aims to determine the effects of endurance training on EFL and dynamic hyperinflation in patients with stable COPD. This was a prospective, single-blinded, non-randomised controlled 12-week study recruiting Chinese patients with stable COPD in an endurance training group (n = 15) or a control group (n = 13). Before and at the end of the study, we measured the EFL, pulmonary function, peak inspiratory flow (PIF) and maximum inspiratory pressure (MIP); moreover, the patients underwent a constant work rate exercise test in which Borg dyspnoea scale, tidal breathing flow volume curves and inspiratory capacity (IC) were determined every other minute. Exercise training significantly improved the exercise endurance time (7.00 ± 3.05 vs 18.13 ± 6.44 min, P < 0.001), MIP (69.49 ± 16.03 vs 80.18 ± 15.97 cmH2 O, P < 0.001) and PIF (3.96 ± 1.01 vs 4.51 ± 1.13 L/s, P = 0.014), but not EFL (3.33 ± 0.49 vs 3.40 ± 0.51, P = 0.334). Subjects on training had decreased breathing frequency (26.26 ± 7.13 vs 23.15 ± 5.34 breaths/min, P = 0.002), minute ventilation (30.28 ± 7.52 vs 26.85 ± 4.17 L, P = 0.013), tidal peak expiratory flow (1.53 ± 0.22 vs 1.32 ± 0.20 L/s, P = 0.006), mean expiratory flow (0.87 ± 0.19 vs 0.68 ± 0.15 L/s, P = 0.011) and Borg dyspnoea score (7.20 ± 1.15 vs 3.93 ± 1.39, P < 0.001), as well as increased IC (1.50 ± 0.34 vs 1.67 ± 0.45 L, P = 0.002), expiratory time (1.47 ± 0.62 vs 1.72 ± 0.62 s, P = 0.004) and inspiratory flow reserve (2.05 ± 1.10 vs 2.95 ± 1.19 L/s, P = 0.002) at isotime. These changes were not observed in the control group. Endurance training may benefit stable COPD patients in improving exercise endurance, inspiratory muscle strength, ventilatory requirements, exercise-induced hyperinflation and exertional dyspnoea.

Chen R ，Chen R ，Chen X ，Chen L ... -  《-》

Exercise training decreases ventilatory requirements and exercise-induced hyperinflation at submaximal intensities in patients with COPD.

Porszasz J ，Emtner M ，Goto S ，Somfay A ，Whipp BJ ，Casaburi R ... -  《CHEST》

Mechanisms of dyspnoea relief and improved exercise endurance after furosemide inhalation in COPD.

Jensen D ，Amjadi K ，Harris-McAllister V ，Webb KA ，O'Donnell DE ... -  《-》

Effect of heliox on lung dynamic hyperinflation, dyspnea, and exercise endurance capacity in COPD patients.

Palange P ，Valli G ，Onorati P ，Antonucci R ，Paoletti P ，Rosato A ，Manfredi F ，Serra P ... -  《-》

Volume effect and exertional dyspnoea after bronchodilator in patients with COPD with and without expiratory flow limitation at rest.

Boni E ，Corda L ，Franchini D ，Chiroli P ，Damiani GP ，Pini L ，Grassi V ，Tantucci C ... -  《-》