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No increase in walking distance on repeated test in COPD patients with exercise induced hypoxemia
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences. (Lungmedicin och allergologi)
2007 (English)In: Advances in Physiotherapy, ISSN 1403-8196, Vol. 9, no 4, 161-168 p.Article in journal (Refereed) Published
Abstract [en]

The aim of the study was to investigate the effect of retesting on the 12-min walking distance (12MWD) in patients with moderate or severe chronic obstructive pulmonary disease (COPD), with and without exercise-induced hypoxaemia (EIH) and to evaluate whether baseline characteristics derived before walking influence on variation of repeated tests. Fifty-seven COPD patients, mean age 66 (range 47 84) years, performed three 12-min walk tests within 1 week. Before and after each test, oxygen saturation (pulse oximetry, SpO2), heart rate, breathing frequency, peak expiratory flow, and subjective ratings of exertion and dyspnoea were measured. EIH was defined as a fall in SpO2 below 90% at the first walk test. The 12MWD did not increase on repeated testing in the EIH group. In the non-EIH group, the 12MWD increased by 12% (p<0.001) from test 1 to test 2 and by 4% (p<0.001) from test 2 to test 3. No day-to-day variation was observed in pre-walking characteristics. At least one training test is needed in non-EIH patients with COPD, as their effort and performance on the 12-min walk test increases on retesting (learning effects). In patients with EIH, the term “training test” is not relevant, as their walking distance did not homogeneously increase on repeated testing.

Place, publisher, year, edition, pages
2007. Vol. 9, no 4, 161-168 p.
Keyword [en]
12-min walk test, chronic obstructive pulmonary disease, exercise testing, exercise-induced hypoxaemia, pulse oximetry, retest effects, walk tests
National Category
Medical and Health Sciences
URN: urn:nbn:se:uu:diva-16774DOI: 10.1080/14038190701532844OAI: oai:DiVA.org:uu-16774DiVA: diva2:44545
Available from: 2008-06-04 Created: 2008-06-04 Last updated: 2013-05-23Bibliographically approved
In thesis
1. Physical Training and Testing in Patients with Chronic Obstructive Pulmonary Disease (COPD)
Open this publication in new window or tab >>Physical Training and Testing in Patients with Chronic Obstructive Pulmonary Disease (COPD)
2007 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall aims of the studies were to investigate the effects of different training modalities on exercise capacity and health-related quality of life (HRQoL) in patients with moderate or severe COPD and, further, to explore two of the physical tests used in pulmonary rehabilitation.

In study I, the 12-minute walking distance (12MWD) did not increase on retesting in patients with exercise-induced hypoxemia (EIH) whereas 12MWD increased significantly on retesting in the non-EIH patients. In study II, we found that the incremental shuttle walking test was as good a predictor of peak exercise capacity (W peak) as peak oxygen uptake (VO2 peak) is. In study III, we investigated the effects of two different combination training programmes when training twice a week for eight weeks. One programme was mainly based on endurance training (group A) and the other on resistance training and callisthenics (group B). W peak and 12MWD increased in group A but not in group B. HRQoL, anxiety and depression were unchanged in both groups. Ratings of perceived exertion at rest were significantly lower in group A than in group B after training and during 12 months of follow-up. Twelve months post-training, 12MWD was back to baseline in group A, but significantly shorter than at baseline in group B. Thus, a short endurance training intervention delayed decline in 12MWD for at least one year. Patients with moderate and severe COPD responded to training in the same way. In study IV, both interval and continuous endurance training increased W peak, VO2 peak, peak exhaled carbon dioxide (VCO2 peak) and 12MWD. Likewise, HRQoL, dyspnoea during activities of daily life, anxiety and depression improved similarly in both groups. At a fixed, submaximal workload (isotime), the interval training reduced oxygen cost and ventilatory demand significantly more than the continuous training did.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2007. 86 p.
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 234
Physical therapy, chronic obstructive pulmonary disease, pulmonary rehabilitation, physical training, endurance training, interval training, health-related quality of life, exercise testing, walking tests, physiotherapy, Sjukgymnastik
urn:nbn:se:uu:diva-7632 (URN)978-91-554-6815-6 (ISBN)
Public defence
2007-03-31, Grönwallsalen, Akademiska sjukhuset, ingång 70, Uppsala, 09:15
Available from: 2007-03-08 Created: 2007-03-08 Last updated: 2013-05-23Bibliographically approved

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