Physiological Changes Differ between Responders and Nonresponders to Pulmonary Rehabilitation in COPD

J. Buekers*, P. De Boever, J. Theunis, S. Houben-Wilke, A.W. Vaes, F.M.E. Franssen, E.F.M. Wouters, S.O. Simons, J.M. Aerts, M.A. Spruit

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

2 Citations (Web of Science)

Abstract

Purpose

Not all patients with chronic obstructive pulmonary disease (COPD) experience similar benefits after pulmonary rehabilitation (PR). This pre-post PR study used a large sample of patients with COPD to determine whether PR-induced changes of oxygen uptake (VO2) kinetics and exercise responses of VO2, carbon dioxide output (VCO2), minute ventilation (V-E), V-E/VCO2, breathing frequency, and tidal volume differed between responders and nonresponders to PR. Methods

Responders to PR were defined as patients with a minimal clinically important increase in endurance time of 105 s. Isotime (=180 s) values of VO2, VCO2, V-E, V-E/VCO2, breathing frequency, and tidal volume; gains of VO2, VCO2, and V-E; and VO2 mean response time of 183 patients with COPD (forced expiratory volume in 1 s: 56% +/- 19% predicted) were compared between pre- and post-PR constant work rate tests. Results

After PR, only the group of responders significantly decreased VO2 mean response time (P < 0.05), VCO2 gain, V-E gain, and isotime values of VCO2, V-E, and V-E/VCO2 (all, P < 0.001), while also improving their breathing pattern (e.g., decreased breathing frequency isotime value; P < 0.0001). These changes were not observed in the group of nonresponders. Changes in physiological exercise responses were correlated with changes in physical performance (e.g., correlation between changes in VO2 mean response time and endurance time: P = 0.0002, r = -0.32). Conclusions

PR-induced changes in physiological exercise responses differed between responders and nonresponders. Physiological changes are relevant to explain the variable improvements of physical performance after PR in patients with COPD.

Original languageEnglish
Pages (from-to)1125-1133
Number of pages9
JournalMedicine and Science in Sports and Exercise
Volume53
Issue number6
DOIs
Publication statusPublished - 1 Jun 2021

Keywords

  • EXERCISE PHYSIOLOGY
  • EXERCISE TRAINING
  • OXYGEN UPTAKE
  • KINETICS
  • OXYGEN-UPTAKE KINETICS
  • GAS-EXCHANGE
  • EXERCISE TOLERANCE
  • INTENSITY EXERCISE
  • EFFICACY
  • FLUCTUATIONS
  • VENTILATION
  • CAT

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