Document Detail


Measurement of symptoms, lung hyperinflation, and endurance during exercise in chronic obstructive pulmonary disease.
MedLine Citation:
PMID:  9817708     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Changes in lung hyperinflation, dyspnea, and exercise endurance are important outcomes in assessing therapeutic responses in chronic obstructive pulmonary disease (COPD). Therefore, we studied the reproducibility of Borg dyspnea ratings, inspiratory capacity (IC; to monitor lung hyperinflation), and endurance time during constant-load symptom-limited cycle exercise in 29 patients with COPD (FEV1 = 40 +/- 2% predicted; mean +/- SEM). Responsiveness was also studied by determining the acute effects of nebulized 500 micrograms ipratropium bromide (IB) or saline placebo (P) on these measurements. During each of four visits conducted over an 8-wk period, spirometry and exercise testing were performed before and 1 h after receiving IB or P (randomized, double-blinded). Highly reproducible measurements included: endurance time (intraclass correlation R = 0.77, p < 0.0001); Borg ratings and IC at rest, at a standardized exercise time (STD), and at peak exercise (R > 0.6, p < 0.0001); and slopes of Borg ratings over time, oxygen consumption (V O2), and ventilation (R > 0.6, p < 0.0001). Responsiveness was confirmed by finding a significant drug effect for: change (Delta) in endurance time (p = 0.0001); DeltaBorgSTD and DeltaBorg-time slopes (p < 0.05); and DeltaIC at rest, at STD, and at peak exercise (p = 0.0001). With all completed visits, DeltaBorgSTD correlated better with DeltaICSTD than any other resting or exercise parameter (n = 115, r = -0.35, p < 0.001). We concluded that Borg dyspnea ratings, and measurements of IC and endurance time during submaximal cycle exercise testing are highly reproducible and responsive to change in severe COPD.
Authors:
D E O'Donnell; M Lam; K A Webb
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American journal of respiratory and critical care medicine     Volume:  158     ISSN:  1073-449X     ISO Abbreviation:  Am. J. Respir. Crit. Care Med.     Publication Date:  1998 Nov 
Date Detail:
Created Date:  1998-12-18     Completed Date:  1998-12-18     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  9421642     Medline TA:  Am J Respir Crit Care Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1557-65     Citation Subset:  AIM; IM    
Affiliation:
Respiratory Investigation Unit, Departments of Medicine, and Community Health and Epidemiology, Queen's University, Kingston, Ontario, Canada. <odonnell@post.queensu.ca>
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MeSH Terms
Descriptor/Qualifier:
Aged
Bronchodilator Agents / administration & dosage,  therapeutic use
Cross-Over Studies
Double-Blind Method
Dyspnea / drug therapy,  physiopathology*
Exercise Test
Female
Follow-Up Studies
Forced Expiratory Volume / drug effects,  physiology
Humans
Inspiratory Capacity / drug effects,  physiology*
Ipratropium / administration & dosage,  therapeutic use
Lung / drug effects,  physiopathology*
Lung Diseases, Obstructive / drug therapy,  physiopathology*
Male
Middle Aged
Nebulizers and Vaporizers
Oxygen Consumption / drug effects,  physiology
Physical Endurance / physiology*
Physical Exertion / physiology*
Placebos
Reproducibility of Results
Respiration / drug effects
Spirometry
Treatment Outcome
Chemical
Reg. No./Substance:
0/Bronchodilator Agents; 0/Placebos; 60205-81-4/Ipratropium

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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