Chest
Clinical InvestigationsCopdEncouraged 6-min Walking Test Indicates Maximum Sustainable Exercise in COPD Patients
Section snippets
Materials and Methods
Eight men with clinically stable COPD were recruited for the study. All of the men had a lack of exacerbations in the preceding 6 weeks. Oxyhemoglobin desaturation during exercise was an exclusion criteria. All patients were receiving inhaled, long-acting β2-agonists and ipratropium bromide. Five of patients were regularly treated with inhaled steroids, but none of the eight patients had received systemic steroids in the last 3 months prior to the study. The study design included two phases:
Results
The study group (mean age, 68 ± 7 years; range, 57 to 77 years) showed moderate-to-severe ventilatory dysfunction (FEV1, 1.63 ± 0.33 L; 50 ± 13% predicted; range, 32 to 67% predicted). Four patients were classified as Global Initiative for Chronic Obstructive Lung Disease (GOLD) type 2, three patients were GOLD type 3, and one patient was GOLD type 4.8 Seven of the eight patients showed air trapping (residual volume, 137 ± 26% predicted; range, 80 to 169%). On average, they presented moderate
Discussion
The current study showed similar physiologic responses between encouraged 6MWT-10 and walking at CWS, which indicates that patients with moderate-to-severe COPD set their walking speed during the test in order to achieve critical o2. The level of o2 achieved at CWS may indicate the integrated response of the systems involved in O2 transport/O2 utilization that ultimately determine the highest sustainable level of exercise. These results might constitute the underlying explanation
References (35)
- et al.
A qualitative systematic overview of the measurement properties of functional walk tests used in the cardiorespiratory domain
Chest
(2001) - et al.
The 6-min walk and peak oxygen consumption in advanced heart failure: aerobic capacity and survival
Am Heart J
(1999) - et al.
Value of 6-min-walk test for assessment of severity and prognosis of heart failure
Lancet
(2000) - et al.
Prediction equations for plethysmografic lung volumes
Respir Med
(1998) - et al.
Estimation of ventilatory reserve by stair climbing: a study in patients with chronic airflow obstruction
Chest
(1993) - et al.
Shuttle versus six-minute walk test in the prediction of outcome in chronic heart failure
Int J Cardiol
(2000) - et al.
Shuttle-walk test to assess chronic heart failure [abstract]
Lancet
(1998) - et al.
Reliability, repeatability and sensitivity to change of externally and self-paced walking tests in COPD patients
Respir Med
(2003) - et al.
Chronic obstructive pulmonary diseases stage and health-related quality of life: the quality of life of chronic obstructive pulmonary disease study group
Ann Intern Med
(1997) Health status measurement in chronic obstructive pulmonary disease
Thorax
(2001)
ATS statement: guidelines for the six-minute walk test
Am J Respir Crit Care Med
Predictive factors of hospitalization for acute exacerbation in a series of 64 patients with chronic obstructive pulmonary disease
Am J Respir Crit Care Med
Risk factors of readmission to hospital for a COPD exacerbation: a prospective study
Thorax
Variables related to increased mortality following out-patient pulmonary rehabilitation
Eur Respir J
Combining 6MWD, FEV1, MRC dyspnea and BMI is Better predictor of mortality than FEV1[abstract]
Am J Respir Crit Care Med
Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. NHLBI/WHO Global Initiative for Chronic Obstructive Lung Disease (GOLD) Workshop summary
Am J Respir Crit Care Med
ATS/ACCP statement on cardiopulmonary exercise testing
Am J Respir Crit Care Med
Alejandro Casas was a Pre-doctoral Research Fellow from Fundación Neumológica Colombiana (Colombia) supported by CHRONIC (IST-1999/12158) from the European Union; and, Anamaria Mayer was a Research Fellow from Federal University of Sao Paulo (Brasil) supported by CAPES and E-Remedy (IST-2000/25146).
Supported by grants FIS 00/0281 from the Fondo de Investigaciones Sanitarias; and Comissionat per a Universitats i Recerca de la Generalitat de Catalunya (1999 SGR 00228); and Red Respira C03/11.