Inspiratory capacity, dynamic hyperinflation, breathlessness, and exercise performance during the 6-minute-walk test in chronic obstructive pulmonary disease.

Patients with severe chronic obstructive pulmonary disease (COPD) develop dynamic lung hyperinflation (DH) during symptom-limited incremental and constant work exercise with cycle ergometer and treadmill. The increase in end-expiratory lung volume seems to be the best predictor of dyspnea. Quantification of DH is based on the relatively complex use of on-line measurement of inspiratory capacity (IC) from flow volume loops. We reasoned that DH could occur during daily activities such as walking, and that it could be simply measured using the spirometrically determined IC. We studied 72 men with COPD (FEV(1) = 45 +/- 13.3% predicted). IC was measured at rest and after a 6-min walk test. Exertional dyspnea was evaluated using the Borg scale and dyspnea during daily activities with the modified Medical Research Council (MRC) scale. IC decreased significantly from 28.9 +/- 6.7% TLC at rest to 24.1 +/- 6.8% TLC after exercise (p < 0.001). Exertional dyspnea correlated with DeltaIC (r = -0.49, p < 0.00001) and baseline MRC (r = 0.59, p < 0.00001). In many patients with COPD, walking leads to DH that can be easily determined with simple spirometric testing. DH helps explain exercise capacity limitation and breathlessness during simple daily activities.

[1]  S. Kesten,et al.  Comparison of hallway and treadmill six-minute walk tests. , 1999, American journal of respiratory and critical care medicine.

[2]  D. O’Donnell,et al.  Spirometric correlates of improvement in exercise performance after anticholinergic therapy in chronic obstructive pulmonary disease. , 1999, American journal of respiratory and critical care medicine.

[3]  P. Jones,et al.  Usefulness of the Medical Research Council (MRC) dyspnoea scale as a measure of disability in patients with chronic obstructive pulmonary disease , 1999, Thorax.

[4]  B. Celli,et al.  Ventilatory drive at rest and perception of exertional dyspnea in severe COPD. , 1999, Chest.

[5]  D. O’Donnell,et al.  Measurement of symptoms, lung hyperinflation, and endurance during exercise in chronic obstructive pulmonary disease. , 1998, American journal of respiratory and critical care medicine.

[6]  P. Śliwiński,et al.  Reliability of inspiratory capacity for estimating end-expiratory lung volume changes during exercise in patients with chronic obstructive pulmonary disease. , 1997, American journal of respiratory and critical care medicine.

[7]  F. Martinez,et al.  Lung-volume reduction improves dyspnea, dynamic hyperinflation, and respiratory muscle function. , 1997, American journal of respiratory and critical care medicine.

[8]  D A Redelmeier,et al.  Interpreting small differences in functional status: the Six Minute Walk test in chronic lung disease patients. , 1997, American journal of respiratory and critical care medicine.

[9]  B. Celli,et al.  Respiratory muscle and cardiopulmonary function during exercise in very severe COPD. , 1996, American journal of respiratory and critical care medicine.

[10]  M. Belman,et al.  Inhaled bronchodilators reduce dynamic hyperinflation during exercise in patients with chronic obstructive pulmonary disease. , 1996, American journal of respiratory and critical care medicine.

[11]  N. Jones,et al.  Muscle strength, symptom intensity, and exercise capacity in patients with cardiorespiratory disorders. , 1995, American journal of respiratory and critical care medicine.

[12]  O. Bauerle,et al.  Role of ventilatory response to exercise in determining exercise capacity in COPD. , 1995, Journal of applied physiology.

[13]  T. W. van der Mark,et al.  Relation of lung function, maximal inspiratory pressure, dyspnoea, and quality of life with exercise capacity in patients with chronic obstructive pulmonary disease. , 1994, Thorax.

[14]  H. Magnussen,et al.  Factor analysis of exercise capacity, dyspnoea ratings and lung function in patients with severe COPD. , 1994, The European respiratory journal.

[15]  R. Light,et al.  Reanalysis of the 12-minute walk in patients with chronic obstructive pulmonary disease. , 1994, Chest.

[16]  D. O’Donnell,et al.  Exertional breathlessness in patients with chronic airflow limitation. The role of lung hyperinflation. , 1993, The American review of respiratory disease.

[17]  J. Bugler,et al.  Effect of arterial oxygen desaturation on six minute walk distance, perceived effort, and perceived breathlessness in patients with airflow limitation. , 1993, Thorax.

[18]  A. Harver,et al.  A factor analysis of dyspnea ratings, respiratory muscle strength, and lung function in patients with chronic obstructive pulmonary disease. , 1992, The American review of respiratory disease.

[19]  P Littlejohns,et al.  Relationships between general health measured with the sickness impact profile and respiratory symptoms, physiological measures, and mood in patients with chronic airflow limitation. , 1989, The American review of respiratory disease.

[20]  J. Dempsey,et al.  Regulation of end-expiratory lung volume during exercise. , 1988, Journal of applied physiology.

[21]  M. Bergner,et al.  Cost and Outcome of Care for Patients With Chronic Obstructive Lung Disease: Analysis by Physician Specialty , 1986, Medical care.

[22]  P. Jones,et al.  Performance, ventilation, and oxygen consumption in three different types of exercise test in patients with chronic obstructive lung disease. , 1985, Thorax.

[23]  G H Guyatt,et al.  Effect of encouragement on walking test performance. , 1984, Thorax.

[24]  L. A. Engel,et al.  Chest wall mechanics during exercise in patients with severe chronic air-flow obstruction. , 1984, The American review of respiratory disease.

[25]  J. Skatrud,et al.  Chest wall and abdominal motion during exercise in patients with chronic obstructive pulmonary disease. , 2015, The American review of respiratory disease.

[26]  G. Borg.  Psychophysical bases of perceived exertion. , 1982, Medicine and science in sports and exercise.

[27]  N. Jones,et al.  Pulmonary mechanics during exercise in subjects with chronic airflow obstruction. , 1980, Journal of applied physiology: respiratory, environmental and exercise physiology.

[28]  M. Artvinli,et al.  Dyspnoea, disability, and distance walked: comparison of estimates of exercise performance in respiratory disease. , 1978, British medical journal.

[29]  G. Grimby,et al.  Flow-volume curves and breathing patterns during exercise in patients with obstructive lung disease. , 1970, Scandinavian journal of clinical and laboratory investigation.

[30]  R. Johnson,et al.  Exercise ventilatory patterns in normal subjects and patientws with airway obstruction. , 1968, Journal of applied physiology.

[31]  J. Mead,et al.  Measurement of the separate volume changes of rib cage and abdomen during breathing. , 1967, Journal of applied physiology.