Exercise responses during endurance testing at different intensities in patients with COPD

Abstract

Endurance time on submaximal exercise tests is a sensitive measure in detecting changes after medical intervention and is used as an outcome in clinical trials, although there has been little discussion regarding the appropriate intensity. Therefore, we investigated whether there were differences in exercise responses between endurance tests at high versus moderate intensity, and analyzed which test was more appropriate. Thirty-seven patients with chronic obstructive pulmonary disease participated in the study. They performed cycle endurance tests at high and moderate submaximal workloads representing 80% and 60% of the maximum work rate reached on progressive cycle ergometry, respectively. Each type of exercise test was performed after inhaling salbutamol 400 μg, ipratropium bromide 80 μg or an identical placebo. Endurance time on the 80% endurance test was much shorter than on the 60% endurance test. The coefficients of variation for the endurance time were lower on the 80% test. Statistically significant improvements in the endurance time after bronchodilators in comparison to placebo were found only on the 80% test. When using the endurance time as an outcome, the high intensity endurance test is preferable to the moderate intensity endurance test, as the high intensity test demonstrated shorter exercise time, less variability and higher sensitivity.