Walking Distance Score Research Articles

Pulmonary Rehabilitation Improves Exercise Capacity in Older Elderly Patients with COPD

Pulmonary rehabilitation has been shown to improve exercise capacity in patients with COPD. It has been suggested that this improvement applies to all age groups; however, to our knowledge, the effects of pulmonary rehabilitation on older elderly patients (> or = 75 years of age) have not been studied. We compared changes in 12-min walking distance (12MD) and self-assessment scores in 47 older elderly patients with moderate to severe COPD who completed inpatient or outpatient pulmonary rehabilitation with those achieved by 87 younger patients who participated in the same programs from 1987 to 1992. There were 28 older elderly individuals (mean +/- SEM, 78 +/- 1 years) in the outpatient group and 56 younger patients (64 +/- 1 years). There were no differences between older and younger outpatients with respect to FEV1, FEV1/FVC, maximum inspiratory pressure (PImax), baseline 12MD, or baseline self-assessment score. After outpatient pulmonary rehabilitation, 12MD and self-assessment scores improved significantly in both groups. Inpatients included 19 older elderly individuals (81 +/- 1 years) who were also similar to the 31 younger inpatients (64 +/- 1 years) in FEV1, FEV1/FVC, PImax, and baseline self-assessment score, but they tended to be more limited in terms of baseline 12MD (p = 0.09). After inpatient pulmonary rehabilitation, significant improvements in 12MD and self-assessment were seen in both groups. We conclude that comprehensive outpatient and inpatient pulmonary rehabilitation programs are as beneficial in older elderly patients with COPD as they are in younger patients with similar lung function abnormalities. Patients 75 years of age or older should be considered for comprehensive pulmonary rehabilitation.

Effects of Buspirone on Anxiety Levels and Exercise Tolerance in Patients With Chronic Airflow Obstruction and Mild Anxiety

The objective of this study was to determine if buspirone would alleviate anxiety and improve exercise tolerance of anxious patients with chronic airflow obstruction (CAO). Eleven male patients with mild to moderate anxiety and CAO completed this study comparing buspirone, 10 to 20 mg given three times a day, with placebo. Patients were evaluated with State Trait Anxiety Inventory, spirometry, 12-min walk, incremental exercise on a cycle ergometer to symptom limitation and measurement of dyspnea with a modified Borg scale at exercise levels and the end of each 2 min on 12-min walk. There were no significant differences in anxiety scores, work load, maximum oxygen consumption per minute, maximum expired volume per minute, PETCO2, PETO2, 12-min walking distance or dyspnea scores after 6 weeks of buspirone or placebo therapy. We conclude that administration of buspirone has no significant effect on anxiety levels, exercise capabilities or PETO2 or PETCO2 in patients with CAO and mild anxiety.

Portable oxygen therapy: assessment and usage

Fifty portable oxygen assessments, based on 6-min walking tests, were reviewed to produce guidelines for assessment and prescription of portable oxygen, and to evaluate factors predicting benefit. Patients with a portable cylinder were questioned about benefits/difficulties and usage of portable oxygen. A significant improvement on the oxygen compared to the air walk was found (median 9.7%) which correlated with the oxygen desaturation on the baseline walk (r = 0.51, P less than 0.05). A placebo effect was demonstrated using an air cylinder (median improvement 6.1%). There was no correlation between improvement in walking distance and decrease in visual analogue scale (VAS) score of breathlessness. We recommend standard portable oxygen assessments based on a series of 6-min walks. Improvements of 10% in walking distance or VAS score from the oxygen to the air walk would lead to the patient being offered a portable oxygen cylinder.

Target-flow inspiratory muscle training at home and during pulmonary rehabilitation in COPD patients with a ventilatory limitation during exercise

The effects of a 10-week inspiratory muscle training (IMT) program at home were compared to IMT during a 10-week pulmonary rehabilitation program (PR) in 40 COPD patients with a ventilatory limitation of the exercise capacity. IMT was performed with a target-flow resistive device; the generated mouth pressure as well as the duty cycle were imposed. The mean age of the patients was 59, the mean FEV1 was 48% of predicted. In the training period the inspiratory muscle strength improved in both groups to the same degree. EMG fatigability of the diaphragm improved in the PR+ IMT group, but not in the IMT group. In the IMT group, the 12-min walking distance increased after the training period, but maximal workload (Wmax), VO2,max, and ADL scores did not change. In the PR + IMT group, however, Wmax, VO2,max, walking distance, and ADL scores improved significantly after the training period. Walking distance and ADL scores showed a significantly greater improvement in the PR + IMT group than in the IMT group. It is concluded that both isolated IMT and PR + IMT in COPD patients with a ventilatory limitation have a beneficial effect on inspiratory muscle strength, but PR + IMT improves the physical exercise capacity significantly more than IMT alone.