Limiting Factors in Walking Performance of Subjects With COPD.

INTRODUCTION: Exercise intolerance is the most predominant symptom in patients with COPD. Nevertheless, it is unclear whether walking economy and gait variability are altered in these patients. Thus, our main objective was to compare the cost of transport and gait variability as a function of speed,...

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Published in:Respiratory Care Vol. 63; no. 3; pp. 301 - 311
Main Authors: Sanseverino, Marcela Alves, Pecchiari, Matteo, Bona, Renata Luisa, Berton, Danilo Cortozi, de Queiroz, Francisco Busolli, Gruet, Mathieu, Peyré-Tartaruga, Leonardo A.
Format: research tables/charts Journal Article
Published: Mary Ann Liebert, Inc. Mar2018
Online Access:View this record in EBSCOhost
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      dt: Mar2018
      vid: 63
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      pub: Mary Ann Liebert, Inc.
      place: New Rochelle, New York
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        128238633
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        10.4187/respcare.05768
        128238633
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        atl: Limiting Factors in Walking Performance of Subjects With COPD.
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          Sanseverino, Marcela Alves
          Pecchiari, Matteo
          Bona, Renata Luisa
          Berton, Danilo Cortozi
          de Queiroz, Francisco Busolli
          Gruet, Mathieu
          Peyré-Tartaruga, Leonardo A.
        affil: Pathophysiology and Pulmonary Function Laboratory of Clinical Hospital of Porto Alegre
      sug:
        subj:
          Pulmonary Disease, Chronic Obstructive Complications
          Walking
          Exercise Tolerance
          Gait Analysis
          Human
          Descriptive Statistics
          Forced Expiratory Volume
          Treadmills
          Oxygen Consumption
          Dyspnea
          Muscle Fatigue
          P-Value
          Pulmonary Disease, Chronic Obstructive Psychosocial Factors
          Quality of Life
          Vital Capacity
          Cross Sectional Studies
          Brazil
          Spirometry
          Exercise Test, Cardiopulmonary
          Data Analysis Software
          Post Hoc Analysis
          Unpaired T-Tests
          Friedman Test
          Mann-Whitney U Test
          Pearson's Correlation Coefficient
          Spearman's Rank Correlation Coefficient
          Linear Regression
          Male
          Female
          Aged
          Middle Age
          Aged: 65+ years
          Middle Aged: 45-64 years
          Male
          Female
      ab: INTRODUCTION: Exercise intolerance is the most predominant symptom in patients with COPD. Nevertheless, it is unclear whether walking economy and gait variability are altered in these patients. Thus, our main objective was to compare the cost of transport and gait variability as a function of speed, including the self-selected walking speed, in subjects with COPD relative to healthy subjects. METHODS: 22 subjects, 11 with COPD (FEV1 = 45 ± 17% of predicted) and 11 age- and sex-matched healthy subjects undertook an evaluation that involved walking on a treadmill at 6 speeds (at 3.2 km/h, at a self-selected walking speed, and at 2 speeds below and 2 speeds above the self-selected walking speed) and measuring the cost of transport (the oxygen consumption normalized by mass and distance), gait variability, perceived dyspnea, and leg fatigue. RESULTS: In subjects with COPD, the cost of transport decreased with increasing walking speed, contrary to healthy subjects, who presented a minimum at the self-selected walking speed. No difference was found in cost of transport between the experimental groups at the same absolute velocity (P = .62). In subjects with COPD, dyspnea sensation rose above the self-selected walking speed, doubling at the maximal walking velocity (P=.03), and gait variability was higher at low speeds. CONCLUSION: Subjects with COPD choose their walking speed so as to keep the dyspnea sensation tolerable and to keep gait variability and cost of transport at an acceptable level. These outcomes suggest that interventions acting on dyspnea and gait pattern may increase patients' self-selected walking speed and improve their quality of life.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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