Physiological and symptom determinants of exercise performance in patients with chronic airway obstruction

K. Foglio, M. Carone, M. Pagani, L. Bianchi, P. W. Jones, N. Ambrosino

Research output: Contribution to journalArticle

60 Citations (Scopus)

Abstract

To evaluate the physiological and symptom determinants of exercise performance (EP) as measured by a 6-min walking test (6MWD), Watt(max), and peak oxygen consumption (VO2 ml/min/kg), 105 patients with chronic airway obstruction (CAO) [50 chronic obstructive pulmonary disease (COPD): 44 men, aged.63 ± 7 years, forced expiratory volume in 1 sec (FEV1) forced vital capacity (FVC)-1% 54 ± 13; and 55 asthmatic: 23 men, aged 55 ± 10 years, FEV1 FVC-1% 65 ± 10] underwent evaluation of 6MWD, symptom limited cyclo-ergometer exercise test, spirometry, respiratory muscle function, arterial blood gases and sensation of dyspnoea [using the Borg scale, Visual Analogue Scale (VAS) and Baseline Dyspnoea Index (BDI)]. A hierarchical method of analysis identified the residual volume (RV), total lung capacity (TLC)-1 ratio, BDI and the patient's age as the strongest and most consistent correlates of EP (r2 = 0.14-0.21). The correlation between EP and its various determinants was not influenced by diagnosis. The relationship between breathlessness and EP was different between men and women at any given level of exercise, women were more breathless than men. In multivariate analyses that contained both RV TLC-1 and BDI, the RV TLC-1 ratio was the strongest correlate of EP, although the BDI remained a significant covariate. Overall, age was the major determinant of EP but inclusion of the RV TLC-1 ratio and the BDI into the model explained a further 9-15% of the variance in EP. These three covariates together explained 26-34% of the variance between patients. We conclude that in stable CAO patients, the prediction of exercise capacity by anthropometric, demographic, clinical and physiological variables is likely to be low. Age, pulmonary hyperinflation and dyspnoea are the strongest and most consistent correlates of impaired exercise performance. Airways obstruction, measured during expiration using FEV1, does not appear to be a predictor of physiological impairment. These results underline the importance of performing exercise evaluation in CAO patients. (C) 2000 HARCOURT PUBLISHERS LTD.

Original languageEnglish
Pages (from-to)256-263
Number of pages8
JournalRespiratory Medicine
Volume94
Issue number3
DOIs
Publication statusPublished - Mar 2000

Fingerprint

Airway Obstruction
Exercise
Dyspnea
Total Lung Capacity
Residual Volume
Forced Expiratory Volume
Vital Capacity
Respiratory Muscles
Symptom Assessment
Spirometry
Visual Analog Scale
Exercise Test
Oxygen Consumption
Chronic Obstructive Pulmonary Disease
Walking
Multivariate Analysis
Gases
Demography
Lung

Keywords

  • Chronic airway obstruction
  • Exercise performance
  • Physiological determinants
  • Symptom determinants

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Physiological and symptom determinants of exercise performance in patients with chronic airway obstruction. / Foglio, K.; Carone, M.; Pagani, M.; Bianchi, L.; Jones, P. W.; Ambrosino, N.

In: Respiratory Medicine, Vol. 94, No. 3, 03.2000, p. 256-263.

Research output: Contribution to journalArticle

@article{fd298d6214774f19ab5bc534335c994a,
title = "Physiological and symptom determinants of exercise performance in patients with chronic airway obstruction",
abstract = "To evaluate the physiological and symptom determinants of exercise performance (EP) as measured by a 6-min walking test (6MWD), Watt(max), and peak oxygen consumption (VO2 ml/min/kg), 105 patients with chronic airway obstruction (CAO) [50 chronic obstructive pulmonary disease (COPD): 44 men, aged.63 ± 7 years, forced expiratory volume in 1 sec (FEV1) forced vital capacity (FVC)-1{\%} 54 ± 13; and 55 asthmatic: 23 men, aged 55 ± 10 years, FEV1 FVC-1{\%} 65 ± 10] underwent evaluation of 6MWD, symptom limited cyclo-ergometer exercise test, spirometry, respiratory muscle function, arterial blood gases and sensation of dyspnoea [using the Borg scale, Visual Analogue Scale (VAS) and Baseline Dyspnoea Index (BDI)]. A hierarchical method of analysis identified the residual volume (RV), total lung capacity (TLC)-1 ratio, BDI and the patient's age as the strongest and most consistent correlates of EP (r2 = 0.14-0.21). The correlation between EP and its various determinants was not influenced by diagnosis. The relationship between breathlessness and EP was different between men and women at any given level of exercise, women were more breathless than men. In multivariate analyses that contained both RV TLC-1 and BDI, the RV TLC-1 ratio was the strongest correlate of EP, although the BDI remained a significant covariate. Overall, age was the major determinant of EP but inclusion of the RV TLC-1 ratio and the BDI into the model explained a further 9-15{\%} of the variance in EP. These three covariates together explained 26-34{\%} of the variance between patients. We conclude that in stable CAO patients, the prediction of exercise capacity by anthropometric, demographic, clinical and physiological variables is likely to be low. Age, pulmonary hyperinflation and dyspnoea are the strongest and most consistent correlates of impaired exercise performance. Airways obstruction, measured during expiration using FEV1, does not appear to be a predictor of physiological impairment. These results underline the importance of performing exercise evaluation in CAO patients. (C) 2000 HARCOURT PUBLISHERS LTD.",
keywords = "Chronic airway obstruction, Exercise performance, Physiological determinants, Symptom determinants",
author = "K. Foglio and M. Carone and M. Pagani and L. Bianchi and Jones, {P. W.} and N. Ambrosino",
year = "2000",
month = "3",
doi = "10.1053/rmed.1999.0734",
language = "English",
volume = "94",
pages = "256--263",
journal = "Respiratory Medicine",
issn = "0954-6111",
publisher = "W.B. Saunders Ltd",
number = "3",

}

TY - JOUR

T1 - Physiological and symptom determinants of exercise performance in patients with chronic airway obstruction

AU - Foglio, K.

AU - Carone, M.

AU - Pagani, M.

AU - Bianchi, L.

AU - Jones, P. W.

AU - Ambrosino, N.

PY - 2000/3

Y1 - 2000/3

N2 - To evaluate the physiological and symptom determinants of exercise performance (EP) as measured by a 6-min walking test (6MWD), Watt(max), and peak oxygen consumption (VO2 ml/min/kg), 105 patients with chronic airway obstruction (CAO) [50 chronic obstructive pulmonary disease (COPD): 44 men, aged.63 ± 7 years, forced expiratory volume in 1 sec (FEV1) forced vital capacity (FVC)-1% 54 ± 13; and 55 asthmatic: 23 men, aged 55 ± 10 years, FEV1 FVC-1% 65 ± 10] underwent evaluation of 6MWD, symptom limited cyclo-ergometer exercise test, spirometry, respiratory muscle function, arterial blood gases and sensation of dyspnoea [using the Borg scale, Visual Analogue Scale (VAS) and Baseline Dyspnoea Index (BDI)]. A hierarchical method of analysis identified the residual volume (RV), total lung capacity (TLC)-1 ratio, BDI and the patient's age as the strongest and most consistent correlates of EP (r2 = 0.14-0.21). The correlation between EP and its various determinants was not influenced by diagnosis. The relationship between breathlessness and EP was different between men and women at any given level of exercise, women were more breathless than men. In multivariate analyses that contained both RV TLC-1 and BDI, the RV TLC-1 ratio was the strongest correlate of EP, although the BDI remained a significant covariate. Overall, age was the major determinant of EP but inclusion of the RV TLC-1 ratio and the BDI into the model explained a further 9-15% of the variance in EP. These three covariates together explained 26-34% of the variance between patients. We conclude that in stable CAO patients, the prediction of exercise capacity by anthropometric, demographic, clinical and physiological variables is likely to be low. Age, pulmonary hyperinflation and dyspnoea are the strongest and most consistent correlates of impaired exercise performance. Airways obstruction, measured during expiration using FEV1, does not appear to be a predictor of physiological impairment. These results underline the importance of performing exercise evaluation in CAO patients. (C) 2000 HARCOURT PUBLISHERS LTD.

AB - To evaluate the physiological and symptom determinants of exercise performance (EP) as measured by a 6-min walking test (6MWD), Watt(max), and peak oxygen consumption (VO2 ml/min/kg), 105 patients with chronic airway obstruction (CAO) [50 chronic obstructive pulmonary disease (COPD): 44 men, aged.63 ± 7 years, forced expiratory volume in 1 sec (FEV1) forced vital capacity (FVC)-1% 54 ± 13; and 55 asthmatic: 23 men, aged 55 ± 10 years, FEV1 FVC-1% 65 ± 10] underwent evaluation of 6MWD, symptom limited cyclo-ergometer exercise test, spirometry, respiratory muscle function, arterial blood gases and sensation of dyspnoea [using the Borg scale, Visual Analogue Scale (VAS) and Baseline Dyspnoea Index (BDI)]. A hierarchical method of analysis identified the residual volume (RV), total lung capacity (TLC)-1 ratio, BDI and the patient's age as the strongest and most consistent correlates of EP (r2 = 0.14-0.21). The correlation between EP and its various determinants was not influenced by diagnosis. The relationship between breathlessness and EP was different between men and women at any given level of exercise, women were more breathless than men. In multivariate analyses that contained both RV TLC-1 and BDI, the RV TLC-1 ratio was the strongest correlate of EP, although the BDI remained a significant covariate. Overall, age was the major determinant of EP but inclusion of the RV TLC-1 ratio and the BDI into the model explained a further 9-15% of the variance in EP. These three covariates together explained 26-34% of the variance between patients. We conclude that in stable CAO patients, the prediction of exercise capacity by anthropometric, demographic, clinical and physiological variables is likely to be low. Age, pulmonary hyperinflation and dyspnoea are the strongest and most consistent correlates of impaired exercise performance. Airways obstruction, measured during expiration using FEV1, does not appear to be a predictor of physiological impairment. These results underline the importance of performing exercise evaluation in CAO patients. (C) 2000 HARCOURT PUBLISHERS LTD.

KW - Chronic airway obstruction

KW - Exercise performance

KW - Physiological determinants

KW - Symptom determinants

UR - http://www.scopus.com/inward/record.url?scp=0034128577&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0034128577&partnerID=8YFLogxK

U2 - 10.1053/rmed.1999.0734

DO - 10.1053/rmed.1999.0734

M3 - Article

VL - 94

SP - 256

EP - 263

JO - Respiratory Medicine

JF - Respiratory Medicine

SN - 0954-6111

IS - 3

ER -