Ventilatory strategies in the six-minute walk test in older patients receiving a three-week rehabilitation programme after cardiac surgery through median sternotomy

Raffaele Molino-Lova, Guido Pasquini, Federica Vannetti, Renato Zipoli, Lorenzo Razzolini, Valentina Fabbri, Roberta Frandi, Francesca Cecchi, Francesco Gigliotti, Claudio Macchi

Research output: Contribution to journalArticle

Abstract

Background: Although the six-minute walk test (6MWT) is widely used in cardiac rehabilitation, little is known about the ventilatory strategies adopted by older patients who have recently undergone median sternotomy, in order to meet the increased metabolic demand in the 6MWT. Methods: Using a portable gas-analyser we assessed the breathing patterns in the 6MWT before and after a 3-week rehabilitation programme in 84 older patients, 58 men and 26 women, mean age 71 years (standard deviation (SD) 6 years), who had undergone median sternotomy. Results: After rehabilitation, patients increased end-test ventilation (33.1 l (SD 9.8) vs 30.9 l (SD 8.4), p <0.001) by increasing tidal volume (1.158 l (SD 0.298) vs 1.065 l (SD 0.255), p <0.001), while breathing frequency remained unchanged (29.9 bpm (SD 5.4) vs 30.2 bpm (SD 5.8), p = 0.621). As a consequence, the ventilatory equivalent for CO2, was significantly improved (39.9 (SD 5.3) vs 43.5 (SD 7.4), p <0.001). Furthermore, the improvement in ventilatory efficiency was significantly (p <0.001) correlated with the improvement in the distance walked on the 6MWT. Conclusion: Older patients who have undergone median sternotomy meet the increased metabolic demand on the 6MWT after cardiac rehabilitation by increasing tidal volume. Accordingly, we should consider including as a routine specific exercises for inspiratory muscle training in current rehabilitation programmes to reduce inspiratory muscle effort and further improve ventilatory efficiency.

Original languageEnglish
Pages (from-to)504-509
Number of pages6
JournalJournal of Rehabilitation Medicine
Volume45
Issue number5
DOIs
Publication statusPublished - 2013

Fingerprint

Sternotomy
Thoracic Surgery
Rehabilitation
Tidal Volume
Respiration
Pulmonary Ventilation
Muscles
Gases
Exercise
Walk Test
Cardiac Rehabilitation

Keywords

  • Breathing pattern
  • Cardiac rehabilitation
  • Cardiopulmonary exercise testing
  • Elderly
  • Six-minute walk test

ASJC Scopus subject areas

  • Rehabilitation
  • Physical Therapy, Sports Therapy and Rehabilitation
  • Medicine(all)

Cite this

@article{bb0691f6f9ee45db884fd13dac4bb4b6,
title = "Ventilatory strategies in the six-minute walk test in older patients receiving a three-week rehabilitation programme after cardiac surgery through median sternotomy",
abstract = "Background: Although the six-minute walk test (6MWT) is widely used in cardiac rehabilitation, little is known about the ventilatory strategies adopted by older patients who have recently undergone median sternotomy, in order to meet the increased metabolic demand in the 6MWT. Methods: Using a portable gas-analyser we assessed the breathing patterns in the 6MWT before and after a 3-week rehabilitation programme in 84 older patients, 58 men and 26 women, mean age 71 years (standard deviation (SD) 6 years), who had undergone median sternotomy. Results: After rehabilitation, patients increased end-test ventilation (33.1 l (SD 9.8) vs 30.9 l (SD 8.4), p <0.001) by increasing tidal volume (1.158 l (SD 0.298) vs 1.065 l (SD 0.255), p <0.001), while breathing frequency remained unchanged (29.9 bpm (SD 5.4) vs 30.2 bpm (SD 5.8), p = 0.621). As a consequence, the ventilatory equivalent for CO2, was significantly improved (39.9 (SD 5.3) vs 43.5 (SD 7.4), p <0.001). Furthermore, the improvement in ventilatory efficiency was significantly (p <0.001) correlated with the improvement in the distance walked on the 6MWT. Conclusion: Older patients who have undergone median sternotomy meet the increased metabolic demand on the 6MWT after cardiac rehabilitation by increasing tidal volume. Accordingly, we should consider including as a routine specific exercises for inspiratory muscle training in current rehabilitation programmes to reduce inspiratory muscle effort and further improve ventilatory efficiency.",
keywords = "Breathing pattern, Cardiac rehabilitation, Cardiopulmonary exercise testing, Elderly, Six-minute walk test",
author = "Raffaele Molino-Lova and Guido Pasquini and Federica Vannetti and Renato Zipoli and Lorenzo Razzolini and Valentina Fabbri and Roberta Frandi and Francesca Cecchi and Francesco Gigliotti and Claudio Macchi",
year = "2013",
doi = "10.2340/16501977-1126",
language = "English",
volume = "45",
pages = "504--509",
journal = "Journal of Rehabilitation Medicine",
issn = "1650-1977",
publisher = "Foundation for Rehabilitation Information",
number = "5",

}

TY - JOUR

T1 - Ventilatory strategies in the six-minute walk test in older patients receiving a three-week rehabilitation programme after cardiac surgery through median sternotomy

AU - Molino-Lova, Raffaele

AU - Pasquini, Guido

AU - Vannetti, Federica

AU - Zipoli, Renato

AU - Razzolini, Lorenzo

AU - Fabbri, Valentina

AU - Frandi, Roberta

AU - Cecchi, Francesca

AU - Gigliotti, Francesco

AU - Macchi, Claudio

PY - 2013

Y1 - 2013

N2 - Background: Although the six-minute walk test (6MWT) is widely used in cardiac rehabilitation, little is known about the ventilatory strategies adopted by older patients who have recently undergone median sternotomy, in order to meet the increased metabolic demand in the 6MWT. Methods: Using a portable gas-analyser we assessed the breathing patterns in the 6MWT before and after a 3-week rehabilitation programme in 84 older patients, 58 men and 26 women, mean age 71 years (standard deviation (SD) 6 years), who had undergone median sternotomy. Results: After rehabilitation, patients increased end-test ventilation (33.1 l (SD 9.8) vs 30.9 l (SD 8.4), p <0.001) by increasing tidal volume (1.158 l (SD 0.298) vs 1.065 l (SD 0.255), p <0.001), while breathing frequency remained unchanged (29.9 bpm (SD 5.4) vs 30.2 bpm (SD 5.8), p = 0.621). As a consequence, the ventilatory equivalent for CO2, was significantly improved (39.9 (SD 5.3) vs 43.5 (SD 7.4), p <0.001). Furthermore, the improvement in ventilatory efficiency was significantly (p <0.001) correlated with the improvement in the distance walked on the 6MWT. Conclusion: Older patients who have undergone median sternotomy meet the increased metabolic demand on the 6MWT after cardiac rehabilitation by increasing tidal volume. Accordingly, we should consider including as a routine specific exercises for inspiratory muscle training in current rehabilitation programmes to reduce inspiratory muscle effort and further improve ventilatory efficiency.

AB - Background: Although the six-minute walk test (6MWT) is widely used in cardiac rehabilitation, little is known about the ventilatory strategies adopted by older patients who have recently undergone median sternotomy, in order to meet the increased metabolic demand in the 6MWT. Methods: Using a portable gas-analyser we assessed the breathing patterns in the 6MWT before and after a 3-week rehabilitation programme in 84 older patients, 58 men and 26 women, mean age 71 years (standard deviation (SD) 6 years), who had undergone median sternotomy. Results: After rehabilitation, patients increased end-test ventilation (33.1 l (SD 9.8) vs 30.9 l (SD 8.4), p <0.001) by increasing tidal volume (1.158 l (SD 0.298) vs 1.065 l (SD 0.255), p <0.001), while breathing frequency remained unchanged (29.9 bpm (SD 5.4) vs 30.2 bpm (SD 5.8), p = 0.621). As a consequence, the ventilatory equivalent for CO2, was significantly improved (39.9 (SD 5.3) vs 43.5 (SD 7.4), p <0.001). Furthermore, the improvement in ventilatory efficiency was significantly (p <0.001) correlated with the improvement in the distance walked on the 6MWT. Conclusion: Older patients who have undergone median sternotomy meet the increased metabolic demand on the 6MWT after cardiac rehabilitation by increasing tidal volume. Accordingly, we should consider including as a routine specific exercises for inspiratory muscle training in current rehabilitation programmes to reduce inspiratory muscle effort and further improve ventilatory efficiency.

KW - Breathing pattern

KW - Cardiac rehabilitation

KW - Cardiopulmonary exercise testing

KW - Elderly

KW - Six-minute walk test

UR - http://www.scopus.com/inward/record.url?scp=84877654564&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84877654564&partnerID=8YFLogxK

U2 - 10.2340/16501977-1126

DO - 10.2340/16501977-1126

M3 - Article

C2 - 23468060

AN - SCOPUS:84877654564

VL - 45

SP - 504

EP - 509

JO - Journal of Rehabilitation Medicine

JF - Journal of Rehabilitation Medicine

SN - 1650-1977

IS - 5

ER -