Respiratory Investigation Unit, Dept of Medicine, Queen's University and Kingston General Hospital, Kingston, ON.
Respiratory Investigation Unit, Dept of Medicine, Queen's University and Kingston General Hospital, Kingston, ON Dept of Physical Therapy and UBC Centre for Heart Lung Innovation, University of British Columbia, Vancouver, BC, Canada.
Eur Respir J. 2014 Jun;43(6):1621-30. doi: 10.1183/09031936.00151513. Epub 2013 Dec 5.
The purpose of this study was to investigate whether differences in physiological responses to weight-bearing (walking) and weight-supported (cycle) exercise influence dyspnoea perception in obese chronic obstructive pulmonary disease (COPD) patients, where such discrepancies are probably exaggerated. We compared metabolic, ventilatory and perceptual responses during incremental treadmill and cycle exercise using a matched linearised rise in work rate in 18 (10 males and eight females) obese (mean ± sd body mass index 36.4 ± 5.0 kg·m(-2)) patients with COPD (forced expiratory volume in 1 s 60 ± 11% predicted). Compared with cycle testing, treadmill testing was associated with a significantly higher oxygen uptake, lower ventilatory equivalent for oxygen and greater oxyhaemoglobin desaturation at a given work rate (p<0.01). Cycle testing was associated with a higher respiratory exchange ratio (p<0.01), earlier ventilatory threshold (p<0.01) and greater peak leg discomfort ratings (p=0.01). Ventilation, breathing pattern and operating lung volumes were similar between tests, as were dyspnoea/work rate and dyspnoea/ventilation relationships. Despite significant between-test differences in physiological responses, ventilation, operating lung volumes and dyspnoea intensity were similar at any given external power output during incremental walking and cycling exercise in obese COPD patients. These data provide evidence that either exercise modality can be selected for reliable evaluation of exertional dyspnoea in this population in research and clinical settings.
本研究旨在探讨肥胖慢性阻塞性肺疾病（COPD）患者在负重（行走）和承重（骑车）运动时生理反应的差异是否会影响呼吸困难感知，因为这种差异可能会被夸大。我们比较了 18 名（10 名男性和 8 名女性）肥胖（平均±标准差体重指数 36.4±5.0 kg·m(-2)) COPD 患者（1 秒用力呼气量占预计值的 60±11%）递增跑步机和自行车运动时的代谢、通气和感知反应，使用匹配的线性工作率增加。与自行车测试相比，跑步机测试与更高的摄氧量、更低的氧通气当量和在给定工作率下更大的氧血红蛋白饱和度下降相关（p<0.01）。自行车测试与更高的呼吸交换比（p<0.01）、更早的通气阈值（p<0.01）和更大的峰值腿部不适评分（p=0.01）相关。在测试之间，通气、呼吸模式和工作肺容积相似，呼吸困难/工作率和呼吸困难/通气关系也相似。尽管在生理反应方面存在显著的测试间差异，但在递增步行和骑车运动中，肥胖 COPD 患者在任何给定的外部功率输出时，通气、工作肺容积和呼吸困难强度相似。这些数据提供了证据，表明在研究和临床环境中，在评估该人群的运动性呼吸困难时，可以选择任何一种运动方式。
