Faculty of Health and Life Sciences, Department of Sport, Exercise and Rehabilitation, 373117Northumbria University Newcastle, Newcastle upon Tyne, UK.
Pulmonary Rehabilitation Services, 5983Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.
Chron Respir Dis. 2022 Jan-Dec;19:14799731221142023. doi: 10.1177/14799731221142023.
Ground-based walking is a simple training modality which would suit pulmonary rehabilitation (PR) settings with limited access to specialist equipment. Patients with COPD are, however, unable to walk uninterruptedly at a relatively fast walking pace to optimise training benefits. We compared an intermittent (IntSW) to a continuous (CSW) shuttle walking protocol. In 14 COPD patients (mean ± SD. FEV: 45 ± 21% predicted) we measured walking distance, cardiac output (CO), arterial oxygen saturation (SpO), and symptoms during (a) an IntSW protocol, consisting of 1-min walking alternating with 1-min rest, and (b) a CSW protocol, both sustained at 85% of predicted VO peak to the limit of tolerance (Tlim). Median (IQR) distance was greater ( = 0.001) during the IntSW protocol (735 (375-1107) m) than the CSW protocol (190 (117-360) m). At iso-distance (distance at Tlim during CSW) the IntSW compared to the CSW protocol was associated with lower CO (8.6 ± 2.6 vs 10.3 ± 3.7 L/min; = 0.013), greater SpO (92 ± 6% versus 90 ± 7%; = 0.002), and lower symptoms of dyspnoea (2.8 ± 1.3 vs 4.9 ± 1.4; = 0.001) and leg discomfort (2.3 ± 1.7 vs 4.2 ± 2.2; = 0.001). At Tlim symptoms of dyspnoea and leg discomfort did not differ between the IntSW (4.4 ± 1.9 and 3.6 ± 2.1, respectively) and the CSW protocol. The IntSW protocol may provide important clinical benefits during exercise training in the PR settings because it allows greater work outputs compared to the CSW.
基于地面的行走是一种简单的训练方式，适合于专业设备有限的肺康复（PR）环境。然而，COPD 患者无法不间断地以相对较快的步行速度行走，以优化训练效果。我们比较了间歇性（IntSW）和连续（CSW）穿梭步行方案。在 14 名 COPD 患者（平均 ± 标准差，FEV：45 ± 21%预计值）中，我们测量了行走距离、心输出量（CO）、动脉血氧饱和度（SpO）和症状，（a）采用 1 分钟行走和 1 分钟休息交替的 IntSW 方案，（b）采用 CSW 方案，均以 85%的预计 VO 峰值持续至耐受极限（Tlim）。IntSW 方案的中位（IQR）距离（= 0.001）大于 CSW 方案（735（375-1107）m 与 190（117-360）m）。在等距（CSW 中的 Tlim 期间的距离）时，IntSW 方案与 CSW 方案相比，CO 较低（8.6 ± 2.6 比 10.3 ± 3.7 L/min；= 0.013），SpO 较高（92 ± 6%比 90 ± 7%；= 0.002），呼吸困难和腿部不适症状较轻（2.8 ± 1.3 比 4.9 ± 1.4；= 0.001）和腿部不适（2.3 ± 1.7 比 4.2 ± 2.2；= 0.001）。在 Tlim 时，IntSW 方案（分别为 4.4 ± 1.9 和 3.6 ± 2.1）和 CSW 方案的呼吸困难和腿部不适症状没有差异。与 CSW 相比，IntSW 方案在 PR 环境中的运动训练中可能提供重要的临床益处，因为它允许更大的工作输出。
