Maximum Intensity Exercise Training in Patients with Chronic Obstructive Pulmonary Disease (9)
For the endurance exercise test, it can be seen in Table 1 that the average target intensity work level represented a high percentage of the maximum work load achieved on baseline exercise testing (95 percent). At this level, patients were able to walk for 12.1 min on the endurance test. After the rehabilitation program, there was a significant increase in endurance presented in Figure 1. In addition, the percentage of baseline maximum achieved at week 8 of training for Vo2, Ve and HR also are indicated. These results demonstrate that, on average, patients were exercising at high percentages that exceeded baseline maximum levels in many cases.
Significant improvement in perceived symptoms during training occurred progressively through the eight-week rehabilitation program. Ratings of per-, ceived breathlessness decreased from 3.6 ± 1.6 at week 1 to 3.1 ±1.7 at week 4 and to 2.6±1.6 at week 8 (p<0.0001 by repeated measures AN OVA.). Similarly, ratings of perceived fatigue decreased from 3.3 ±1.5 to 2.8 ± 1.3 to 2.5 ± 1.4 at weeks 1, 4 and 8, respectively (p<0.001).
To better understand the determinants of the training intensity reached during rehabilitation, selected baseline characteristics were compared with the percentage of baseline maximum work load achieved during training. Based on the initial strategy for selecting training targets, we expected that patients with more severe lung disease who were ventilatory-limited would achieve high percentages of maximum during training.
Figure 1. Percentage of baseline maximum work load in METs for target level of the endurance exercise test and training weeks 1, 4 and 8. Also indicated are percentage of baseline maximum achieved at training week 8 for Vo2, Ve and HR.