Pulmonary Rehabilitation in Patients with COPD (4)
The duration of the inspiration was set at 3 s by means of a metronome, the (unloaded) expiration at 4 s. The respiratory frequency, therefore, was eight to nine breaths per minute. ventolin 100 mcg
The patient performed TF-IMT during 15 minutes twice a day, supervised by the physiotherapist. Twice a week, PImax was measured and the target-flow was adjusted to the new PImax.
Lung function: Lung function measurements were made before the training period, and after four and ten weeks of training. Total lung capacity (TLC) was measured by means of the closed circuit helium-dilution method (Pulmonet III, Gould-Godart). Spirometry was performed with a wet spirometer (Pulmonet III).
Bicycle Ergometer Test: A maximal incremental exercise test until exhaustion was performed on an electrically braked bicycle ergometer (Lode). An estimation of the maximal work load (Wmax, watts) was made by the following equation: Wmax predicted = 1.7 x weight (kg) + 40x FEV,(L) —25.“ Every minute the work load was increased by 10 percent of the predicted Wmax. Heart rate and peripheral oxygen saturation were monitored with a pulse oximeter (Oxyshuttle, SensorMedics). An arterial blood sample for blood gas analysis (Ciba Corning 178 DMS) was taken every 3 minutes and at Wmax. Every 30 s, an output was printed of minute ventilation (Ve), 02 uptake (VOj), COa output (VcoJ, and derived parameters (Oxycon IV, Mijnhardt).