Factors limiting exercise capacity in COPD patients

  • Authors

    • R. Djebaili university Batna 2
    • N. Righi Department of Infectious diseases, public hospital establishment of Batna, faculty of medicine of Batna
    • A. Benbouza Department of Microbiology, public hospital establishment of Batna, faculty of medicine of Batna- Algeria
    • B. Chiboub Department of Epidemiology, university hospital center of Batna, faculty of medicine of Batna -Algeria
    2024-04-05
    https://doi.org/10.14419/mrga5j48
  • COPD; Exercise Capacity; 6-Minute Walk Test; Muscle Dysfunction.

  • Introduction: Impaired exercise capacity in COPD patients leads to deterioration in their physical activity and quality of life. The aim of our study was to assess the exercise capacity of COPD patients using the 6-minute walk test (6MWT) and to determine the factors limiting their exercise capacity.

    Methods: Stable COPD patients were included in this study to assess their exercise capacity using the 6-minute walk test (6MWT) and to investigate the relationship between exercise capacity, functional status (FEV1), quadriceps muscle dysfunction (strength and endurance), and fat free mass index (FFMI).

    Results: 175 COPD patients (166 males and 9 females) aged between 40 and 86 years with a mean age of 67.95 years. The functional stages distribution according to GOLD was GOLDI: 19.43%, GOLDII: 30.29%, GOLDIII: 33.71%, GOLD IV: 16.57%. 25% of patients received long-term oxygen therapy (LTOT). The mean distance covered by COPD patients was 432.26 ± 129.731 meters, corresponding to 64.71 ± 19.04%. 56 (32%) COPD patients had exercise intolerance as assessed by the distance walked over 6 minutes (6MWD). A significant correlation was found between the 6MWD, quadriceps endurance (P<0.000) and FEV1 (p<0.002), whereas no correlation was found with MVC (P<0.039) and (FFMI) (P<0.062).

    Conclusion: Muscle dysfunction and the severity of bronchial obstruction are the factors most associated with impaired exercise capacity in COPD patients.

  • References

    1. Prefaut C, Piperno D: Value and Indications of Exercice Tests in Pneumology. Rev Pneumol Clin 1997 ;53(5) :247-50.
    2. ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med 2002; 166: 111–17. https://doi.org/10.1164/ajrccm.166.1.at1102.
    3. Butland RJ, Pang J, Gross ER, Woodcock AA, Geddes DM. Two-, six-, and 12-minute walking tests in respiratory disease. Br Med J (Clin Res Ed) 1982; 284(6329):1607–1608. https://doi.org/10.1136/bmj.284.6329.1607.
    4. Enright, PL; McBurnie, MA; Bittner, V; Tracy, RP; McNamara, R; Arnold, A; Newman, A B. The 6-min walk test - A quick measure of functional status in elderly adults. Chest 2003;123(2) 387-398. https://doi.org/10.1378/chest.123.2.387.
    5. Brown C.D., Wise R.A. Field Tests of Exercise in COPD: The Six-Minute Walk Test and the Shuttle Walk Test COPD: Journal of Chronic Obstructive Pulmonary Disease, 2007(4):217–223, https://doi.org/10.1080/15412550701480125.
    6. Revill S M, Morgan M D, Singh S J, Williams J, Hardman A E The endurance shuttle walk: a new field test for the assessment of en-durance capacity in chronic obstructive pulmonary disease. Thorax. 1999 ;54(3) :213-22. https://doi.org/10.1136/thx.54.3.213.
    7. Singh S J, Morgan M D, Hardman A E, Rowe C, Bardsley P A. Comparison of oxygen uptake during a conventional treadmill test and the shuttle walking test in chronic airflow limitation Eur Respir J1994 ;7(11):2016-20. https://doi.org/10.1183/09031936.94.07112016.
    8. Onorati P, Antonucci R, Valli G, Berton E, De Marco F, Serra P, Palange P. Non-invasive evaluation of gas exchange during a shuttle walking test vs. a 6-min walking test to assess exercise tolerance in COPD patients. Eur J Appl Physiol 2003; 89(3–4)331–336 https://doi.org/10.1007/s00421-003-0803-9.
    9. Bowen J B, Votto J J, Thrall R S, Haggerty M C, Stockdale-Woolley R, Bandyopadhyay T, Zu Wallack R L. Functional status and sur-vival following pulmonary rehabilitation. Chest 2000; 118(3)697–703 https://doi.org/10.1378/chest.118.3.697.
    10. Celli B R, Cote C G, Marin J M, Casanova C, Montes de Oca M, Mendez R A, Pinto Plata R, Cabral H J. The body-mass index, airflow obstruction, dyspnea, and exercise capacity index in chronic obstructive pulmonary disease. N Engl J Med 2004; 350(10)1005–1012 https://doi.org/10.1056/NEJMoa021322.
    11. Poulain M, Durand F, Palomba B, Ceugniet F, Desplan J, Varray A, Préfaut C. 6-minute walk testing is more sensitive than maximal incremental cycle testing for detecting oxygen desaturation in patients with COPD. Chest 2003 ;123(5):1401-7. https://doi.org/10.1378/chest.123.5.1401.
    12. Solway S, Brooks D, Lacasse Y, Thomas S: A qualitative systematic overview of the measurement properties of functional walk tests used in the cardiorespiratory domain. Chest 2001;119(1):256-70. https://doi.org/10.1378/chest.119.1.256.
    13. Marek W, Marek E, Vogel P, Mückenhoff K, Kotschy-Lang N. A New Procedure for the Estimation of Physical Fitness of Patients dur-ing Clinical Rehabilitation using the 6-Minute-Walk-Test. Pneumologie. 2008 ;62 (11):643-54. https://doi.org/10.1055/s-2008-1038204.
    14. Celli B, Maltais F, O’Donnell D et al. American Thoracic Society/European Respiratory Society Statement on Pulmonary rehabilitation. Am J Respir Crit Care Med. 2006 Jun 15;173(12):1390-413. https://doi.org/10.1164/rccm.200508-1211ST.
    15. Ben Saad H, Prefaut C, Tabka Z, Hadj Mtir A, Chemit M, Hassaoune R, Ben Abid T, Zara K, Mercier G, Zbidi A, Hayot M.6-Minute walk distance in healthy North Africans older than 40 years: Influence of parity. Respiratory Medicine 2009 ;103 :74-84. https://doi.org/10.1016/j.rmed.2008.07.023.
    16. Villiot-Danger E, Reychler G, Villiot-Danger JC. Évaluation des paramètres cardio-respiratoires pendant le test de montée d’escalier et le test de marche de 6min 2015 Revue des Maladies Respiratoires 32 : A39-A40. https://doi.org/10.1016/j.rmr.2014.10.054.
    17. McGavin C R, Gupta S P, McHardy G J R: Twelve-minute Walking test for assessing disability in chronic bronchitis. British Medical Journal 1976; 1: 822-3. https://doi.org/10.1136/bmj.1.6013.822.
    18. Gosselink R, Troosters T, Decramer M. Peripheral muscle weakness contributes to exercise limitation in COPD. Am J Respir Crit Care Med 1996; 153:976–980. https://doi.org/10.1164/ajrccm.153.3.8630582.
    19. Wijkstra P J, TenVergert E M, van der Mark T W, Postma D S, R Van Altena, Kraan J, Koëter G H. Relation of lung function, maximal inspiratory pressure, dyspnoea, and quality of life with exercise capacity in patients with chronic obstructive pulmonary disease. Thor-ax. 1994 May;49(5):468-72. https://doi.org/10.1136/thx.49.5.468.

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    Djebaili, R., Righi, N., Benbouza, A., & Chiboub, B. (2024). Factors limiting exercise capacity in COPD patients. International Journal of Medicine, 12(1), 23-25. https://doi.org/10.14419/mrga5j48