title: Helium-hyperoxia: a novel intervention to improve the benefits of pulmonary rehabilitation for patients with COPD.
abstract: BACKGROUND
  Helium-hyperoxia (HH) reduces dyspnea and increases exercise tolerance in patients with COPD. We investigated whether breathing HH would allow patients to perform a greater intensity of exercise and improve the benefits of a pulmonary rehabilitation program.
  
  
  METHODS
  Thirty-eight nonhypoxemic patients with COPD (FEV(1)=47 +/- 17%(pred)) were randomized to rehabilitation breathing HH (60:40 He:O(2); n = 19) or air (n = 19). Patients cycled for 30 min, 3 days/week for 6 weeks breathing the assigned gas. Exercise intensity was prescribed from baseline, gas-specific, incremental exercise tests and was advanced as tolerated. The primary outcome was exercise tolerance assessed as a change in constant-load exercise time (CLT) following rehabilitation. Secondary outcomes were changes in exertional symptoms, health related quality of life (as assessed by the Short-form 36 and St George respiratory questionnaires), and peak oxygen consumption during an incremental exercise test.
  
  
  RESULTS
  The HH group had a greater change in CLT following rehabilitation compared to the air group (9.5 +/- 9.1 vs 4.3 +/- 6.3 min, p < 0.05). At an exercise isotime, dyspnea was significantly reduced in both groups, while leg discomfort only decreased in the HH group. The changes in exertional symptoms and peak oxygen consumption were not different between groups. Health-related quality of life significantly improved in both groups; however, the change in St. George respiratory questionnaire total score was greater with HH (-7.6 +/- 6.4 vs -3.6 +/- 5.6, p < 0.05). During rehabilitation, the HH group achieved a higher exercise intensity and training duration throughout the program (p < 0.05).
  
  
  CONCLUSIONS
  Breathing HH during pulmonary rehabilitation increases the intensity and duration of exercise training that can be performed and results in greater improvements in CLT for patients with COPD.
authors.affiliation: Faculty of Kinesiology and the Division of Respiratory Medicine, Faculty of Medicine, University of Calgary, Calgary, AB, Canada. Electronic address: neves@ucalgary.ca.
authors.forename: Neil D
authors.initials: ND
authors.lastname: Eves
authors.affiliation: Caritas Centre for Lung Health, Edmonton General Continuing Care Centre, Edmonton, AB, Canada.
authors.forename: Laura C
authors.initials: LC
authors.lastname: Sandmeyer
authors.affiliation: Pulmonary Division, University of Alberta, Edmonton, AB, Canada.
authors.forename: Eric Y
authors.initials: EY
authors.lastname: Wong
authors.affiliation: Pulmonary Division, University of Alberta, Edmonton, AB, Canada; Department of Surgery, Duke University Medical Center, Durham, NC.
authors.forename: Lee W
authors.initials: LW
authors.lastname: Jones
authors.affiliation: Caritas Centre for Lung Health, Edmonton General Continuing Care Centre, Edmonton, AB, Canada.
authors.forename: Giles F
authors.initials: GF
authors.lastname: MacDonald
authors.affiliation: Division of Respiratory Medicine, Faculty of Medicine, Rockyview General Hospital, Calgary, AB, Canada.
authors.forename: Gordon T
authors.initials: GT
authors.lastname: Ford
authors.affiliation: Department of Medicine, and the Faculty of Physical Education and Recreation, University of Alberta, Edmonton, AB, Canada.
authors.forename: Stewart R
authors.initials: SR
authors.lastname: Petersen
authors.affiliation: Pulmonary Division, University of Alberta, Edmonton, AB, Canada.
authors.forename: Marc D
authors.initials: MD
authors.lastname: Bibeau
authors.affiliation: Faculty of Kinesiology and the Division of Respiratory Medicine, Faculty of Medicine, University of Calgary, Calgary, AB, Canada.
authors.forename: Richard L
authors.initials: RL
authors.lastname: Jones
mesh_terms: D000368:Aged; D004311:Double-Blind Method; D004417:Dyspnea / Q000209:etiology / Q000628:therapy; D005080:Exercise Test; D005081:Exercise Therapy; D017079:Exercise Tolerance; D005260:Female; D006371:Helium / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010102:Oxygen Inhalation Therapy; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology / Q000534:rehabilitation*; D011788:Quality of Life; D012129:Respiratory Function Tests
chemical_list: D006371:Helium