title: Comprehensive exercise training improves ventilatory muscle function and reduces dyspnea perception in patients with COPD.
abstract: BACKGROUND
  Comprehensive exercise training (CET) is an efficient strategy to decrease dyspnea perception in chronic obstructive pulmonary disease (COPD) and may result in significant improvement in ventilatory muscles function. Our aim was to evaluate the effects of general exercise training on dyspnea perception and on respiratory muscles strength in COPD patients.
  
  
  METHODS
  Consecutive COPD patients were enrolled to complete a CET programme. The patients underwent a routine that included a global warm up, upper and lower limbs endurance exercise as well as stretching and relaxation. Before and after the CET programme, patients completed maximal inspiratory (PImax) and expiratory (PEmax) pressures measurements, maximal incremental test, endurance test, and 6-min walk distance (6MWD).
  
  
  RESULTS
  71 patients (52 male). Mean age 67.6 +/- 8.6 years, FEV1 (%) 44.2 +/- 16.2 and Mahler dyspnea scale 6.4 +/- 1.8. The results before and after the exercise programme were: PImax 64.7 +/- 22.9 vs. 75.5 +/- 23.7 cmH2O (p=0.001), PEmax 110.8 +/- 28.1 vs. 120.4 +/- 28.1 cmH2O (p=0.004), 6MWD 510.6 +/- 90.3 vs. 528.2 +/- 99.7 metres (p=0.88), time of incremental test 672 +/- 135 vs. 856 +/- 226 sec (p<0.0001). Compared with the pre exercise programme, we observed a significant reduction on Borg dyspnea scale (6.1 +/- 2.8 to 3.6 +/- 2.3, p<0.0001) as well as a longer test time (504 +/- 218 to 1.038 +/- 841, p<0.0001) at the end of the endurance test after CET programme. Improvement of PImax correlated negatively with dyspnea perception at iso-time during the endurance test (r = -0.33, p=0.03).
  
  
  CONCLUSIONS
  Our results confirm that CET is associated with significant improvement in PImax, PEmax and provide evidence demonstrating that CET reduces dyspnea perception in patients with COPD.
authors.affiliation: Universidade Federal de Sao Paulo, Escola Paulista de Medicina, Sao Paulo, Brazil. fcortopassi@copdnet.org
authors.forename: F
authors.initials: F
authors.lastname: Cortopassi
authors.forename: A A M
authors.initials: AA
authors.lastname: Castro
authors.forename: E F
authors.initials: EF
authors.lastname: Porto
authors.forename: M
authors.initials: M
authors.lastname: Colucci
authors.forename: G
authors.initials: G
authors.lastname: Fonseca
authors.forename: L
authors.initials: L
authors.lastname: Torre-Bouscoulet
authors.forename: V
authors.initials: V
authors.lastname: Iamonti
authors.forename: J R
authors.initials: JR
authors.lastname: Jardim
mesh_terms: D000368:Aged; D003627:Data Interpretation, Statistical; D004417:Dyspnea / Q000175:diagnosis / Q000517:prevention & control*; D005080:Exercise Test; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000534:rehabilitation / Q000628:therapy*; D012129:Respiratory Function Tests; D012132:Respiratory Muscles / Q000502:physiology*; D012907:Smoking / Q000009:adverse effects; D013147:Spirometry; D013997:Time Factors; D016896:Treatment Outcome; D016138:Walking