Impact of bronchodilator therapy on exercise tolerance in COPD.
Exercise tolerance is an important parameter in patients with COPD and a primary goal of treatment is to reduce dyspnea to facilitate physical activities and improve health-related quality of life. This review examines the link between expiratory flow limitation and dyspnea to explain the rationale for the use of bronchodilators and review the characteristics of different types of exercise tests, with specific focus on which tests are likely to show a response to bronchodilators. An earlier literature search of studies published up to 1999 assessed the effects of bronchodilatort therapy on dypsnea and exercise tolerance among patients with COPD. This current review examines the clinical evidence published since 1999. Thirty-one randomized studies of exercise tolerance associated with short- and long-acting beta(2)-agonists and anticholinergics were identified. Evidence for the efficacy of bronchodilators in enhancing exercise capacity is often contradictory and possibly depends on the exercise test and study methodology. However, further studies should confirm the benefit of long-acting bronchodilators in improving spontaneous everyday physical activities.
Aguilaniu
B
B
HYLAB, Laboratory of Clinical Physiology and Exercise, Grenoble, France. b.aguilaniu@wanadoo.fr
D001993:Bronchodilator Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D017079:Exercise Tolerance / Q000187:drug effects*; D006801:Humans; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy* / Q000503:physiopathology; D055815:Young Adult
D001993:Bronchodilator Agents
Chest. 1994 Dec;106(6):1740-5
7988193
Chest. 2003 Nov;124(5):1743-8
14605043
Am J Respir Crit Care Med. 1999 Aug;160(2):542-9
10430726
Eur Respir J. 2009 Aug;34(2):340-5
19251787
Cardiopulm Phys Ther J. 2008 Dec;19(4):115-8
20467508
Lancet. 2004 Aug 14-20;364(9434):613-20
15313363
J Cardiopulm Rehabil Prev. 2008 Nov-Dec;28(6):402-9
19008696
Thorax. 2008 Sep;63(9):775-7
18390634
Chest. 2000 Sep;118(3):672-8
10988188
Am J Respir Crit Care Med. 1998 Nov;158(5 Pt 1):1557-65
9817708
Image J Nurs Sch. 1995 Spring;27(1):23-34
7721307
Thorax. 2005 Nov;60(11):916-24
15994253
Am J Respir Crit Care Med. 2001 May;163(6):1395-9
11371407
Lung. 2006 Jul-Aug;184(4):201-4
17006746
Chest. 2002 Feb;121(2):597-608
11834677
Int J Chron Obstruct Pulmon Dis. 2008;3(1):127-36
18488436
Int J Chron Obstruct Pulmon Dis. 2008;3(4):771-80
19281092
Chest. 2009 Feb;135(2):384-390
18753470
Respirology. 2003 Jun;8(2):123-30
12753525
Chest. 2005 Mar;127(3):809-17
15764761
Semin Respir Crit Care Med. 2005 Apr;26(2):221-34
16088439
Am J Respir Crit Care Med. 2003 Feb 15;167(4):544-9
12446268
Br J Dis Chest. 1987 Jan;81(1):55-61
2959307
Chest. 2000 Feb;117(2 Suppl):23S-8S
10673470
Am J Respir Crit Care Med. 1997 Apr;155(4):1278-82
9105067
Thorax. 1992 Dec;47(12):1019-24
1494764
Chest. 2003 Jun;123(6):1810-6
12796154
Respir Med. 1991 Nov;85(6):495-500
1775676
Am J Respir Crit Care Med. 2002 Jul 1;166(1):111-7
12091180
Respir Med. 2007 Sep;101(9):2017-24
17475459
Respir Med. 2006 Feb;100(2):316-23
15941658
Eur Respir J. 2004 Jul;24(1):6-7
15293597
Thorax. 2009 Mar;64(3):216-23
19052054
Respir Med. 2007 Oct;101(10):2056-64
17658249
Tuberk Toraks. 2006;54(2):105-13
16924565
Thorax. 2006 Feb;61(2):122-8
16443706
Physiother Theory Pract. 2008 Jul-Aug;24(4):255-63
18574751
Presse Med. 2009 Mar;38(3):413-20
19152776
Thorax. 2006 Jul;61(7):559-67
16467067
Eur Respir J. 2002 May;19(5):936-43
12030736
Indian J Chest Dis Allied Sci. 2002 Jul-Sep;44(3):165-72
12206475
Am J Respir Crit Care Med. 2000 Jun;161(6):1897-901
10852763
Thorax. 1981 Oct;36(10):787-9
7036401
Intern Med. 1996 Oct;35(10):772-8
8933184
Respir Med. 2008 Aug;102(8):1203-7
18573647
Eur Respir J. 2004 Jul;24(1):86-94
15293609
J Cardiopulm Rehabil. 2006 May-Jun;26(3):180-7; discussion 188-90
16738459
Am J Respir Crit Care Med. 2003 Jan 15;167(2):211-77
12524257
Eur Respir J. 2002 Nov;20(5):1138-46
12449166
Cochrane Database Syst Rev. 2000;(4):CD001285
11034709
Thorax. 1978 Dec;33(6):711-3
154748
Lancet. 1996 Oct 26;348(9035):1115-9
8888163
Respir Med. 2007 Feb;101(2):286-93
16806873
Med Sci Sports Exerc. 2001 Jul;33(7 Suppl):S647-55
11462073
Chest. 2006 Sep;130(3):647-56
16963658
Thorax. 2004 Jun;59(6):471-6
15170026
Respir Med. 2007 Apr;101(4):746-53
17000096
Clin Cornerstone. 2004;Suppl 2:S5-16
15500179
Am J Respir Crit Care Med. 2005 Dec 15;172(12):1517-22
16166613
Eur Respir J. 2008 Mar;31(3):579-84
18057052
Age Ageing. 1995 Jul;24(4):278-82
7484482
Arzneimittelforschung. 2008;58(1):24-8
18368947
Am J Respir Crit Care Med. 2006 Jun 15;173(12):1326-34
16543549
Respiration. 2006;73(4):420-7
16484769
Thorax. 2007 Apr;62(4):291-8
17099077
Eur Respir J. 2008 Sep;32(3):637-43
18550610
Am J Respir Crit Care Med. 2001 Apr;163(5):1087-92
11316640
Eur Respir J. 2004 Jun;23(6):832-40
15218994
Eur Respir J. 1992 Jun;5(6):659-64
1628722
Thorax. 1983 Apr;38(4):292-6
6867983
Respir Med. 2008 Oct;102(10):1425-30
18621519
Respir Med. 2008 Jun;102(6):912-8
18280129
Thorax. 1993 Nov;48(11):1145-50
8296259
Respir Med. 2009 Feb;103(2):251-7
18930646
Chest. 2005 Sep;128(3):1168-78
16162703
Respir Med. 2002 Aug;96(8):559-66
12195835
Eur Respir J. 2002 Oct;20(4):799-805
12412667
Respirology. 2003 Mar;8(1):17-21
12856737
Chest. 1995 Sep;108(3):730-5
7656624
Am J Respir Crit Care Med. 2003 Aug 15;168(4):425-30
12714348
Curr Med Res Opin. 1983;8(5):345-9
6340975
Chest. 1993 Jun;103(6):1774-82
8404100