Prescribing Cycle Exercise Intensity Using Moderate Symptom Levels in Chronic Obstructive Pulmonary Disease.
OBJECTIVE
Laboratory-based cardiopulmonary exercise testing from which to prescribe cycle training intensity in pulmonary rehabilitation for people with chronic obstructive pulmonary disease (COPD) is not readily available in clinical practice. Alternative methods of prescribing cycle exercise intensity, such as patient symptoms of dyspnea or rating of perceived exertion (RPE), have been used, but it is unknown whether cycle intensity based on such symptoms elicits an exercise intensity appropriate for achieving physiological training responses. The aim of the study was to determine the exercise intensity elicited when continuous cycle exercise was prescribed at symptoms of moderate dyspnea or RPE in people with COPD.


METHODS
Participants with diagnosed COPD performed lung function tests and an incremental cycle test to peak work capacity. On a subsequent day, participants performed 10 minutes of cycle exercise based on moderate symptoms (CycleSYMP) of either dyspnea or RPE, depending on which symptom limited the incremental cycle test. Oxygen uptake ((Equation is included in full-text article.)O2) was measured during all exercise using a portable metabolic system (Cosmed K4b).


RESULTS
Thirty participants, mean age of 70 ± 9 years and FEV1 60 ± 12% predicted, completed the study. The mean intensity achieved during CycleSYMP was 78 ± 12%(Equation is included in full-text article.)O2peak and 71 ± 18 % (Equation is included in full-text article.)O2Reserve. Steady-state (Equation is included in full-text article.)O2 was achieved by the sixth minute of CycleSYMP.


CONCLUSIONS
Using symptoms of moderate dyspnea or RPE as a method of prescribing cycle exercise elicited a high training intensity at which steady-state was achieved in people with mild to moderate COPD.
Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney (Drs Zainuldin, Mackey, and Alison), and Department of Physiotherapy, Royal Prince Alfred Hospital (Dr Alison), Sydney, New South Wales, Australia; and Physiotherapy, Rehabilitation Department, Ng Teng Fong General Hospital, JurongHealth, Singapore (Dr Zainuldin).
Rahizan
R
Zainuldin
Martin G
MG
Mackey
Jennifer A
JA
Alison
D000368:Aged; D004417:Dyspnea / Q000209:etiology; D015444:Exercise / Q000502:physiology*; D005081:Exercise Therapy / Q000379:methods*; D017079:Exercise Tolerance; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption; D005082:Physical Exertion; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000503:physiopathology / Q000534:rehabilitation*; D012720:Severity of Illness Index; D063189:Symptom Assessment