COMPARISON OF 2 TRAINING-PROGRAMS IN CHRONIC AIRWAY LIMITATION PATIENTS - STANDARDIZED VERSUS INDIVIDUALIZED PROTOCOLS

This study tested the effect of two methods of training, one individua lized at the heart rate corresponding to the gas exchange threshold (G ET) and the other at the heart rate corresponding to 50% of maximal he art rate reserve, on maximal and submaximal cardiorespiratory response in 24 patients with chronic airway limitation (CAL). The patients wer e randomly assigned to either the individualized training group (IT; n =12) or the standardized training group (ST; n=12). The training progr amme consisted of 4 weeks of stationary bicycle exercise, 5 days . wee k(-1). Before reconditioning began, the target level based on heart ra te was not significantly different between groups (109+/-4 versus 110/-3 beats . min(-1), in IT and ST, respectively). Post-training, a sig nificant increase in symptom-limited oxygen uptake ((VO2)-O-1,sl) and maximal O-2 pulse was found in IT, whereas ST exhibited no significant change. In each group, GET was statistically increased in much the sa me way as (VO2)-O-1,sl, with a higher increase in IT (p<0.01) than ST (p<0.05). Nevertheless, IT exhibited a concomitant and gradual decreas e in minute ventilation (V(1)E), carbon dioxide production ((VCO2)-C-1 ), and venous lactate concentration ([La]), whereas ST presented no si gnificant change in these parameters (intergroup p<0.01). Breathing pa ttern was also altered after IT, at the same metabolic level and at th e same ventilation level (intergroup p<0.05). Cardiac responses were m odified in the two groups, At the same metabolic level, a significantl y lower cardiac frequency was found both for IT and ST (intragroup p<0 .05 after training). In contrast, the increase in O-2 pulse was only s ignificantly higher in IT after training. These data show the greater efficiency of an individualized training protocol based on determinati on of gas exchange threshold as compared to a standardized protocol in improving exercise performance, when applied to a patient group. Desp ite an apparently similar target training level, the individualized me thod clearly optimized the physiological training effects in patients with chronic airway limitation and, more particularly, decreased their ventilatory requirement. (C)ERS Journals Ltd 1997.