The effect of walking aids on exercise capacity and oxygenation in elderlypatients with chronic obstructive pulmonary disease

Background: high walking frames may improve exercise capacity in young pati ents with chronic obstructive pulmonary disease (COPD). We have assessed th e effect of Zimmer, rollator and gutter frames on 6-min walking distance an d on arterial oxygenation during exercise in elderly patients with COPD. Methods: 27 out-patients (15 men) aged 70-82 (mean 75) years were recruited . Exclusions comprised: COPD exacerbation or oral steroid use within 6 week s, confusional state, participation in a pulmonary rehabilitation programme and exercise limitation by other diseases. Subjects completed 6-min walk t ests unaided and with the three frames on four separate days in random orde r 30 min after nebulized salbutamol (5 mg) and ipratropium (0.5 mg) and wer e accompanied by an investigator blinded to results of all other walk tests undertaken. Oxygen saturation (SaO(2)) was monitored by finger probe durin g exercise. Grouped t-tests were used to compare distances and reductions i n SaO(2). Results: Unaided, the mean (SEM) 6-min walk distance was 210 (16) m and fal l in oxygen saturation was 6.0 (1.1)%. Use of a rollator frame did not sign ificantly affect either of these values. Using the Zimmer frame reduced the mean distance to 165 (13) m (t = 5.2, P < 0.001 vs unaided walk) with an S aO(2) fall similar to that recorded during the unaided walk. Using the gutt er frame increased the mean distance to 234 (150) m (t = 3.1, P = 0.004 vs unaided walk) and reduced the fall in SaO(2) to 3.7 (0.8)% (t = 2.3, P = 0. 03 vs unaided walk). Conclusions: gutter frames improve exercise capacity and SaO(2) during exer cise in elderly COPD patients who remain symptomatic on optimal therapy, wh ereas unwheeled Zimmer frames have a deleterious effect in such patients.