EXERCISE TRAINING IMPROVES RECOVERY IN PATIENTS WITH COPD AFTER AN ACUTE EXACERBATION

Clinical experience suggests that exercise is beneficial for recovery after an acute exacerbation in patients with severe chronic obstructiv e pulmonary disease (COPD). The aim of this study was to quantify the clinical bene-st of exercise in these patients. Twenty-nine inpatients were randomly assigned to a training group (n=15, FEV1 34% pred) or a control group (n=14, FEV1 38% pred). On ten consecutive days, patient s in the training group performed a 6-min treadmill walking test and, in addition, five walking sessions per day at greater than or equal to 75% of the respective treadmill walking distance. Patients in the con trol group performed only treadmill walking tests on days 1, 5, and IO . To directly compare the possible benefit of exercise training all pa tients had an exercise test on day 11 at the same work load as on day 1. In the training group, 6-min walking distance increased from 237 to 420 m, in the control group from 230 to 255 m over the 10 day period which was significantly different (P<0.0001). Minute ventilation and o xygen uptake increased significantly (P<0.05) in the training but not in the control group. When comparing exercise tests on days 1 and II, minute ventilation, oxygen uptake, PaCO2, lactic acid concentration, a nd Borg scale were significantly reduced to achieve the same work load (P<0.01) only in the training group. Intrathoracic gas volume and res idual volume decreased, and FEV1 and vital capacity increased in the t raining (P<0.05) but not in the control group, Our data demonstrate th at exercise training significantly improves the exercise capacity in p atients with severe COPD after an acute exacerbation of their disease.