0
Clinical Investigations: DYSPNEA |

The Cumulative Effect of Long-Acting Bronchodilators, Exercise, and Inspiratory Muscle Training on the Perception of Dyspnea in Patients With Advanced COPD*

Paltiel Weiner, MD; Rasmi Magadle, MD; Noa Berar-Yanay, MD; Avi Davidovich, MD; Margalit Weiner, PhD
Author and Funding Information

*From the Department of Medicine A, Hillel-Yaffe Medical Center, Hadera, Israel.

Correspondence to: Paltiel Weiner, MD, Department of Medicine A, Hillel-Yaffe Medical Center, Hadera, Israel 38100



Chest. 2000;118(3):672-678. doi:10.1378/chest.118.3.672
Text Size: A A A
Published online

Background: Dyspnea is a common complaint during daily activities in patients with advanced COPD. The mechanisms underlying dyspnea and the appropriate treatment strategies to relieve it are still not totally understood. We hypothesized that the perception of dyspnea (POD) may be modified by the accumulative effect of bronchodilator therapy, exercise, and inspiratory muscle training (IMT).

Methods: Spirometry, submaximal exercise performance, inspiratory muscle strength and endurance, and the POD were assessed before and following three consecutive 6-week periods of therapy with a long-acting bronchodilator (LABD), the LABD plus exercise, and the LABD plus exercise plus IMT in 30 patients with moderate-to-severe COPD.

Results: There was a small, statistically insignificant, increase in FEV1 in the study group (mean [± SEM] increase, 1.42 ± 0.3 to 1.49 ± 0.4 L) following the LABD therapy period, and no additional increase following the two other periods of therapy. There was a significant increase (p < 0.05) in the 6-min walk distance following the therapy period with the LABD plus exercise (mean increase, 252 ± 41 to 294 ± 47 m) and an additional small increase following the therapy period with the LABD plus exercise plus IMT period (mean increase, 252 ± 41 to 302 ± 49 m). The decrease in the POD was small and statistically not significant following the therapy periods with the LABD and the LABD plus exercise. The major and statistically significant decrease in the POD was noted following the therapy period with the LABD plus exercise plus IMT.

Conclusions: In patients with moderate-to-severe COPD, following sequential periods of therapy with the LABD, the LABD plus exercise, and the LABD plus exercise plus IMT, there is a cumulative benefit in the POD. The most significant improvement was associated with IMT and not with the LABD and exercise training. The FEV1 was moderately increased following the therapy period with the LABD, and the addition of exercise has most affected the 6-min walk distance.

Figures in this Article

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
Inspiratory Muscle Training in Patients With COPD*: Effect on Dyspnea, Exercise Performance, and Quality of Life
PubMed Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543