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Which Exercise Test Should Be Used for Patients With Symptomatic COPD?

James E. Johnson, MD, FCCP
Author and Funding Information

Affiliations: Birmingham, AL
 ,  Dr. Johnson is Associate Professor of Medicine, Physiology and Biophysics, Division of Pulmonary, Allergy and Critical, Care Medicine, University of Alabama at Birmingham.

Correspondence to: James E. Johnson, MD, FCCP, BDB 398, 1808 Seventh Ave South, Birmingham, AL 35294-0012; e-mail: jej@uab.edu



Chest. 2004;126(3):668-670. doi:10.1378/chest.126.3.668
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Over the past decade, our understanding of exercise pathophysiology in patients with chronic airflow obstruction has expanded rapidly. Several articles, including one in this issue of CHEST by Turner et al (see page 765), have explored the responses to various testing protocols. I will argue that the 6-min walk test (6MWT) is the best one to use at a single point in time to assess a patient with symptomatic airflow limitation. It is also a good test to repeat to document declining exercise tolerance, and an adequate test to document improvement in function. Treadmill testing at constant workload is more sensitive for the latter purpose.1 Treadmill testing is also better if more advanced monitoring such as continuous electrocardiography or expired gas analysis is required during exercise. Cycle ergometry is less desirable since it has been shown to have important respiratory differences when compared with walking in this group, and is less closely related to the patient’s usual activities.2

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