Pulmonary rehabilitation (PR) has become widely recognized as a cornerstone in the management of chronic obstructive pulmonary disease (COPD). Current PR guidelines advocate high-intensity exercise training, as it seems to induce the greatest physiological adaptations in COPD patients. However, this approach is believed to be unpleasant and difficult to comply to for this patient population. This belief needs to be verified. The main objective of this pilot study was to measure the affective response (i.e. pleasant versus unpleasant feelings) to high-intensity exercise training in COPD patients to determine if this approach is indeed perceived as unpleasant.
Individuals with COPD were recruited from an outpatient clinic at Hôpital du Sacré-Coeur de Montréal. Included subjects completed several baseline assessments as part of a larger study. For the present study, affective and physiological measures were taken during a single exercise bout. Patients were asked to perform 25 minutes of high-intensity exercise (excluding warm-up and cool-down) on a cycle ergometer. Affective response was measured using the Positive and Negative Affect Schedule (PANAS) and the Global Vigor and Affect Instrument (GVA) throughout the exercise session. In addition, various physiological parameters (e.g., inspiratory capacity) were measured breath by breath throughout the same session using a portable metabolic system. Changes in affective and physiological measures were analyzed with repeated-measures analyses of variance.
To date, seven subjects have completed all assessments. Positive and negative affect scores from the PANAS remained constant from rest to end-exercise to post-exercise. Likewise, no significant time effect was observed for global vigor (level of alertness) and global affect from the GVA. However, an upward trend was observed in global affect scores from rest to post-exercise (p = 0.06). A clinically significant decrease in inspiratory capacity was observed in only two subjects.
Preliminary results from this study suggest that high-intensity exercise training does not have a negative impact on affect in COPD patients.
Preliminary findings from this study suggest that high-intensity exercise training is well tolerated by COPD patients.
Amanda Rizk, Grant monies (from sources other than industry) V. Pepin, S. Bacon, and K. Lavoie are current research scholars of the Fonds de la recherche en santé du Québec (FRSQ). They have also received operating grants from the Canadian Lung Association, the FRSQ, the Canadian Institutes of Health Research, and GlaxoSmithKline (Collaborative Innovative Research Fund).; No Product/Research Disclosure Information