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Original Research: COPD |

Defining the Relationship Between Average Daily Energy Expenditure and Field-Based Walking Tests and Aerobic Reserve in COPDEnergy Expenditure and Aerobic Reserve in COPD

Kylie Hill, PhD; Thomas E. Dolmage, MSc; Lynda Woon, BScPT; Debbie Coutts, RRT; Roger Goldstein, MD, FCCP; Dina Brooks, PhD
Author and Funding Information

From the Department of Respiratory Medicine (Drs Hill, Goldstein, and Brooks; Mr Dolmage; and Ms Woon) and Respiratory Diagnostic and Evaluations Services (Mr Dolmage), West Park Healthcare Centre, and Departments of Physical Therapy and Medicine (Drs Hill, Goldstein, and Brooks), University of Toronto, Toronto, ON, Canada; School of Physiotherapy and Curtin Health Innovation Research Institute (Dr Hill), Curtin University, Bentley, WA, Australia; Lung Institute of Western Australia and Centre for Asthma (Dr Hill), Allergy and Respiratory Research, University of Western Australia, Crawley, WA, Australia; and Department of Respiratory Medicine (Ms Coutts), Credit Valley Hospital, Mississauga, ON, Canada.

Correspondence to: Dina Brooks, PhD, Department of Physical Therapy, University of Toronto, 160-500 University Ave, Toronto, ON, M5G 1V7, Canada; e-mail: dina.brooks@utoronto.ca


Funding/Support: Funding was provided by the Physicians’ Services Incorporated Foundation [grant 06-41]. Dr Brooks is supported by a Canadian Research Chair and Dr Goldstein by the NSA Chair in Respiratory Rehabilitation Research.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).


© 2012 American College of Chest Physicians


Chest. 2012;141(2):406-412. doi:10.1378/chest.11-0298
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Background:  The aims of this study were to determine which tests of exercise capacity relate to average daily energy expenditure (DEE) and to quantify aerobic reserve during daily life in people with COPD.

Methods:  A cross-sectional study was undertaken in 26 people with COPD (16 men; FEV1, 50% ± 16%). Six-min walk distance (6MWD) and incremental shuttle walk distance (ISWD) measures were collected, and peak oxygen uptake (V˙ o2 peak) was measured during a symptom-limited ramp cycle ergometry test. The SenseWear Armband was worn during the waking hours for 4.4 ± 1.1 days to measure DEE. The intensity at which activities of daily living were undertaken was expressed as a percentage of V˙ o2 peak.

Results:  DEE was associated with 6MWD (r = 0.40, P = .046) and ISWD (r = 0.52, P = .007) but not V˙ o2 peak (mL/kg per min) (r = 0.07, P = .74). Stronger associations were observed between DEE and the body weight-walking distance product for the 6MWD (r = 0.73, P < .001) and ISWD (r = 0.75, P < .001). The average intensity of daily activity was equivalent to 58% ± 11% of V˙ o2 peak, leaving an average aerobic reserve of 42%.

Conclusions:  Both 6MWD and ISWD, but not V˙ o2 peak, were related to DEE. Because activities of daily living were performed at a high percentage of V˙ o2 peak, it may be more realistic to optimize habitual DEE in COPD by increasing the frequency or duration rather than the intensity of physical activity.

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