Effect of pulmonary rehabilitation on exhaled nitric oxide in patients with chronic obstructive pulmonary disease
E Clini, L Bianchi, K Foglio, R Porta, M Vitacca, N Ambrosino
Lung
Function Unit and Respiratory Disease Department, Salvatore Maugeri
Foundation IRCCS, Scientific Institute of Gussago, I-25064 Gussago
(BS), Italy
Correspondence to: Dr E Clini eclini{at}fsm.it
Received 6 September 2000; Returned to authors 2 December 2000; Revised version received 9 January 2001; Accepted for publication 19 March 2001
BACKGROUND
In patients
with mild to moderate chronic obstructive pulmonary disease (COPD) the
exercise induced increase in exhaled nitric oxide (eNO) parallels that
observed in normal untrained subjects. There is no information on the
effects of the level of exercise tolerance on eNO in these patients.
The aim of this study was to evaluate the effect of a pulmonary
rehabilitation programme including exercise training on eNO in patients
with COPD.
METHODSIn 14 consecutive male patients with stable COPD of mean (SD) age 64 (9)
years and forced expiratory volume in one second (FEV1) 55 (14)% predicted, fractional eNO concentration (FeNO), peak
work rate (Wpeak) and oxygen uptake
(
O2peak) were assessed at baseline
(T-1), at the end of a 1 month run in period (T0), and after an 8 week
outpatient multidisciplinary pulmonary rehabilitation programme (T1)
including cycloergometer training.
RESULTSFeNO
did not significantly differ at T-1 and T0 (mean (SE) 4.3 (0.6) and
4.4 (0.6) ppb, respectively), whereas it rose significantly at T1 to
6.4 (0.7) ppb (p<0.02). Compared with T0, both Wpeak and
O2 were significantly (p<0.05)
increased at T1 (mean (SE) Wpeak from 89 (5.6) W to 109 (6.9) W);
O2peak from 1.27 (0.1) l/min to 1.48 (0.1) l/min). A significant correlation was found between baseline
FEV1 and the change in FeNO following the
rehabilitation programme (r=-0.71; p<0.05)
and between changes in FeNO and Wpeak from T0 to
T1(r=0.60; p<0.05).
CONCLUSIONSPulmonary
rehabilitation in patients with mild to moderate COPD is associated
with an increase in exhaled nitric oxide.
Keywords: chronic obstructive pulmonary disease; exercise training; exhaled nitric oxide
© 2001 by Thorax
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