EDITORIAL

Exercise in COPD

Exercise in COPD: damned if you do and damned if you don’t

P T Macklem

Correspondence to:
Correspondence to:
Professor P T Macklem
Meakins Christie Laboratories, Montreal Chest Institute, McGill University Health Centre Research Institute, P O Box 250, Lansdowne ON, Canada K0E 1L0; ptm01@hotmail.com

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Recruitment of the expiratory muscles by COPD patients during exercise

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Keywords: chronic obstructive pulmonary disease; breathing pattern; chest wall volume; muscle recruitment; exercise

The first 150 words of the full text of this article appear below.

In this issue of Thorax Aliverti et al¹ present the most complete description of the effect of bronchodilators in chronic obstructive pulmonary disease (COPD) to date. Surprisingly, they found that the patient population separated cleanly into two groups: those whose exercise endurance was improved and those whose exercise endurance decreased. This unexpected adverse effect was not trivial: endurance time at constant workload decreased on average by 34%, while endurance time in those who improved increased by 86%. They called this group the "improvers", and those whose exercise performance became worse the "non-improvers"; a more accurate moniker for the non-improvers would be "worseners". Both groups dynamically hyperinflated to the same extent during exercise after placebo, whereas following bronchodilation the improvers hyperinflated more than the worseners so that, at the limit of endurance, inspiratory reserve volume was considerably larger in the latter.

In a previous paper Aliverti et al² . . . [Full text of this article]

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This article has been cited by other articles:

• Aliverti, A., Macklem, P. T. (2008). The major limitation to exercise performance in COPD is inadequate energy supply to the respiratory and locomotor muscles. J. Appl. Physiol. 105: 749-751 [Full Text]  
• Vogiatzis, I., Stratakos, G., Athanasopoulos, D., Georgiadou, O., Golemati, S., Koutsoukou, A., Weisman, I., Roussos, C., Zakynthinos, S. (2008). Chest wall volume regulation during exercise in COPD patients with GOLD stages II to IV. Eur Respir J 32: 42-52 [Abstract] [Full Text]  
• Macklem, P. T. (2006). Circulatory effects of expiratory flow-limited exercise, dynamic hyperinflation and expiratory muscle pressure. ERR 15: 80-84 [Abstract] [Full Text]