Exercise Capacity and Ventilatory, Circulatory, and Symptom Limitation in Patients with Chronic Airflow Limitation

Authors:
  • PLPierre Leblanc
    Pierre Leblanc
  • DMDavid H. Martin
    David H. Martin
  • ESEdith Summers
    Edith Summers
  • NJNorman L. Jones
    Norman L. Jones
  • ECE. J. Moran Campbell
    E. J. Moran Campbell
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Abstract
Dyspnea, leg effort (Borg 0 to 10 scale), ventilation, and heart rate ( e max/ e cap; HRmax/HRcap expressed as a percentage of capacity) were measured at maximal exercise (cycle ergometer) in 97 patients with chronic airflow limitation (CAL) (FEV1 46.6 ± 14.23% of predicted) and compared with 320 matched control subjects. Patients with CAL achieved a maximum power output of 86 ± 39.5 W (60 ± 23.2% of predicted) compared with 140 ± 37.5 W (98 ± 14.5% of predicted) in controls (p < 0.0001), e max/ e cap was 72 ± 19.3% compared with 53 ± 18.6% (p < 0.0001), and HRmax/HRcap was 76 ± 13.5% compared with 82 ± 13% (p < 0.001). These findings were expected. The median intensity of dyspnea was 6 (severe to very severe) and leg effort was 7 (very severe) in both groups, and these findings were unexpected. The patients with CAL were handicapped by an increase in both dyspnea and peripheral muscular effort relative to the actual power output. The rating of dyspnea exceeded leg effort in 25 (26%) of CAL versus 69 (22%) control subjects: the rating of leg effort exceeded dyspnea in 42 (43%) CAL and 117 (36%) control subjects; both were rated equally in 30 (31%) CAL and 134 (42%) control subjects, respectively (NS). e max/ e cap and HRmax/HRcap were not significantly different in those limited by dyspnea, leg fatigue, or a combination of both. All values are expressed ± SD.

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