Effects of a walking aid in COPD patients receiving oxygen therapy

STUDY OBJECTIVES: To elucidate whether a simple walking aid may improve physical performance in COPD patients with chronic respiratory insufficiency who usually carry their own heavy oxygen canister. DESIGN: Randomized crossover trial. SETTING: Physiopathology laboratory of three rehabilitation centers. PATIENTS AND INTERVENTIONS: We studied 60 stable COPD patients (mean age, 70.6 +/- 7.9 years; FEV(1), 44.8 +/- 14.3% of predicted [+/- SD]) with chronic respiratory insufficiency who randomly performed, on 2 consecutive days, a standardized 6-min walking test using two different modalities: a full-weight oxygen canister transported using a small wheeled cart and pulled by the patient (Aid modality) or full-weight oxygen canister carried on the patient's shoulder (No-Aid modality). MEASUREMENTS AND RESULTS: The distance walked, peak effort dyspnea, and leg fatigue scores as primary outcomes, and other cardiorespiratory parameters as secondary outcomes were recorded during both tests. A significant difference (p < 0.05) between the two tests occurred for all the measured outcomes in favor of the Aid modality. Most importantly, significant changes for distance (+ 43 m, p < 0.001), peak effort dyspnea (- 2.0 points, p < 0.001), leg fatigue (- 1.4 points, p < 0.001), as well as for mean and nadir oxygen saturation and heart rate with the Aid modality (but not with the No-Aid modality) were recorded in the subgroup of patients walking < 300 m at baseline. CONCLUSIONS: This study suggests that a simple walking aid may be helpful in COPD patients receiving long-term oxygen therapy, particularly in those with lower residual exercise capacity

Six-minute walk test in patients with chronic obstructive pulmonary disease: Comparison with and without active coaching

Aim. To assess the sk-minute walk test (6 MWT) with and without encouragement in patients with severe chronic obstructive pulmonary disease (COPD). Methods. Thirty-eight COPD patients (72 ± 6 years, FEV 37 ± 12% pred.) performed 6 MWT in random order in two non consecutive days. The first test was carried out including encouragement according to the ATS standard procedure (WTE), the second without any phrase of encouragement (WTNE). Subgroup analysis has been also performed by dividing patients on the basis of their own level of exercise tolerance at the baseline test (6 MWT < 300 and > 300 meters). The measured variables included the total distance covered (M), subjective dyspnoea (D) and leg fatigue (F) as assessed by Borg scale, the main cardio-respiratory parameters as recorded along the test. Results. M was significantly higher during WTE than during WTNE (370 ± 78 and 336 ± 79 meters, respectively), whereas D and F only showed a non significant trend to increase during WTE. No significant differences of the other physiological parameters have been recorded between the two tests. Results similar to those obtained in the whole group have also been observed in both pre-defined subgroups of patients. Conclusions. Our study has shown that the encouraged recommended modality of 6 MWT is associated to a better result in terms of walked distance as compared with the non encouraged test in severe COPD patients. This was not associated with a detrimental effect on the cardiopulmonary responses