ZuWallack - Figure 22
Exercise Training and Exertional Dyspnea
FIG. 22: This Figure summarizes the results from the studies shown in the previous five Figures,[14-18] demonstrating the beneficial effects of exercise training on exertional dyspnea. As a simple algorithm, it shows that exercise training produces decreased lactate at isowork, which results in a decreased ventilatory demand during exercise and reduced exertional dyspnea. The decreased ventilatory demand for exercise allows for a decreased respiratory rate, prolonged expiratory time, less dynamic hyperinflation, and this in turn reduces exertional dyspnea, all of which represent very important aspects of exercise training in pulmonary rehabilitation.
References
Casaburi R, Patessio A, Ioli F, et al. Reductions in exercise lactic acidosis and ventilation as a result of exercise training in patients with obstructive lung disease. Am Rev Respir Dis. 1991;143:9–18.
Maltais F, Simard AA, Simard C, et al. Oxidative capacity of the skeletal muscle and lactic acid kinetics during exercise in normal subjects and in patients with COPD. Am J Respir Crit Care Med. 1996;153:288293.
Maltais F, LeBlanc P, Whittom F, et al. Oxidative enzyme activities of the vastus lateralis muscle and the functional status in patients with COPD. Thorax. 2000;55:848–853.
Ries AL, Kaplan RM, Limberg TM, Prewitt LM. Effects of pulmonary rehabilitation on physiologic and psychosocial outcomes in patients with COPD. Ann Intern Med 1995;122:823–832.
Porszasz J, Emtner M, Goto S, et al. Exercise training decreases ventilatory requirements and exercise-induced hyperinflation at submaximal intensities in patients with COPD. Chest 2005;128:2025–2034.