Influence of Rehabilitation on Oxygen Uptake Kinetics during High Intensity Exercise in Patients with Idiopathic Pulmonary Fibrosis

• 作者: Kim Harrison Michael Lewis Sameera Peumal Senanayake Simon Hilldrup
• 来源期刊: 呼吸病期刊(英文)
• 学科: 医学
• 关键词: IPF VO2 OUES REHABILITATION PHYSIOLOGY
• 年，卷（期）: 2020,（4）
• 页码范围: 59-74
• 页数: 16页
• 分类号: R56

摘要

Idiopathic Pulmonary Fibrosis (IPF) is a chronic, progressive and life-limiting condition of unknown cause with no curative treatment. The impact of IPF on a patient’s quality of life is devastating and palliative treatment such as pulmonary rehabilitation programmes are used to improve quality of life among these individuals, yet relatively little attention has been made to access the effectiveness of rehabilitation programs aimed designed for these patients. There are large gaps in our knowledge on the cardiorespiratory response to exercise and rehabilitation among IPF patients and this study aims to fill this gap in a physiological prospective. We quantified the effects of an eight-week pulmonary rehabilitation program for IPF patients, conducted at Morriston Hospital, Swansea. Fifteen individuals (13 with Idiopathic Pulmonary Fibrosis and two with Pulmonary Fibrosis associated with Rheumatoid Disease) underwent physical and physiological assessments during a three-day testing protocol: 1) On Day 1, physical function (six-minute walk test) and ventilatory function (spirometry) were measured;2) On Day 2, patients’ cardio-respiratory responses to slowly-increasing, wide-ranging metabolic challenge (using a protocol consisting of periods of rest, incremental bicycle exercise to maximal effort, and post-exercise recovery) were assessed via respiratory gas analysis and ECG recording;3) On Day 3, patients’ cardio-respiratory responses to rapid-onset, high-workload metabolic challenge were assessed (using a protocol including a rapid-onset, constant workload bicycle exercise) by modelling dynamic respiratory oxygen and heart rate responses. Respiratory gas analysis was used to measure the rate of oxygen uptake ( VO₂ ) and oxygen uptake efficiency (OUES). All assessments were performed before and after participants completed the pulmonary rehabilitation programme. A Holter ECG recorder (Pathfinder/Lifecard Digital CF system;Spacelabs Medical Ltd., UK) provided continuous ECG data throughout each exerc