Effect of exercise training and detraining on gas exchange kinetics in patients with chronic obstructive pulmonary disease

Symptom-limited incremental exercise tests are used to estimate the training effect on patients with chronic obstructive pulmonary disease (COPD). However, there is a need for objective parameters for measurement on submaximal exercise testing. The purpose of this study was to assess the usefulness of measurement of oxygen uptake (VO2) kinetics during a constant work rate exercise test of patients with COPD after exercise training. Eleven patients with COPD performed exercise tests before and after cycle ergometer training on 3 days per week for 8 weeks; they then went without training for 5 months and performed the same tests. They performed an incremental exercise test to symptom-limited maximum and a constant work rate exercise test for 6 min on a cycle ergometer. The time constant of VO2 during the onset of constant work rate exercise was significantly decreased (from 63.5 +/- 7.8 s to 53.2 +/- 8.0 s) after exercise training (P = 0.021), but was significantly increased (to 73.4 +/- 14.9 s) after 5 months without training (P = 0.001). The oxygen pulse at steady state during constant work rate exercise testing was significantly increased after exercise training but decreased 5 months later. The change in blood lactate from rest to steady state during constant work rate exercise was significantly decreased after exercise training, but increased 5 months later. Measurement of the time constant of VO2 and oxygen pulse during constant work rate exercise are useful for the objective evaluation of the training effect of patients with COPD.