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Reduced variability of endurance time in new protocols for exercise tests in COPD

Tufvesson, Ellen LU ; Radner, Finn LU orcid ; Papapostolou, Georgia LU orcid ; Jarenbäck, Linnea LU ; Jönsson, Saga ; Nihlén, Ulf LU ; Ankerst, Jaro LU orcid ; Tunsäter, Alf LU ; Peterson, Stefan and Bjermer, Leif LU , et al. (2020) In International Journal of COPD 15. p.3003-3012
Abstract

Purpose: For exercise testing of COPD patients, a standard endurance test (ET) with constant workload is recommended. The test suffers from large inter-individual variability and need for large sample sizes in order to evaluate treatment effects. Methods: A new protocol for ET in COPD was designed. In contrast to the standard ET, the new ET involved an increasing workload in order to reduce the standard deviation of endurance time. Two new ETs were compared with the standard ET. In Study A, the new ET started at 75% of the patient’s maximum workload (WMAX) and increased stepwise with 3%/2 min until exhaustion. Study B started at 70% of WMAX and increased linearly with 1%/ min. Results: In Study A, that included 15... (More)

Purpose: For exercise testing of COPD patients, a standard endurance test (ET) with constant workload is recommended. The test suffers from large inter-individual variability and need for large sample sizes in order to evaluate treatment effects. Methods: A new protocol for ET in COPD was designed. In contrast to the standard ET, the new ET involved an increasing workload in order to reduce the standard deviation of endurance time. Two new ETs were compared with the standard ET. In Study A, the new ET started at 75% of the patient’s maximum workload (WMAX) and increased stepwise with 3%/2 min until exhaustion. Study B started at 70% of WMAX and increased linearly with 1%/ min. Results: In Study A, that included 15 patients, the standard deviation and range for endurance time and work capacity were narrower for the new versus the standard ET. However, the higher mean workload at end and the low mean work capacity relative to the standard ET indicated that the stepwise increase was too aggressive. In Study B, that included 18 patients, with a modified protocol, the averages for endurance time, workload at end and work capacity were similar for new and standard ET, while the standard deviations and ranges for endurance time and work capacity were kept more narrow in the new ET. The variances for endurance time were not equal between the standard ET and the two new ETs (p<0.05 for both according to Levene’s test). Conclusion: The new ET reduced the number of patients with extreme endurance times (short and long) compared to the standard test. The new test showed a significant lower variance for endurance time, which potentially can lead to fewer patients needed in com-parative studies. The overall best results were observed with a low linear increase during endurance.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Constant endurance test, COPD, Endurance time, Exercise testing
in
International Journal of COPD
volume
15
pages
10 pages
publisher
Dove Medical Press Ltd.
external identifiers
  • pmid:33239872
  • scopus:85096376273
ISSN
1176-9106
DOI
10.2147/COPD.S268894
language
English
LU publication?
yes
id
3d129b8d-20ef-4504-bff0-3053a1329b68
date added to LUP
2020-12-02 07:58:01
date last changed
2024-04-03 19:01:29
@article{3d129b8d-20ef-4504-bff0-3053a1329b68,
  abstract     = {{<p>Purpose: For exercise testing of COPD patients, a standard endurance test (ET) with constant workload is recommended. The test suffers from large inter-individual variability and need for large sample sizes in order to evaluate treatment effects. Methods: A new protocol for ET in COPD was designed. In contrast to the standard ET, the new ET involved an increasing workload in order to reduce the standard deviation of endurance time. Two new ETs were compared with the standard ET. In Study A, the new ET started at 75% of the patient’s maximum workload (W<sub>MAX</sub>) and increased stepwise with 3%/2 min until exhaustion. Study B started at 70% of W<sub>MAX</sub> and increased linearly with 1%/ min. Results: In Study A, that included 15 patients, the standard deviation and range for endurance time and work capacity were narrower for the new versus the standard ET. However, the higher mean workload at end and the low mean work capacity relative to the standard ET indicated that the stepwise increase was too aggressive. In Study B, that included 18 patients, with a modified protocol, the averages for endurance time, workload at end and work capacity were similar for new and standard ET, while the standard deviations and ranges for endurance time and work capacity were kept more narrow in the new ET. The variances for endurance time were not equal between the standard ET and the two new ETs (p&lt;0.05 for both according to Levene’s test). Conclusion: The new ET reduced the number of patients with extreme endurance times (short and long) compared to the standard test. The new test showed a significant lower variance for endurance time, which potentially can lead to fewer patients needed in com-parative studies. The overall best results were observed with a low linear increase during endurance.</p>}},
  author       = {{Tufvesson, Ellen and Radner, Finn and Papapostolou, Georgia and Jarenbäck, Linnea and Jönsson, Saga and Nihlén, Ulf and Ankerst, Jaro and Tunsäter, Alf and Peterson, Stefan and Bjermer, Leif and Eriksson, Göran}},
  issn         = {{1176-9106}},
  keywords     = {{Constant endurance test; COPD; Endurance time; Exercise testing}},
  language     = {{eng}},
  pages        = {{3003--3012}},
  publisher    = {{Dove Medical Press Ltd.}},
  series       = {{International Journal of COPD}},
  title        = {{Reduced variability of endurance time in new protocols for exercise tests in COPD}},
  url          = {{http://dx.doi.org/10.2147/COPD.S268894}},
  doi          = {{10.2147/COPD.S268894}},
  volume       = {{15}},
  year         = {{2020}},
}