Comparisons of walking-based training techniques in COPD

Background: Low exercise capacity is a negative prognostic factor in COPD. Exercise training improves exercise capacity. Walking-based endurance training programs are very effective in improving exercise capacity and quality of life in COPD. Exercise-induced dyspnea is a major limiting factor for endurance training in COPD. Downhill walking has been recently proposed as a brand new low metabolic-cost training program in COPD patients. Aim: we performed an exploratory study to evaluate and compare the respiratory patterns and the magnitude of dyspnea during different modalities of walking-based training programs in COPD. Methods: 10 moderate-to-severe COPD patients were included in the analysis. In a random orders patients were submitted for 3 consecutive days to walking-based training sessions on treadmill set-ups at different inclination (+1% or -10%) or free walking on the ground. The session lasted 6 minutes at a controlled walking speed of 80% of the mean speed recorded during baseline 6MWT. All patients were equipped with Spiropalm® which allowed measurement of the ventilatory pattern and continuous monitoring of heart rate and oxygen saturation. Results: Compared to the other two walking-based training modalities, the walking session on treadmill set-ups at negative inclination (-10%) induced a significant reduction of minute ventilation during the session (p Conclusion: Walking-based training session at negative inclination can represent an effective modality for exercise training in COPD. Studies evaluating long-term effects of this technique on relevant clinical outcomes in COPD patients are needed.