Skip to main content
Thorax logoLink to Thorax
. 2004 Dec;59(12):1026–1031. doi: 10.1136/thx.2004.026617

Continuous and intermittent exercise responses in individuals with chronic obstructive pulmonary disease

S Sabapathy 1, R Kingsley 1, D Schneider 1, L Adams 1, N Morris 1
PMCID: PMC1746915  PMID: 15563700

Abstract

Background: While the acute physiological responses to continuous exercise have been well documented in individuals with chronic obstructive pulmonary disease (COPD), no previous study has examined the response to intermittent exercise in these patients.

Methods: We examined the physiological responses of 10 individuals with moderate COPD (forced expiratory volume in 1 second 52 (15)% predicted) who performed both an intermittent (1 min exercise and rest intervals) and a continuous cycle ergometer test on separate days. Both intermittent and continuous exercise tests were performed at the same power output, calculated as 70% of the peak power attained during an incremental exercise test.

Results: Intermittent exercise was associated with significantly lower values for oxygen uptake, carbon dioxide output, expired ventilation, heart rate, plasma lactate concentration, and ratings of breathlessness than continuous exercise. Subjects were able to complete a significantly greater total amount of work during intermittent exercise (71 (32) kJ) than during continuous exercise (31 (24) kJ). The degree of dynamic lung hyperinflation (change in end expiratory lung volume) was significantly lower during intermittent exercise (0.23 (0.07) l) than in continuous exercise (0.52 (0.13) l).

Conclusions: The greater amount of work performed and lower measured physiological responses achieved with intermittent exercise may allow for greater peripheral training adaptations in individuals with more limited lung function. The results suggest that intermittent exercise may be superior to continuous exercise as a mode of training for patients with COPD.

Full Text

The Full Text of this article is available as a PDF (151.4 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. ASTRAND I., ASTRAND P. O., CHRISTENSEN E. H., HEDMAN R. Intermittent muscular work. Acta Physiol Scand. 1960 Apr 25;48:448–453. doi: 10.1111/j.1748-1716.1960.tb01879.x. [DOI] [PubMed] [Google Scholar]
  2. ASTRAND I., ASTRAND P. O., CHRISTENSEN E. H., HEDMAN R. Myohemoglobin as an oxygen-store in man. Acta Physiol Scand. 1960 Apr 25;48:454–460. doi: 10.1111/j.1748-1716.1960.tb01880.x. [DOI] [PubMed] [Google Scholar]
  3. Babb T. G., Viggiano R., Hurley B., Staats B., Rodarte J. R. Effect of mild-to-moderate airflow limitation on exercise capacity. J Appl Physiol (1985) 1991 Jan;70(1):223–230. doi: 10.1152/jappl.1991.70.1.223. [DOI] [PubMed] [Google Scholar]
  4. Barstow T. J. Characterization of VO2 kinetics during heavy exercise. Med Sci Sports Exerc. 1994 Nov;26(11):1327–1334. [PubMed] [Google Scholar]
  5. Casaburi R., Patessio A., Ioli F., Zanaboni S., Donner C. F., Wasserman K. Reductions in exercise lactic acidosis and ventilation as a result of exercise training in patients with obstructive lung disease. Am Rev Respir Dis. 1991 Jan;143(1):9–18. doi: 10.1164/ajrccm/143.1.9. [DOI] [PubMed] [Google Scholar]
  6. Coppoolse R., Schols A. M., Baarends E. M., Mostert R., Akkermans M. A., Janssen P. P., Wouters E. F. Interval versus continuous training in patients with severe COPD: a randomized clinical trial. Eur Respir J. 1999 Aug;14(2):258–263. doi: 10.1034/j.1399-3003.1999.14b04.x. [DOI] [PubMed] [Google Scholar]
  7. Elliott Alison M., Luzze Henry, Quigley Maria A., Nakiyingi Jessica S., Kyaligonza Steven, Namujju Proscovia B., Ducar Constance, Ellner Jerrold J., Whitworth James A. G., Mugerwa Roy. A randomized, double-blind, placebo-controlled trial of the use of prednisolone as an adjunct to treatment in HIV-1-associated pleural tuberculosis. J Infect Dis. 2004 Jul 29;190(5):869–878. doi: 10.1086/422257. [DOI] [PubMed] [Google Scholar]
  8. Essén B. Studies on the regulation of metabolism in human skeletal muscle using intermittent exercise as an experimental model. Acta Physiol Scand Suppl. 1978;454:1–32. [PubMed] [Google Scholar]
  9. Jones N. L., Makrides L., Hitchcock C., Chypchar T., McCartney N. Normal standards for an incremental progressive cycle ergometer test. Am Rev Respir Dis. 1985 May;131(5):700–708. doi: 10.1164/arrd.1985.131.5.700. [DOI] [PubMed] [Google Scholar]
  10. Lansing Robert W., Moosavi Shakeeb H., Banzett Robert B. Measurement of dyspnea: word labeled visual analog scale vs. verbal ordinal scale. Respir Physiol Neurobiol. 2003 Mar 3;134(2):77–83. doi: 10.1016/s1569-9048(02)00211-2. [DOI] [PubMed] [Google Scholar]
  11. Maltais F., LeBlanc P., Jobin J., Bérubé C., Bruneau J., Carrier L., Breton M. J., Falardeau G., Belleau R. Intensity of training and physiologic adaptation in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 1997 Feb;155(2):555–561. doi: 10.1164/ajrccm.155.2.9032194. [DOI] [PubMed] [Google Scholar]
  12. Maltais F., Simard A. A., Simard C., Jobin J., Desgagnés P., LeBlanc P. 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 Jan;153(1):288–293. doi: 10.1164/ajrccm.153.1.8542131. [DOI] [PubMed] [Google Scholar]
  13. Morris Norman, Gass Gregory, Thompson Martin, Bennett Gregory, Basic David, Morton Hugh. Rate and amplitude of adaptation to intermittent and continuous exercise in older men. Med Sci Sports Exerc. 2002 Mar;34(3):471–477. doi: 10.1097/00005768-200203000-00014. [DOI] [PubMed] [Google Scholar]
  14. Morris Norman, Gass Gregory, Thompson Martin, Conforti David. Physiological responses to intermittent and continuous exercise at the same relative intensity in older men. Eur J Appl Physiol. 2003 Aug 16;90(5-6):620–625. doi: 10.1007/s00421-003-0918-z. [DOI] [PubMed] [Google Scholar]
  15. Nery L. E., Wasserman K., Andrews J. D., Huntsman D. J., Hansen J. E., Whipp B. J. Ventilatory and gas exchange kinetics during exercise in chronic airways obstruction. J Appl Physiol Respir Environ Exerc Physiol. 1982 Dec;53(6):1594–1602. doi: 10.1152/jappl.1982.53.6.1594. [DOI] [PubMed] [Google Scholar]
  16. O'Donnell D. E., Revill S. M., Webb K. A. Dynamic hyperinflation and exercise intolerance in chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2001 Sep 1;164(5):770–777. doi: 10.1164/ajrccm.164.5.2012122. [DOI] [PubMed] [Google Scholar]
  17. O'Donnell D. E. Ventilatory limitations in chronic obstructive pulmonary disease. Med Sci Sports Exerc. 2001 Jul;33(7 Suppl):S647–S655. doi: 10.1097/00005768-200107001-00002. [DOI] [PubMed] [Google Scholar]
  18. Palange P., Galassetti P., Mannix E. T., Farber M. O., Manfredi F., Serra P., Carlone S. Oxygen effect on O2 deficit and VO2 kinetics during exercise in obstructive pulmonary disease. J Appl Physiol (1985) 1995 Jun;78(6):2228–2234. doi: 10.1152/jappl.1995.78.6.2228. [DOI] [PubMed] [Google Scholar]
  19. Pauwels R. A., Buist A. S., Calverley P. M., Jenkins C. R., Hurd S. S., GOLD Scientific Committee Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. NHLBI/WHO Global Initiative for Chronic Obstructive Lung Disease (GOLD) Workshop summary. Am J Respir Crit Care Med. 2001 Apr;163(5):1256–1276. doi: 10.1164/ajrccm.163.5.2101039. [DOI] [PubMed] [Google Scholar]
  20. Sabapathy Surendran, Schneider Donald A., Comadira Greg, Johnston Iain, Morris Norman R. Oxygen uptake kinetics during severe exercise: a comparison between young and older men. Respir Physiol Neurobiol. 2004 Jan 15;139(2):203–213. doi: 10.1016/j.resp.2003.09.008. [DOI] [PubMed] [Google Scholar]
  21. Smodlaka V. N., Adamovich D. R. Reconditioning of emphysema patients using interval training. N Y State J Med. 1974 Jun;74(6):951–955. [PubMed] [Google Scholar]
  22. Vogiatzis I., Nanas S., Roussos C. Interval training as an alternative modality to continuous exercise in patients with COPD. Eur Respir J. 2002 Jul;20(1):12–19. doi: 10.1183/09031936.02.01152001. [DOI] [PubMed] [Google Scholar]
  23. Whipp B. J., Ward S. A., Lamarra N., Davis J. A., Wasserman K. Parameters of ventilatory and gas exchange dynamics during exercise. J Appl Physiol Respir Environ Exerc Physiol. 1982 Jun;52(6):1506–1513. doi: 10.1152/jappl.1982.52.6.1506. [DOI] [PubMed] [Google Scholar]

Associated Data

This section collects any data citations, data availability statements, or supplementary materials included in this article.

Supplementary Materials

[Web-only Appendix]
thorax_59_12_1026__1.pdf (99.1KB, pdf)

Articles from Thorax are provided here courtesy of BMJ Publishing Group

RESOURCES