Physiological and perceptual responses to exercise according to locus of symptom limitation in COPD

Lauren Tracey; Hayley Lewthwaite; Sara J Abdallah; Steven Murray; Courtney A Wilkinson-Maitland; Adamo Donovan; Francois Maltais; Denis E O'Donnell; Jean Bourbeau; Benjamin M Smith; Dennis Jensen; Canadian Respiratory Research Network (CRRN)

doi:10.1016/j.resp.2019.103322

Physiological and perceptual responses to exercise according to locus of symptom limitation in COPD

Respir Physiol Neurobiol. 2020 Feb:273:103322. doi: 10.1016/j.resp.2019.103322. Epub 2019 Oct 17.

Affiliations

¹ Clinical Exercise and Respiratory Physiology Laboratory, Department of Kinesiology and Physical Education, Faculty of Education, McGill University, Montréal, QC, Canada.
² Clinical Exercise and Respiratory Physiology Laboratory, Department of Kinesiology and Physical Education, Faculty of Education, McGill University, Montréal, QC, Canada; Alliance for Research in Exercise, Nutrition and Activity, School of Health Sciences, University of South Australia, Adelaide, Australia.
³ Division of Experimental Medicine, Faculty of Medicine, McGill University, Montréal, QC, Canada.
⁴ Centre de Recherche, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec City, QC, Canada.
⁵ Respiratory Investigation Unit, Department of Medicine, Queen's University, Kingston, ON, Canada.
⁶ Research Institute of the McGill University Health Centre, Translational Research in Respiratory Diseases Program, Montréal, QC, Canada; Division of Respiratory Medicine, Faculty of Medicine, McGill University, Montréal, QC, Canada.
⁷ Clinical Exercise and Respiratory Physiology Laboratory, Department of Kinesiology and Physical Education, Faculty of Education, McGill University, Montréal, QC, Canada; Research Institute of the McGill University Health Centre, Translational Research in Respiratory Diseases Program, Montréal, QC, Canada; Division of Respiratory Medicine, Faculty of Medicine, McGill University, Montréal, QC, Canada; Research Centre for Physical Activity and Health, Faculty of Education, McGill University, Montréal, QC, Canada. Electronic address: dennis.jensen@mcgill.ca.

PMID: 31629879
DOI: 10.1016/j.resp.2019.103322

Abstract

Chronic obstructive pulmonary disease (COPD) is a heterogeneous disease, with pulmonary and extra-pulmonary factors contributing to exercise intolerance. The primary self-reported exercise-limiting symptom may reflect the primary pathophysiological factor contributing to exercise intolerance. We compared physiological and perceptual responses at the symptom-limited peak of incremental cardiopulmonary cycle exercise testing between people with COPD reporting breathlessness (B, n = 34), leg discomfort (LD, n = 16), or a combination of B and LD (BOTH, n = 42) as their main exercise-limiting symptom(s). Despite similarly impaired health status, symptomology and peak exercise capacity, the B group had greater restrictive constraints on tidal volume expansion at end-exercise and was more likely to report unpleasant qualities of exertional breathlessness than LD and BOTH groups. In conclusion, reporting breathlessness as the primary exercise-limiting symptom indicated the presence of distinct lung pathophysiology and symptom perception during exercise in people with COPD.

Keywords: Breathlessness; COPD; Dyspnea; Exercise limitation; Symptom.

Publication types

Clinical Trial
Research Support, Non-U.S. Gov't

MeSH terms

Aged
Cross-Sectional Studies
Dyspnea / physiopathology*
Exercise / physiology*
Exercise / psychology*
Female
Humans
Male
Middle Aged
Pulmonary Disease, Chronic Obstructive / physiopathology*
Retrospective Studies

Grants and funding

CIHR/Canada