Effect of Ventilation-Feedback Training on Exercise Performance in COPD
Effect of Ventilation-Feedback Training on Exercise Performance in COPD
The primary objective of the study is to determine whether individuals with Chronic
 Obstructive Pulmonary Disease (COPD) who complete ventilation-feedback training combined with
 a moderately-high intensity exercise and upper body strength program will demonstrate
 significantly longer exercise duration on a constant work rate treadmill test when compared
 to subjects who are randomly assigned to a moderately-high intensity exercise and upper body
 strength training program without ventilation-feedback or ventilation-feedback only.
 Secondary study objectives are to determine whether individuals with COPD who complete
 ventilation-feedback training combined with a moderately-high intensity exercise and upper
 body strength training program will demonstrate significantly: (a) greater exercise tolerance
 and aerobic power; (b) lower perception of breathlessness during progressive and constant
 work rate leg-cycle and treadmill exercise testing; (c) higher tidal volume and lower
 breathing frequency during constant work rate and at any given workload during progressive
 testing; (d) lower score on the Chronic Respiratory Disease Questionnaire indicating improved
 quality of life; (e) higher transition focal score (less dyspnea) on the Transition Dyspnea
 Index; (f) maintain a sustained breathing-pattern adjustment to exercise when compared to
 subjects who are randomly assigned to a moderately-high intensity exercise and upper body
 strength program without ventilation-feedback or ventilation-feedback only.
Statement of the Problem: Chronic obstructive pulmonary disease (COPD) is a term used to
 characterize those individuals with chronic bronchitis or emphysema who have obstruction to
 airflow on a spirogram. 1) Patients with COPD have a poor exercise capacity that is
 reflective of their underlying disease. 2) The symptoms of lung disease triggered by simple
 low-intensity activities of daily living such as dressing and undressing, bathing and
 shopping are insufferable, consequently these patients become sedentary. An increasingly
 sedentary lifestyle leads to muscle deconditioning making physical activity even more
 intolerable. 3) The cycle continues in a downward spiral. Pulmonary rehabilitation is
 essential to assist persons with COPD to cope with their disease. The two primary objectives
 of pulmonary rehabilitation are to control and alleviate the symptoms of the respiratory
 illness and to assist the patient toward optimal capabilities in carrying out his/her
 activities of daily living. 4) The proposed study will evaluate the efficacy of a unique
 program of ventilation-feedback training combined with leg-cycle and walking exercise to
 improve exertional endurance, perceived dyspnea and quality of life in persons with COPD.

 Hypothesis: Individuals with COPD who complete 12-weeks of ventilation-feedback training
 combined with a moderately-high intensity exercise and upper body strength training program
 will demonstrate significantly longer exercise duration on the treadmill constant work rate
 (CWR) exercise test when compared to subjects who are randomly assigned to a moderately-high
 intensity exercise and upper body strength training or a ventilation-feedback training only
 program.

 Specific Objectives:

 Short-term Objectives- The primary objective of the proposed study is to determine whether
 individuals with COPD who complete 12-weeks of ventilation-feedback training combined with a
 moderately-high intensity exercise and upper body strength training program will demonstrate
 significantly longer exercise duration on the treadmill CWR exercise test when compared to
 subjects who are randomly assigned to a moderately-high intensity exercise and upper body
 strength training program without ventilation-feedback or a ventilation-feedback program
 only. The secondary objectives of the proposed research are to determine whether individuals
 with COPD who complete ventilation-feedback training combined with a moderately-high
 intensity exercise and upper body strength training or ventilation-feedback only program
 will, when compared to subjects who are randomly assigned to a moderately-high intensity
 exercise and upper body strength training program only, demonstrate significantly: (a)
 greater work tolerance and aerobic power on maximal leg-cycle and treadmill exercise tests;
 (b) lower perception of breathlessness during progressive and CWR leg-cycle and treadmill
 exercise tests; (c) significantly higher tidal volume (VT) and lower breathing frequency
 during CWR and at any given workload on the progressive leg-cycle and treadmill exercise
 tests; (d) lower score on the Chronic Respiratory Disease Questionnaire (CRDQ)5 indicating
 better quality of life; and (e) higher transition focal score on the Transition Dyspnea Index
 (TDI).6 In addition, six weeks after completing the training program all subjects will repeat
 the treadmill CWR test. This will be done to assess whether the positive effects of the
 ventilation-feedback training persist beyond the 12-week training period.

 Long-term Objectives: If our hypothesis is correct, we will use the ventilation-feedback
 technique to teach a more efficient breathing pattern during activities of daily living. In
 time, the system will be miniaturized and portable thereby making this new technique readily
 usable during pulmonary rehabilitation.
Inclusion Criteria:

 Patients with chronic obstructive pulmonary disease

 Exclusion Criteria: