Chest

Chest

Volume 126, Issue 4, October 2004, Pages 1102-1107
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Clinical Investigations
COPD
Mechanisms of Improvement in Exercise Capacity Using a Rollator in Patients With COPD

https://doi.org/10.1378/chest.126.4.1102Get rights and content

Study objective:

We analyzed the effects of the use of a rollator on walking distance and physiologic variables: pulmonary gas exchange, heart rate, minute ventilation (

e), oxygen saturation, and symptoms during the 6-min walk test (6MWT) in patients with COPD.

Setting:

Outpatient clinic at university hospital.

Patients:

Fourteen patients with COPD in stable clinical condition. One patient had mild COPD, five patients had moderate COPD, six patients had severe COPD, and two patients had very severe COPD.

Interventions:

Two 6MWTs were performed with a portable metabolic system (

maxST 1.0; Viasys Healthcare; MEDA; Aartselaar, Belgium) with a rollator and without a rollator, in random order. In addition, maximal voluntary ventilation (MVV) was measured with and without a rollator, randomly.

Results:

The median 6MWT distance increased significantly with a rollator: 416 m without a rollator (interquartile range [IQR], 396 to 435 m), vs 462 m with a rollator (IQR, 424 to 477 m) [p = 0.04]. Significant increases were also seen in oxygen uptake (0.04 L/min [IQR, − 0.002 to 0.09 L/min]); tidal volume (0.06 L/min [IQR, − 0.001 to 0.11 L/min]); and

e (0.95 L/min [IQR, − 0.67 to 7.1 L/min]), recorded in the last minute of the 6MWT; as well as in MVV (3 L/min [IQR, 0 to 12 L/min]) [p < 0.05 for all]. Borg dyspnea scores tended to be lower with a rollator: 6 (IQR, 4 to 7) without a rollator, vs 5 (IQR, 4 to 7) with a rollator (p = 0.10). The variation in the 6MWT was explained by individual changes in walking efficiency (partial R2 = 0.31) and changes in
e (partial R2 = 0.36) [p model < 0.04].

Conclusion:

The use of a rollator improves walking distance of patients with COPD through an increased ventilatory capacity and/or better walking efficiency.

Section snippets

Patients and Design

Fifteen clinically stable patients with COPD who met the following criteria were studied: (1) no locomotory, neurologic condition, or disability limiting the ability to walk; (2) no need for oxygen supplementation during the 6MWT; (3) familiarity with the 6MWT; and (4) naivety to the use of walking aids. After the explanation of all procedures, informed consent was obtained. Subjects performed three 6MWTs. The first 6MWT was a practice walk with the rollator (Rollmobil 540; Ortopedia; Kiel,

Results

Fifteen patients were screened and tested. One patient was excluded from the analysis, as we failed to measure the physiologic variables during the walking tests due to technical problems. Baseline characteristics of the remaining 14 patients are shown in Table 1. On average, patients showed moderate-to-severe airflow obstruction, normal body mass index, and reduced Dlco. One patient had mild COPD, five patients had moderate COPD, six patients had severe COPD, and two patients had very severe

Discussion

This study confirms that the use of a rollator enables the most impaired patients to increase walking distance. In addition, this is the first study to show that the variation in walking distance was explained by changes in ventilatory capacity and/or walking efficiency.

The magnitude of the overall increase in walking distance is in accordance with previous findings.678 In our study, patients showed a median increase in the 6MWT of 27 m when using the rollator. This improvement slightly exceeds

ACKNOWLEDGMENT

The authors thank Hilde Heyvaert, PT, from the UZ Gasthuisberg Respiratory Rehabilitation Division, for the help in the assessments; and Viasys, MEDA, Aartselaar, Belgium, for technical support.

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    This study was supported by FWD Levenslijn grant 7.0007.00.

    Dr. Troosters is a postdoctoral fellow of the FWO-Vlaanderen.

    Dr. Pitta is supported by CAPES/Brasil.

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    Copyright © 2004 The American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.