Prevention of Post-exercise Muscle Fatigue and Effect on Exercise Training in Severe Patients With COPD.

Prevention of Post-exercise Muscle Fatigue Using a Non Invasive Ventilation and Effect on Exercise Training in Severe Patients With COPD. QUADRIVEND Study

In patients with severe Chronic Obstructive Pulmonary Disease (COPD), exercise tolerance is severely impaired due to a ventilatory limitation, levelling off the intensity of exercise. This reduces the physiological benefit of pulmonary rehabilitation. In these patients, it is then proposed to add an Inspiratory Pressure Support (IPS) in order to increase the intensity and the duration of every training session. In a preliminary study, the investigators showed that IPS applied during an exhaustive cycling exercise allowed to prevent the onset of post-exercise quadriceps fatigue evaluated by the endurance time to isotonic quadriceps contractions (TlimQ).

The aim of this study is to determine the relationship between the prevention of post-exercise fatigue (TlimQ) and the change in training load (intensity x time x number of sessions) during a pulmonary rehabilitation programme. At the beginning of the training programme, 25 patients will be evaluated for TlimQ after a cycling exercise (70% maximal workload) with and without IPS in random order. The training load was then monitored at every exercise session of the programme.

Inclusion Criteria:

• Severe COPD patients in stable condition (Gold class 3 or 4)
• Ventilatory limitation to exercise during the incremental cardiopulmonary exercise test (at least one of the following criteria) :
• No breathing reserve
• Exercise hypoventilation (increase arterial PCO2> 5 mmHg)
• Maximal workload <50 Watts

Exclusion Criteria:

• IPS not tolerated during a preliminary cycling exercise test
• Enable to perform the exercise tests or the rehabilitation programme
• Decline to participate