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

•Exercise limited by breathlessness was associated with distinct lung pathophysiology at peak exercise.•The qualities of exertional breathlessness was more unpleasant when it was the locus of symptom limitation to exercise.•Knowing a patient’s exercise limiting symptom may allow for a more targeted...

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Bibliographic Details
Published in:Respiratory physiology & neurobiology 2020-02, Vol.273, p.103322-103322, Article 103322
Main Authors: Tracey, Lauren, Lewthwaite, Hayley, Abdallah, Sara J., Murray, Steven, Wilkinson-Maitland, Courtney A., Donovan, Adamo, Maltais, Francois, O’Donnell, Denis E., Bourbeau, Jean, Smith, Benjamin M., Jensen, Dennis
Format: Article
Language:English
Subjects:
Aged
Breathlessness
COPD
Cross-Sectional Studies
Dyspnea
Dyspnea - physiopathology
Exercise - physiology
Exercise - psychology
Exercise limitation
Female
Humans
Male
Middle Aged
Pulmonary Disease, Chronic Obstructive - physiopathology
Retrospective Studies
Symptom
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Summary:•Exercise limited by breathlessness was associated with distinct lung pathophysiology at peak exercise.•The qualities of exertional breathlessness was more unpleasant when it was the locus of symptom limitation to exercise.•Knowing a patient’s exercise limiting symptom may allow for a more targeted and personalized approach to disease management. 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.
ISSN:1569-9048
1878-1519
DOI:10.1016/j.resp.2019.103322