Meta- analysis revealed few clinical ly relevant and statistically significant benefits of " add-on " therapies on exercise performance compared with exercise training .
The aim of this review was to identify the effectiveness of therapies added on to conventional exercise training to maximise exercise capacity in patients with chronic obstructive pulmonary disease ( COPD ) .
Can ventilation-feedback training augment exercise tolerance in patients with chronic obstructive pulmonary disease?
RATIONALE Exercise-induced dynamic hyperinflation contributes to decreased exercise tolerance in chronic obstructive pulmonary disease ( COPD ) . It is unknown whether respiratory retraining ( ventilation-feedback [ VF ] training ) can affect exercise-induced dynamic hyperinflation and increase exercise tolerance . OBJECTIVES To determine whether patients with COPD would achieve longer exercise duration if r and omized to a combination of exercise training plus VF training than either form of training on its own . METHODS A total of 64 patients r and omized to 1 of 3 groups : VF plus exercise ( n = 22 ) , exercise alone ( n = 20 ) , and VF alone ( n = 22 ) . MEASUREMENTS AND MAIN RESULTS Exercise duration before and after 36 training sessions and exercise-induced dynamic hyperinflation and respiratory pattern before and after training were measured . In the 49 patients who completed training , duration of constant work-rate exercise was 40.0 ( + /- 20.4 ) minutes ( mean + /- SD ) with VF plus exercise , 31.5 ( + /- 17.3 ) minutes with exercise alone , and 16.1 ( + /- 19.3 ) minutes with VF alone . Exercise duration was longer in VF plus exercise than in VF alone ( P < 0.0001 ) , but did not reach predetermined statistical significance when VF plus exercise was compared with exercise alone ( P = 0.022 ) ( because of multiple comparisons , P < /= 0.0167 was used for statistical significance ) . After training , exercise-induced dynamic hyperinflation , measured at isotime , in VF plus exercise was less than in exercise alone ( P = 0.014 for between-group changes ) and less than in VF alone ( P = 0.019 for between-group changes ) . After training , expiratory time was longer in VF plus exercise training ( P < 0.001 ) , and it was not significantly changed in the other two groups . CONCLUSIONS The combination of VF plus exercise training decreases exercise-induced dynamic hyperinflation and increases exercise duration more than VF alone . An additive effect to exercise training from VF was not demonstrated by predetermined statistical criteria
Meta- analysis revealed few clinical ly relevant and statistically significant benefits of " add-on " therapies on exercise performance compared with exercise training .
The aim of this review was to identify the effectiveness of therapies added on to conventional exercise training to maximise exercise capacity in patients with chronic obstructive pulmonary disease ( COPD ) .