Volume 106, Issue 12, Pages (December 2012)

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Volume 106, Issue 12, Pages 1695-1705 (December 2012) Walking exercise response to bronchodilation in mild COPD: A randomized trial Philippe Gagnon, Didier Saey, Steeve Provencher, Julie Milot, Jean Bourbeau, Wan C. Tan, Simon Martel, François Maltais Respiratory Medicine Volume 106, Issue 12, Pages 1695-1705 (December 2012) DOI: 10.1016/j.rmed.2012.08.021 Copyright © 2012 Elsevier Ltd Terms and Conditions

Figure 1 Flow chart of the study according to CONSORT guidelines. FEV1: Forced expiratory volume in 1 s; FVC: forced vital capacity. Respiratory Medicine 2012 106, 1695-1705DOI: (10.1016/j.rmed.2012.08.021) Copyright © 2012 Elsevier Ltd Terms and Conditions

Figure 2 Schematic representation of the experimental protocol used for the two treatment visits. In a double-blind randomized cross-over design, an endurance shuttle walking test (ESWT) was performed following the inhalation of nebulized placebo or a bronchodilator (BD) [ipratropium bromide 500 μg and salbutamol sulfate 2.5 mg combination]. Quadriceps strength was measured before and after exercise by magnetic stimulation of the femoral nerve (TwQpot). Respiratory Medicine 2012 106, 1695-1705DOI: (10.1016/j.rmed.2012.08.021) Copyright © 2012 Elsevier Ltd Terms and Conditions

Figure 3 Forced expiratory volume in 1 s (FEV1, panel A), forced vital capacity (FVC, panel B) and inspiratory capacity (IC, panel C) pre and 60-min post-nebulization of either placebo or bronchodilator (BD). Values are mean ± SEM. **p < 0.0001 vs. pre-bronchodilator measures and versus the post-pre BD changes seen in the placebo group. Respiratory Medicine 2012 106, 1695-1705DOI: (10.1016/j.rmed.2012.08.021) Copyright © 2012 Elsevier Ltd Terms and Conditions

Figure 4 Individual and group mean (±SEM) walking endurance time following either placebo and bronchodilation (BD) inhalation (panel A). Mean difference in walking endurance time between the two conditions with 95% confidence interval (panel B). The dotted lines represent the minimal important difference (MID) of 65 s for the endurance shuttle walking test. Respiratory Medicine 2012 106, 1695-1705DOI: (10.1016/j.rmed.2012.08.021) Copyright © 2012 Elsevier Ltd Terms and Conditions

Figure 5 Ventilation (V˙E, panel A), tidal volume reported as % of predicted vital capacity (VC) (VT, panel B), breathing frequency (Bf, panel C), breathing frequency to tidal volume ratio (Bf/VT, panel D) and ventilation to maximal voluntary ventilation ratio (V˙E /MVV, panel E) at 0%, 25%, 50%, 75%, 100% isotime and end-exercise. Inspiratory capacity (IC, panel F) at baseline, 2-min and end-exercise. Leg fatigue (panel G) and dyspnea (panel H) Borg scores at baseline, 1-min, isotime and end-exercise. Submaximal (circles) and end-exercise (diamonds) values are represented for placebo (open symbols) and bronchodilator (closed symbols) conditions. Values are mean ± SEM. * Indicates that the time course was statistically different (p < 0.05) between the 2 conditions; †p < 0.05 vs. placebo condition at a given time point. Respiratory Medicine 2012 106, 1695-1705DOI: (10.1016/j.rmed.2012.08.021) Copyright © 2012 Elsevier Ltd Terms and Conditions