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ABSTRACT: Although spirometry plays an important role in the evaluation of chronic obstructive pulmonary disease (COPD), it provides only a rough estimate of the patient's functional impairment. A variety of [...]

Objectives: Current criteria use FE[V.sub.1] to assess bronchodilator responsiveness, despite its insensitivity and inability to predict improvement in symptoms or exercise tolerance. Response in lung volumes remains largely unexplored even [...]

Ventilatory limitations in patients with chronic obstructive pulmonary disease cause intense breathlessness and severely restrict exercise capabilities. Therapeutic interventions that effectively reduce lung volumes during physical activity help to prevent dynamic lung hyperinflation and improve exercise tolerance in patients with chronic obstructive pulmonary disease.

Study objective: To explore mechanisms of relief of exertional breathlessness following surgery to reduce thoracic gas volume in patients with emphysema. Materials arid methods: We studied 8 patients with emphysema [...]

(Chest 1994; 106:904-912 CAL=ehronic airflow limitation; CPAP=continuous positive airway pressure; DC=dynamic airway compression; DH=dynamic lung hyperinflation; CA--expiratory assist; EELV=end-expiratory lung volume; IMT=inspiratory muscle training; MBC=maximal breathing capacity; NVD =neuroventilatory dissociation; [...]

Chronic obstructive pulmonary disease (COPD) is a leading cause of mortality and functional disability in older adults. In its advanced stages, it is characterized by progressive breathlessness and serious exercise curtailment. Aerobic exercise training (EXT) is recommended for patients who remain breathless despite optimal pharmacologic treatment. Although the physiologic rationale for EXT in COPD patients remains controversial, it is generally accepted that even older incapacitated COPD sufferers who participate in an individualized training program show significant reductions in breathlessness, increased exercise capacity, and enhanced psychosocial function. An 8-week outpatient program that is carefully regulated and includes an educational component is recommended., Chronic obstructive pulmonary disease (COPD)--including chronic bronchitis and emphysema--is the fifth leading cause of death in the United States.|1~ Despite welcome trends in reduced tobacco consumption, mortality rates for COPD [...]

We wished to identify the physiologic abnormalities that distinguish severely breathless (SB) patients with chronic airflow limitation (CAL) from mildly breathless (MB) patients. Thirty-seven patients with stable, advanced CAL ([FEV.sub.1] [...]

International guidelines (1) have correctly highlighted dyspnea alleviation and improvement in exercise tolerance as being among the most important management goals in patients with COPD. Bronchodilator therapy is the first [...]

A review of contemporary exercise models and data acquisition and analysis techniques for evaluation of muscle blood-flow dynamics at exercise onset is presented together with a summary of the available information on exercising muscle blood-flow dynamics based on the forearm exercise model. Preliminary findings indicate that the major characteristics differentiating the limbs reflect a sensitivity of the forearm vasculature to aging and chronic obstructive pulmonary disease (COPD) that is not demonstrated by the leg vasculature.

Is Spirometry Useful? Bronchodilator therapy in COPD is deemed successful if it improves ventilatory mechanics to a degree where effective symptom alleviation and increased exercise capacity are achieved. A greater [...]