PHYSIOLOGIC BASIS OF TRAINING PATIENTS WITH EMPHYSEMA

Abstract

The effects of training patients with pulmonary emphysema were investigated. Eight subjects previously stabilized by a maximal therapeutic regimen were subjected to a 3 week treadmill training program. Four were trained while breathing O2 and 4 while breathing air. All the subjects demonstrated a marked improvement related to the specific task. They increased their ability to walk, and did so with a relatively slower pulse and a lenghtening of stride. Comparative studies made during exercise on a bicycle ergometer showed that, after training, there was no change in ventilation but there was a tendency of decreased O2 consumption and respiratory quotient, and a significant decrease in cardiac output with a concomitant widening of the arteriovenous O2 difference. Lactate production and O2 debt were unaffected by the training program. The red cell mass increased in those trained while breathing air and decreased when the training was carried out breathing O2. The training of emphysematous patients improved their ability to exercise. This improvement was most pronounced while carrying out the specific exercise which they were trained to do and was related to better coordination and economy of movement. The principal transferable result of this training appeared to be the development of an ability to extract O2 more completely from the circulating blood.