Effect of exercise mode on oxygen uptake and blood gases in COPD patients

Patients with chronic obstructive pulmonary disease (COPD) are characterised by decreased exercise tolerance, and, more variably, exercise induced hypoxaemia (EIH). Evaluation of physical work capacity and physiological responses to exercise may be performed by various procedures, but there are diverging opinions as to which exercise test should be preferred. In the current study, oxygen uptake and arterial blood gases in COPD patients have been compared during submaximal and maximal exercise on treadmill and ergometer bicycle. Treadmill exercise resulted in higher peak oxygen uptake than bicycle exercise (1111+/-235 vs. 987+/-167 ml min(-1), P<0.02), while the plasma lactate levels were higher during cycling (1.8+/-0.8 vs. 3.8+/-1.7 mmol l(-1), P<0.001). Neither carbon dioxide output, ventilation, nor rate of perceived exertion (Borg RPE scale) showed significant differences between the two modes of exercise. The EIH during both maximal (delta Sa,O2 = -5.6+/-4.2 vs. -3.4+/-5.1%) and sub-maximal exercise was more pronounced during treadmill walking than during cycling. The present study indicates that the VO2peak in COPD patients is higher, the maximal lactate concentrations lower and the development of EIH more pronounced when exercise testing is performed on a treadmill than on a bicycle ergometer.