Use of supplemental oxygen during exercise testing and training for people with chronic obstructive pulmonary disease: a survey of Australian pulmonary rehabilitation programs.

OBJECTIVES: The aims of this study were to determine, in Australian pulmonary rehabilitation programs for people with COPD: (1) whether oxygen saturation (SpO2) was monitored during exercise testing; (2) whether supplemental oxygen was available during exercise testing and/or training; (3) whether oxygen was prescribed during exercise training; and the reason for providing oxygen; (4) whether a protocol was available for supplemental oxygen prescription during exercise training. METHODS: This was a cross-sectional multi-center study using a purposed-designed survey. De-identified survey data were analyzed and the absolute number and percentage of responses were recorded for each question. RESULTS: The survey was sent to 261 pulmonary rehabilitation programs and 142 surveys (54%) were available for analysis. Oxygen saturation was monitored during exercise testing in 92% of programs. Supplemental oxygen was available in the majority of programs during exercise testing (82%) and training (84%). The rationale cited by 87 programs (73%) for prescribing oxygen during exercise training was maintaining SpO2 above a threshold ranging from SpO2 80-88%. Forty-five (32%) programs had a protocol for oxygen prescription during exercise training. CONCLUSION: While monitoring of SpO2 during exercise testing and using supplemental oxygen during testing and training is common in Australian pulmonary rehabilitation programs, few programs had a protocol in place for the prescription of supplemental oxygen for people with COPD who were not on long-term oxygen therapy. This may be due to lack of strong evidence to support the use of supplemental oxygen during exercise training.

Exercise training for people following curative intent treatment for non-small cell lung cancer: a randomized controlled trial.

OBJECTIVE: In people following curative intent treatment for non-small cell lung cancer, to investigate the effects of supervised exercise training on exercise capacity, physical activity and sedentary behavior, peripheral muscle force, health-related quality of life, fatigue, feelings of anxiety and depression, and lung function. METHOD: This pilot randomized controlled trial included participants 6-10 weeks after lobectomy for non-small cell lung cancer or, for those who required adjuvant chemotherapy, 4-8 weeks after their last cycle. Participants were randomized to either 8 weeks of supervised exercise training (exercise group) or 8 weeks of usual care (control group). Prior to and following the intervention period, both groups completed measurements of exercise capacity, physical activity and sedentary behavior, quadriceps and handgrip force, HRQoL, fatigue, feelings of anxiety and depression, and lung function. Intention-to-treat analysis was undertaken. RESULTS: Seventeen participants (mean age 67, SD=9 years; 12 females) were included. Nine and eight participants were randomized to the exercise and control groups, respectively. Four participants (44%) adhered to exercise training. Compared with any change seen in the control group, those in the exercise group demonstrated greater gains in the peak rate of oxygen consumption (mean difference, 95% confidence interval for between-group difference: 0.19 [0.04-0.33]Lmin-1) and 6-minute walk distance (52 [12-93]m). No other between-group differences were demonstrated. CONCLUSIONS: In people following curative intent treatment for non-small cell lung cancer, 8 weeks of supervised exercise training improved exercise capacity, measured by both laboratory- and field-based exercise tests. These results suggest that this clinical population may benefit from attending exercise training programs.