Contrasting breathing retraining and helium-oxygen during pulmonary rehabilitation in COPD: a randomized clinical trial Journal Article

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Authors: Collins, E. G.; Jelinek, C.; O'Connell, S.; Butler, J; McBurney, C.; Gozali, C.; Reda, D; Laghi, F.
Article Title: Contrasting breathing retraining and helium-oxygen during pulmonary rehabilitation in COPD: a randomized clinical trial
Abstract: BACKGROUND: Breathing-retraining and helium-oxygen (heliox) have been used to improve exercise tolerance in COPD. We hypothesized that, in patients with COPD, exercise duration after exercise-training plus breathing-retraining and oxygen would be longer than after exercise-training plus heliox or after exercise-training plus oxygen alone. We also explored the short-term maintenance of gains in exercise duration after using each technique. METHODS: Of 192 COPD patients recruited, 103 were randomly assigned to exercise-training plus heliox (n = 33), exercise-training plus breathing-retraining and oxygen (n = 35) and exercise-training and oxygen (n = 35). FiO2 was 0.30 during testing and training in all groups. Patients exercised on a treadmill thrice-weekly for eight weeks. Before, at completion of training, and six-weeks later, patients underwent constant-load treadmill testing. RESULTS: At completion of training, improvements in exercise duration in the heliox and breathing-retraining groups were not significantly different. Compared to the exercise-training plus oxygen group, exercise duration improved more in the breathing-retraining group (P = 0.008) but not in the heliox group (P = 0.142). Hyperinflation was reduced with breathing-retraining plus oxygen compared to the other two groups. Six-weeks later, improvements in exercise duration were still greater with breathing-retraining than with exercise-training (P = 0.015). In contrast, improvements in exercise duration with heliox did not differ from those in the other two groups. CONCLUSIONS: In moderate-to-severe COPD, exercise-training combined with either heliox or with breathing-retraining yielded not significantly different improvements in exercise duration - with only the latter being superior to exercise-training. Six-weeks after training, these improvements were still greater after exercise-training plus breathing-retraining than after exercise-training. TRIAL REGISTRY: ClinicalTrials.gov; No.: NCT00123422.
Journal Title: Respiratory medicine
Volume: 108
Issue: 2
ISSN: 1532-3064; 0954-6111
Publisher: Unknown  
Journal Place: England
Date Published: 2014
Start Page: 297
End Page: 306
Language: eng
DOI/URL:

10.1016/j.rmed.2013.10.023
Notes: CI: Published by Elsevier Ltd.; ClinicalTrials.gov/NCT00123422; JID: 8908438; 206GF3GB41 (Helium); 58933-55-4 (heliox); S88TT14065 (Oxygen); OTO: NOTNLM; 2013/04/17 [received]; 2013/10/21 [revised]; 2013/10/27 [accepted]; 2013/11/05 [aheadofprint]; ppublish