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Intermittent Hypoxia and Human Diseases pp 127–134Cite as

Effects of Intermittent Hypoxic Training on Exercise Tolerance in Patients with Chronic Obstructive Pulmonary Disease

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Abstract

Intermittent hypoxic training (IHT) has been suggested to increase exercise tolerance in patients with cardiovascular disease by enhancing stress resistance and/or improving oxygen delivery. This is also assumed to be true for patients with chronic obstructive pulmonary disease (COPD). This chapter discusses findings, derived from randomized controlled studies, on the effects of IHT on exercise tolerance in patients suffering from mild COPD. Three weeks of IHT increased total haemoglobin mass (+4% vs. 0%, P < 0.05), total exercise time (+9.7% vs. 0%, P < 0.05) and the exercise time to the anaerobic threshold (+13% vs. −7.8%, P < 0.05) compared to controls. Changes in the total exercise time were positively related to the changes in total haemoglobin mass (r = 0.59, P < 0.05), and changes in the time to the anaerobic threshold were positively related to the changes in the lung diffusion capacity for carbon monoxide (DLCO) (r = 0.48, P < 0.05). Increases in vagal activity after IHT were related to the reduced values of heart rate and blood lactate concentration observed during submaximal exercise (6-min walk test), and changes in respiratory pattern after IHT were related to the lower ventilatory equivalents for oxygen and carbon dioxide (V E/VO2 and V E/VCO2) at the anaerobic threshold determined by incremental cycle ergometry. In conclusion, IHT can improve exercise tolerance in patients with mild COPD. IHT is considered as repeated stress training and subsequent adaptations resulting in corrections of impaired DLCO, improved ventilatory efficiency, enhancement of total haemoglobin mass and changes of the autonomic balance to higher vagal and lower sympathetic activity. Thus, IHT may be a valuable tool to complement the known beneficial effects of exercise training in patients with COPD.

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Abbreviations

AT:

Anaerobic threshold

CO2-et:

End-tidal CO2

COPD:

Chronic obstructive pulmonary disease

DLCO:

Lung diffusion capacity for carbon monoxide

FEV1:

Forced expiratory volume in 1 s

FEVC:

Forced expiratory vital capacity

FiO2 :

Inspiratory fraction of oxygen

HCVR:

Hypercapnic ventilatory response

HIF:

Hypoxia-inducible factor

HR:

Heart rate

HVR:

Hypoxic ventilatory response

IH:

Intermittent hypoxia

IHT:

Intermittent hypoxic training

NO:

Nitric oxide

OSA:

Obstructive sleep apnoea

RPE:

Ratings of perceived exertion

SaO2 :

Arterial oxygen saturation

SD:

Standard deviation

V E :

Minute ventilation

VO2 :

Oxygen uptake

V E/VO2 :

Ventilatory equivalent for oxygen

V E/VCO2 :

Ventilatory equivalent for carbon dioxide

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Author information

Authors and Affiliations

  1. Department of Sport Science, Medical Section, University of Innsbruck, Innsbruck, Austria

    Martin Burtscher

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  1. Martin Burtscher
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Correspondence to Martin Burtscher .

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Editors and Affiliations

  1. , Division of Cardiology, Virginia Commonwealth University, Richmond, 23298, Virginia, USA

    Lei Xi

  2. Bogomoletz Institute of Physiology, Kiev, 01601, Ukraine

    Tatiana V. Serebrovskaya

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Burtscher, M. (2012). Effects of Intermittent Hypoxic Training on Exercise Tolerance in Patients with Chronic Obstructive Pulmonary Disease. In: Xi, L., Serebrovskaya, T. (eds) Intermittent Hypoxia and Human Diseases. Springer, London. https://doi.org/10.1007/978-1-4471-2906-6_10

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  • DOI: https://doi.org/10.1007/978-1-4471-2906-6_10

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  • Print ISBN: 978-1-4471-2905-9

  • Online ISBN: 978-1-4471-2906-6

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