• Eileen G Collins, Christine Jelinek, Susan O'Connell, Jolene Butler, Conor McBurney, Christopher Gozali, Domenic Reda, and Franco Laghi.
• Center for Management of Complex Chronic Care, Physical Performance Laboratory, Research & Development Service, Edward Hines Jr. Veterans Affairs Hospital, Hines, IL, USA; Department of Biobehavioral Health Science, College of Nursing, University of Illinois at Chicago, Chicago, IL, USA. Electronic address: eileen.collins@va.gov.
• Respir Med. 2014 Feb 1; 108 (2): 297-306.

BackgroundBreathing-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.MethodsOf 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.ResultsAt 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.ConclusionsIn 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 RegistryClinicalTrials.gov; No.: NCT00123422.Published by Elsevier Ltd.

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