Validation of Walking Trails for the Urban Training™ of Chronic Obstructive Pulmonary Disease Patients

PLoS One. 2016 Jan 14;11(1):e0146705. doi: 10.1371/journal.pone.0146705. eCollection 2016.

Abstract

Purpose: Accessible interventions to train patients with chronic obstructive pulmonary disease (COPD) are needed. We designed urban trails of different intensities (low, moderate and high) in different types of public spaces (boulevard, beach and park). We aimed to validate the trails' design by assessing the physiological response to unsupervised walking trails of: (1) different intensities in COPD patients, and (2) same intensity from different public spaces in healthy adults.

Methods: On different days and under standardized conditions, 10 COPD patients walked the three intensity trails designed in a boulevard space, and 10 healthy subjects walked the three intensity trails in three different spaces. We measured physiological response and energy expenditure using a gas analyzer. We compared outcomes across trails intensity and/or spaces using mixed-effects linear regression.

Results: In COPD patients, physiological response and energy expenditure increased significantly according to the trails intensity: mean (SD) peak V̇O2 15.9 (3.5), 17.4 (4.7), and 17.7 (4.4) mL/min/kg (p-trend = 0.02), and MET-min 60 (23), 64 (26), 72 (31) (p-trend<0.01) in low, moderate and high intensity trails, respectively. In healthy subjects there were no differences in physiological response to walking trails of the same intensity across different spaces.

Conclusions: We validated the trails design for the training of COPD patients by showing that the physiological response to and energy expenditure on unsupervised walking these trails increased according to the predefined trails' intensity and did not change across trails of the same intensity in different public space. Walkable public spaces allow the design of trails that could be used for the training of COPD patients in the community.

Publication types

  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Adult
  • Case-Control Studies
  • Exercise Therapy / adverse effects
  • Exercise Therapy / methods*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Oxygen Consumption
  • Pulmonary Disease, Chronic Obstructive / rehabilitation*
  • Pulmonary Disease, Chronic Obstructive / therapy
  • Walking*

Grants and funding

The study was funded by grants from Supported by Fondo de Investigacion Sanitaria, Ministry of Health, Spain (FIS PI11/01283), integrated into Plan Estatal I+D+I 2013-2016 and co-funded by ISCIII-Subdirección General de Evaluación y Fomento de la Investigación and Fondo Europeo de Desarrollo Regional (FEDER); Spanish Society of Pneumology and Thoracic Surgery (SEPAR 147/2011 and 201/2011), and Catalan Society of Pneumology (SOCAP Fisioteràpia 2013). Anael Barberan-Garcia had personal funding from Agaur 2014-SGR-661, Catalan Government. There was no involvement of any funding source in study design, in the collection, analysis and interpretation of data, in the writing of the report, nor in the decision to submit the article for publication.