Inducing variable breathing ratios during walking to improve exercise capacity in patients with chronic obstructive pulmonary disease.

The long-term goal of our research is to improve pulmonary rehabilitation outcomes for Veterans with Chronic Obstructive Pulmonary Disease (COPD) using novel exercise regimes. The primary objective of this project is to determine the effect of a pulmonary rehabilitation program that utilizes inclined versus standard exercise for patients with COPD. COPD is a significant health challenge, especially for Veterans who have a higher prevalence of COPD compared to the general U.S. population. Our preliminary data indicate that COPD patients exhibit an abnormal coupling pattern between walking and breathing, which limits exercise capacity. Increasing walking speed leads to higher respiratory rates, dynamic hyperinflation, and dyspnea, thereby limiting exercise duration and intensity. The project's primary goal is to evaluate the impact of a pulmonary rehabilitation program that uses inclined walking to promote variable coupling between breathing and walking for individuals with COPD. This project will examine the impact of a 12-week (3 times per week) pulmonary rehabilitation program on walking and respiratory outcomes in Veteran COPD patients. The study will compare the effects of two exercise components: walking at an increased speed versus walking on an incline. Moderate to severe COPD patients from the Omaha VAMC will participate in the program, with 28 subjects undergoing inclined rehab and 28 receiving standard rehab. The study will address three specific aims: 1. Investigate the impact of inclined versus standard training on respiratory rate, dyspnea, and hyperinflation. 2. Determine the effect of inclined versus standard training on the coupling between walking and breathing, total walking time, and metabolic equivalence of task. 3. Assess the effect of inclined versus standard training on health status and quality of life. Participants will undergo two 6-minute overground walking tests before and after the intervention period, while walking distance, dynamic hyperinflation, respiratory rate, oxygen uptake, dyspnea, and the variability of breathing/walking coupling ratios will be measured during each session of the training program. The data collected will inform future studies aimed at developing more effective rehabilitation programs, ultimately reducing the impact of COPD on the Veteran population. Project Number: 1I01RX005337-01A1 | Fiscal Year: 2026 | NIH Institute/Center: Veterans Affairs (VA) | Principal Investigator: Kristina Bailey | Institution: OMAHA VA MEDICAL CENTER, OMAHA, NE | Activity Code: I01 | Study Section: Chronic Medical Conditions & Aging[RRD6] View on NIH RePORTER: https://reporter.nih.gov/project-details/11110916