At the other temperature extreme, studies have suggested that very cold, dry air acts as an airway irritant, yet primarily results in exacerbations of exercise-induced asthma [ 5- 7], which is not a part of this study.
We will perform a baseline assessment including detailed patient history, questionnaires, lung function, history of exacerbations, measurement of exercise capacity and blood sampling.
There is no single measure of COPD severity, and a patient's experience of the disease can be heavily influenced by, for example, the frequency of exacerbations, exercise tolerance, presence of co-morbidities and a range of psychological factors.
2– 6 There is increasing agreement among experts that characterizing patients should be based on combinations of prognostically important characteristics such as frequency of exacerbations, exercise capacity, and dyspnea that better reflect the multifaceted nature of COPD than a single parameter.
It has long been noticed that COPD patients constitute a heterogeneous group of patients and a large observational study recently confirmed that subjects with similar range of airflow limitation (as defined by FEV1% predicted) had marked differences in symptoms (dyspnea, cough, and sputum production), rates of exacerbations, exercise capacity, and health status [ 2].
Our study was confined to a limited number of readily available predictors; therefore, variables with potential relevance to mortality risk such as exacerbation frequency or measures of exercise capacity were not included.
The main finding of study 1 was that non-invasive ventilation can significantly increase exercise tolerance in patients with acute exacerbations of chronic respiratory disease, reducing exercise desaturation.
Furthermore, the healthcare providers were trained in adopting self management action plans, including early recognition and treatment of exacerbations, encouragement of regular exercise and guideline based physical reactivation, cooperation with secondary care, and instructions in nutritional support.
Furthermore, the healthcare providers were trained in adopting self-management action plans, including early recognition and treatment of exacerbations, encouragement of regular exercise and guideline-based physical reactivation, cooperation and collaboration with secondary care, and instructions in dietician support for nutritionally depleted patients.
Although smoking cessation is an important goal, interventions are not effective for all individuals with COPD, thus other therapies must be used to manage the symptoms of the disease, reduce the frequency and severity of exacerbations, and improve exercise tolerance.
Ploeger et al. [ 44] tested the effect of moderate intensity continuous exercise and high intensity intermittent exercise in youth with CD and concluded that such patients can engage in different types of exercise without a significant exacerbation of the disease.
