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  1. Gosens, Willem MSc
  2. van't Hul, Alex J. PhD
  3. Oomen, Joost M. PhD
  4. Hesselink, Matthijs K. C. PhD
  5. Borghouts, Lars B. PhD


PURPOSE: The primary aims of this study were (1) to evaluate whole-body mechanical efficiency (ME) in a large group of chronic obstructive pulmonary disease (COPD) patients with a wide range of degrees of illness and (2) to examine how ME in COPD is related to absolute work rate and indices of disease severity during exercise testing.


METHODS: A total of 569 patients (301 male patients; GOLD stage I: 28, GOLD stage II: 166, GOLD stage III: 265, and GOLD stage IV: 110) with chronic obstructive pulmonary disease (COPD) were included in the data analysis. Individual maximal workload (watt), peak minute ventilation (



E, L/min body temperature and pressure, saturated), and peak oxygen uptake (



O2, mL/min standard temperature and pressure, dry) were determined from a maximal incremental cycle ergometer test. Ventilatory and metabolic response parameters were collected during a constant work rate test at 75% of the individual maximal workload. From the exercise responses of the constant work rate test, the gross ME was calculated.


RESULTS: The mean whole-body gross ME was 11.0 +/- 3.5% at 75% peak power. The ME declined significantly (P < .001) with increasing severity of the disease when measured at the same relative power. Log-transformed absolute work rate (r = .87, P < .001) was the strongest independent predictor of gross ME. Body mass was the single other variable that contributed significantly to the linear regression model.


CONCLUSIONS: Gross ME in COPD was largely predicted by the absolute work rate (r = .87; P < .001) while indices of the severity of the disease did not predict ME in COPD.