Use of supplemental oxygen during exercise testing and training for people with chronic obstructive pulmonary disease: a survey of Australian pulmonary rehabilitation programs

Regina W M Leung; Jennifer A Alison; Sue C Jenkins; Anne E Holland; Kylie Hill; Norman R Morris; Lissa M Spencer; Catherine J Hill; Annemarie L Lee; Helen E Seale; Nola M Cecins; Christine F McDonald; Zoe J McKeough

doi:10.1016/j.bjpt.2020.04.003

Use of supplemental oxygen during exercise testing and training for people with chronic obstructive pulmonary disease: a survey of Australian pulmonary rehabilitation programs

Braz J Phys Ther. 2021 Jan-Feb;25(1):97-102. doi: 10.1016/j.bjpt.2020.04.003. Epub 2020 May 15.

Authors

Affiliations

¹ Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, Sydney, Australia; Department of Thoracic Medicine, Concord Repatriation General Hospital, Concord, NSW, Australia. Electronic address: regina.leung@health.nsw.gov.au.
² Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, Sydney, Australia; Sydney Local Health District, Sydney, NSW, Australia.
³ School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, Perth, Australia; Institute for Respiratory Health, Sir Charles Gairdner Hospital, Perth, Australia; Department of Physiotherapy, Sir Charles Gairdner Hospital, Perth, Australia.
⁴ Discipline of Physiotherapy, School of Allied Health, LaTrobe University, Melbourne, Australia; Department of Physiotherapy, Alfred Health, Melbourne, Australia; Institute for Breathing and Sleep, Melbourne, Australia.
⁵ School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, Perth, Australia; Institute for Respiratory Health, Sir Charles Gairdner Hospital, Perth, Australia.
⁶ School of Allied Health Sciences and Menzies Health Institute, Griffith University, Gold Coast, Australia; Metro North Hospital and Health Service, The Prince Charles Hospital, Allied Health Research Collaborative, Brisbane, Australia.
⁷ Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, Sydney, Australia.
⁸ Department of Physiotherapy, Royal Prince Alfred Hospital, Sydney, Australia; Department of Physiotherapy, Austin Health, Melbourne, Australia.
⁹ Department of Physiotherapy, Monash University, Melbourne, Australia.
¹⁰ Department of Physiotherapy, The Prince Charles Hospital, Brisbane, Australia.
¹¹ Institute for Respiratory Health, Sir Charles Gairdner Hospital, Perth, Australia.
¹² Institute for Breathing and Sleep, Melbourne, Australia; Department of Respiratory and Sleep Medicine, Austin Health, Melbourne, Australia.

Abstract

Objectives: The aims of this study were to determine, in Australian pulmonary rehabilitation programs for people with COPD: (1) whether oxygen saturation (SpO₂) was monitored during exercise testing; (2) whether supplemental oxygen was available during exercise testing and/or training; (3) whether oxygen was prescribed during exercise training; and the reason for providing oxygen; (4) whether a protocol was available for supplemental oxygen prescription during exercise training.

Methods: This was a cross-sectional multi-center study using a purposed-designed survey. De-identified survey data were analyzed and the absolute number and percentage of responses were recorded for each question.

Results: The survey was sent to 261 pulmonary rehabilitation programs and 142 surveys (54%) were available for analysis. Oxygen saturation was monitored during exercise testing in 92% of programs. Supplemental oxygen was available in the majority of programs during exercise testing (82%) and training (84%). The rationale cited by 87 programs (73%) for prescribing oxygen during exercise training was maintaining SpO₂ above a threshold ranging from SpO₂ 80-88%. Forty-five (32%) programs had a protocol for oxygen prescription during exercise training.

Conclusion: While monitoring of SpO₂ during exercise testing and using supplemental oxygen during testing and training is common in Australian pulmonary rehabilitation programs, few programs had a protocol in place for the prescription of supplemental oxygen for people with COPD who were not on long-term oxygen therapy. This may be due to lack of strong evidence to support the use of supplemental oxygen during exercise training.

Keywords: COPD; Exercise testing; Exercise training; Oxygen; Rehabilitation.

MeSH terms

Australia
Cross-Sectional Studies
Exercise Test
Exercise Therapy / methods*
Exercise Tolerance
Humans
Oxygen Inhalation Therapy
Pulmonary Disease, Chronic Obstructive / physiopathology*
Quality of Life