“
“Chronic obstructive pulmonary disease (COPD) is a leading

cause of morbidity and mortality worldwide (Lopez et al 2006) and results in an economic and social burden that is substantial and increasing (Access Economics Pty Limited 2008, Chapman et al 2006). The real prevalence of COPD is likely to be under-estimated due to under-diagnosis or misdiagnosis of the disease (Bednarek et al 2008). Pulmonary rehabilitation is recognised as an essential component of the management of people with COPD and improves exercise capacity and health-related quality of life (Lacasse et al 2006, Ries et al 2007). Due to the increasing prevalence of COPD, modes of training that are widely available

and easy to implement need to be evaluated in order to meet AUY-922 order the growing demand (The Australian Lung Foundation 2007). Ground walk training is one such mode of training. While ground walking, which requires no equipment, has been incorporated into rehabilitation programs, it has not been evaluated extensively as a training modality Epigenetics Compound Library chemical structure in people with COPD. The few studies that have examined walk training in COPD have used treadmills (Puente-Maestu et al 2000); used unsupervised walking programs that either Liothyronine Sodium had a high drop-out rate (Hernandez et al 2000) or used the assistance

of technology to monitor walking speed (Liu et al 2008); or used peak and endurance cycle capacity as the main outcome (Na et al 2005), which may not best reflect change in functional walking capacity. No studies have evaluated supervised, individually prescribed, high intensity ground walking as a training modality in people with COPD, and none have evaluated the effects of ground walk training on exercise capacity compared to the commonly used training modality of stationary cycling. Therefore, the research questions for this study were: 1. Does ground walk training improve endurance walking capacity in people with COPD compared to cycle training? If walk training is effective in improving exercise capacity and quality of life in people with COPD, compared to equipment-dependent training such as cycle training, it would provide an easily available training modality, particularly for those living in places with limited resources such as rural and remote areas. A randomised trial was conducted with concealed allocation, blinded outcome assessment, and intention-to-treat analysis. Participants were recruited from referrals to the pulmonary rehabilitation program at Concord Repatriation General Hospital, Sydney.