The randomisation was stratified for lung function (FEV1 > or ≤ 40% predicted), 6-minute walk distance (> or ≤ 50% predicted) (Troosters et al 1999), and the main limiting symptom in the initial endurance cycle test (ie, dyspnoea, leg fatigue, or a combination of both symptoms). Participants

undertook three sessions per week of supervised group training in their allocated exercise mode for eight weeks. Each participant maintained his/her medication regimen during the intervention period. NVP-BGJ398 nmr An assessor, blinded to group allocation, performed the outcome measures at the end of the intervention period. Participants were included if they had COPD stage I to IV (Global Initiative for COPD classification (GOLD) 2008). Participants were excluded if any of the following criteria applied: acute exacerbation of COPD within the last 4 weeks, significant co-morbidity including malignancy, symptomatic PFI-2 cell line cardiovascular disease, or other systemic or musculoskeletal disease that could hinder the exercise training. As well, participants were excluded if they had a body mass index (weight in kg/height in m2) ≥ 35 kg/m2, required supplemental

oxygen during exercise training, or used a walking aid. The study participants underwent pulmonary function testing including spirometry, lung volumes, and carbon monoxide transfer factor, and the six-minute walk test. Pulmonary function tests were performed according to the recommended standards (ATS/ERS Task Force 2005a, 2005b, 2005c) and results were compared with predicted normal values (Quanjer et al 1993). In the walk group, participants trained on a 26-m circular indoor track with the

initial training speed set at 75% of the participant’s peak walking speed, achieved in the incremental shuttle walk test (Hernandez et al 2000). Each participant was given a goal of completing a set number of laps in each five-minute period. All participants used a lap counter to monitor the number of laps walked during the prescribed duration. In the cycle group, participants were trained on an upright cycle ergometer with the initial training intensity set at 60% of the peak work capacity achieved in the incremental cycle test (Maltais et al 1997). The initial training intensities were chosen based on previous studies that reported that these training intensities were tolerated by participants Astemizole with COPD (Hernandez et al 2000, Maltais et al 1997). The training intensities for both groups were progressed as symptoms permitted so that the dose of training was maximised, with participants in the walk group walking at a faster pace and those in the cycle group cycling at a higher work rate. In the walk group, if walking speed became limited by stride length, further progress of training intensity was achieved by adding weights in 2 kg increments to a backpack. The duration of training for both groups was 30 minutes in the first week and increased by five minutes every two weeks to a maximum of 45 minutes by Week 6.