Two participants reported being unable to increase walking speed despite minimal symptoms, suggesting stride length was a limiting factor. Consequently, a 2 kg weight in a backpack was BIBF 1120 added during training. The mean training intensity of participants in the cycle group increased to 95% (SD 38) of the initial peak work rate by Week 8. Group data for exercise capacity and health-related quality of life at baseline (Week 0) and following training (Week 8) for the walk group and cycle group are presented in Table 2. Following training, the mean difference in endurance walk time between the walk group and cycle group was 279 seconds (95% CI 79

to 483). Six participants in the walk group and three participants in the cycle group reached the 20-minute completion time

of the endurance shuttle walk test following training. There were no significant differences Table 4. Mean (SD) of groups, mean (SD) difference within groups, and mean (95% CI) difference between groups for dyspnoea and rate of perceived exertion score (RPE) at the end of and at isotime of the exercise tests. Group data for physiological responses at end exercise and at isotime of the endurance cycle test at baseline and following training are presented in Table 3. Following training, there were no significant differences between groups in any of the physiological measures at end exercise Selleck EX 527 or at isotime. Furthermore, following training there was no significant difference between groups in dyspnoea or rating of perceived exertion at the end of any of the exercise tests. In terms of the responsiveness of the endurance shuttle Calpain walk test, the SRM of the endurance walk time was 0.97. The main finding of this study was that supervised, progressed walk training resulted in a significantly greater increase in endurance walking

capacity compared to supervised, progressed stationary cycle training in people with COPD. In addition, walk training had very similar effects to cycle training on peak walking capacity, peak cycle capacity, endurance cycle capacity, and health-related quality of life. To our knowledge, this is the first study to demonstrate that supervised, ground walk training was more effective than cycle training in improving endurance walking capacity in people with COPD. As cycle training is the most commonly used mode of training that has demonstrated physiological training effects to improve exercise capacity and healthrelated quality of life in people with COPD (Casaburi et al 1991, Maltais et al 1996, Maltais et al 2008), the superiority of walk training in improving endurance walking capacity compared to cycle training is impressive.