Exercise Testing in Laryngectomized Patients | 221 9 Results Subjects Nine (out of ten) patients were male, and six of them had been treated with (chemo) radiotherapy before TL. One participant had asthma, not limiting in daily life activities and sports. None of the other participants were diagnosed with pulmonary diseases. All patients were former smokers but had stopped since treatment. For further patient and treatment characteristics, see Table 2. Feasibility of CPET None of the ten patients experienced air leakage through the connector and/or adhesive baseplate, and there were no abnormalities in the results from the breathing gas analysis. All patients were comfortable wearing the connector, there were no complaints of discomfort or dyspnea, and no (serious) adverse events occurred during the CPETs or in the following days. So, all first three feasibility criteria were met. Feasibility criterion four was not met. An RER>1.1 was reached by four patients, of which two in the first test and two in the second (all with the 0.6 hPa HME), while only two patients reached it in both tests. Only one subject reached 95% of his maximum predicted heart rate in one test. This was the test with his regular 0.6 hPa HME. See Table 3 and 4 for more details. Overall CPET results The overall average time in test was 958.5 seconds, with a median Wpeak of 126 Watts (range 39-254), and a median VO2peak of 1.55 L/minute (range 1.07-2.71), over all CPETs conducted. Median VO2 peak for patients reaching RER>1.1 was 1.85 L/minute (1.33-2.71). Under all testing conditions (see table 3), we observed normal responses to exercise for heart rate (HR), oxygen consumption (VO2), ventilatory efficiency (VE/ VCO2), minute ventilation (VE), and respiratory exchange ratio. On average, relative VO2peak was quite low, especially for the regular 0.3 hPa HME users. Regular 0.6 hPa HME users (n=8) performed better compared to regular 0.3 hPa HME users (n=2) in this sample: they cycled longer, achieved higher workloads, and higher peak values. When comparing the CPET results obtained with the regular HME to those obtained using the lowest resistance HME, we observed no meaningful differences. For seven patients, their anaerobic threshold (AT) could be determined, see table 4. For two patients (8 and 9), the AT could not be determined, while one subject (3) did not reach the AT in both tests because of subjective exhaustion and feeling out of breath. Only one subject reached his 95% predicted heart rate, in the test with his regular resistance (0.6 hPa).
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