Endurance and Strength Training in Patients With Copd

Mador, M. Jeffery; Bozkanat, Erkan; Aggarwal, A.; Shaffer, Mary; Kufel, Thomas J.

doi:10.1097/00008483-200503000-00015

Cited by 30 publications

(66 citation statements)

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“…There were no differences between groups in terms of HRQL or functional and maximum exercise capacity improvements (figs 4 and 5). Improvements in exercise endurance were similar in both groups in one trial 40 (mean difference between endurance exercise alone and combined endurance and strength exercise group 20.3, 95% CI 28.1 to 7.5), while another trial 37 showed larger, although statistically not significant, improvements in the endurance exercise group (mean difference 9.6 minutes, 95% CI 23.9 to 23.1). The larger improvements in muscle strength in the groups with endurance plus strength exercise as reported in three trials 37 39 40 did not therefore translate into additional benefits in terms of HRQL or exercise capacity.…”

Section: Endurance Exercise V Strength Exercisementioning

confidence: 80%

“…A difference of 0 means that both study groups improved or deteriorated to the same amount. Dashed lines at ¡53 metres represent the minimal important difference of the 6 minute walk test.Endurance exercise v endurance + strength exerciseSix articles[37][38][39][40][41][42] reported on seven RCTs comparing endurance exercise only with endurance plus strength exercise(table 1). Wurttemberger presented the results of patients with andTable 1 Characteristics of randomised controlled trials comparing strength and endurance exercise Wmax, maximum exercise capacity; IET, incremental exercise test; CWRT, constant work rate test; 6MWT and 12MWT, 6 and 12 minute walk test; SWT, shuttle walk test; Edu, education; BE, breathing exercises; Psy, psychological support; Rel, relaxation exercises; CRQ, Chronic Respiratory Questionnaire; BDI and TDI, baseline and transitional dyspnoea index.…”

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confidence: 99%

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How should COPD patients exercise during respiratory rehabilitation? Comparison of exercise modalities and intensities to treat skeletal muscle dysfunction

Puhan

2005

Thorax

118

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Background: Physical exercise is an important component of respiratory rehabilitation because it reverses skeletal muscle dysfunction, a clinically important manifestation of COPD associated with reduced healthrelated quality of life (HRQL) and survival. However, there is controversy regarding the components of the optimal exercise protocol. A study was undertaken to systematically evaluate and summarise randomised controlled trials (RCTs) comparing different exercise protocols for COPD patients. Methods: Six electronic databases, congress proceedings and bibliographies of included studies were searched without imposing language restrictions. Two reviewers independently screened all records and extracted data on study samples, interventions and methodological characteristics of included studies. Results: The methodological quality of the 15 included RCTs was low to moderate. Strength exercise led to larger improvements of HRQL than endurance exercise (weighted mean difference for Chronic Respiratory Questionnaire 0.27, 95% CI 0.02 to 0.52). Interval exercise seems to be of similar effectiveness as continuous exercise, but there are few data on clinically relevant outcomes. One small RCT which included patients with mild COPD compared the effect of high and low intensity exercise (at 80% and 40% of the maximum exercise capacity, respectively) and found larger physiological training effects from high intensity exercise. Conclusions: Strength exercise should be routinely incorporated in respiratory rehabilitation. There is insufficient evidence to recommend high intensity exercise for COPD patients and investigators should conduct larger high quality trials to evaluate exercise intensities in patients with moderate to severe COPD.

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Section: Endurance Exercise V Strength Exercisementioning

confidence: 80%

mentioning

confidence: 99%

How should COPD patients exercise during respiratory rehabilitation? Comparison of exercise modalities and intensities to treat skeletal muscle dysfunction

Puhan

2005

Thorax

118

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“…62 Cycling tests reportedly induce more quadriceps contractile fatigue than walking tests, 65 and patients with COPD are more sensitive to such leg fatigue than are healthy individuals cycling for equivalent durations and with similar levels of oxygen consumption. 92 Therefore, respiratory symptoms are not always the limiting factor in cycling endurance tests of patients with COPD, and such tests may therefore be less sensitive than walking endurance tests to bronchodilation. 65 Conversely, breathing discomfort is more likely to be the limiting symptom during walking than during cycling.…”

Section: Assessing Exercise Parameters In Patients With Copdmentioning

confidence: 99%

“…105 It is not unusual for exercise capacity to double after a course of rehabilitation. 92,96,106 The effect sizes of pulmonary rehabilitation in patients with COPD are thus larger than those of pharmacotherapy alone (eg, different studies of tiotropium in patients with severe COPD have found increases in cycle endurance time of 21% 73 and 44% 89 ). High-intensity training decreased the breath rate and minute ventilation and increased the inspiratory capacity during constant work-rate cycle testing at 75% of maximum effort, showing that rehabilitation reduced dynamic hyperinflation.…”

Section: Contributions Of Pulmonary Rehabilitation To Exercise Capacimentioning

confidence: 99%

Exercise and COPD: Therapeutic Responses, Disease-Related Outcomes, and Activity-Promotion Strategies

Maltais

2013

The Physician and Sportsmedicine

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Chronic obstructive pulmonary disease (COPD) reduces patients' exercise capacities and their abilities to perform daily physical activities, thereby increasing morbidity and mortality rates. The cycle of dyspnea, deconditioning, and declining physical activity not only accelerates the progression of COPD but also increases the risk for developing or aggravating metabolic and cardiovascular diseases. Cardiovascular and metabolic comorbidities also limit physical function, and their disabling effects in combination with COPD may be greater than the effects of each disease alone. The impact of COPD and its treatment on the ability to exercise, and the degree of physical activity in daily life, can be measured by field-based tests (eg, the 6-minute walk test or incremental and endurance shuttle-walk test), laboratory-based tests (eg, incremental or constant work-rate treadmill and cycle-ergometer tests), and physical activity assessments (eg, questionnaires and accelerometers). Walking tests increase oxygen consumption and desaturation in patients with COPD more than cycling tests with similar work-rate profiles and may more closely resemble patients' normal activities. Despite the questionable relevance of exercise testing to patients' daily functionality, exercise parameters remain important predictors of survival in patients with COPD. Treatment of COPD (pharmacotherapy, pulmonary rehabilitation, or both) can increase exercise capacity and physical activity in daily life, which potentially slows the decline of lung function, reduces the frequencies of exacerbations and hospitalizations, decreases mortality, slows the progression of comorbidities, improves health-related quality of life, and increases the activity reserve for routine function. This article examines the interactions of reduced physical activity and decreased exercise capacity with the progression of COPD, comorbidities, and mortality. The article also describes the available exercise tests for patients with COPD and reviews the evidence indicating that treating COPD improves exercise capacity. Notably, it appears that even mild COPD reduces exercise capacity and daily physical activity, indicating the need for early intervention.

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“…An exercise training programme is found to be effective on lessening the degeneration of physical capability contributing to a reduction in fall rates (Campbell et al , 1999; Gardner et al , 2002). Advantages of strength and balance training among older adults are that it plays a significant role in improving neural recruitment patterns resulting in strength gain (Aagaard et al , 2002 Aagaard et al , 2003; Mador et al , 2004). Moreover, strength gain by exercise training plays a role in the improved coordination of other fixator muscles necessary for body support while performing daily tasks such as cooking, gardening, reaching for an object, and walking, and in gaining more coordinated contractions between agonist and antagonist muscle groups leading to greater net force in the imposing movements (Jones et al , 1989; Rutherford and Jones, 1986; Sale 1988).…”

Section: Discussionmentioning

confidence: 99%

The effects of eight‐week balance training or weight training

Kim

Lockhart

Roberto

2009

Quality in Ageing and Older Adults

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The purpose of this study was to examine the influence of participating in an 8-week physical training (ie: balance or weight training) on psychosocial outcomes for independently living healthy older adults. Eighteen older adults (65 years old or older) voluntarily participated for this study. Participants were randomly and evenly distributed in 3 different groups such as balance, weight, or control group; 6 participants each. Fear of falling and social activity levels were statistically tested by evaluating questionnaires validated in previous studies. Psychological factors improved in all groups after 8 weeks (P < 0.05). Social interaction level did not improve in any of the three groups, although all participants exhibited improvements in being physically independent (P < 0.05). Results suggested that being physically active as well as being socially active could result in being less fearful of falls, more confident of leaving residency, being more independent, and being more active.

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Endurance and Strength Training in Patients With Copd

Cited by 30 publications

References 0 publications

How should COPD patients exercise during respiratory rehabilitation? Comparison of exercise modalities and intensities to treat skeletal muscle dysfunction

How should COPD patients exercise during respiratory rehabilitation? Comparison of exercise modalities and intensities to treat skeletal muscle dysfunction

Exercise and COPD: Therapeutic Responses, Disease-Related Outcomes, and Activity-Promotion Strategies

The effects of eight‐week balance training or weight training

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