Resistanceversusendurance training in patients with COPD and peripheral muscle weakness

Abstract

The effects of endurance training on exercise capacity and health-related quality of life (HRQL) in chronic obstructive pulmonary disease (COPD) patients have been studied thoroughly, while resistance training has been rarely evaluated. This study investigated the effects of resistance training in comparison with endurance training in patients with moderate to severe COPD and peripheral muscle weakness (isometric knee extension peak torque v75% predicted).Forty-eight patients (age 64 ¡ 8 yrs, forced expiratory volume in one second 38 ¡ 17% pred) were randomly assigned to resistance training (RT, n=24) or endurance training (ET, n=24). The former consisted of dynamic strengthening exercises. The latter consisted of walking, cycling and arm cranking. Respiratory and peripheral muscle force, exercise capacity, and HRQL were re-evaluated in all patients who completed the 12-week rehabilitation (RT n=14, ET n=16).Statistically significant increases in knee extension peak torque (RT 20¡21%, ET 42¡21%), maximal knee flexion force (RT 31¡39%, ET 28¡37%), elbow flexion force (RT 24¡19%, ET 33¡25%), 6-min walking distance (6MWD) (RT 79¡74 m, ET 95¡57 m), maximum workload (RT 15¡16 Watt, ET 14¡13 Watt) and HRQL (RT 16¡25 points, ET 16¡15 points) were observed. No significant differences in changes in HRQL and 6MWD were seen between the two treatments.Resistance training and endurance training have similar effects on peripheral muscle force, exercise capacity and health-related quality of life in chronic obstructive pulmonary disease patients with peripheral muscle weakness.

Effects of 2 Exercise Training Programs on Physical Activity in Daily Life in Patients With COPD

“…These results corroborate other studies that used similar training programs 3,28,30 and reinforce the importance of high-intensity exercise in patients with COPD, and the added benefit of strength training in conjunction with endurance training. Interestingly, despite the observed improvement in exercise capacity and muscle force in the endurance-and-strength group, these patients did not significantly improve their level of physical activity in daily life.…”

Cardiopulmonary stress during exercise training in patients with COPD

“…However, the load progression observed in the present study was similar to that achieved in other studies, including COPD patients, which showed a significant effect on lower limb muscle force [2,5].…”

“…However, in addition to walking and cycling, other exercise modalities have been described during PR for COPD patients, e.g. resistance training [2], callisthenics [3], arm cranking [4] and stair climbing [5]. In clinical rehabilitation, a combination of several of these exercises, is often applied.…”

Recommendations on the use of exercise testing in clinical practice

“…TROOSTERS et al [276] reported a mean increase of 52 m in a study of the short-and longer-term benefits of pulmonary rehabilitation delivered over a 6-month period. Results from similar rehabilitation studies confirm the magnitude of change [277,278]. Pharmaceutical interventions have employed the 6-MWT as an outcome measure with some success [279].…”