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Baltasar-Fernandez I, Losa-Reyna J, Carretero A, Rodriguez-Lopez C, Alfaro-Acha A, Guadalupe-Grau A, Ara I, Alegre LM, Gomez-Cabrera MC, García-García FJ, Alcazar J. Residual effects of 12 weeks of power-oriented resistance training plus high-intensity interval training on muscle dysfunction, systemic oxidative damage, and antioxidant capacity after 10 months of training cessation in older people with COPD. Scand J Med Sci Sports 2023; 33:1661-1676. [PMID: 37322570 DOI: 10.1111/sms.14428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 05/30/2023] [Accepted: 06/02/2023] [Indexed: 06/17/2023]
Abstract
OBJECTIVE This study aimed to assess the residual effects of a 12-week concurrent training program (power training + high-intensity interval training) in older adults with chronic obstructive pulmonary disease (COPD). METHODS A total of 21 older adults with COPD [intervention (INT), n = 8; control (CON), n = 13; 76.9 ± 6.8 years] were assessed at baseline and 10 months after the completion of the intervention by the short physical performance battery (SPPB), health-related quality of life (EQ-5D-5L), vastus lateralis muscle thickness (MT), peak pulmonary oxygen uptake (peak VO2 ) and peak work rate (Wpeak ), early and late isometric rate of force development (RFD), leg and chest press maximum muscle power (LPmax and CPmax ), and systemic oxidative damage and antioxidant capacity. RESULTS Compared to baseline, after 10 months of detraining, the INT group presented increased SPPB (∆ = 1.0 point), health-related quality of life (∆ = 0.07 points), early RFD (∆ = 834 N∙s-1 ), LPmax (∆ = 62.2 W), and CPmax (∆ = 16.0 W) (all p < 0.05). In addition, a positive effect was noted in INT compared to CON regarding MT and Wpeak (both p < 0.05). No between-group differences were reported in peak VO2 , late RFD, systemic oxidative damage, and antioxidant capacity from baseline to 10 months after the completion of the intervention (all p > 0.05). CONCLUSIONS Twelve weeks of concurrent training were enough to ensure improved physical function, health-related quality of life, early RFD and maximum muscle power and to preserve MT and Wpeak but not peak VO2 , late RFD, systemic oxidative damage and antioxidant capacity in the subsequent 10 months of detraining in older adults with COPD.
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Affiliation(s)
- Ivan Baltasar-Fernandez
- GENUD Toledo Research Group, Faculty of Sports Sciences, Universidad de Castilla-La Mancha, Toledo, Spain
- CIBER on Frailty and Healthy Ageing (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
- Faculty of Health Sciences, Universidad de Castilla-La Mancha, Talavera de la Reina, Spain
- Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Junta de Comunidades de Castilla-La Mancha (JCCM), Spain
| | - Jose Losa-Reyna
- CIBER on Frailty and Healthy Ageing (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
- Valoración del Rendimiento Deportivo, Actividad Física y Salud y Lesiones Deportivas (REDAFLED), Universidad de Valladolid, Soria, Spain
| | - Aitor Carretero
- CIBER on Frailty and Healthy Ageing (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
- Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia and Fundación Investigación Hospital Clínico Universitario/INCLIVA, Valencia, Spain
| | - Carlos Rodriguez-Lopez
- CIBER on Frailty and Healthy Ageing (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
- Geriatric Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| | - Ana Alfaro-Acha
- CIBER on Frailty and Healthy Ageing (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
- Department of Geriatrics, Hospital Virgen del Valle, Complejo Hospitalario Universitario de Toledo, Toledo, Spain
| | - Amelia Guadalupe-Grau
- GENUD Toledo Research Group, Faculty of Sports Sciences, Universidad de Castilla-La Mancha, Toledo, Spain
- CIBER on Frailty and Healthy Ageing (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
- Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Junta de Comunidades de Castilla-La Mancha (JCCM), Spain
| | - Ignacio Ara
- GENUD Toledo Research Group, Faculty of Sports Sciences, Universidad de Castilla-La Mancha, Toledo, Spain
- CIBER on Frailty and Healthy Ageing (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
- Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Junta de Comunidades de Castilla-La Mancha (JCCM), Spain
| | - Luis M Alegre
- GENUD Toledo Research Group, Faculty of Sports Sciences, Universidad de Castilla-La Mancha, Toledo, Spain
- CIBER on Frailty and Healthy Ageing (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
- Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Junta de Comunidades de Castilla-La Mancha (JCCM), Spain
| | - Mari Carmen Gomez-Cabrera
- CIBER on Frailty and Healthy Ageing (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
- Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia and Fundación Investigación Hospital Clínico Universitario/INCLIVA, Valencia, Spain
| | - Francisco J García-García
- CIBER on Frailty and Healthy Ageing (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
- Department of Geriatrics, Hospital Virgen del Valle, Complejo Hospitalario Universitario de Toledo, Toledo, Spain
| | - Julian Alcazar
- GENUD Toledo Research Group, Faculty of Sports Sciences, Universidad de Castilla-La Mancha, Toledo, Spain
- CIBER on Frailty and Healthy Ageing (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
- Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Junta de Comunidades de Castilla-La Mancha (JCCM), Spain
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Nyberg A, Milad N, Martin M, Patoine D, Morissette MC, Saey D, Maltais F. Role of progression of training volume on intramuscular adaptations in patients with chronic obstructive pulmonary disease. Front Physiol 2022; 13:873465. [PMID: 36082219 PMCID: PMC9446145 DOI: 10.3389/fphys.2022.873465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 07/15/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction: Quadriceps dysfunction is a common systemic manifestation of chronic obstructive pulmonary disease (COPD), for which treatment using resistance training is highly recommended. Even though training volume is suggested to be a key explanatory factor for intramuscular adaptation to resistance training in healthy older adults, knowledge is scarce on the role of progression of training volume for intramuscular adaptations in COPD. Methods: This study was a sub-analysis of a parallel-group randomized controlled trial. Thirteen patients with severe to very severe COPD (median 66 yrs, forced expiratory volume in 1 s 44% predicted) performed 8 weeks of low-load resistance training. In a post hoc analysis, they were divided into two groups according to their training volume progression. Those in whom training volume continued to increase after the first 4 weeks of training outlined the continued progression group (n = 9), while those with limited increase (<5%) or even reduction in training volume after the initial 4 weeks composed the discontinued progression group (n = 4). Fiber-type distribution and oxidative muscle protein levels, i.e., citrate synthase (CS), hydroxyacyl-coenzyme A dehydrogenase (HADH), mitochondrial transcription factor A (TfAM) as well as quadriceps endurance measures (total work from elastic band and isokinetic knee extension tests), were assessed before and after the intervention period. Results: The continued progression group sustained their training volume progression during weeks 5–8 compared to weeks 1–4 (median +25%), while the discontinued progression group did not (median -2%) (p = 0.007 between groups). Compared with baseline values, significant between-group differences in fiber type distribution and TfAM muscle protein levels (range ± 17–62%, p < 0.05) and in individual responses to change in Type I and Type IIa fiber type proportion, CS, HADH, and TfAM muscle protein levels outcomes (median 89 vs. 50%, p = 0.001) were seen in favor of the continued progression group. Moreover, only the continued progression group had a significant increase in HADH muscle protein levels (+24%, p = 0.004), elastic band (+56%, p = 0.004) and isokinetic (+7%, p = 0.004) quadriceps endurance, but the between-group differences did not reach statistical significance (range 14–29%, p = 0.330–1.000). Discussion: The novel findings of the current study were that patients with COPD who had a continued progression of training volume across the 8-weeks intervention had an increased proportion of Type I fibers, and TfAM muscle protein levels and decreased proportion of Type II fibers compared to those that did not continue to progress their training volume after the initial weeks. Additionally, HADH muscle protein levels and quadriceps endurance measurements only improved in the continued progression group, although no significant between-group differences were seen. These findings highlight the importance of continued progression of training volume during resistive training to counteract quadriceps dysfunction within the COPD population. Still, considering the small sample size and the post hoc nature of our analyses, these results should be interpreted cautiously, and further research is necessary.
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Affiliation(s)
- Andre Nyberg
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, QC, Canada
- Department of Community Medicine and Rehabilitation, section of Physiotherapy, Umeå University, Umeå, Sweden
- *Correspondence: Andre Nyberg,
| | - Nadia Milad
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, QC, Canada
| | - Mickael Martin
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, QC, Canada
| | - Dany Patoine
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, QC, Canada
| | - Mathieu C Morissette
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, QC, Canada
| | - Didier Saey
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, QC, Canada
| | - François Maltais
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, QC, Canada
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Li P, Li J, Wang Y, Xia J, Liu X. Effects of Exercise Intervention on Peripheral Skeletal Muscle in Stable Patients With COPD: A Systematic Review and Meta-Analysis. Front Med (Lausanne) 2021; 8:766841. [PMID: 34869477 PMCID: PMC8636927 DOI: 10.3389/fmed.2021.766841] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 10/18/2021] [Indexed: 12/05/2022] Open
Abstract
Objectives: Peripheral skeletal muscle dysfunction is an important extrapulmonary manifestation of chronic obstructive pulmonary disease (COPD) that can be counteracted by exercise training. This study aimed to review the effect of three major exercise training modalities, which are used in pulmonary rehabilitation to improve on skeletal muscle mass, function, and exercise capacity in COPD. Methods: PubMed, Embase, EBSCO, Web of Science, and the PEDro database were searched on April 25, 2020. Only randomized controlled studies published in English evaluating the effects of exercise interventions on peripheral skeletal muscle mass, strength, and exercise capacity in stable COPD patients were included. The quality of included studies was evaluated using the PEDro scale. The mean difference (MD) or the standardized mean difference (SMD) with 95% CI was calculated to summarize the results. Subgroup meta-analysis was used to investigate the effects of different exercise training modalities and different outcome measures. The Grading of Recommendations Assessment, Development, and Evaluation guidelines were used to rate evidence quality. Results: A total of 30 randomized controlled trials involving 1,317 participants were included. Data from trials investigating endurance exercise (EE), resistance exercise (RE), and combined aerobic and resistance exercise (CE) were pooled into a meta-analysis, and the differences compared with the non-exercising COPD control were improvement in the muscle strength and exercise capacity in stable COPD patients. Subgroup meta-analysis for different exercise training modalities showed that RE significantly improved muscle strength (SMD = 0.6, 95% CI 0.35–0.84, I2 = 61%), EE and CE significantly increased VO2peak (EE: MD = 3.5, 95% CI 1.1–5.91, I2 = 92%; CE: MD = 1.66, 95% CI 0.22–3.1, I2 = 1%). Subgroup meta-analysis for different outcome measures showed that only isotonic strength was improved after exercise interventions (SMD = 0.89, 95% CI 0.51–1.26, I2 = 71%). Conclusion: Moderate evidence supports that exercise training in stable COPD patients has meaningful and beneficial effects on peripheral skeletal muscle strength and exercise capacity. Peripheral skeletal muscle shows a higher response to RE, and the isotonic test is relatively sensitive in reflecting muscle strength changes. The proportion of aerobic and resistance exercise components in a combined exercise program still needs exploration. Systematic Review Registration: The review was registered with the PROSPERO: (The website is https://www.crd.york.ac.uk/PROSPERO/, and the ID is CRD42020164868).
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Affiliation(s)
- Peijun Li
- Department of Sports Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Jian Li
- Department of Sports Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Yingqi Wang
- Department of Sports Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Jun Xia
- Department of Sports Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Xiaodan Liu
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China.,Institute of Rehabilitation Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Bhadra R, Bhattacharya S, D'Souza GA, Schols AMWJ, Sambashivaiah S. Pulmonary Rehabilitation in the Management of Chronic Obstructive Pulmonary Disease among Asian Indians- Current Status and Moving Forward. COPD 2021; 18:476-481. [PMID: 34380343 DOI: 10.1080/15412555.2021.1962267] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Chronic Obstructive Pulmonary Disease (COPD) is a significant public health concern in India with high prevalence and associated disability, morbidity, mortality. The progression of COPD is not confined to the lungs but includes extrapulmonary involvement that reduces the functional capacity and quality of life. Pulmonary Rehabilitation (PR) is an evidence-based intervention, targeting multiple domains of pulmonary and extrapulmonary manifestations, and therefore, is recommended as an integral part of COPD management. The practical implementation of PR in India is poor. In this review, we have summarized the latest pieces of evidence in support of PR and highlight the challenges and potential solutions for PR implementation in India.
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Affiliation(s)
- Rohini Bhadra
- St John's Research Institute, St John's Medical College, Bengaluru, India
| | | | - George A D'Souza
- Department of Pulmonary Medicine, St John's Medical College, Bengaluru, India
| | - Annemie M W J Schols
- NUTRIM School of Nutrition and Translational Research in Metabolism, Department of Respiratory Medicine, Maastricht University, Maastricht, The Netherlands
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Oliveira A, Rebelo P, Paixão C, Jácome C, Cruz J, Martins V, Simão P, Brooks D, Marques A. Minimal Clinically Important Difference for Quadriceps Muscle Strength in People with COPD following Pulmonary Rehabilitation. COPD 2021; 18:35-44. [PMID: 33533285 DOI: 10.1080/15412555.2021.1874897] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Quadriceps strength training is a key component of pulmonary rehabilitation (PR). Clinical interpretability of changes in muscle strength following PR is however limited due to the lack of cut-off values to define clinical improvement. This study estimated the minimal clinically important difference (MCID) for the isotonic and isometric quadriceps muscle strength assessed with the one-repetition maximum (1RM) and hand-held dynamometry (HHD) in people with chronic obstructive pulmonary disease (COPD) following PR.A secondary analysis of a real life non-randomised controlled study was conducted in people with COPD enrolled in a 12-week community-based PR programme. Anchor and distribution-based methods were used to compute the MCIDs. The anchors explored were the St. George's respiratory questionnaire (SGRQ) and the six-minute walk test (6MWT) using Pearson's correlations. Pooled MCIDs were computed using the arithmetic weighted mean (2/3 anchor, 1/3 distribution-based methods) and reported as absolute and/or percentage of change values.Eighty-nine people with COPD (84% male, 69.9 ± 7.9 years, FEV1 49.9 ± 18.9% predicted) were included. No correlations were found between changes in 1RM and the SGRQ neither between changes in HHD and the SGRQ and 6MWT (p > 0.05). Thus, anchor-based methods were used only in the MCID of the 1RM with the 6MWT as the anchor. The pooled MCIDs were 5.7Kg and 26.9% of change for the isotonic quadriceps muscle strength with 1RM and 5.2KgF for isometric quadriceps muscle strength assessed with HHD.The MCIDs found are estimates to improve interpretability of community-based PR effects on quadriceps muscle strength and may contribute to guide interventions.
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Affiliation(s)
- Ana Oliveira
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada.,Respiratory Medicine, West Park Healthcare Centre, Toronto, ON, Canada.,Lab3R - Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, University of Aveiro (ESSUA), Aveiro, Portugal
| | - Patrícia Rebelo
- Lab3R - Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, University of Aveiro (ESSUA), Aveiro, Portugal.,iBiMED - Institute of Biomedicine, Department of Medical Sciences, University of Aveiro, Aveiro, Portugal
| | - Cátia Paixão
- Lab3R - Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, University of Aveiro (ESSUA), Aveiro, Portugal.,iBiMED - Institute of Biomedicine, Department of Medical Sciences, University of Aveiro, Aveiro, Portugal
| | - Cristina Jácome
- CINTESIS -Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, Porto, Portugal.,Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal
| | - Joana Cruz
- School of Health Sciences, Polytechnic Institute of Leiria, Leiria, Portugal; Centre for Innovative Care and Health Technology (ciTechCare), School of Health Sciences (ESSLei), Polytechnic of Leiria, Leiria, Portugal
| | - Vitória Martins
- Pulmonology Department, Hospital Distrital da Figueira da Foz, Figueira da Foz, Portugal
| | - Paula Simão
- Pulmonology Department, Unidade Local de Saúde de Matosinhos, Matosinhos, Portugal
| | - Dina Brooks
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada.,Respiratory Medicine, West Park Healthcare Centre, Toronto, ON, Canada
| | - Alda Marques
- Lab3R - Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, University of Aveiro (ESSUA), Aveiro, Portugal.,iBiMED - Institute of Biomedicine, Department of Medical Sciences, University of Aveiro, Aveiro, Portugal
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Freire APCF, Marçal Camillo CA, de Alencar Silva BS, Uzeloto JS, Francisco de Lima F, Alberto Gobbo L, Ramos D, Cipulo Ramos EM. Resistance training using different elastic components offers similar gains on muscle strength to weight machine equipment in Individuals with COPD: A randomized controlled trial. Physiother Theory Pract 2020; 38:14-27. [PMID: 31975638 DOI: 10.1080/09593985.2020.1716422] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Purpose: To compare the effects of three modalities of resistance training, two using elastic components and one using conventional weight machine on peripheral muscle strength in Individuals with chronic obstructive pulmonary disease (COPD). Effects on exercise capacity, impact of disease on health status, body composition and daily level of physical activity were investigated as secondary endpoints.Methods: Forty-eight participants were randomly allocated (Trials Registry #RBR-6V9SJJ) into Elastic band group (Theraband®) (EBG), Elastic tubes training using Lemgruber® (ETG), and Conventional training with weight machine equipment (CG). Participants were evaluated before and after 12 weeks of training regarding peripheral muscle strength by dynamometry; impact of disease on health status via COPD Assessment Test, CAT; exercise capacity by 6-min walk test, 6MWT; body composition by bioelectrical impedance; and daily level of physical activities via accelerometry.Results: Inter-group comparison of training effects did not elucidate significant differences between the modalities in muscle strength (p ≥ .2). Likewise, all training modalities showed similar effects on CAT, body composition and daily physical activity variables with no statistical significance observed (p ≥ .15).Conclusions: Modalities of resistance training using elastic components presented similar effects on muscle strength, health status, exercise capacity, body composition and daily level of physical activity in individuals with COPD. The effects of elastic resistance were similar to conventional resistance training.
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Affiliation(s)
| | | | | | - Juliana Souza Uzeloto
- Department of Physiotherapy, São Paulo State University, Presidente Prudente, São Paulo, Brazil
| | | | - Luis Alberto Gobbo
- Department of Physiotherapy, São Paulo State University, Presidente Prudente, São Paulo, Brazil
| | - Dionei Ramos
- Department of Physiotherapy, São Paulo State University, Presidente Prudente, São Paulo, Brazil
| | - Ercy Mara Cipulo Ramos
- Department of Physiotherapy, São Paulo State University, Presidente Prudente, São Paulo, Brazil
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Frykholm E, Klijn P, Saey D, van Hees HWH, Stål P, Sandström T, Sörlin A, Maltais F, Nyberg A. Effect and feasibility of non-linear periodized resistance training in people with COPD: study protocol for a randomized controlled trial. Trials 2019; 20:6. [PMID: 30606240 PMCID: PMC6318913 DOI: 10.1186/s13063-018-3129-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 12/11/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In people with chronic obstructive pulmonary disease (COPD), limb-muscle dysfunction is one of the most troublesome systemic manifestations of the disease, which at the functional level is evidenced by reduced strength and endurance of limb muscles. Improving limb-muscle function is an important therapeutic goal of COPD management, for which resistance training is recommended. However, current guidelines for resistance training in COPD mainly focus on improving muscle strength which only reflects one aspect of limb-muscle function and does not address the issue of reduced muscle endurance. The latter is of importance considering that the reduction in limb-muscle endurance often is greater than that of muscle weakness, and also, limb-muscle endurance seems to be closer related to walking capacity as well as arm function than to limb-muscle strength within this group of people. Thus, strategies targeting multiple aspects of the decreased muscle function are warranted to increase the possibility for an optimal effect for the individual patient. Periodized resistance training, which represents a planned variation of resistance training variables (i.e., volume, intensity, frequency, etc.), is one strategy that could be used to target limb-muscle strength as well as limb-muscle endurance within the same exercise regimen. METHODS This is an international, multicenter, randomized controlled trial comparing the effect and feasibility of non-linear periodized resistance training to traditional non-periodized resistance training in people with COPD. Primary outcomes are dynamic limb-muscle strength and endurance. Secondary outcomes include static limb-muscle strength and endurance, functional performance, quality of life, dyspnea, intramuscular adaptations as well as the proportion of responders. Feasibility of the training programs will be assessed and compared on attendance rate, duration, satisfaction, drop-outs as well as occurrence and severity of any adverse events. DISCUSSION The proposed trial will provide new knowledge to this research area by investigating and comparing the feasibility and effects of non-linear periodized resistance training compared to traditional non-periodized resistance training. If the former strategy produces larger physiological adaptations than non-periodized resistance training, this project may influence the prescription of resistance training in people with COPD. TRIAL REGISTRATION ClinicalTrials.gov, ID: NCT03518723 . Registered on 13 April 2018.
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Affiliation(s)
- Erik Frykholm
- Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden.
| | - Peter Klijn
- Department of Pulmonology, Pulmonary Rehabilitation Centre Merem, Hilversum, The Netherlands.,Department of Pulmonology, Academic Medical Center, Amsterdam, The Netherlands
| | - Didier Saey
- Centre de recherche, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Faculté de médecine, Université Laval, Québec, QC, Canada
| | | | - Per Stål
- Department of Integrative Medical Biology, Umeå University, Umeå, Sweden
| | - Thomas Sandström
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Ann Sörlin
- Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden
| | - François Maltais
- Centre de recherche, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Faculté de médecine, Université Laval, Québec, QC, Canada
| | - André Nyberg
- Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden
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Tarigan AP, Pandia P, Mutiara E, Pradana A, Rhinsilva E, Efriyandi E. Impact of Lower-Limb Endurance Training on Dyspnea and Lung Functions in Patients with COPD. Open Access Maced J Med Sci 2018; 6:2354-2358. [PMID: 30607190 PMCID: PMC6311482 DOI: 10.3889/oamjms.2018.381] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 11/08/2018] [Accepted: 11/09/2018] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Patients with chronic obstructive pulmonary disease (COPD) exhibit persistent dyspnea in daily activities and irreversible airflow obstruction. These will finally lead to an inability to carry on daily activities and markedly decrease their quality of life. Endurance training was considered as therapy modality to alleviate several symptoms experienced by COPD patients. AIM This study aims to identify the impact of lower-limb exercise on dyspnea and spirometry test results in COPD patients. METHODS We performed a quasi-experimental study in July 2017 on 20 stable COPD patients divided both in group C and D according to GOLD 2017 criteria. Patients were given an individualised dose of stationary cycling twice a week for one month in which every session lasted 5-20 minutes gradually. Before and after rehabilitation program, pulmonary function tests were measured by spirometry to obtain per cent predicted of Forced Expiratory Volume in 1 second (FEV1), Forced Volume Capacity (FVC), Peak Expiratory Flow (PEF) and Forced Expiratory Flow at 25-75% of the pulmonary volume (FEF25-75), and dyspnea was measured by the mMRC index. Statistical analysis was performed by Wilcoxon and T-dependent test. RESULTS Baseline value of FVC (49.6 ± 21.6%) increased significantly to 59.65 ± 16.53% after one month of endurance training program (p = 0.01). Surprisingly, there was also a significant increase in FEV1 value from 46.9 ± 21.7 to 52.9 ± 20.7% (p < 0.005). The increase of FVC and FEV1 in group C was slightly higher than in group D although not statistically significant (p = 0.29; p = 0.25 respectively). However, no difference was observed in PEF and FEF25-75 value (p > 0.05). Patients' dyspnea scale also showed significant improvement (p < 0.001) from mMRC median scale 2 (range 1-3) to 1 (range 0-2) in both groups C and D. There was no exacerbation found during rehabilitation program. CONCLUSION Twice a week lower-limb endurance training for one-month improved dyspnea and pulmonary function test results in COPD patients safely and effectively.
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Affiliation(s)
- Amira Permatasari Tarigan
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Sumatera Utara, Jalan Bunga Lau 17, Adam Malik General Hospital, Sumatera Utara, Indonesia
| | - Pandiaman Pandia
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Sumatera Utara, Jalan Bunga Lau 17, Adam Malik General Hospital, Sumatera Utara, Indonesia
| | - Erna Mutiara
- Department of Biostatistics, Faculty of Public Health, Universitas Sumatera Utara, Medan, Indonesia
| | - Andika Pradana
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Sumatera Utara, Jalan Bunga Lau 17, Adam Malik General Hospital, Sumatera Utara, Indonesia
| | - Ella Rhinsilva
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Sumatera Utara, Jalan Bunga Lau 17, Adam Malik General Hospital, Sumatera Utara, Indonesia
| | - Efriyandi Efriyandi
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Sumatera Utara, Jalan Bunga Lau 17, Adam Malik General Hospital, Sumatera Utara, Indonesia
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Yekefallah L, Keshaavarz Sarkar O, Zohal MA, Barikani A. Effect of upper extremity exercise and respiratory training on the quality of life in patients with Chronic Obstructive Pulmonary Disease in Velayat Hospital, Qazvin, Iran. THE JOURNAL OF QAZVIN UNIVERSITY OF MEDICAL SCIENCES 2018. [DOI: 10.29252/qums.22.5.51] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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Gong H, Jiang Q, Shen D, Gao J. Neuromuscular electrical stimulation improves exercise capacity in adult patients with chronic lung disease: a meta-analysis of English studies. J Thorac Dis 2018; 10:6722-6732. [PMID: 30746217 DOI: 10.21037/jtd.2018.11.133] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Neuromuscular electrical stimulation (NMES) has been suggested as an alternative rehabilitative therapy to enhance exercise performance and skeletal muscle function in adult patients with chronic lung disease. However, the results of individual studies have been inconsistent. We performed a meta-analysis to evaluate the effectiveness of NMES with regard to increasing exercise capacity, quadriceps strength, muscle mass, cross-sectional area, and quality of life and decreasing dyspnea in adult patients with chronic lung disease. Methods A systematic search was conducted of the PubMed, Cochrane Library and EMBASE databases for randomized controlled trials (RCTs) published in English-language journals before January 2018. Data were extracted using standardized forms, and the weighted mean difference (WMD) or standardized mean difference (SMD) with 95% confidence intervals (CIs) was calculated. Results Eleven RCTs involving 368 patients were included in this meta-analysis. The pooled results showed that NMES significantly improved the 6-min walk distance (WMD: 37.93 m, 95% CI: 19.53-56.33 m; P<0.0001; P for heterogeneity =0.11; I2=47%) but not the incremental shuttle walk test (WMD: 18.18 m, 95% CI: -79.41 to 115.77 m, P=0.72; P for heterogeneity <0.0001, I2=94%) or endurance shuttle walk test (ESWT) (WMD: 96.73 m, 95% CI: -45.58 to 239.03 m, P=0.18; P heterogeneity =0.22, I2=34%). Moreover, NMES was associated with a significant improvement in quadriceps strength (SMD: 1.14, 95% CI: 0.86-1.43, P<0.00001; P heterogeneity =0.02, I2=58%). Conclusions This systemic review and meta-analysis provided evidence supporting the beneficial role of NMES in improving exercise capacity in patients with chronic respiratory disease.
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Affiliation(s)
- Haihong Gong
- Department of Respiratory Disease, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Qinghe Jiang
- Department of Respiratory Disease, Liaocheng People's Hospital, Liaocheng 252000, China
| | - Dongchao Shen
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Jinming Gao
- Department of Respiratory Disease, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
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