A randomized clinical trial to assess the influence of a three months training program (Gym-based individualized vs. Calisthenics-based non-invidualized) in COPD-patients

Abstract

IntroductionPulmonary rehabilitation has been demonstrated to improve exercise capacity, dyspnoea, quality of life and to reduce the adverse effects of acute exacerbations. Current guidelines recommend exercise training in patients with mild to very severe disease. However, there is insufficient data comparing the efficacy of different training approaches and intensities.MethodsBetween January 2009 and December 2012, 105 COPD patients were screened to participate in the study. 61 patients were randomly assigned into an individualized training group or into a non-individualized training group. Both groups exercised once a week for 60 minutes over a time period of three months. At the beginning and after three months, the following measurements were performed: 6-minute walking test (6-MWT), health-related quality of life (St. Georges Respiratory Questionnaire; SGRQ and COPD-Assessment-Test; CAT), M. rectus femoris cross-sectional area, and inflammatory markers in peripheral blood.ResultsOnly in the individualized training group we observed a significant change of the 6-MWT (increase of 32.47 m; p = 0.012) and the cross-sectional area of the M. rectus fermoris (increase of 0.57 cm2; p = 0.049), while no significant changes occurred in the non-individualized training group. Peroxisome-proliferator-activated receptor-γ coactivator 1α increased in the individualized training only after the three months training period (increase of 0.43 relative copies; p = 0.017), all other myokines and inflammatory markers were not influenced by either of the programs. The total drop-out-rate was 44.3%.ConclusionA low frequency outpatient training program may induce modest improvements in exercise capacity and muscle mass only if it is performed on an individualized basis.

Effects of concurrent exercise training on muscle dysfunction and systemic oxidative stress in older people with COPD

“…In terms of muscle hypertrophy, we observed a 5% increase in mid‐thigh muscle CSA and an 11% increase in VL muscle thickness among the trained subjects. Similar increments have been reported in the literature in resistance‐trained COPD patients (4%‐11%) . Although muscle excitation levels were not registered in our subjects, the disparity between adaptations in muscle size and muscle function, along with the greater adaptations observed in RFD at 100 ms compared with 400 ms, suggests that the improvement in muscle power might have been mostly driven by neural adaptations …”

“…Similar increments have been reported in the literature in resistancetrained COPD patients (4%-11%). 23,[45][46][47] Although muscle excitation levels were not registered in our subjects, the disparity between adaptations in muscle size and muscle function, along with the greater adaptations observed in RFD at 100 ms compared with 400 ms, suggests that the improvement in muscle power might have been mostly driven by neural adaptations. 48 One of the novelties of our investigation was the evaluation of muscle architecture in older subjects with COPD.…”

Effects of Oxygen Supply During Training on Subjects With COPD Who Are Normoxemic at Rest and During Exercise: A Blinded Randomized Controlled Trial

“…However, it has occasionally been observed in such settings. 27 Furthermore, our results cannot be applied directly to different training forms, such as strength training or endurance training with small muscle groups. Additional studies focusing on long-term effects of these alternative training programs should be performed.…”

Exploratory mixed methods study of respiratory physiotherapy for patients with lower respiratory tract infections

“…In respiratory interventions, dropout rates are approximately 43% to 50% [17]. As such, 62 participants were recruited.…”