Benefits of High-Intensity Exercise Training to Patients with Chronic Obstructive Pulmonary Disease: A Controlled Study

Abstract

Background: Various exercise training programs are used for patients with chronic obstructive pulmonary disease (COPD) of different severity. Objectives: To investigate the impact of individualized high-intensity training on exercise capacity with COPD. Methods: A total of 49 patients agreed to participate. Of these, 31 were assigned to the training group and 18 served as controls. The training group exercised twice a week for 90 min with consecutively increasing loads. At the time of enrollment (T₀), as well as after 3 (T₁) and 6 (T₂) months, a 6-min walk test (6-MWT) was performed and data on health-related quality of life, femoral muscle thickness, and various serum markers were obtained. Results: The training group improved in their 6-MWT results (T₀ = 407 ± 152 m vs. T₁ = 459 ± 127 m, p = 0.002, vs. T₂ = 483.2 ± 130.1 m, p = 0.004), in their cross-sectional area of the musculus rectus femoris (T₀ = 6.2 ± 1.2 cm² vs. T₁ = 6.9 ± 1.2 cm², p = 0.003, vs. 7.5 ± 1.6 cm², p = 0.002), and in their St. George's Respiratory Questionnaire (SGRQ) score (T₀ = 43.3 ± 18.0 vs. T₁ = 36.0 ± 18.4, p = 0.001, vs. T₂ = 34.7 ± 18. 0, p = 0.004). Serum levels of myostatin, irisin, resistin, and α-Klotho did not change significantly within the training period. Of note, the exercise group showed an inverse relationship between serum levels of resistin and those of α-Klotho after 6 months (r = -0.608, p = 0.021). Conclusions: COPD patients undergoing an individualized, structured, high-intensity training program improved their exercise capacity, gained muscle mass, and improved their quality of life.

Serum Myostatin Levels Are Higher in Fitter, More Active, and Non-Frail Long-Term Nursing Home Residents and Increase after a Physical Exercise Intervention

“…Aerobic training was reported to reduce myostatin expression in myocytes or serum protein levels in middle-aged men and older women [17, 18]. However, other studies did not find exercise-induced changes in serum myostatin concentration in patients with obstructive pulmonary disease [19]. …”

Utilization of non-invasive imaging tools for assessment of peripheral skeletal muscle size and composition in chronic lung disease: A systematic review

“…This review highlighted the clinical application of muscle imaging in rehabilitation and acute care settings. All three imaging modalities have been utilized to assess change in quadriceps muscle size with exercise training [50,57,68,77], which can serve as an important rehabilitation outcome in the clinical and research settings, given its close association with quadriceps strength [9] and exercise capacity [54,87]. Furthermore, US is gaining increased recognition for assessment of muscle size during hospitalization in the acute [4,55] and critical care settings [88] given its low cost, portability, and technical ease, which may help to further characterize the rehabilitation needs of these patients.…”

“…Four studies used US [50,57], CT [77], or MRI [68] to evaluate the response to exercise training in COPD. Despite variability in training protocols, there was a significant increase in rectus femoris CSA assessed with US (range 11e22%) in two studies using high intensity isokinetic resistance training [50,57], an 8% increase (p < 0.001) in mid-thigh CSA by CT with combined aerobic and resistance training [77], and an increase (4%, p ¼ 0.01) in mid-thigh CSA by MRI with combined exercise training and nutritional supplementation [68].…”

Belastungsuntersuchungen in der Pneumologie – Empfehlungen der Deutschen Gesellschaft für Pneumologie und Beatmungsmedizin e. V.

“…10 m [401]. Offenbar korreliert die Zunahme im 6-MWT mit der Steigerung der Muskelmasse des M. quadriceps femoris [402].…”