Effect of Pulmonary Rehabilitation on Peripheral Muscle Fiber Remodeling in Patients With COPD in GOLD Stages II to IV

Practical recommendations for exercise training in patients with COPD

“…Accordingly, there is a significant reduction in the proportion of anaerobic fast-twitch (type IIb) muscle fibres following both training regimes yielding a higher percentage of aerobic slowtwitch (type I) muscle fibres [21]. The benefits in terms of improving exercise tolerance, quality of life and muscle fibre morphology and typology were comparable across patients with COPD in Global Initiative of Chronic Obstructive Lung Disease (GOLD) stages II, III and IV [25].…”

An Official American Thoracic Society/European Respiratory Society Statement: Update on Limb Muscle Dysfunction in Chronic Obstructive Pulmonary Disease

“…A shift in fiber type distribution of the quadriceps, from type I fibers in favor of type IIx fibers, is a typical feature of advanced COPD (137,(161)(162)(163)(164)(165). This finding is inconsistent with normal aging, which is not associated with a shift toward type II fibers (67,166).…”

Selected clinical highlights from the 2012 ERS congress in Vienna: Table 1–

“…HEINZELMANN et al [23] showed small but significant increases in quadriceps muscle capillarisation following a 3-week inpatient pulmonary rehabilitation programme, in particular in patients with the highest degree of airflow limitation. Even though these preliminary data show early intramuscular changes, exercise-based pulmonary rehabilitation programmes of a longer duration have been shown to result in even greater intramuscular changes [20,24]. Moreover, the sustainability of intramuscular changes following exercise-based pulmonary rehabilitation remains to be determined in COPD patients.…”

“…Our current knowledge about the effects of exercise-based pulmonary rehabilitation on intramuscular abnormalities in COPD patients are limited [20]. GOUZI et al [21] reported a blunted muscle angiogenic response following a 6-week exercise training programme in patients with COPD compared to sedentary healthy elderly subjects.…”