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

Abstract

Oxidative stress is associated with disease severity and limb muscle dysfunction in COPD. Our main goal was to assess the effects of exercise training on systemic oxidative stress and limb muscle dysfunction in older people with COPD. Twenty‐nine outpatients with COPD (66‐90 years) were randomly assigned to a 12‐week exercise training (ET; high‐intensity interval training (HIIT) plus power training) or a control (CT; usual care) group. We evaluated mid‐thigh muscle cross‐sectional area (CSA; computed tomography); vastus lateralis (VL) muscle thickness, pennation angle, and fascicle length (ultrasonography); peak VO2 uptake (VO2peak) and work rate (Wpeak) (incremental cardiopulmonary exercise test); rate of force development (RFD); maximal muscle power (Pmax; force‐velocity testing); systemic oxidative stress (plasma protein carbonylation); and physical performance and quality of life. ET subjects experienced changes in mid‐thigh muscle CSA (+4%), VL muscle thickness (+11%) and pennation angle (+19%), VO2peak (+14%), Wpeak (+37%), RFD (+32% to 65%), Pmax (+38% to 51%), sit‐to‐stand time (−24%), and self‐reported health status (+20%) (all P < 0.05). No changes were noted in the CT group (P > 0.05). Protein carbonylation decreased among ET subjects (−27%; P < 0.05), but not in the CT group (P > 0.05). Changes in protein carbonylation were associated with changes in muscle size and pennation angle (r = −0.44 to −0.57), exercise capacity (r = −0.46), muscle strength (r = −0.45), and sit‐to‐stand performance (r = 0.60) (all P < 0.05). The combination of HIIT and power training improved systemic oxidative stress and limb muscle dysfunction in older people with COPD. Changes in oxidative stress were associated with exercise‐induced structural and functional adaptations.

Post-COVID-19 Syndrome and the Potential Benefits of Exercise

“…In addition, muscle dysfunction as a consequence of lung disease (muscle atrophy, reduced oxidative capacity and a decreased proportion of type I muscle fibres) can be mitigated and even reversed with strength training interventions [105,106]. Accordingly, concurrent training (endurance and strength) stands as the preferable treatment for lung diseases to improve peak pulmonary oxygen uptake, systematic oxidative stress, muscle strength, muscle size, functional capacity, and quality of life [107,108]. It has been recently described that a pulmonary rehabilitation program after hospitalization improved respiratory function, quality of life, mobility and psychological function in older adults with COVID-19 [109].…”

Effects of high intensity interval training on exercise capacity in people with chronic pulmonary conditions: a narrative review

“…Two studies have compared the use of HIIT, embedded within a 12-week pulmonary rehabilitation program, to no exercise (i.e. the comparison is a control group with no exercise or pulmonary rehabilitation program), on measures of exercise capacity in people with COPD [51,52]. In one study, the HIIT intervention commenced with 'work' intervals at 80% of the W max , interspersed with an active recovery (40% W max ), for 30 and 90 s, respectively, for 20 min, repeated twice per week [51].…”

“…the comparison is a control group with no exercise or pulmonary rehabilitation program), on measures of exercise capacity in people with COPD [51,52]. In one study, the HIIT intervention commenced with 'work' intervals at 80% of the W max , interspersed with an active recovery (40% W max ), for 30 and 90 s, respectively, for 20 min, repeated twice per week [51]. When compared with the usual care group (n = 15, aged 80 ± 6 years, FEV 1 60 ± 15% predicted), those who undertook HIIT (n = 14, aged 80 ± 8 years, FEV 1 47 ± 18% predicted) demonstrated greater changes in VO 2peak (MD 4 mL/kg/min, 95% CI 1 to 7) [51].…”

The Feasibility of High-Intensity Interval Training in Patients with Intensive Care Unit-Acquired Weakness Syndrome Following Long-Term Invasive Ventilation

“…Physical activity (PA) reduces morbidity and mortality by reducing the burden of arrhythmias and improvement of cardiorespiratory fitness (CRF) through modulating lipid profiles, increasing aerobic capacities in adolescents, grown-ups and the elderly [3][4][5]. High-intensity interval (HIIT) and moderate continuous training (MCT) are established methods to preserve and boost endurance in professional and recreational sports as well as in patients [6][7][8]. Several studies have also demonstrated improvements in aerobic capacity (VO 2peak ) as well as cardiac remodelling in heart failure patients with reduced ejection fraction (HF r EF) treated with HIIT [9].…”