Effects of nutritional supplementation combined with conventional pulmonary rehabilitation in muscle‐wasted chronic obstructive pulmonary disease: A prospective, randomized and controlled study

Gürgün, Alev; Deniz, Serdar; Argın, Mehmet; Karapolat, Hale

doi:10.1111/resp.12019

Cited by 52 publications

(52 citation statements)

References 30 publications

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“…39 In muscle-wasted COPD patients concurrent pulmonary rehabilitation and dietary supplementation improved FFMI, but improvement in dyspnea and functional capacity was similar to pulmonary rehabilitation alone, which raises the possibility that nutritional supplementation may be more effective if applied prior to pulmonary rehabilitation. 40 In patients without fat-free mass depletion dietary supplementation did not improve pulmonary rehabilitation outcomes compared to pulmonary rehabilitation alone. 41 To date, there are no data available in more severe patients suffering from sarcopenia as to whether improving FFMI prior to initiating pulmonary rehabilitation would enhance pulmonary rehabilitation outcomes.…”

Section: Discussionmentioning

confidence: 93%

Resistance training as a preconditioning strategy for enhancing aerobic exercise training outcomes in COPD

Covey

Collins

Reynertson

et al. 2014

Respiratory Medicine

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Purpose Aerobic exercise training is a recognized approach for improving functional capacity in COPD. People with greater disease severity often have difficulty achieving higher aerobic exercise training intensity. The effects of resistance training prior to aerobic training were examined to determine if this sequential approach was associated with greater gains in functional status than aerobic training alone or concurrent aerobic and resistance training. Methods Patients were randomized to: 1) sequential resistance then aerobic training (RT-then-AT) (8 weeks resistance training followed by 8 weeks aerobic exercise training), 2) control group (CE-then-AT+RT) (8 weeks of ‘sham’ training followed by 8 weeks concurrent aerobic and resistance training), 3) control group (CE-then-AT) (8 weeks ‘sham’ training followed by 8 weeks aerobic training). Outcomes were assessed at study entry, after week 8, and after week 16: aerobic exercise performance; muscle strength and endurance. Results 75 patients completed training: FEV1 %pred 40±10, V̇O2peak %predicted, 71±22, fat-free mass index 19.5±3.1. RT-then-AT had greater acquisition of peripheral muscle endurance than CE-then-AT+RT and CE-then-AT, but improvements in aerobic exercise performance were similar. Improvements in muscle strength were similar between RT-then-AT and CE-then-AT+RT. Sarcopenia was associated with poorer attendance, and lower aerobic and resistance training volumes. Conclusion Although the sequential approach to resistance and aerobic training yielded a greater increase in muscle endurance and higher resistance training volume compared to concurrent resistance and aerobic training, other training outcomes were similar between the two groups, thus the sequential approach is not clearly superior to the concurrent approach in severe COPD. ClinicalTrials.gov Identifier NCT01058213.

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Section: Discussionmentioning

confidence: 93%

Resistance training as a preconditioning strategy for enhancing aerobic exercise training outcomes in COPD

Covey

Collins

Reynertson

et al. 2014

Respiratory Medicine

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“…We compared outcomes from RCTs of 8-week PR programmes and RCTs of 12-week PR programmes. For the outcome of 6MWT, there were six RCTs of 8-week programmes compared with usual care (n = 218) [86][87][88][89][90][91] and four RCTs of 12-week programmes compared with usual care (n = 225). 72,75,92,93 Meta-analyses demonstrated an MD for 6MWT of 77 m (95% CI: 54-100) for the 8-week programmes and 57 m (95% CI: 27-88) for the 12-week programmes.…”

Section: Summary Of Evidencementioning

confidence: 99%

“…No significant difference in improvement in 6MWT between programmes of different durations was observed (P = 0.31). For the outcome of SGRQ, there were five RCTs of 8-week programmes compared with usual care (n = 182) [86][87][88]91,94 and only one RCT of a 12-week PR programme compared with usual care (n = 26); 92 thus, there were insufficient data to compare SGRQ between programmes of 8-and 12-week duration for HRQoL. For the 8-week programmes versus usual care, the MD for SGRQ Total score was −9.6 units (95% CI: −15 to −4) which is greater than the MID of −4 points.…”

Section: Summary Of Evidencementioning

confidence: 99%

Australian and New Zealand Pulmonary Rehabilitation Guidelines

et al. 2017

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“…Animal models have shown that refeeding and increasing body weight can reverse emphysema and COPD . Improvement of sarcopenia have shown favourable effects on clinical outcomes in COPD . Improvement of sarcopenia and cachexia may be protective for COPD development, and it can also lead to favourable outcomes in COPD.…”

Section: Discussionmentioning

confidence: 99%

The effect of low body mass index on the development of chronic obstructive pulmonary disease and mortality

et al. 2019

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Background Sarcopenia may worsen disease progression and lead to poor outcomes in chronic obstructive pulmonary disease (COPD). Objectives We aimed to determine the effect of BMI on the development of COPD and mortality. Methods We enrolled 437 584 participants registered in the physical health check‐up cohort database of the Korean National Health Interview Survey from 2002 to 2003, and we defined COPD diagnosis based on the ICD‐10 code and prescribed medication. BMI (kg m−2) classified them to five groups (low BMI < 18.5, normal BMI 18.5–23, overweight 23–25, obesity 25–30, severe obesity ≥30) at baseline. Results Participants in the low BMI group had a significantly higher rate of COPD development for 13 years (7.6%) than those in other groups (3.4–4.1%, P < 0.0001). Amongst never or light smokers, COPD development in the low BMI group (5.6–6.7%) was significantly higher than that in other groups (2.8–4.7%). Similarly, amongst participants with a smoking history of ≥30 years, COPD development in the low BMI group (20.1%) was higher than those in other groups (8.4–12.4%). On multivariable analysis, normal or higher than normal body weight was significantly protective against the development of COPD (hazard ratio [HR], 0.609–0.739,) compared to low BMI. COPD‐free‐survival (HR, 0.491–0.622) and overall survival (HR, 0.440–0.585) were also better in them compared to those with low BMI (all P < 0.0001). Conclusions Low BMI is an important risk factor for COPD development and mortality. Maintaining adequate body weight may reduce the risk for COPD development and mortality.

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Effects of nutritional supplementation combined with conventional pulmonary rehabilitation in muscle‐wasted chronic obstructive pulmonary disease: A prospective, randomized and controlled study

Abstract: The combination of NS with PR resulted in improvements particularly in lean body mass and mid-thigh CSA. This study suggests combining NS with PR in reversing weight loss and muscle wasting in COPD.

Cited by 52 publications

References 30 publications

Resistance training as a preconditioning strategy for enhancing aerobic exercise training outcomes in COPD

Resistance training as a preconditioning strategy for enhancing aerobic exercise training outcomes in COPD

Australian and New Zealand Pulmonary Rehabilitation Guidelines

The effect of low body mass index on the development of chronic obstructive pulmonary disease and mortality

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