Exercise Training Improves Exertional Dyspnea in Patients With COPDa

Gigliotti, Francesco; Coli, Claudia; Bianchi, Roberto; Romagnoli, Paola; Lanini, Barbara; Binazzi, Barbara; Scano, Giorgio

doi:10.1378/chest.123.6.1794

Cited by 96 publications

(92 citation statements)

References 32 publications

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“…In previous studies the combination of improved mechanical efficiency, improved respiratory and skeletal muscle strength, 36 adaptations in breathing pattern, 37 desensitization to dyspnea, 37 and consequently reduced dynamic hyperinflation, 38 all contributed to the benefits of PR. It is not clear if the mechanisms of benefit for subjects with normal exercise capacity are the same as in previous studies.…”

Section: Discussionmentioning

confidence: 92%

Benefits of Pulmonary Rehabilitation in Patients With COPD and Normal Exercise Capacity

et al. 2013

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BACKGROUND: Pulmonary rehabilitation (PR) is beneficial for patients with COPD, with improvement in exercise capacity and health-related quality of life. Despite these overall benefits, the responses to PR vary significantly among different individuals. It is not clear if PR is beneficial for patients with COPD and normal exercise capacity. We aimed to investigate the effects of PR in patients with normal exercise capacity on health-related quality of life and exercise capacity. METHODS: Twenty-six subjects with COPD and normal exercise capacity were studied. All subjects participated in 12-week, 2 sessions per week, hospital-based, out-patient PR. Baseline and post-PR status were evaluated by spirometry, the St George's Respiratory Questionnaire, cardiopulmonary exercise test, respiratory muscle strength, and dyspnea scores. RESULTS: The mean FEV 1 in the subjects was 1.29 ؎ 0.47 L/min, 64.8 ؎ 23.0% of predicted. After PR there was significant improvement in maximal oxygen uptake and work rate. Improvements in St George's Respiratory Questionnaire scores of total, symptoms, activity, and impact were accompanied by improvements of exercise capacity, respiratory muscle strength, maximum oxygen pulse, and exertional dyspnea scores (all P < .05). There were no significant changes in pulmonary function test results (FEV 1 , FVC, and FEV 1 /FVC), minute ventilation, breathing frequency, or tidal volume at rest or exercise after PR. CONCLUSIONS: Exercise training can result in significant improvement in health-related quality of life, exercise capacity, respiratory muscle strength, and exertional dyspnea in subjects with COPD and normal exercise capacity. Exercise training is still indicated for patients with normal exercise capacity.

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Section: Discussionmentioning

confidence: 92%

Benefits of Pulmonary Rehabilitation in Patients With COPD and Normal Exercise Capacity

et al. 2013

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“…16,17 Gigliotti et al recruited COPD patients to perform a series of exercise training programs in an out-patient setting, and reported that the subjects' respiratory rate decreased and V T increased after training. 18 In another study examining the effects of respiratory muscle training, Shahin et al showed a significant improvement in respiratory muscle power in subjects after the intervention period. 19 The participants in our study also demonstrated significant improvement in V T and RSBI after receiving the training program.…”

Section: Discussionmentioning

confidence: 98%

Effects of Exercise Training on Pulmonary Mechanics and Functional Status in Patients With Prolonged Mechanical Ventilation

et al. 2012

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BACKGROUND:The functional status and outcomes in patients with prolonged mechanical ventilation (PMV) are often limited by poor endurance and pulmonary mechanics, which result from the primary diseases or prolonged time bedridden. We evaluate the impact of exercise training on pulmonary mechanics, physical functional status, and hospitalization outcomes in PMV patients. METHODS: Twenty-seven subjects with PMV in our respiratory care center (RCC) were divided randomly into an exercise training group (n ‫؍‬ 12) and a control group (n ‫؍‬ 15). The exercise program comprised 10 sessions of exercise training. The measurement of pulmonary mechanics and physical functional status (Functional Independence Measurement and Barthel index) were performed pre-study and post-study. The hospitalization outcomes included: days of mechanical ventilation, hospitalization days, and weaning and mortality rates during RCC stay. RESULTS: The training group had significant improvement in tidal volume (143.6 mL vs 192.5 mL, P ‫؍‬ .02) and rapid shallow breathing index after training (162.2 vs 110.6, P ‫؍‬ .009). No significant change was found in the control group except respiratory rate. Both groups had significant improvement in functional status during the study. However, the training group had greater changes in FIM score than the control group (44.6 vs 34.2, P ‫؍‬ .024). The training group also had shorter RCC stay and higher weaning and survival rates than the control group, although no statistical difference was found. CONCLUSIONS: Subjects with PMV in our RCC demonstrated significant improvement in pulmonary mechanics and functional status after exercise training. The application of exercise training may be helpful for PMV patients to improve hospitalization outcomes.

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“…43,44 A meta-analysis conducted by Strasser et al 15 showed that resistance training did not increase FEV 1 but may carry potential benefits for FVC. Because of the inclusion of all studies with resistance training, there was a high heterogeneity with regard to percent-of-predicted FEV 1 (I 2 ϭ 68.1%).…”

Section: Discussionmentioning

confidence: 99%

Impact of Resistance Training in Subjects With COPD: A Systematic Review and Meta-Analysis

Liao¹,

Chen²,

Chen

et al. 2015

Respir Care

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BACKGROUND: The goal of this study was to evaluate the effects of resistance training on subjects with COPD. METHODS: We performed a systematic search in MEDLINE, PubMed, Embase, CINAHL, Elsevier ScienceDirect, EBM Reviews, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov and also of leading respiratory journals for randomized controlled trials on COPD treatment for > 4 weeks with resistance training compared with non-exercise control or with combined resistance and endurance training compared with endurance training alone. Data from these studies were pooled to calculate odds ratio and weighted mean differences (WMDs) with 95% CI. RESULTS: Eighteen trials with 750 subjects with advanced COPD met the inclusion criteria. There were 2 primary and 5 secondary outcomes. Compared with non-exercise control, resistance training led to significant improvements in the dyspnea domain of the Chronic Respiratory Disease Questionnaire (WMD of 0.59, 95% CI 0.26 -0.93, I2 ‫؍‬ 0%, P < .001), skeletal muscle strength, and percent-of-predicted FEV 1 (WMD of 6.88%, 95% CI 0.41-13.35%, I2 ‫؍‬ 0%, P ‫؍‬ .04). The combination of resistance and endurance training significantly improved the St George Respiratory Questionnaire total score (WMD of ؊7.44, 95% CI ؊12.62 to ؊2.25, I2 ‫؍‬ 0%, P ‫؍‬ .005), each domain score, and skeletal muscle strength. There were no significant differences in 6-min walk distance, 6-min pegboard and ring test, maximum exercise work load, and maximum oxygen consumption between the 2 groups. There were no reports of adverse events related to resistancetraining intervention. CONCLUSIONS: Resistance training can be successfully performed alone or in conjunction with endurance training without increased adverse events during pulmonary rehabilitation in COPD.

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Exercise Training Improves Exertional Dyspnea in Patients With COPDa

Cited by 96 publications

References 32 publications

Benefits of Pulmonary Rehabilitation in Patients With COPD and Normal Exercise Capacity

Benefits of Pulmonary Rehabilitation in Patients With COPD and Normal Exercise Capacity

Effects of Exercise Training on Pulmonary Mechanics and Functional Status in Patients With Prolonged Mechanical Ventilation

Impact of Resistance Training in Subjects With COPD: A Systematic Review and Meta-Analysis

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