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

Abstract

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.

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

“…Both continuous and interval endurance training have been reported to be effective to improve dyspnea, exercise capacity, and quality of life in patients with COPD . In addition, the combination of endurance and resistance training has been shown to provide greater adaptations in muscle strength and quality of life compared with endurance training alone . Power training has been proven to achieve greater functional benefits than traditional resistance training in older people, and it might be especially beneficial to patients with COPD because of the lower cardiovascular loading and higher muscle oxygenation levels that are experienced during exercise compared with traditional strength training.…”

Effects of home‐based lower limb resistance training on muscle strength and functional status in stable Chronic obstructive pulmonary disease patients

“…In a previous study, PR (including home‐based PR) may consist of different types of training and support, as well as various protocols (GOLD Science Committee Members ; Reardon, Casaburi, Morgan, Nici, & Rochester, ; Takigawa et al., ). The variations include endurance training (Aquino et al., ), resistance training (RT) (da Silva & Dourado, ), balance training (Beauchamp et al., ) and tai‐chi (Ng et al., ) performed individually or in combination (Liao et al., ).…”

Comparison of Effects of Endurance and Strength Training Programs in Patients with COPD

“…A recent meta-analysis by Iepsen and colleagues examined studies comparing the effects of combining strength training with endurance training against endurance training alone and concluded that both programs showed similar improvements in physical function and health related quality of life (14). In contrast, a meta-analysis by Liao et al concluded that a combined strength and endurance training program may provide greater improvements in health related quality of life (15). …”