Upper-Body Resistance Training and Self-Efficacy Enhancement in COPD

Abstract

Purpose Loss of skeletal muscle strength is commonly seen with chronic obstructive pulmonary disease (COPD). The study aim was to determine the effects of comprehensive upper-body resistance training (8 different lifts) and a self-efficacy enhancing intervention in COPD with respect to muscle strength, symptoms, functional status and exercise adherence. Methods This randomized trial had 3 groups: upper-body resistance training with an intervention to enhance self-efficacy (UBR + SE), upper-body resistance training and health education (UBR + HE), gentle chair exercises and health education (CE + HE). Subjects performed 16 weeks of supervised training, then 12 months of long-term maintenance at home. Outcomes were: muscle strength, dyspnea, functional status, self-efficacy, and adherence. Results Sixty-four subjects completed 16 wks of training: age 71 ± 8 yr, fat-free mass index 19 ± 3 kg/m2, forced expiratory volume in one second 58 ± 18 percent predicted. The UBR + SE intervention produced a 46% increase in strength compared to a 36% increase in the UBR + HE group (P = 0.054). The combined UBR + SE and UBR + HE groups produced a 41% increase in strength compared to an 11% increase in the CE+HE (P < 0.001). The combined UBR groups also demonstrated increases in lean arm mass (P = 0.003) and a trend toward decreased dyspnea (P = 0.053). There were no group differences in attrition, attendance and training progression. Fifty subjects completed long-term maintenance and the UBR + SE and UBR + HE groups retained some gains in muscle strength, 24% and 21% respectively, and the CE + HE group lost 3% of muscle strength from baseline. Conclusion The study provides strong evidence that comprehensive resistance training increased strength and lean arm mass and that strength can be partially maintained through a simple home program using hand weights. It provides limited evidence that upper-body resistance training improved dyspnea and that the exercise-specific self-efficacy enhancing intervention was beneficial.

Self-efficacy enhancing intervention increases light physical activity in people with chronic obstructive pulmonary disease

“…We then screened respondents to determine if they met the inclusion criteria as previously described. 7 …”

“…The upper body resistance training and gentle chair exercises are described elsewhere. 7 Briefly, the upper body resistance training included three sets of eight lifts. Gentle chair exercises included stretching and toning exercises that were not aerobic.…”

Ejercicio aeróbico y de fuerza en personas con una enfermedad pulmonar obstructiva (epoc): estudio de caso

“…En dichos programas se han trabajado solamente la capacidad aeróbica (Rocha Leite et al, 2015) y la fuerza muscular (Covey et al, 2012). Además, estas mejoras también se han observado con programas mixtos que trabajan ambas capacidades (Ortega et al, 2002;Troosters et al, 2000;Vonbank et al, 2012).…”

“…Sin embargo, existen otras medidas que pueden mejorar la calidad de vida de las personas que padecen esta enfermad, por ejemplo, mediante el uso de técnicas específicas como la oxigenoterapia (Escarrabil, 2005;Fernández-Fernández et al, 2003), la ventilación no invasiva (GOLD, 2016) o trabajos quirúrgicos (GOLD, 2016). Además, investigaciones recientes han demostrado que la realización de actividad física es uno de los pilares básicos en la rehabilitación pulmonar (Covey et al, 2012;Iepsen et al, 2015;Rocha Leite et al, 2015) debido a que se ha reconocido que los programas de actividad física de mínimo ocho semanas son un tratamiento efectivo (Troosters, Gosselink, Janssens y Decramer, 2010).…”

“…Según Iepsen et al (2015), el entrenamiento de fuerza mejora la capacidad de realizar ejercicio, la calidad de vida (Lacasse et al, 2006) y reduce el número de días de ingreso en el hospital (Griffiths et al, 2000). El fortalecimiento de las extremidades superiores podría reducir la disnea y mejorar la capacidad aeróbica, así como aumentar la fuerza de la pared torácica y de los músculos respiratorios (Covey et al, 2012;O'Shea, Taylor y Paratz, 2007). En esta línea, el trabajo de la musculatura inspiratoria adquiere tanta importancia como el fortalecimiento de los músculos de las extremidades superiores (Bernardi, Pomidori, Bassal, Contoli y Cogo, 2015).…”