Chronic Obstructive Pulmonary Disease Does Not Impair Responses to Resistance Training

AbstractRationaleSubjects with chronic obstructive pulmonary disease (COPD) are prone to accelerated decay of muscle strength and mass with advancing age. This is mediated by systemic pathophysiologies, which are also believed to impair responses to exercise training, a notion that remains largely unstudied.ObjectivesTo investigate the presence of impaired training responsiveness in COPD, measured as responses to resistance training compared to healthy participants.MethodsCOPD (GOLD grade II-III, n=20, age 69±5) and Healthy (n=58, age 67±4) conducted identical whole-body resistance training interventions, consisting of two weekly, supervised training sessions for 13 weeks. Leg exercises were performed unilaterally, with one leg conducting high-load training (10 repetitions maximum; RM) and the contralateral leg conducting low-load training (30RM).Measurements and Main ResultsMeasurements included muscle strength (n=7), endurance performance (n=6), muscle mass (n=2), muscle quality, muscle biology (vastus lateralis; muscle fiber characteristics, RNA content including transcriptome) and health-related variables (body composition, blood). For core outcome domains, weighted combined factors were calculated from the range of singular assessments.COPD showed marked improvements in lower-limb muscle strength/mass/quality and lower-limb/whole-body endurance performance, resembling or exceeding those of Healthy, measured as both relative and absolute change terms. This was accompanied by similar changes in muscle biological hallmarks (total RNA/rRNA content↑, muscle fiber cross-sectional area↑, type IIX proportions↓, changes in the mRNA transcriptome). Neither of the core outcome domains were differentially affected by resistance training load.ConclusionsCOPD showed marked, unimpaired and hitherto unrecognized responsiveness to resistance training, rejecting the notion of disease-related impairments in training responsiveness.

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

Journal of Clinical Nursing ◽

10.1111/jocn.14131 ◽

2018 ◽

Vol 27 (5-6) ◽

pp. e1022-e1037 ◽

Cited By ~ 12

Author(s):

Yi Chen ◽

Mei'e Niu ◽

Xiuqin Zhang ◽

Hongying Qian ◽

Anwei Xie ◽

...

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Resistance Training ◽

Muscle Strength ◽

Functional Status ◽

Pulmonary Disease ◽

Lower Limb ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Home Based

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Chronic obstructive pulmonary disease does not impair responses to resistance training

Journal of Translational Medicine ◽

10.1186/s12967-021-02969-1 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Knut Sindre Mølmen ◽

Daniel Hammarström ◽

Gunnar Slettaløkken Falch ◽

Morten Grundtvig ◽

Lise Koll ◽

...

Keyword(s):

Resistance Training ◽

Muscle Strength ◽

Muscle Mass ◽

Lower Limb ◽

Endurance Performance ◽

Muscle Quality ◽

Whole Body ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Muscle Biology

Abstract Background Subjects with chronic obstructive pulmonary disease (COPD) are prone to accelerated decay of muscle strength and mass with advancing age. This is believed to be driven by disease-inherent systemic pathophysiologies, which are also assumed to drive muscle cells into a state of anabolic resistance, leading to impaired abilities to adapt to resistance exercise training. Currently, this phenomenon remains largely unstudied. In this study, we aimed to investigate the assumed negative effects of COPD for health- and muscle-related responsiveness to resistance training using a healthy control-based translational approach. Methods Subjects with COPD (n = 20, GOLD II-III, FEV1predicted 57 ± 11%, age 69 ± 5) and healthy controls (Healthy, n = 58, FEV1predicted 112 ± 16%, age 67 ± 4) conducted identical whole-body resistance training interventions for 13 weeks, consisting of two weekly supervised training sessions. Leg exercises were performed unilaterally, with one leg conducting high-load training (10RM) and the contralateral leg conducting low-load training (30RM). Measurements included muscle strength (nvariables = 7), endurance performance (nvariables = 6), muscle mass (nvariables = 3), muscle quality, muscle biology (m. vastus lateralis; muscle fiber characteristics, RNA content including transcriptome) and health variables (body composition, blood). For core outcome domains, weighted combined factors were calculated from the range of singular assessments. Results COPD displayed well-known pathophysiologies at baseline, including elevated levels of systemic low-grade inflammation ([c-reactive protein]serum), reduced muscle mass and functionality, and muscle biological aberrancies. Despite this, resistance training led to improved lower-limb muscle strength (15 ± 8%), muscle mass (7 ± 5%), muscle quality (8 ± 8%) and lower-limb/whole-body endurance performance (26 ± 12%/8 ± 9%) in COPD, resembling or exceeding responses in Healthy, measured in both relative and numeric change terms. Within the COPD cluster, lower FEV1predicted was associated with larger numeric and relative increases in muscle mass and superior relative improvements in maximal muscle strength. This was accompanied by similar changes in hallmarks of muscle biology such as rRNA-content↑, muscle fiber cross-sectional area↑, type IIX proportions↓, and changes in mRNA transcriptomics. Neither of the core outcome domains were differentially affected by resistance training load. Conclusions COPD showed hitherto largely unrecognized responsiveness to resistance training, rejecting the notion of disease-related impairments and rather advocating such training as a potent measure to relieve pathophysiologies. Trial registration: ClinicalTrials.gov ID: NCT02598830. Registered November 6th 2015, https://clinicaltrials.gov/ct2/show/NCT02598830

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Changes in lower limb muscle function and muscle mass following exercise-based interventions in patients with chronic obstructive pulmonary disease: A review of the English-language literature

Chronic Respiratory Disease ◽

10.1177/1479972317709642 ◽

2017 ◽

Vol 15 (2) ◽

pp. 182-219 ◽

Cited By ~ 12

Author(s):

Jana De Brandt ◽

Martijn A Spruit ◽

Dominique Hansen ◽

Frits ME Franssen ◽

Wim Derave ◽

...

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Muscle Strength ◽

Pulmonary Disease ◽

Lower Limb ◽

Muscle Function ◽

Chronic Obstructive ◽

Lower Limb Muscle ◽

Limb Muscle ◽

Obstructive Pulmonary Disease ◽

Copd Patients

Chronic obstructive pulmonary disease (COPD) patients often experience lower limb muscle dysfunction and wasting. Exercise-based training has potential to improve muscle function and mass, but literature on this topic is extensive and heterogeneous including numerous interventions and outcome measures. This review uses a detailed systematic approach to investigate the effect of this wide range of exercise-based interventions on muscle function and mass. PUBMED and PEDro databases were searched. In all, 70 studies ( n = 2504 COPD patients) that implemented an exercise-based intervention and reported muscle strength, endurance, or mass in clinically stable COPD patients were critically appraised. Aerobic and/or resistance training, high-intensity interval training, electrical or magnetic muscle stimulation, whole-body vibration, and water-based training were investigated. Muscle strength increased in 78%, muscle endurance in 92%, and muscle mass in 88% of the cases where that specific outcome was measured. Despite large heterogeneity in exercise-based interventions and outcome measures used, most exercise-based trials showed improvements in muscle strength, endurance, and mass in COPD patients. Which intervention(s) is (are) best for which subgroup of patients remains currently unknown. Furthermore, this literature review identifies gaps in the current knowledge and generates recommendations for future research to enhance our knowledge on exercise-based interventions in COPD patients.

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The Effects of Creative Dance Based Exercise Training on Respiratory, Balance and Cognitive Functions, Respiratory and Peripheral Muscle Strength and Functional Capacity in Patients With Chronic Obstructive Pulmonary Disease (COPD)

Case Medical Research ◽

10.31525/ct1-nct04039334 ◽

2019 ◽

Author(s):

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Muscle Strength ◽

Exercise Training ◽

Pulmonary Disease ◽

Functional Capacity ◽

Cognitive Functions ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Creative Dance ◽

Peripheral Muscle

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Inspiratory muscle strength in chronic obstructive pulmonary disease depending on disease severity

Clinical Science ◽

10.1042/cs20060362 ◽

2007 ◽

Vol 113 (5) ◽

pp. 243-249 ◽

Cited By ~ 18

Author(s):

Hans-Joachim Kabitz ◽

Stephan Walterspacher ◽

David Walker ◽

Wolfram Windisch

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Muscle Strength ◽

Pulmonary Disease ◽

Disease Severity ◽

Inspiratory Muscle ◽

Walking Distance ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Copd Patients ◽

Inspiratory Muscle Strength

Staging criteria for COPD (chronic obstructive pulmonary disease) include symptoms and lung function parameters, but the role of reduced inspiratory muscle strength related to disease severity remains unclear. Therefore the present study tested whether inspiratory muscle strength is reduced in COPD and is related to disease severity according to GOLD (Global Initiative for Chronic Obstructive Lung Disease) criteria and assessed its clinical impact. PImax (maximal inspiratory mouth occlusion pressure), SnPna (sniff nasal pressure) and TwPmo (twitch mouth pressure) following bilateral anterior magnetic phrenic nerve stimulation were assessed in 33 COPD patients (8 GOLD0, 6 GOLDI, 6 GOLDII, 7 GOLDIII and 6 GOLDIV) and in 28 matched controls. Furthermore, all participants performed a standardized 6 min walking test. In comparison with controls, PImax (11.6±2.5 compared with 7.3±3.0 kPa; P<0.001), SnPna (9.7±2.5 compared with 6.9±3.3 kPa; P<0.001) and TwPmo (1.6±0.6 compared with 0.8±0.4 kPa; P<0.001) were markedly lower in COPD patients. TwPmo decreased with increasing COPD stage. TwPmo was correlated with walking distance (r=0.75; P<0.001), dyspnoea (r=−0.61; P<0.001) and blood gas values following exercise (r>0.57; P<0.001). Inspiratory muscle strength, as reliably assessed by TwPmo, decreased with increasing severity of COPD and should be considered as an important factor in rating disease severity and to reflect burden in COPD.

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Response to Letter to Editor: Whole body vibration for patients with chronic obstructive pulmonary disease – ‘Thoughts for clinical practice’

Respiratory Medicine ◽

10.1016/j.rmed.2012.01.011 ◽

2012 ◽

Vol 106 (5) ◽

pp. 756

Author(s):

Rainer Gloeckl

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Clinical Practice ◽

Pulmonary Disease ◽

Whole Body Vibration ◽

Whole Body ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Body Vibration

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Diagnostic performance of lung volumes in assessment of reversibility in chronic obstructive pulmonary disease

Egyptian Journal of Bronchology ◽

10.1186/s43168-021-00066-x ◽

2021 ◽

Vol 15 (1) ◽

Author(s):

Gamal Agmy ◽

Manal A. Mahmoud ◽

Azza Bahaa El-Din Ali ◽

Mohamed Adam

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Cutoff Point ◽

Whole Body ◽

Significant Response ◽

Chronic Obstructive ◽

Lung Volumes ◽

Obstructive Pulmonary Disease ◽

Gold Stage ◽

Clinically Significant

Abstract Background Reversibility measured by spirometry in chronic obstructive pulmonary disease (COPD) is defined as an increase in forced expiratory volume in first second (FEV1) that is both more than 12% and 200 mL above the pre-bronchodilator value in response to inhaled bronchodilators. FEV1 only may not fully reverberate the changes caused by reduction in air trapping or hyperinflation. To date, the studies that examined the effect of inhaled bronchodilators (BD) on residual volume (RV) and total lung capacity (TLC) are limited. This study was carried out to assess the differences between flow and volume responses after bronchodilator reversibility testing in patients with different COPD GOLD stages (GOLD stage I to stage IV). Spirometry and whole body plethysmography were done before and 15 min after inhalation of 400 μg salbutamol. Results Majority (53.3%) of cases were volume responders, 18.7% were flow responders, 20% were flow and volume responders, and 8% were non responders. Significant increase in Δ FEV1% was found in 15% of cases while 55% showed a significant increase in Δ FVC (P= < 0.001). Mean difference of Δ FVC (L) post BD was significantly increased with advancing GOLD stage (P= 0.03). A cutoff point > 20% for Δ RV% had 70% sensitivity and 60% specificity and > 12% for Δ TLC% showed 90% sensitivity and 45% specificity for prediction of clinically significant response to BD based on FEV1. A cutoff point > 18% for Δ RV% had 78% sensitivity and 29% specificity and > 14% for Δ TLC% had 50% sensitivity and 70% specificity for prediction of clinically significant response to BD based on FVC. Conclusion ΔFEV1 underestimates the true effect of bronchodilators with advancing GOLD stage. Measurement of lung volumes in addition to the standard spirometric indices is recommended when determining bronchodilator response in COPD patients.

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