Aerobic and strength training in patients with chronic obstructive pulmonary disease.

The purpose of this study was to evaluate whether strength training is a useful addition to aerobic training in patients with chronic obstructive pulmonary disease (COPD). Forty-five patients with moderate to severe COPD were randomized to 12 wk of aerobic training alone (AERO) or combined with strength training (AERO + ST). The AERO regimen consisted of three weekly 30-min exercise sessions on a calibrated ergocycle, and the ST regimen included three series of eight to 10 repetitions of four weight lifting exercises. Measurements of peripheral muscle strength, thigh muscle cross-sectional area (MCSA) by computed tomographic scanning, maximal exercise capacity, 6-min walking distance (6MWD), and quality of life with the chronic respiratory questionnaire were obtained at baseline and after training. Thirty-six patients completed the program and constituted the study group. The strength of the quadriceps femoris increased significantly in both groups (p < 0.05), but the improvement was greater in the AERO + ST group (20 +/- 12% versus 8 +/- 10% [mean +/- SD] in the AERO group, p < 0.005). The thigh MCSA and strength of the pectoralis major muscle increased in the AERO + ST group by 8 +/- 13% and 15 +/- 9%, respectively (p < 0.001), but not in the AERO group (3 +/- 6% and 2 +/- 10%, respectively, p > 0.05). These changes were significantly different in the two study groups (p < 0.01). The increase in strength of the latissimus dorsi muscle after training was modest and of similar magnitude for both groups. The changes in peak exercise work rate, 6MWD, and quality of life were comparable in the two groups. In conclusion, the addition of strength training to aerobic training in patients with COPD is associated with significantly greater increases in muscle strength and mass, but does not provide additional improvement in exercise capacity or quality of life.

[1]  F. Maltais,et al.  Peripheral muscle weakness in patients with chronic obstructive pulmonary disease. , 1998, American journal of respiratory and critical care medicine.

[2]  P. Zabel,et al.  Serum level of interleukin 8 is elevated in idiopathic pulmonary fibrosis and indicates disease activity. , 1998, American journal of respiratory and critical care medicine.

[3]  C. Mcevoy,et al.  Association between corticosteroid use and vertebral fractures in older men with chronic obstructive pulmonary disease. , 1998, American journal of respiratory and critical care medicine.

[4]  Alison E. Ries Pulmonary rehabilitation: joint ACCP/AACVPR evidence-based guidelines. ACCP/AACVPR Pulmonary Rehabilitation Guidelines Panel. American College of Chest Physicians. American Association of Cardiovascular and Pulmonary Rehabilitation. , 1997, Chest.

[5]  R. Casaburi,et al.  Physiologic benefits of exercise training in rehabilitation of patients with severe chronic obstructive pulmonary disease. , 1997, American journal of respiratory and critical care medicine.

[6]  F. Maltais,et al.  Intensity of training and physiologic adaptation in patients with chronic obstructive pulmonary disease. , 1997, American journal of respiratory and critical care medicine.

[7]  Ari Heinonen,et al.  Randomised controlled trial of effect of high-impact exercise on selected risk factors for osteoporotic fractures , 1996, The Lancet.

[8]  Gordon H Guyatt,et al.  Meta-analysis of respiratory rehabilitation in chronic obstructive pulmonary disease , 1996, The Lancet.

[9]  F. Maltais,et al.  Skeletal muscle adaptation to endurance training in patients with chronic obstructive pulmonary disease. , 1996, American journal of respiratory and critical care medicine.

[10]  M. Decramer,et al.  Peripheral muscle weakness contributes to exercise limitation in COPD. , 1996, American journal of respiratory and critical care medicine.

[11]  F. Maltais,et al.  Oxidative capacity of the skeletal muscle and lactic acid kinetics during exercise in normal subjects and in patients with COPD. , 1996, American journal of respiratory and critical care medicine.

[12]  N. Jones,et al.  Muscle strength, symptom intensity, and exercise capacity in patients with cardiorespiratory disorders. , 1995, American journal of respiratory and critical care medicine.

[13]  E. Wouters,et al.  Physiologic effects of nutritional support and anabolic steroids in patients with chronic obstructive pulmonary disease. A placebo-controlled randomized trial. , 1995, American journal of respiratory and critical care medicine.

[14]  B. Celli Pulmonary rehabilitation in patients with COPD. , 1995, American journal of respiratory and critical care medicine.

[15]  B. Make,et al.  Standards for the diagnosis and care of patients with chronic obstructive pulmonary disease. American Thoracic Society. , 1995, American journal of respiratory and critical care medicine.

[16]  W. Evans,et al.  Changes in Skeletal Muscle with Aging: Effects of Exercise Training , 1993, Exercise and sport sciences reviews.

[17]  N. Jones,et al.  Exercise capacity and ventilatory, circulatory, and symptom limitation in patients with chronic airflow limitation. , 1992, The American review of respiratory disease.

[18]  N. Jones,et al.  Randomised controlled trial of weightlifting exercise in patients with chronic airflow limitation. , 1992, Thorax.

[19]  J. Janosky,et al.  Skeletal muscle density: effects of obesity and non-insulin-dependent diabetes mellitus. , 1991, The American journal of clinical nutrition.

[20]  R. McKelvie,et al.  Usefulness of weightlifting training in improving strength and maximal power output in coronary artery disease. , 1991, The American journal of cardiology.

[21]  L. Lipsitz,et al.  High-intensity strength training in nonagenarians. Effects on skeletal muscle. , 1990, JAMA.

[22]  W. Frontera,et al.  Strength training and determinants of VO2max in older men. , 1990, Journal of applied physiology.

[23]  G. Guyatt,et al.  Measurement of health status. Ascertaining the minimal clinically important difference. , 1989, Controlled clinical trials.

[24]  W. Frontera,et al.  Strength conditioning in older men: skeletal muscle hypertrophy and improved function. , 1988, Journal of applied physiology.

[25]  G. Guyatt,et al.  A measure of quality of life for clinical trials in chronic lung disease. , 1987, Thorax.

[26]  G H Guyatt,et al.  Effect of encouragement on walking test performance. , 1984, Thorax.

[27]  M. Lebowitz,et al.  The maximal expiratory flow-volume curve. Normal standards, variability, and effects of age. , 1976, The American review of respiratory disease.

[28]  Goldman Hi,et al.  Respiratory function tests; normal values at median altitudes and the prediction of normal results. , 1959 .