Exercise training: which impact on COPD patients?

  • Authors

    • R. Djebaili university Batna 2
    • B. Chiboub Department of Epidemiology, university hospital center of Batna, faculty of medicine of Batna -Algeria
    2024-01-15
    https://doi.org/10.14419/xya73q42

  • Abstract

    Introduction: Exercise training reactivates the aerobic pathway through physical exercise, thereby improving dyspnea and breaking deconditioning spiral in chronic obstructive pulmonary disease (COPD) patients.

    Method: 60 COPD patients were selected to benefit from a four-week outpatient exercise training and muscle strengthening program, at a rate of 3 sessions per week, after excluding the following cases: patients who have contraindications to exercise training; severe patients or those receiving long-term oxygen therapy. The program combined exercise training on a bicycle ergometer for 45 min, muscle strengthening of the lower limbs and nutritional monitoring. Nutritional management included a diet based on nutritional status and the prescription of oral food supplements for malnourished COPD patients. Parameters assessed before and after training were bioimpedance analysis (BIA),6MWT, quadriceps isometric voluntary contraction (MVC) and dynamic endurance, and the quality-of-life questionnaire (Q11).

    Result: Forty COPD patients (36 men and 4 women) aged 67.22 (± 10) years were able to complete the program. Amid them, 36 were non-smokers. Ten patients (GOLD I), 14 patients (GOLD II), 16 patients (GOLD III), no patients (GOLD IV). Dyspnea was stage 2 (± 1) m MRC. After training, quadriceps muscle function ((MVC) and endurance) improved significantly (p < 0.0001). The improvement in distance covered during 6MWT was also significant (p < 0.0001). A significant improvement in quality of life after training was noted on the total score of the Q11 questionnaire. No significant improvement in body composition after training in COPD patients.

    Conclusion: this study has confirmed the beneficial effects of training mainly on muscle function, effort capacity and quality of life in COPD patients.

  • References

    1. Prefaut C, Ninot G. La réhabilitation du malade respiratoire chronique. Masson 2009 ;502 p. https://doi.org/10.1016/S0761-8425(09)73342-X.
    2. Birot O., Bigard A X. Réponses du réseau capillaire du muscle squelettique à l’entrainement Sciences et sports, 2003,18,1-10 https://doi.org/10.1016/S0765-1597(02)00052-7.
    3. Hood D. Invited review contractile activity-induced mithochondrial biognecis in squeletal muscle.J Appl Physiol, 2001 ,901137-57.
    4. Zool J, Koulman Nbahi L et coll Quantitative and qualitative adaptation of skeletal muscle mithochondria to increased physical activity. J Cell Physiol, 2003, 194,186 -93. https://doi.org/10.1002/jcp.10224.
    5. Terada S, Goto M, Kato M, et coll. Effect of low intensity prolonged exercise on PGC -1mRNA Expresion in rat epitrochlearis muscle. Biochim Biophys Res Commun, 2002, 296, 350-4. https://doi.org/10.1016/S0006-291X(02)00881-1.
    6. Prefaut C. Réhabilitation respiratoire AKOS Encyclopédie Pratique de Médecine 6-0990
    7. Whittom F, Jobin J, Simard PM, Leblanc P, Simard C, Bernard S, Belleau R, Maltais F: Histochemical and morphological characteristics of the vastus lateralis muscle in COPD patients. Comparison with normal subjects and effects of exercise training. Med Sci Sports Ex-erc 1998; 30:1467-74. https://doi.org/10.1097/00005768-199810000-00001.
    8. Green H, Goreham C, Ouyang J. et coll. Regulation of fiber size, oxidative potential and capillarization in human muscle by resistance exercise, Am J Physiol,1998, 276, R591- 596. https://doi.org/10.1152/ajpregu.1999.276.2.R591.
    9. Prefaut C, Donner CF. Dyspnoea and exercise training in patients with heart and lung disease. Eur Respir Rev 1995; 5: 1-71.
    10. Porszasz J, Cao R, Morishige R, van Eykern LA, Stenzler A, Casaburi R. Physiologic effects of an ambulatory ventilation system in chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2013 Aug 1; 188(3):334-42. https://doi.org/10.1164/rccm.201210-1773OC.
    11. Hoff J, Tjønna AE, Steinshamn S, Høydal M, Richardson RS, Helgerud J. Maximal strength training of the legs in COPD: A therapy for mechanical inefficiency. Med Sci Sports Exerc, 2007; 39:220-6. https://doi.org/10.1249/01.mss.0000246989.48729.39.
    12. Sabit R, Griffiths TL, Watkins AJ, Evans W, Bolton CE, Shale DJ, Lewis KE. Predictors of poor attendance at an outpatient pulmonary rehabilitation programme. Respir Med 2008 ;102 :819–824 https://doi.org/10.1016/j.rmed.2008.01.019.
    13. Crisafulli E, Gorgone P, Vagaggini B, Pagani M, Rossi G, Costa F, Guarriello V, Paggiaro P, Chetta A, de Blasio F, et al. Efficacy of standard rehabilitation in COPD outpatients with comorbidities. Eur Respir J 2010; 36:1042–1048. https://doi.org/10.1183/09031936.00203809.
    14. Ortega F, Toral J, Cejudo P, Villagomez R, Sanchez H, Castillo J, Montemayor T. Comparison of effects of strength and endurance training in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2002; 166(5):669-674. https://doi.org/10.1164/rccm.2107081.
    15. Schols A, Soeters PB, Dingemans AMC, Mostert R, Frantzen PJ, Wouters EFM. Prevalence and characteristics of nutritional depletion Am Rev Respir Dis 1993 May;147(5):1151-6 https://doi.org/10.1164/ajrccm/147.5.1151.
    16. Troosters T, Gosselink R, Decramer M. Short- and long-term effects of outpatient rehabilitation in patients with chronic obstructive pulmonary disease: a randomized trial. Am J Med 2000;109: 207–212. https://doi.org/10.1016/S0002-9343(00)00472-1.
    17. Casaburi R, Bhasin S, Cosentino L, Porszasz J, Somfay A, Lewis MI, Fournier M, Storer TW. Effects of testosterone and resistance training in men with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2004 Oct 15;170(8):870-8 https://doi.org/10.1164/rccm.200305-617OC.
    18. Bernard S, Whittom F, Leblanc P, Jobin J, Belleau R, Berube C, Carrier G, Maltais F. Aerobic and strength training in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 1999 ;159 (3):896- 901. https://doi.org/10.1164/ajrccm.159.3.9807034.
    19. Puhan M. A, Mador M. J., Held U, Goldstein R, Guyatt G. H, Schünemann H. J. Interpretation of treatment changes en 6-minute walk distance in patients with COPD. European Respiratory Journal 2008 32: 637-643. https://doi.org/10.1183/09031936.00140507.
    20. Pitta F, Troosters T, Probst VS, Langer D, Decramer M, Gosselink R. Are patients with COPD more active after pulmonary rehabilita-tion? Chest 2008; 134:273–280 https://doi.org/10.1378/chest.07-2655.
    21. Troosters T, Casaburi R. Gosselink R, and. Decramer M. “Pulmonary rehabilitation in chronic obstructive pulmonary disease,” Amer-ican Journal of Respiratory and Critical Care Medicine, vol. 172, no. 1, pp. 19–38, 2005.) https://doi.org/10.1164/rccm.200408-1109SO.
    22. Menon MK, Houchen L, Harrison S, Singh S J, Morgan MD, Steiner MC Ultrasound assessment of lower limb muscle mass in re-sponse to resistance training in COPD. Respiratory Research 2012; 13(1): 119. https://doi.org/10.1186/1465-9921-13-119.
    23. Laviolette L, Bourbeau J, Bernard S, Lacasse Y, Pepin V, Breton M-J, Baltzan M, Rouleau M, Maltais F: Assessing the impact of pul-monary rehabilitation on functional status in COPD. Thorax 2008; 63:115–121. https://doi.org/10.1136/thx.2006.076844.

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  • How to Cite

    Djebaili, R. (2024). Exercise training: which impact on COPD patients? (B. Chiboub , Trans.). International Journal of Medicine, 12(1), 4-7. https://doi.org/10.14419/xya73q42