Effectiveness of Two Exercise Training Programs in Patients with Chronic Obstructive Pulmonary Disease

Angela Maria Pereira,Sónia Vicente,Ernesto Pereira,Helena Santa-Clara

doi:10.11648/j.ajim.20210904.11

Abstract

This study intended to assess the effectiveness ten years later, after attending to a combined or aerobic exercise training program, in Chronic Obstructive Pulmonary Disease (COPD) patients. Methods: Twenty moderate COPD men, were randomized into two groups: ten patients (age-66.5±6.2 years) to a combined exercise training program (CETG), and ten (age-65.4±3.6 years) to an aerobic program (AETG), for 10W, 3xW. Outcome variables included cardiopulmonary function (cardiopulmonary exercise test (CPET) and 6-min-walk-distance (6MWD), muscular strength (1-RM); and quality of life (HRQL) with SF-36 and SGRQ. Ten years later, both groups were compared with ten patients who weren’t submitted to exercise programs (CG), evaluating health service recurrence (HSR) and respiratory mortality. Results: Both exercise groups increased (p<.05) functional capacity (VO<sub>2</sub>peak: CETG-25±18%, AETG-26±25%); CPET time/power (CETG-42±30%, AETG-65±47%), 6MWD (CETG, 12±3%; AETG, 7±4%) and HRQL immediately after exercise, with greater benefits for the CETG (p<.05) in all variables. Ten years later, there were no differences between exercise groups on mortality and HSR. Between exercise groups and CG there were only significant differences on HSR. Conclusions: Combined exercise was more effective than aerobic with greater improvement in muscular strength, functional capacity and HRQL. Participation in exercise programs seems to reduce HSR at long-term follow-up.

Highlights

Chronic Obstructive Pulmonary Disease (COPD) is a major cause of chronic morbidity and mortality worldwide with important clinical consequences, such as a decline of health status and quality of life [1,2,3].Exercise training is recognized as a fundamental component of respiratory rehabilitation because of its positive effects on muscle function [2, 4]
All results reported for the training exercise groups are based on 15 subjects who completed all tests and training requirements; 5 patients dropped out of the study, 2 from AET Group (AETG) and 3 from CET Group (CETG) for professional reasons, being posteriorly integrated in control group
The present study showed that exercise has beneficial effects on functional capacity in subjects with moderate COPD

Summary

Introduction

Chronic Obstructive Pulmonary Disease (COPD) is a major cause of chronic morbidity and mortality worldwide with important clinical consequences, such as a decline of health status and quality of life [1,2,3].Exercise training is recognized as a fundamental component of respiratory rehabilitation because of its positive effects on muscle function [2, 4]. Aerobic exercise enhances muscle oxidative capacity with muscular function improvement but it has small effect in muscle atrophy and weakness [5]. Resistance training improves muscle strength, endurance, when assessed by the six-minute walk distance (6MWD), and perceived dyspnea in COPD patients. It appears to have little effect on VO2max, [3, 6, 7]. Evidence suggests that combined exercise (resistance/aerobic) training (CET) provides similar endurance benefits and greater improvements in muscle strength compared to aerobic training alone (AET) [8,9]. For quality of life, studies have shown improvement with resistance training [6], the effects are different between CET and AET, with better results for Health-related Quality of life (HRQL) and dyspnea perception in CET [10]

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