Abstract
IntroductionFunctional training has been shown to be a viable alternative for the elderly and patients with chronic obstructive pulmonary disease (COPD). However, whether the combination of this type of training with aerobic and resistance training, commonly performed in pulmonary rehabilitation (PR) programs, induces more pronounced effects on daily physical activities and functionality remains unclear. The aims of the study will be to evaluate the short-term and sustained effects of the combination of a functional circuit program with a training program consisting of aerobic and resistance exercise.MethodsIn this randomized controlled trial, patients with COPD will be randomly assigned (1:1:1) to an 8-week training program to follow one of the three a priori defined groups: (I) resistance and aerobic and functional exercises, (II) a conventional program including only resistance and aerobic exercises, or (III) a usual care program. Patients will be evaluated before and upon completion of 8 weeks of training regarding physical activity in daily life (PADL) using an activity monitor (accelerometer), activities of daily living (London Chest Activity of Daily Living), functional exercise capacity (6-minute walk test), and muscle strength (dynamometry). Additionally, the sustained effects of the interventions will be evaluated 22 weeks after commencing the study.DiscussionThe inclusion of a protocol of functional physical training in the training conventionally performed by patients with COPD as an alternative to increase PADL and functionality may provide subsidies for the treatment of these patients, representing an advance and impacting on the physical training of patients with COPD.Trial registrationBrazilian Clinical Trials Registry (ReBEC) ID: RBR-3zmh3r. Registered: March 7, 2018.
Highlights
Functional training has been shown to be a viable alternative for the elderly and patients with chronic obstructive pulmonary disease (COPD)
The interpretation will be in accordance with the American Thoracic Society (ATS) and European Respiratory Society (ERS) [30], and values of normality will be relative to the Brazilian population [31]
Primary outcome The physical activity in daily life (PADL) will be used as the primary outcome of the study, measured by step counts days and time spent on activities, using an accelerometer-type movement sensor, ActiGraph GT3X (ActiGraph LLC, Pensacola, FL, USA), which measures and records acceleration variations with magnitudes ranging from approximately 0.05 to 2.5 G (g = 9.8 m/s [2]) within a frequency range of 0.25 to 2.5 Hz
Summary
Functional training has been shown to be a viable alternative for the elderly and patients with chronic obstructive pulmonary disease (COPD). Whether the combination of this type of training with aerobic and resistance training, commonly performed in pulmonary rehabilitation (PR) programs, induces more pronounced effects on daily physical activities and functionality remains unclear. Despite its primarily respiratory character, chronic obstructive pulmonary disease (COPD) presents extrapulmonary consequences, including the reduction in functional exercise capacity and musculoskeletal function (i.e., strength and peripheral muscular resistance) [1, 2]. Resistance and aerobic training are among the exercises commonly proposed for these patients [12, 13, 16] The combination of these modalities has been shown to be the best form of training for these individuals [17] as well as being recommended by international guidelines for the clinical treatment of these patients in PR programs [13, 18]. Despite the functional gains obtained in PR programs, the evidence for increased PADL in patients with COPD is still contradictory and inconsistent [19], especially in short-term PR programs [20,21,22,23,24]
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