Abstract
BackgroundLow-load, high-repetitive single-limb resistance training may increase limb muscle function and functional exercise capacity in patients with chronic obstructive pulmonary disease (COPD) while minimizing the occurrence of limiting exertional symptoms. Whether high-repetitive single-limb resistance training would perform better than high-repetitive two-limb resistance training is unknown. In addition, the mechanisms underlying possible benefits of high-repetitive resistance training has not been investigated. The aims of this study are to compare single versus two-limb high-repetitive resistance training in patients with COPD and to investigate mechanisms of action of these training modalities.Methods/DesignThis trial is a prospective, assessor-blind, randomized controlled trial. The participants are patients with stable severe to very severe COPD who are older than 40 years of age and healthy controls. The intervention is single-limb, high-repetitive, resistance training with elastic bands, three times/week for 8 weeks.The control is two-limb high-repetitive resistance training with elastic bands, three times/week for 8 weeks.The primary outcomes is change in the 6-min walking distance after 8 weeks of single-limb or two-limb high-repetitive resistance training.The secondary outcomes are changes in limb muscle strength and endurance capacity, key protein involved in quadriceps anabolic/catabolic signalization, fiber-type distribution and capillarization, subjective dyspnea and muscle fatigue, muscle oxygenation, cardiorespiratory demand and health-related quality-of-life after 8 weeks of single-limb or two-limb high-repetitive resistance training.The acute effects of single-limb versus two-limb high-repetitive resistance training on contractile fatigue, exercise stimulus (the product of number of repetition and load), subjective dyspnea and muscle fatigue, muscle oxygenation, and cardiorespiratory demand during upper and lower limb exercises will also be investigated in patients with COPD and healthy controls.Randomization will be performed using a random number generator by a person independent of the recruitment process, using 1:1 allocation to the intervention and the control group using random block sizes.Blinding: All outcome assessors will be blinded to group assignment.DiscussionThe results of this project will provide important information to help developing and implementing customized exercise training programs for patients with COPD.Trial registrationClinicalTrials.gov Identifier NCT02283580 Registration date: 4 November 2014. First participant randomized: 10 November 2014.Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-015-0698-x) contains supplementary material, which is available to authorized users.
Highlights
Low-load, high-repetitive single-limb resistance training may increase limb muscle function and functional exercise capacity in patients with chronic obstructive pulmonary disease (COPD) while minimizing the occurrence of limiting exertional symptoms
The prevention of limb muscle dysfunction in patients with COPD is considered of utmost importance [3]
The proposed trial will give new knowledge to this research area by investigating the mechanisms and effects of single limb exercises in comparison to exercises incorporating a larger amount of muscle mass in patients with COPD and healthy individuals
Summary
Low-load, high-repetitive single-limb resistance training may increase limb muscle function and functional exercise capacity in patients with chronic obstructive pulmonary disease (COPD) while minimizing the occurrence of limiting exertional symptoms. Since quadriceps endurance is a determinant of physical activity level [5] and may be reduced to a larger extent than quadriceps strength [9,5], the possibility of improving limb muscle endurance is of interest To achieve this goal, highrepetition resistance exercises is recommended [10]. Regardless the type of exercise performed, achieving an optimal exercise stimulus for involved muscles could be challenging in patients with COPD because ventilatory limitation and dyspnea may occur prior to contracting muscles being maximally stressed [11,12] This is of importance because the degree of exercise stimulus is central to optimize benefits from the exercise training performed
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