Advanced COPD patients often have reduced exercise capacity and associated peripheral muscle weakness. These issues can quickly lead to reduced health-related quality of life, including an increased prevalence of fatigue and depression, and a reduced sense of emotional wellbeing. It is not clear, however, whether an increase in muscle strength would be sufficient to improve exercise capacity and therefore help avoid, reduce, or even reverse some of the negative effects described above. Currently, COPD rehabilitation includes peripheral muscle endurance, but not strength training.

In order to assess how strength training might be able to help COPD patients better their health, we’re going to take a look today at a study that researches just that. In the study, peripheral muscle endurance or combined endurance and strength training were tested for improvement of exercise capacity in elderly COPD patients.

Key Findings

• COPD patients have reduced exercise capacity due to peripheral muscle weakness, contributing to reduced quality of life (QOL).
• Currently, COPD rehabilitation focuses on peripheral endurance, but not strength training.
• 8 weeks of muscle strength training significantly improves muscle strength compared to endurance training alone.
• Both muscle strength and endurance training improve exercise capacity and QOL.
• Muscle strength training did not improve exercise capacity or QOL more than endurance training did.

Patient Impact

Muscle strength and/or endurance training improve exercise capacity and QOL in COPD patients.

Study Methods

Twenty four patients with advanced COPD underwent either endurance (cycle ergometer) or a combination of endurance and strength (including chest presses, knee flexion and extension, shoulder adduction and elbow flexion) training for eight weeks. Quadriceps, hamstring, pectoralis major, and latissimus dorsi muscle strength, as well as quadriceps fatigability, exercise endurance and health-related quality of life (hrQOL) were assessed before and after the training period.

Study Results

The increase in muscle strength was significant in patients who underwent the combined endurance and strength program when compared to those patients who did the endurance training alone. Exercise capacity, endurance, quadriceps fatigability and hrQOL significantly improved in both training groups. The increased muscle strength observed in the combined training group, however, did not result in improved hrQOL, exercise capacity or muscle fatigability when compared to the endurance training group.

Muscle strength training in addition to muscle endurance training is beneficial for increased muscle strength in elderly COPD patients, but does not lead to further improvements in exercise capacity and hrQOL when compared to endurance training alone.

References

Mador MJ et al. Endurance and Strength Training in Patients With COPD. Chest. 2004 Jun;125(6):2036-45.