Download PDF
Int J Sports Med 2017; 38(13): 1001-1008
DOI: 10.1055/s-0043-112339
Training & Testing
© Georg Thieme Verlag KG Stuttgart · New York

Effects of Combined Aerobic-Strength Training vs Fitness Education Program in COPD Patients

Nicoletta Rinaldo   *
1   Department of Neurological, Biomedical and Movement Sciences, University of Verona, Italy
,
Elisabetta Bacchi   *
2   Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Verona, Italy
,
Giuseppe Coratella   *
1   Department of Neurological, Biomedical and Movement Sciences, University of Verona, Italy
3   Department of Biomedical Sciences for Health, University of Milano, Italy
,
Francesca Vitali
1   Department of Neurological, Biomedical and Movement Sciences, University of Verona, Italy
,
Chiara Milanese
1   Department of Neurological, Biomedical and Movement Sciences, University of Verona, Italy
,
Andrea Rossi
4   Department of Medicine, Azienda Ospedaliera Universitaria Integrata Verona, Pulmonary Unit, Verona, Italy
,
Federico Schena
1   Department of Neurological, Biomedical and Movement Sciences, University of Verona, Italy
,
Massimo Lanza
1   Department of Neurological, Biomedical and Movement Sciences, University of Verona, Italy
› Author Affiliations
Further Information

Publication History



accepted 14 May 2017

Publication Date:
05 October 2017 (online)

Also available at
    Permissions and Reprints

Abstract

We compared the effects of a new physical activity education program approach (EDU), based on a periodically supervised protocol of different exercise modalities vs traditionally supervised combined strength-endurance training (CT) on health-related factors in patients with stable chronic obstructive pulmonary disease (COPD). Twenty-eight COPD patients without comorbidities were randomly assigned to receive either EDU or CT. CT was continuously supervised to combine strength-endurance training; EDU was taught to progressively increase the rate of autonomous physical activity, through different training modalities such as Nordic walking, group classes and circuit training. Body composition, walking capacity, muscle strength, flexibility and balance, total daily energy expenditure and quality of life were evaluated at baseline, after 28 weeks training period (3d/week) and after a 14-week follow-up. No adverse events occurred during the interventions. After training, CT and EDU similarly improved walking capacity, body composition and quality of life. However, after 14 weeks of follow-up, such improvements were not maintained. Only in CT, muscle strength and flexibility improved after training but returned to baseline after follow-up. EDU, similar to CT, can effectively and safely improve health-related parameters in COPD patients. EDU could be an attractive alternative to traditional supervised training for improving quality of life in COPD patients.

Key words

aerobic training - strength training - chronic obstructive pulmonary disease - quality of life - walking capacity - muscle strength - bone mineral content

* These authors equally contributed to the work


 

  • References

  • 1 Beauchamp MK, Janaudis-Ferreira T, Parreira V, Romano JM, Woon L, Goldstein RS, Brooks D. A randomized controlled trial of balance training during pulmonary rehabilitation for individuals with COPD. Chest 2013; 144: 1803-1810
    CrossrefPubMedGoogle Scholar
  • 2 Beauchamp MK, O’Hoski S, Goldstein RS, Brooks D. Effect of pulmonary rehabilitation on balance in persons with chronic obstructive pulmonary disease. Arch Phys Med Rehabil 2010; 91: 1460-1465
    CrossrefPubMedGoogle Scholar
  • 3 Bernard S, Whittom F, Leblanc P, Jobin J, Belleau R, Bérubé C, Carrier G, Maltais F. Aerobic and strength training in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 1999; 159: 896-901
    CrossrefPubMedGoogle Scholar
  • 4 Boccia G, Coratella G, Dardanello D, Rinaldo N, Lanza M, Schena F, Rainoldi A. Severe COPD alters muscle fiber conduction velocity during knee extensors fatiguing contraction. COPD J Chronic Obstr Pulm Dis 2016; 2555: 1-6
    PubMedGoogle Scholar
  • 5 Boccia G, Dardanello D, Rinaldo N, Coratella G, Schena F, Rainoldi A. Electromyographic manifestations of fatigue correlate with pulmonary function, 6-minute walk test, and time to exhaustion in COPD. Respir Care 2015; 1295-1302
    PubMedGoogle Scholar
  • 6 Brazeau A-S, Beaudoin N, Bélisle V, Messier V, Karelis AD, Rabasa-Lhoret R. Validation and reliability of two activity monitors for energy expenditure assessment. J Sci Med Sport 2014
    PubMed
  • 7 Brooks D, Solway S, Gibbons WJ. ATS statement on six-minute walk test. Am J Respir Crit Care Med 2003; 167: 1287
    PubMedGoogle Scholar
  • 8 Brzycki M. Strength testing—predicting a one-rep max from reps-to-fatigue. J Physical Educ Recreat Danc 1993; 68: 88-90
    PubMedGoogle Scholar
  • 9 Coratella G, Milanese C, Schena F. Unilateral eccentric resistance training: a direct comparison between isokinetic and dynamic constant external resistance modalities. Eur J Sport Sci 2015; 15: 720-726
    CrossrefPubMedGoogle Scholar
  • 10 Coratella G, Milanese C, Schena F. Cross-education effect after unilateral eccentric-only isokinetic vs dynamic constant external resistance training. Sport Sci Health 2015; 11: 329-335
    CrossrefPubMedGoogle Scholar
  • 11 Deci EL, Ryan RM. Intrinsic Motivation and Self-Determination in Human Behavior. New York: Springer Science+Business Media; 1985
    Google Scholar
  • 12 Greulich T, Kehr K, Nell C, Koepke J, Haid D, Koehler U, Koehler K, Filipovic S, Kenn K, Vogelmeier C, Koczulla AR. A randomized clinical trial to assess the influence of a three months training program (gym-based individualized vs. calisthenics-based non-individualized) in COPD patients. Respir Res 2014; 15: 36
    CrossrefPubMedGoogle Scholar
  • 13 Hagger MS, Chatzisarantis NLD. Integrating the theory of planned behaviour and self-determination theory in health behaviour: A meta-analysis. Br J Health Psychol 2009; 14: 275-302
    CrossrefPubMedGoogle Scholar
  • 14 Hagger MS, Chatzisarantis NLD, Biddle SJH. The influence of autonomous and controlling motives on physical activity intentions within the Theory of Planned Behaviour. Br J Health Psychol 2002; 7: 283-297
    CrossrefPubMedGoogle Scholar
  • 15 Harriss DJ, Atkinson G. Ethical standards in sport and exercise scienceresearch: 2016 update. Int J Sports Med 2015; 36: 1121-1124
    Article in Thieme ConnectPubMedGoogle Scholar
  • 16 Iepsen UW, Jørgensen KJ, Ringbæk T, Hansen H, Skrubbeltrang C, Lange P. A combination of resistance and endurance training increases leg muscle strength in COPD: An evidence-based recommendation based on systematic review with meta-analyses. Chron Respir Dis 2015; 12: 132-145
    CrossrefPubMedGoogle Scholar
  • 17 Jones CJ, Rikli RE, Max J, Noffal G. The reliability and validity of a chair sit-and-reach test as a measure of hamstring flexibility in older adults. Res Q Exerc Sport 1998; 69: 338-343
    CrossrefPubMedGoogle Scholar
  • 18 Jonsson E, Seiger A, Hirschfeld H. One-leg stance in healthy young and elderly adults: a measure of postural steadiness?. Clin Biomech 2004; 19: 688-694
    CrossrefPubMedGoogle Scholar
  • 19 Kahn EB, Ramsey LT, Brownson RC, Heath GW, Howze EH, Powell KE, Stone EJ, Rajab MW, Corso P. The effectiveness of interventions to increase physical activity. A systematic review. Am J Prev Med 2002; 22: 73-107
    PubMedGoogle Scholar
  • 20 Keating A, Lee A, Holland AE. What prevents people with chronic obstructive pulmonary disease from attending pulmonary rehabilitation? A systematic review. Chron Respir Dis 2011; 8: 89-99
    CrossrefPubMedGoogle Scholar
  • 21 Langer D, Hendriks E, Burtin C, Probst V, van der Schans C, Paterson W, Verhoef-de Wijk M, Straver R, Klaassen M, Troosters T, Decramer M, Ninane V, Delguste P, Muris J, Gosselink R. A clinical practice guideline for physiotherapists treating patients with chronic obstructive pulmonary disease based on a systematic review of available evidence. Clin Rehabil 2009; 23: 445-462
    CrossrefPubMedGoogle Scholar
  • 22 Mahler DA. The measurement of dyspnea during exercise in patients with lung disease. Chest 1992; 101: 242S-247S
    CrossrefPubMedGoogle Scholar
  • 23 Miller MR, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A, Crapo R, Enright P, van der Grinten CPM, Gustafsson P, Jensen R, Johnson DC, MacIntyre N, McKay R, Navajas D, Pedersen OF, Pellegrino R, Viegi G, Wanger J. Standardisation of spirometry. Eur Respir J 2005; 26: 319-338
    CrossrefPubMedGoogle Scholar
  • 24 Nici L, Donner C, Wouters E, Zuwallack R, Ambrosino N, Bourbeau J, Carone M, Celli B, Engelen M, Fahy B, Garvey C, Goldstein R, Gosselink R, Lareau S, MacIntyre N, Maltais F, Morgan M, O’Donnell D, Prefault C, Reardon J, Rochester C, Schols A, Singh S, Troosters T. American Thoracic Society/European Respiratory Society statement on pulmonary rehabilitation. Am J Respir Crit Care Med 2006; 173: 1390-1413
    CrossrefPubMedGoogle Scholar
  • 25 Ortega F, Toral J, Cejudo P, Villagomez R, Sánchez 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: 669-674
    Google Scholar
  • 26 Panton LB, Golden J, Broeder CE, Browder KD, Cestaro-Seifer DJ, Seifer FD. The effects of resistance training on functional outcomes in patients with chronic obstructive pulmonary disease. Eur J Appl Physiol 2004; 91: 443-449
    CrossrefPubMedGoogle Scholar
  • 27 Pitta F, Troosters T, Probst VS, Langer D, Decramer M, Gosselink R. Are patients with COPD more active after pulmonary rehabilitation?. Chest 2008; 134: 273-280
    CrossrefPubMedGoogle Scholar
  • 28 Probst VS, Kovelis D, Hernandes NA, Camillo CA, Cavalheri V, Pitta F. Effects of 2 exercise training programs on physical activity in daily life in patients with COPD. Respir Care 2011; 56: 1799-1807
    CrossrefPubMedGoogle Scholar
  • 29 Ries AL, Bauldoff GS, Carlin BW, Casaburi R, Emery CF, Mahler DA, Make B, Rochester CL, Zuwallack R, Herrerias C. Pulmonary Rehabilitation: Joint ACCP/AACVPR Evidence-Based Clinical Practice Guidelines. Chest 2007; 131: 4S-42S
    CrossrefPubMedGoogle Scholar
  • 30 Roig M, Eng JJ, MacIntyre DL, Road JD, FitzGerald JM, Burns J, Reid WD. Falls in people with chronic obstructive pulmonary disease: An observational cohort study. Respir Med 2011; 105: 461-469
    CrossrefPubMedGoogle Scholar
  • 31 Spruit MA, Troosters T, Trappenburg JCA, Decramer M, Gosselink R. Exercise training during rehabilitation of patients with COPD: A current perspective. Patient Educ Couns 2004; 52: 243-248
    CrossrefPubMedGoogle Scholar
  • 32 Valero C, Monteagudo M, Llagostera M, Bayona X, Granollers S, Acedo M, Ferro JJ, Rodríguez-Latre L, Almeda J, Muñoz L. Evaluation of a combined strategy directed towards health-care professionals and patients with chronic obstructive pulmonary disease (COPD): Information and health education feedback for improving clinical monitoring and quality-of-life. BMC Public Health 2009; 9: 442
    CrossrefPubMedGoogle Scholar
  • 33 Vestbo J, Hurd SS, Agustí AG, Jones PW, Vogelmeier C, Anzueto A, Barnes PJ, Fabbri LM, Martinez FJ, Nishimura M, Stockley RA, Sin DD, Rodriguez-Roisin R. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit Care Med 2013; 187: 347-365
    CrossrefPubMedGoogle Scholar
  • 34 Vidotto G, Carone M, Jones PW, Salini S, Bertolotti G. Maugeri Respiratory Failure questionnaire reduced form: A method for improving the questionnaire using the Rasch model. Disabil Rehabil 2007; 29: 991-998
    CrossrefPubMedGoogle Scholar
  • 35 Skeletal muscle dysfunction in chronic obstructive pulmonary disease. A statement of the American Thoracic Society and European Respiratory Society. Am J Respir Crit Care Med 1999; 159: S1-S40
    PubMedGoogle Scholar