Effectiveness of Different Exercise Training Programs to the Profile of COPD Patients - Full Text View

Purpose

Aims: To prove the benefits of an specific strength training program in COPD patients compared to those achieved with the traditional endurance training. We will assess which is the proper training modality and which of them is the most beneficial according to the features of the patient to whom it is applied.

Subjects and Methods: We will study 66 patients diagnosed of COPD with a moderate-severe obstruction (FEV1<60%) and clinically symptomatic. The monitoring will be done for 3 moths. Patients will be differentiated between COPD with "predominant chronic bronchitis" and COPD with "predominant emphysema", with regard to clinical, functional and radiological criteria. After stratification of the sample, patients will be prospectively assigned to three groups of 22 patients each: a) Endurance training group, on cycle ergometer at a workload of 70% VO2max. b) Strength training group, with 5 different weightlifting exercises (4 sets of 6-8 repetitions). c) Mixed training group, with half the time dedicated to each type of training. Training will be developed during 12 weeks, three times per week, in 40 minutes sessions. Analysed variables, at the beginning and at the end of program will be: Chest X-ray, basic blood analyses, electrocardiogram, simple spirometry and bronchodilator test, blood gases, static pulmonary volumes, diffusion measurement and respiratory muscle pressure. Muscle strength will be assessed by means of 1RM test and the Myometer® dynamometer. Using the muscle skeletal ultrasound, we will control changes in muscle fibre size. Maximal and submaximal exercise tests on cycle ergometer will be also performed, so as a walking test (shuttle walking test). At last, we will assess treatment effect on dyspnea (Mahler`s test) and quality of life (CRDQ).

Hypothesis: A strength training program would significantly increase peripheral muscle power. This type of training would mainly have effect on the "predominant emphysema" COPD patient, where the important weight lost causes a decrease in muscle strength.

Condition	Intervention	Phase
Obstructive Chronic Pulmonary Disease Emphysema	Other: Endurance training Other: Strength training Other: Combined training	Phase 4

Study Type:	Interventional
Study Design:	Allocation: Randomized Intervention Model: Parallel Assignment Masking: Single Blind (Investigator) Primary Purpose: Treatment
Official Title:	Effectiveness of Different Exercise Training Programs to the Profile of COPD Patients

Resource links provided by NLM:

MedlinePlus related topics: Emphysema Exercise and Physical Fitness Rehabilitation

U.S. FDA Resources

Further study details as provided by Hospitales Universitarios Virgen del Rocío:

Primary Outcome Measures:

Increase in minute submaximal exercise test [ Time Frame: Parameters will be measured at baseline and end of follow-up period of 12 months ] [ Designated as safety issue: No ]
Check that exercise training increases the tolerance time of submaximal test

Secondary Outcome Measures:

Meters increased 6-minute test after training exercise [ Time Frame: Parameters will be measured at baseline and end of follow-up period of 12 months ] [ Designated as safety issue: No ]
Check that exercise training increases the distance stroll on the walking test
Kg increase in the 1RM test after training exercise [ Time Frame: Parameters will be measured at baseline and end of follow-up period of 12 months ] [ Designated as safety issue: No ]
Increased peripheral muscle strength (1RM test) after training exercise
Improvement in dyspnea with a fall of one point in the BDI [ Time Frame: Parameters will be measured at baseline and end of follow-up period of 12 months ] [ Designated as safety issue: No ]
better control of symptoms (BDI test) after exercise training
Improved quality of life (CRQ) of at least one point (clinically significant) after exercise training [ Time Frame: Parameters will be measured at baseline and end of follow-up period of 12 months ] [ Designated as safety issue: No ]
better quality of life (CRQ) after exercise training

Enrollment:	66
Study Start Date:	March 2003
Study Completion Date:	December 2010
Primary Completion Date:	December 2010 (Final data collection date for primary outcome measure)

Arms	Assigned Interventions
Active Comparator: COPD with emphysema Analyze what type of training is more appropriate and beneficial as the patient characteristics that apply to you.	Other: Endurance training compare the efficacy of endurance, strength, and the combination of strength and endurance exercise training in patients with COPD. Other Name: Respiratory rehabilitation Other: Strength training compare the efficacy of endurance, strength, and the combination of strength and endurance exercise training in patients with COPD. Other Name: Respiratory Rehabilitation Other: Combined training compare the efficacy of endurance, strength, and the combination of strength and endurance exercise training in patients with COPD. Other Name: Respiratory Rehabilitation
Active Comparator: COPD non-emphysema compare the efficacy of endurance, strength, and the combination of strength and endurance exercise training in patients with COPD.	Other: Endurance training compare the efficacy of endurance, strength, and the combination of strength and endurance exercise training in patients with COPD. Other Name: Respiratory rehabilitation Other: Strength training compare the efficacy of endurance, strength, and the combination of strength and endurance exercise training in patients with COPD. Other Name: Respiratory Rehabilitation Other: Combined training compare the efficacy of endurance, strength, and the combination of strength and endurance exercise training in patients with COPD. Other Name: Respiratory Rehabilitation

Arms

Assigned Interventions

Active Comparator: COPD with emphysema

Analyze what type of training is more appropriate and beneficial as the patient characteristics that apply to you.

Other: Endurance training