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Effects of the resistance training intervention on cross-sectional area of muscle fiber types I and II in m. vastus lateralis in COPD (n = 18) and Healthy (n = 55). A presents comparison of overall training effects on fiber CSA between COPD and Healthy, measured as relative changes from baseline to after the training intervention (per study cluster; left panel) and as relative differences in change scores between study clusters (right panel). In these analyses, high- and low-load resistance training (10RM and 30RM, respectively) were combined, warranted by the lack of significant differences between training load conditions in (B, C), though COPD tended to show higher efficacy of 30RM resistance training for changes in fiber type I CSA. B, C presents comparisons of effects of 10RM and 30RM resistance training on fiber CSA in COPD (B) and Healthy (C) (i.e. per study cluster), measured as relative changes from baseline to after the training intervention (left panels) and as relative and numeric differences in change scores between load conditions (right panels). Data are presented as means with 95% confidence limits
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Background
Subjects with chronic obstructive pulmonary disease (COPD) are prone to accelerated decay of muscle strength and mass with advancing age. This is believed to be driven by disease-inherent systemic pathophysiologies, which are also assumed to drive muscle cells into a state of anabolic resistance, leading to impaired abilities to adapt to...
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Citations
... In healthy elderly people, a dose-response relation with training parameters as well as with protein intake has been observed [81,82]. In patients with COPD, there is currently insufficient data to confirm this, although it is likely to be similar [83] as the overall response in muscle biology to resistance training in COPD is generally comparable with the response in healthy participants [84]. Importantly, resistance training also has effects on whole-body functional exercise tolerance and health-related quality of life in patients with COPD [85]. ...
Pulmonary rehabilitation has established a status of evidence-based therapy for patients with symptomatic COPD in the stable phase and after acute exacerbations. Rehabilitation should have the possibility of including different disciplines and be offered in several formats and lines of healthcare. This review focusses on the cornerstone intervention, exercise training, and how training interventions can be adapted to the limitations of patients. These adaptations may lead to altered cardiovascular or muscular training effects and/or may improve movement efficiency. Optimising pharmacotherapy (not the focus of this review) and oxygen supplements, whole-body low- and high-intensity training or interval training, and resistance (or neuromuscular electrical stimulation) training are important training modalities for these patients in order to accommodate cardiovascular and ventilatory impairments. Inspiratory muscle training and whole-body vibration may also be worthwhile interventions in selected patients. Patients with stable but symptomatic COPD, those who have suffered exacerbations and patients waiting for or who have received lung volume reduction or lung transplantation are good candidates. The future surely holds promise to further personalise exercise training interventions and to tailor the format of rehabilitation to the individual patient's needs and preferences.
... Exclusion criteria were unstable cardiovascular disease, chronic granulomatous disease, known active malignancy in the last five years, serious psychiatric comorbidity, and musculoskeletal disorders preventing the participant from participating in resistance training. The study's primary aim was to investigate the combined effects of vitamin D 3 supplementation and resistance training on a range of biological and health-and performance-related outcomes [13]. Only data from the first visit were used (i.e., prior to the onset of the supplementation and exercise training intervention). ...
Background:
Changes in tryptophan metabolism through the kynurenine pathway (KP) are observed in several disorders and coupled with pathophysiological deviations.
Methods:
This study retrospectively compared the KP in serum in healthy subjects (108) with subjects with obesity (141), depression (49), and chronic obstructive pulmonary disease (COPD) (22) participating in four clinical studies and explored predictors of the changes in the KP metabolites.
Results:
Compared with the healthy group, the KP was upregulated in the disease groups with high kynurenine, quinolinic acid (QA), kynurenine/tryptophan-ratio and QA/xanthurenic acid-ratio and low kynurenic acid/QA-ratio. Tryptophan and xanthurenic acid were upregulated in the depressed group compared with the groups with obesity and COPD. The covariates BMI, smoking, diabetes, and C-reactive protein explained the significant differences between the healthy group and the group with obesity but not between the healthy group and the groups with depression and COPD, indicating that different pathophysiological conditions result in the same changes in the KP.
Conclusions:
The KP was significantly upregulated in the disease groups compared with the healthy group, and there were significant differences between the disease groups. Different pathophysiological abnormalities seemed to result in the same deviations in the KP.
... The vitamin D 3 supplementation protocol did not affect mitochondrial function compared with placebo, evident as a lack of vitamin D 3 effect of both vitamin D 3 supplementation only and combined vitamin D 3 and RT ( Figure S1, legend). Adherence to the RT protocol was high and corresponded to a mean of 24.8 completed sessions (min-max: [21][22][23][24][25][26] in COPD and 25.3 (21)(22)(23)(24)(25)(26)(27) in controls. ...
... At baseline, 78 genes associated with mitochondrial function were differentially expressed between COPD and controls Resistance training increases mitochondrial function in COPD (Table S3); mostly genes related to metabolism. 27 Specifically, COPD showed lower expression of genes related to carbohydrate, fat, and protein metabolism (Table 4). Only one mitochondrial gene, TXNRD2, was differentially affected by 13 weeks of RT between COPD and controls (Table S3), and no MitoPathway categories were differentially changed, indicating similar mRNA responses to RT in COPD and controls. ...
... Of note, this scenario seems unlikely, as pulmonary function and scores of the COPD assessment test were preserved from before to after the intervention. 27 Second, the comparison of RT responses between COPD and control individuals was likely limited by the relatively small sample size. It thus remains possible that individuals with COPD are more amenable to RT-associated alterations in oxidative enzyme activity and mitochondrial respiration than healthy individuals. ...
Background
Chronic obstructive pulmonary disease (COPD) is associated with skeletal muscle mitochondrial dysfunction. Resistance exercise training (RT) is a training modality with a relatively small pulmonary demand that has been suggested to increase skeletal muscle oxidative enzyme activity in COPD. Whether a shift into a more oxidative profile following RT also translates into increased mitochondrial respiratory capacity in COPD is yet to be established.
Methods
This study investigated the effects of 13 weeks of RT on m. vastus lateralis mitochondrial capacity in 11 persons with moderate COPD [45% females, age: 69 ± 4 years (mean ± SD), predicted forced expiratory volume in 1 s (FEV1): 56 ± 7%] and 12 healthy controls (75% females, age: 66 ± 5 years, predicted FEV1: 110 ± 16%). RT was supervised and carried out two times per week. Leg exercises included leg press, knee extension, and knee flexion and were performed unilaterally with one leg conducting high‐load training (10 repetitions maximum, 10RM) and the other leg conducting low‐load training (30 repetitions maximum, 30RM). One‐legged muscle mass, maximal muscle strength, and endurance performance were determined prior to and after the RT period, together with mitochondrial respiratory capacity using high‐resolution respirometry and citrate synthase (CS) activity (a marker for mitochondrial volume density). Transcriptome analysis of genes associated with mitochondrial function was performed.
Results
Resistance exercise training led to similar improvements in one‐legged muscle mass, muscle strength, and endurance performance in COPD and healthy individuals. In COPD, mitochondrial fatty acid oxidation capacity and oxidative phosphorylation increased following RT (+13 ± 22%, P = 0.033 and +9 ± 23%, P = 0.035, respectively). Marked increases were also seen in COPD for mitochondrial volume density (CS activity, +39 ± 35%, P = 0.001), which increased more than mitochondrial respiration, leading to lowered intrinsic mitochondrial function (respiration/CS activity) for complex‐1‐supported respiration (−12 ± 43%, P = 0.033), oxidative phosphorylation (−10 ± 42%, P = 0.037), and electron transfer system capacity (−6 ± 52%, P = 0.027). No differences were observed between 10RM and 30RM RT, nor were there any adaptations in mitochondrial function following RT in healthy controls. RT led to differential expression of numerous genes related to mitochondrial function in both COPD and healthy controls, with no difference being observed between groups.
Conclusions
Thirteen weeks of RT resulted in augmented skeletal muscle mitochondrial respiratory capacity in COPD, accompanied by alterations in the transcriptome and driven by an increase in mitochondrial quantity rather than improved mitochondrial quality.
Chronic obstructive pulmonary disease (COPD) patients manifest muscle dysfunction and impaired muscle oxidative capacity, which result in reduced exercise capacity and poor health status. The aim of this study was to compare the physical performance, systemic inflammation, and oxidative stress of patients with moderate COPD, and to associate physical performance with inflammatory and oxidative stress plasma markers. Twenty CONTROL (n = 10) and moderate COPD (n = 10) patients participated in this study. Systematic inflammation and oxidative stress plasma markers, maximal aerobic capacity (VO2peak), and maximal isometric strength (MVIC) of the knee extensor (KE) muscles were measured. VO2peak was 31.3% greater in CONTROL compared to COPD (P = 0.006). The MVIC strength of the KE was 43.9% greater in CONTROL compared to COPD (P = 0.002). Tumor necrosis factor-alpha (TNF-α) was 79.6% greater in COPD compared to CONTROL (P < 0.001). Glutathione peroxidase activity (GPx) activity was 27.5% lesser in COPD compared to CONTROL (P = 0.05). TNF-α concentration was correlated with KE MVC strength (R = −0.48; P = 0.045) and VO2peak (R = −0.58; P = 0.01). Meanwhile, malondialdehyde (MDA) and GPx activity were not associated with KE strength or VO2peak (P = 0.74 and P = 0.14, respectively). COPD patients showed lesser muscle strength and aerobic capacity than healthy control individuals. Furthermore, patients with COPD showed greater systemic inflammation and lesser antioxidant capacity than healthy counterparts. A moderate association was evident between levels of systemic inflammation and physical performance variables.KeywordsCOPDPulmonary rehabilitationRespiratoryTNF-alpha
Introduction
Low fat-free mass (FFM) is linked to poor health outcomes in COPD, including impaired exercise tolerance and premature death. The aim of this systematic review was to synthesise evidence on the effectiveness of interventions for increasing FFM in COPD.
Methods
Searches of electronic databases (MEDLINE, Cochrane Library, EMBASE, Web of Science, Scopus) and trial registers (ClinicalTrials.gov) were undertaken from inception to August 2022 for randomised studies of interventions assessing measures of FFM in COPD. The primary outcome was change in FFM (including derivatives). Secondary outcomes were adverse events, compliance, and attrition.
Results
99 studies (n=5138 people with COPD) of 11 intervention components, used alone or in combination, were included. Exercise training increased mid-thigh cross-sectional area ( k =3, SMD=1.04, 95% CI 0.02–2.06, p=0.04), but not FFM ( k =4, SMD=0.03, 95% CI −0.18–0.24, p=0.75). Nutritional supplementation significantly increased FFM index ( k =11, SMD=0.31, 95% CI 0.13–0.50, p<0.001), but not FFM ( k =19, SMD=0.16, 95% CI −0.06–0.39, p=0.16). Combined, exercise training and nutritional supplementation increased measures related to FFM in 67% of studies. Anabolic steroids increased FFM ( k =4, SMD=0.98, 95% CI 0.24–1.72, p=0.009). Neuromuscular electrical stimulation increased measures related to FFM in 50% of studies. No interventions were more at risk of serious adverse events, low compliance, or attrition.
Discussion
Exercise training and nutritional supplementation were not effective in isolation to increase FFM but were for localised muscle and index measures, respectively. Combined, exercise and nutritional supplementation shows promise as a strategy to increase FFM in COPD. Anabolic steroids are efficacious for increasing FFM in COPD.
Bakgrunn: Regelmessig styrketrening gir gunstige helseeffekter for personer med kronisk obstruktiv lungesykdom (KOLS), og er derfor en naturlig del av lungerehabiliteringen. Pasienters opplevelse av slik trening er imidlertid lite studert. Hensikten med denne kvalitative studien var å kartlegge erfaringer med styrketrening hos deltakere i The Granheim COPD Study.
Materiale og metode: Åtte av 24 prosjektdeltakere med KOLS (kvinner/menn, n=3/n=5; KOLS grad II/III, n=4/n=4; alder, 64-79 år) gjennomførte semistrukturerte, kvalitative intervjuer i den femte av totalt 13 uker med styrketrening.
Funn: Samlet for alle prosjektdeltakerne med KOLS var treningsadherensen høy (97%) og frafallet lavt (n=2 av 22) under treningsperioden. Informantene som gjennomførte kvalitative intervjuer opplevde nokså høy og stigende grad av motivasjon for å trene under intervensjonen. Dette var knyttet til tett personlig oppfølging fra treningskyndig personell og opplevelse av trygghet under treningsøktene, samt økt mestringsfølelse og økt kompetanse.
Fortolkning: Personlig veiledning fra treningskyndig personell var en avgjørende faktor for å øke treningsmotivasjonen blant studiedeltakerne. Individuell tilrettelegging og oppfølging ser derfor ut til å være en forutsetning for å oppnå gode aktivitetsvaner hos personer med KOLS.
Nøkkelord: atferdsendring, kvalitativ forskning, lungerehabilitering, personlig treningsveiledning, treningsmotivasjon.
https://fysioterapeuten.no/fagfellevurdert-fysioterapi-kols/styrketrening-ved-kronisk-obstruktiv-lungesykdom-erfaringer-fra-the-granheim-copd-study-en-kvalitativ-analyse-av-motivasjonsfaktorer/134035
