Endurance and strength training in pulmonary rehabilitation for COPD patients

Abstract

This study aimed to evaluate whether strength training is a useful addition to aerobic training in an early pulmonary rehabilitation (PR) program implemented for patients with COPD. Also to assess the outcomes of this program on the patients’ symptoms, spirometry, peripheral muscle strength, exercise capacity and health-related quality of life (HRQL). The study included 45 patients hospitalized with acute exacerbation of COPD. After receiving standard treatment for acute exacerbations, patients were randomly allocated to three groups. Besides medical treatment, the first two groups were assigned to an early PR program. Group1 performed endurance training (ET) alone, while group 2 performed combined training (CT) in the form of endurance plus strength training. The third group received medical treatment only. Baseline and outcome assessment included Medical Research Council dyspnea scale (mMRC), spirometry, peripheral muscle strength by measuring one repetition maximum (1RM), 6 min walk test and HRQL using St. George’s Respiratory Questionnaire. Both training modalities resulted in significant improvements in the degree of dyspnea, the HRQL and the functional exercise capacity measured by 6MWT. The CT was associated with additional improvements in peripheral muscle strength without increasing the duration of the training sessions (P < 0.01). PR is an effective intervention for the post-exacerbation management of COPD patients. It leads to significant improvements of dyspnea, HRQL and functional exercise capacity. When added to a program of ET, strength training confers additional benefits in muscle force, but not in overall exercise capacity or health status.