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Effect of pulmonary rehabilitation on peripheral muscle fiber remodelling in COPD patients with GOLD stages II to IV.
MedLine Citation:
PMID:  21493697     Owner:  NLM     Status:  Publisher    
Abstract BACKGROUND: In most patients with chronic obstructive pulmonary disease (COPD), rehabilitative exercise training partially reverses the morphological and structural abnormalities of peripheral muscle fibers. Whether the degree of improvement in muscle fiber morphology and typology with exercise training varies depending on disease severity remains, however, unknown. METHODS: Forty six clinically stable patients with COPD classified by GOLD as stage II (n=14), III (n=18) and IV (n=14), completed a 10-week comprehensive pulmonary rehabilitation program consisting of high-intensity exercise three times weekly. RESULTS: At baseline, muscle fibre mean cross sectional area and capillary density did not significantly differ between COPD patients and healthy controls, whereas muscle fiber type I and II proportion was respectively lower (p<0.001) and higher (p<0.002), in patients with GOLD stage IV compared to healthy subjects and patients with GOLD stages II and III. Exercise training improved to a comparable degree functional capacity and the St' Georges Respiratory Questionnaire health-related quality of life score, across all three GOLD stages. Vastus lateralis muscle fiber mean cross sectional area was increased (p<0.001) in all patient groups [stage II: from 4507±280 to 5091±271 μm(2) (14±3%); stage III: from 3753±258 to 4212±268 μm(2) (14±3%); stage IV: from 3961±266 to 4551±262 μm(2) (17±5%)], whilst all groups exhibited a comparable reduction (p<.001) in type IIb fiber proportion (stage II: by 6±2%; stage III: by 6±1%; stage IV: by 7±1%) and an increase (p<0.001) in capillary-fiber ratio [stage II: from 1.48±0.10 to 1.81±0.10 (23±5%); stage III: from 1.29±0.06 to 1.56±0.09 (21±5%); stage IV: from 1.43±0.10 to 1.71±0.13 (18±3%)]. The magnitude of changes in the aforementioned variables did not differ across GOLD stages. CONCLUSION: Functional capacity, morphologic and typologic adaptations to rehabilitation in peripheral muscle fibers were similar across GOLD stages II to IV. Pulmonary rehabilitation should be implemented in patients at all COPD stages.
Ioannis Vogiatzis; Gerasimos Terzis; Grigoris Stratakos; Evgenia Cherouveim; Dimitris Athanasopoulos; Stauroula Spetsioti; Ioannis Nasis; Panagiota Manta; Charis Roussos; Spyros Zakynthinos
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-4-14
Journal Detail:
Title:  Chest     Volume:  -     ISSN:  1931-3543     ISO Abbreviation:  -     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-4-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
1National of Kapodistrian University of Athens, Department of Critical Care Medicine, Pulmonary Rehabilitation Center, Evangelismos Hospital.
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