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Resistance training preserves skeletal muscle function in patients with COPD who are hospitalised with an acute exacerbation.
MedLine Citation:
PMID:  21843836     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
QUESTION: In patients with chronic obstructive pulmonary disease (COPD), hospitalised with an acute exacerbation, does resistance training preserve quadriceps muscle force or change markers of systemic inflammation or muscle metabolism?
DESIGN: Randomised controlled trial with concealed allocation. Neither the investigators nor the participants were blinded to group allocation.
SETTING: Tertiary hospital in Leuven, Belgium.
PARTICIPANTS: Key inclusion criteria were: people with COPD, hospitalised with an acute exacerbation, aged <85 years, not hospitalised in the previous 14 days, not participating in a rehabilitation program, and no co-morbid conditions precluding participation in resistance training. Randomisation of 40 patients allocated equal numbers to the intervention and groups.
INTERVENTIONS: Both groups received standard doses of oral corticosteroids and physiotherapy limited to airway clearance techniques and breathing exercises. In addition, each day, the intervention group performed three sets of eight repetitions of quadriceps resistance exercise, at a load set at 70% of the one repetition maximum. The load was progressed according to symptoms of dyspnoea and fatigue. Training sessions were supervised by physiotherapists.
OUTCOME MEASURES: The primary outcome was maximum isometric quadriceps force. Secondary outcomes included six-minute walk distance (6MWD) and serum concentrations of C-reactive protein, testosterone and insulin-like growth factor-1. In a sub-group of patients (n=20), gene expression for anabolism and catabolism were obtained via biopsy of vastus lateralis.
RESULTS: Data were available on 36 patients at the time of hospital discharge. At discharge, the mean difference in the magnitude of change in quadriceps force in the intervention group relative to the control group was 10.7% (95% CI 0.9 to 20.7%). The intervention group demonstrated a predominant expression of anabolic markers, whereas the control group tended to demonstrate a predominance of catabolic markers. There were no other significant between-group differences.
CONCLUSION: Resistance training for patients with COPD who were hospitalised for an exacerbation preserved quadriceps force without increasing biomarkers of systemic inflammation. [Mean difference and 95% CIs calculated by the CAP Editor].
Authors:
Didier Saey; Fernanda Ribeiro
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of physiotherapy     Volume:  57     ISSN:  1836-9553     ISO Abbreviation:  J Physiother     Publication Date:  2011  
Date Detail:
Created Date:  2011-08-16     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101528691     Medline TA:  J Physiother     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  194     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Australian Physiotherapy Association. Published by .. All rights reserved.
Affiliation:
Institut Universitaire de cardiologie et de pneumologie, de Québec, Canada.
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