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Peripheral Muscle Strength Training in COPD

A Systematic Review

      Background:

      Skeletal muscle weakness, and the associated impact on exercise tolerance, provides a strong theoretical rationale for strength training intervention for people with COPD.

      Aim:

      The purpose of this review was to examine systematically the current evidence for peripheral muscle strength training in people with COPD.

      Method:

      Empirical trials and reviews relating to strength training in COPD were obtained by searching electronic databases and citation tracking, using the keywords of COPD with strength/resistance training and skeletal muscle. Two reviewers completed data extraction and quality assessment independently, using the PEDro (physiotherapy evidence database) scale and a checklist for review articles. Effect sizes and 95% confidence intervals were determined for empiric trials and metaanalysis used where appropriate.

      Results:

      The search strategy yielded 13 articles (9 empirical trials and 4 reviews). Strength training was found to have strong evidence for improving upper body and leg strength. However, no strong evidence for strength training was found for other outcome measures.

      Conclusions:

      Further research is required to investigate the effects of strength training on functional activities, such as balance, upper limb function, self care, and participation in daily life.

      Key words

      Abbreviations:

      CI (confidence interval), CRDQ (chronic respiratory disease questionnaire), HRQL (health-related quality of life), ICF (International Classification of Functioning), PEDro (physiotherapy evidence database), SF-36 (Short Form-36 Health Status Questionnaire), SGRQ (St. George Respiratory Questionnaire), Ve (minute ventilation), Vo2 (oxygen consumption), 1RM (one repetition maximum), 6MWT (6-min walk test), 12MWT (12-min walk test)
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      References

        • Gosselink R
        • Troosters T
        • Decramer M
        Exercise training in COPD patients: the basic questions.
        Eur Respir J. 1997; 10: 2884-2891
        • Decramer M
        • Gosselink R
        • Troosters T
        • et al.
        Muscle weakness is related to utilization of health care resources in COPD patients.
        Eur Respir J. 1997; 10: 417-423
        • Morgan M
        • Singh S
        Practical pulmonary rehabilitation. Chapman & Hall, London, UK1997
        • ATS, ERS
        Skeletal muscle dysfunction in chronic obstructive pulmonary disease: a joint statement of the American Thoracic Society and European Respiratory Society.
        Am J Respir Crit Care Med. 1999; 159: S1-S40
        • Debigare R
        • Cote C
        • Maltais F
        Peripheral muscle wasting in chronic obstructive pulmonary disease.
        Am J Respir Crit Care Med. 2001; 164: 1712-1717
        • Jobin J
        • Maltais F
        • Doyon JF
        • et al.
        Chronic obstructive pulmonary disease: capillarity and fibre-type characteristics of skeletal muscle.
        J Cardiopulm Rehab. 1998; 18: 432-437
        • Serres I
        • Hayot M
        • Prefaut C
        • et al.
        Skeletal muscle abnormalities in patients with COPD: contribution to exercise intolerance.
        Med Sci Sports Exerc. 1998; 30: 1019-1027
        • Casaburi R
        Skeletal muscle function in COPD.
        Chest. 2000; 117: S267-S271
        • Centre for Evidence Based Medicine
        The physiotherapy evidence database (PEDro) scale items. New South Wales, Australia: University of Sydney.
        (Accessed April 10, 2003)
        • Oxman A
        Systematic reviews: checklists for review articles.
        BMJ. 1994; 309: 648-651
        • Schwarzer R
        Meta-analysis programs, version 5.1. Free University of Berlin, Berlin, Germany1989
        • Hedges L
        • Olkin I
        Statistical methods for meta-analysis. Academic Press, Orlando, FL1985
        • Howell DC
        Statistical methods for psychology. 3rd ed. PWS-Kent Publishing Company, Belmont, CA1992
        • Cohen J
        Statistical power analysis for behavioural sciences. Academic Press, New York, NY1988
        • WHO
        International classification of functioning, disability and health. World Health Organization, Geneva, Switzerland2002
        • O'Hara W
        • Lasachuk K
        • Matheson P
        • et al.
        Weight training and backpacking in chronic obstructive pulmonary disease.
        Respir Care. 1984; 29: 1202-1210
        • Ortega F
        • Toral J
        • Cejudo P
        • et al.
        Comparison of effects of strength and endurance training in patients with chronic obstructive pulmonary disease.
        Am J Respir Crit Care Med. 2002; 166: 669-674
        • Simpson K
        • Killian K
        • McCartney N
        • et al.
        Randomised controlled trial of weightlifting exercise in patients with chronic airflow limitation.
        Thorax. 1992; 47: 70-75
        • Spruit MA
        • Gosselink R
        • Troosters T
        • et al.
        Resistance versus endurance training in patients with COPD and peripheral muscle weakness.
        Eur Respir J. 2002; 19: 1072-1078
        • Bernard S
        • Whittom F
        • LeBlanc P
        • et al.
        Aerobic and strength training in patients with chronic obstructive pulmonary disease.
        Am J Respir Crit Care Med. 1999; 159: 896-901
        • Clark CJ
        • Cochrane LM
        • Mackay E
        • et al.
        Skeletal muscle strength and endurance in patients with mild COPD and the effects of weight training.
        Eur Respir J. 2000; 15: 92-97
        • Wright PR
        • Heck H
        • Langenkamp H
        • et al.
        Influence of a resistance training on pulmonary function and performance measures of patients with COPD. [in German].
        Pneumologie. 2002; 56: 413-417
        • Kaelin ME
        • Swank AM
        • Barnard KL
        • et al.
        Physical fitness and quality of life outcomes in a pulmonary rehabilitation program utilizing symptom limited interval training and resistance training.
        Journal of exercise physiology. 2001; 4: 30-37
        • Troosters T
        • Gosselink R
        • Decramer M
        Short- and long-term effects of outpatient rehabilitation in patients with chronic obstructive pulmonary disease: a randomized trial.
        Am J Med. 2000; 109: 207-212
        • Gosselink R
        • Decramer M
        Peripheral skeletal muscles and exercise performance in patients with chronic obstructive pulmonary disease.
        Monaldi Arch Chest Dis. 1998; 53: 419-423
        • Gosselink R
        • Decramer M
        Muscle training in pulmonary rehabilitation.
        Eur Respir Monograph. 2000; 5: 99-110
        • Montemayor T
        • Ortega F
        Strategies for muscular training in COPD: training of resistance, strength or both?.
        Arch Bronconeumol. 2001; 37: 279-285
        • Storer TW
        Exercise in chronic pulmonary disease: resistance exercise prescription.
        Med Sci Sports Exerc. 2001; 33: S680-S686
        • Guyatt GH
        • Berman LB
        • Townsend M
        • et al.
        A measure of quality of life for clinical trials in chronic lung disease.
        Thorax. 1987; 42: 773-778
        • Ware JE
        • Sherbourne CD
        The MOS 36 item short form health survey (SF-36): 1. Conceptual framework and item selection.
        Med Care. 1992; 30: 473-483
        • Butland RJA
        • Pang J
        • Gross ER
        • et al.
        Two, six and 12 minute walking tests in respiratory disease.
        BMJ. 1982; 284: 1607-1608
        • McGavin CR
        • Gupta SP
        • McHardy GJR
        Twelve-minute walking test for assessing disability in chronic bronchitis.
        BMJ. 1976; 1: 822-823
        • Singh SJ
        • Morgan MDL
        • Scott S
        • et al.
        Development of a shuttle walking test of disability in patients with chronic airways obstruction.
        Thorax. 1992; 47: 1019-1024
        • Jones P
        • Quirk FH
        • Baveystock CM
        • et al.
        A self complete measure of health status for chronic airflow limitation: the St. George's Respiratory Questionnaire.
        Am Rev Respir Dis. 1992; 145: 1321-1327
        • Kraemer WJ
        • Adams K
        • Cafarelli E
        • et al.
        American college of sports medicine position stand: progression models in resistance training for healthy adults.
        Med Sci Sports Exerc. 2002; 34: 364-380
        • Dodd K
        • Taylor N
        • Bradley S
        Strength training for older people Shoo, A Morris, M eds.Promoting physical activity and exercise in older people. Optimizing exercise and physical activity in older people. Butterworth Heinemann, Edinburgh, UK2003: 125-158
        • ATS
        Pulmonary Rehabilitation, 1999.
        Am J Respir Crit Care Med. 1999; 159: 1666-1682
        • ACCP, AACVPR
        Pulmonary rehabilitation: joint ACCP/AACVPR evidence-based guidelines.
        Chest. 1997; 112: 1363-1395
        • Pollock ML
        • Gaesser GA
        • Butcher JD
        • et al.
        American College of Sports Medicine position stand: the recommended quantity and quality of exercise for developing and maintaining cardiorespiratory and muscular fitness, and flexibility in health adults.
        Med Sci Sports Exerc. 1998; 30: 975-991
        • McArdle WD
        • Katch FI
        • Katch VL
        Essentials of exercise physiology. 2nd ed. Lippincott, Williams & Wilkins, Baltimore, MD2000
        • Morgan AD
        • Peck DF
        • Buchanan DR
        • et al.
        Effects of attitudes and beliefs on exercise tolerance in chronic bronchitis.
        BMJ. 1983; 286: 171-173
        • Weaver TE
        • Narsavage GL
        Physiological and psychological variables related to functional status in chronic obstructive pulmonary disease.
        Nurs Res. 1992; 41: 286-291
        • American Thoracic Society
        Quality of life resources.
        (Accessed May 20, 2003)
        • Curtis JR
        • Deyo RA
        • Hudson LD
        Health related quality of life among patients with chronic obstructive pulmonary disease.
        Thorax. 1994; 49: 162-170
        • Singh S
        The use of field walking tests for assessment of functional capacity in patients with chronic airways obstruction.
        Physiotherapy. 1992; 78: 102-104
        • Campbell AJ
        • Borrie MJ
        • Spears GF
        Risk factors for falls in a community-based prospective study of people 70 years and older.
        J Gerontol. 1989; 44: M112-M117
        • Aniansson A
        • Zetterberg C
        • Hedberg M
        • et al.
        Impaired muscle function with aging: a background factor in the incidence of fractures of the proximal end of the femur.
        Clin Orthop. 1984; 191: 193-201