Abstract
Background: Exercise training targets impaired exercise capacity in patients with advanced COPD, but the inter-individual response to a standardized training varies substantially.
Aim: to investigate variability in exercise response in male patients with advanced COPD attending a short-term high-intensity rehabilitation program.
Methods: Patients exercised 5x pw for 4 weeks in a supervised clinical setting. Blood samples, muscle biopsies, anthropometrics, body composition (DEXA) and exercise performance (6-minute walk test-6MWT, incremental shuttle test-ISWT, incremental cycle ergometry) were evaluated at start and end. Response was defined as difference in peak cycling performance: no response (A; <0 W), intermediate response (B; 0-10 W) and response > MCID (C; > 10 W); (MCID ref: Cazzola et al, ERJ 2008).
Results: 61 male patients (66±8 years, 85% GOLD III/IV) with no difference in age, disease severity or number of comorbidities across groups were included. B and C had high body mass index (BMI), waist circumference (WC) and baseline exercise performance. A had high CRP and low hemoglobin (Hb) and skeletal muscle mass index (SMI). B and C did not differ, except in ISWT. Muscle biopsies analyses are ongoing.
| A: No response (N=11) | B: Intermediate response (N=25) | C: Response (N=25) | p<0.05 | |
| CRP (mg/L) | 24.5 | 4.3 | 14 | AB |
| Hb (g/L) | 140 | 150 | 151 | AB, AC |
| BMI (kg/m2) | 22.6 | 26.1 | 26.8 | AB, AC |
| WC (cm) | 93 | 103 | 104 | AB, AC |
| SMI (kg/m2) | 7.3 | 7.5 | 7.8 | AC |
| ISWT (m) | 198 | 233 | 300 | AB, BC |
| 6MWT (m) | 273 | 330 | 370 | AC |
Conclusion: Body and muscle wasting and inflammation coincide with lack of training response in advanced COPD patients, but the indices are not discriminative for the responders.
- Copyright ©ERS 2015
