Changes in Exercise Tolerance, Health Related Quality of Life, and Peripheral Muscle Characteristics of Chronic Obstructive Pulmonary Disease Patients After 6 Weeks' Training

Montes de Oca, M.; Torres, S.H.; González, Y.; Romero, E.; Hernández, N.; Tálamo, C.

doi:10.1016/S1579-2129(06)60255-3

Archivos de Bronconeumología

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Vol. 41. Issue 8.

Pages 413-418 (August 2005)

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Pages 413-418 (August 2005)

Original Articles

DOI: 10.1016/S1579-2129(06)60255-3

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Changes in Exercise Tolerance, Health Related Quality of Life, and Peripheral Muscle Characteristics of Chronic Obstructive Pulmonary Disease Patients After 6 Weeks' Training

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M. Montes de Ocaa,

Corresponding author

mmdeoca@cantv.net

Correspondence: Dra M. Montes de Oca. CCS 5150, PO Box 025323, Miami, FL 33102-5323, USA

, S.H. Torresb, Y. Gonzáleza, E. Romeroc, N. Hernándezb, C. Tálamoa

a Servicio de Neumonología, Hospital Universitario de Caracas, Universidad Central de Venezuela, Caracas, Venezuela

b Sección de Adaptación Muscular, Instituto de Medicina Experimental, Universidad Central de Venezuela, Caracas, Venezuela

c Instituto Nacional de Enfermedades Respiratorias, Universidad Nacional Autónoma de México, México DF, Mexico

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Objective

This study was designed to assess changes in skeletal muscle characteristics after 6 weeks' high-intensity physical training of patients with moderate to severe chronic obstructive pulmonary disease (COPD) and to determine how the changes were related to improvements in exercise tolerance and health related quality of life (HRQL).

Patients and methods

Ten patients with a mean (SD) age of 60 (10) years and a forced expiratory volume in 1 second of 32% (9%) were enrolled. The effect of training on the 6-minute walk test, HRQL questionnaires, and skeletal muscles was examined for the 8 patients who completed the program. The structural and chemical characteristics of skeletal muscles before and after training were studied in vastus lateralis muscle biopsies.

Results

Training significantly modified the 6-minute walk test (P <.01), HRQL (P <.05), and citrate synthetase activity (P <.05). Changes in distances walked during the 6-minute walk test were significantly related to changes in the mean area of fibers (r=0.81).

Conclusions

The results of this study indicate that 6 weeks of high-intensity physical training of COPD patients produces moderate changes in skeletal muscles which could partly explain improvements observed in exercise tolerance after respiratory rehabilitation.

Key Words:

Chronic obstructive pulmonary disease (COPD)

Respiratory rehabilitation

Skeletal muscles

Objetivo

Este estudio se diseñó para evaluar los cambios en las características de los músculos esqueléticos después de 6 semanas de entrenamiento físico de alta intensidad, en pacientes con enfermedad pulmonar obstructiva crónica (EPOC) moderada-grave, y para determinar cómo se relacionan con la mejoría de la tolerancia al esfuerzo y la calidad de vida relacionada con la salud (CVRS).

Pacientes t métodos

Se estudió a 10 pacientes (edad media ± desviación estándar: 60 ± 10 años) con un volumen espiratorio forzado en el primer segundo del 32 ± 9%. Se analizaron el efecto del entrenamiento sobre la marcha de 6 min (M6M), cuestionarios de CVRS y músculos esqueléticos en los 8 pacientes que completaron el programa. Se estudia-ron las características histoquímicas y morfológicas de los músculos esqueléticos antes y después del entrenamiento en biopsias del vastus lateralis.

Resultados

La intervención de estos pacientes modificó significativamente la M6M (p < 0,01), la CVRS (p < 0,05) y la actividad de la citrato sintetasa (p < 0,05). El cambio en la distancia recorrida durante la M6M se relacionó significativamente con el cambio en el área promedio de las fibras (r = 0,81).

Conclusiones

Los resultados de este trabajo indican que la intervención con 6 semanas de entrenamiento físico de alta intensidad en pacientes con EPOC induce cambios mo-destos en los músculos esqueléticos, que podrían explicar en parte los beneficios observados en la tolerancia al esfuerzo tras la rehabilitación respiratoria.

Palabras clave:

Enfermedad pulmonar obstructiva crónica (EPOC)

Rehabilitación respiratoria

Músculos esqueléticos

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