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Trials
Published in: Trials 1/2015

Open Access 01-12-2015 | Study protocol

Muscular and functional effects of partitioning exercising muscle mass in patients with chronic obstructive pulmonary disease - a study protocol for a randomized controlled trial

Authors: Andrè Nyberg, Didier Saey, Mickaël Martin, François Maltais

Published in: Trials | Issue 1/2015

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Abstract

Background

Low-load, high-repetitive single-limb resistance training may increase limb muscle function and functional exercise capacity in patients with chronic obstructive pulmonary disease (COPD) while minimizing the occurrence of limiting exertional symptoms. Whether high-repetitive single-limb resistance training would perform better than high-repetitive two-limb resistance training is unknown. In addition, the mechanisms underlying possible benefits of high-repetitive resistance training has not been investigated. The aims of this study are to compare single versus two-limb high-repetitive resistance training in patients with COPD and to investigate mechanisms of action of these training modalities.

Methods/Design

This trial is a prospective, assessor-blind, randomized controlled trial. The participants are patients with stable severe to very severe COPD who are older than 40 years of age and healthy controls. The intervention is single-limb, high-repetitive, resistance training with elastic bands, three times/week for 8 weeks.
The control is two-limb high-repetitive resistance training with elastic bands, three times/week for 8 weeks.
The primary outcomes is change in the 6-min walking distance after 8 weeks of single-limb or two-limb high-repetitive resistance training.
The secondary outcomes are changes in limb muscle strength and endurance capacity, key protein involved in quadriceps anabolic/catabolic signalization, fiber-type distribution and capillarization, subjective dyspnea and muscle fatigue, muscle oxygenation, cardiorespiratory demand and health-related quality-of-life after 8 weeks of single-limb or two-limb high-repetitive resistance training.
The acute effects of single-limb versus two-limb high-repetitive resistance training on contractile fatigue, exercise stimulus (the product of number of repetition and load), subjective dyspnea and muscle fatigue, muscle oxygenation, and cardiorespiratory demand during upper and lower limb exercises will also be investigated in patients with COPD and healthy controls.
Randomization will be performed using a random number generator by a person independent of the recruitment process, using 1:1 allocation to the intervention and the control group using random block sizes.
Blinding: All outcome assessors will be blinded to group assignment.

Discussion

The results of this project will provide important information to help developing and implementing customized exercise training programs for patients with COPD.

Trial registration

ClinicalTrials.gov Identifier NCT02283580 Registration date: 4 November 2014. First participant randomized: 10 November 2014.
Appendix
Available only for authorised users
Literature
1.
Houchen L, Steiner MC, Singh SJ. How sustainable is strength training in chronic obstructive pulmonary disease? Physiotherapy. 2009;95:1–7.CrossRefPubMed
2.
O’Shea SD, Taylor NF, Paratz J. Peripheral muscle strength training in COPD: a systematic review. Chest. 2004;126:903–14.CrossRefPubMed
3.
Burtscher M. Exercise Limitations by the Oxygen Delivery and Utilization Systems in Aging and Disease: Coordinated Adaptation and Deadaptation of the Lung-Heart Muscle Axis - A Mini-Review. Gerontology. 2013;59:289–96.CrossRefPubMed
4.
Rabe KF, Hurd S, Anzueto A, Barnes PJ, Buist SA, Calverley P, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit Care Med. 2007;176:532–55.CrossRefPubMed
5.
Serres I, Gautier V, Varray A, Prefaut C. Impaired skeletal muscle endurance related to physical inactivity and altered lung function in COPD patients. Chest. 1998;113:900–5.CrossRefPubMed
6.
Gosselink R, Troosters T, Decramer M. Peripheral muscle weakness contributes to exercise limitation in COPD. Am J Respir Crit Care Med. 1996;153:976–80.CrossRefPubMed
7.
Seymour JM, Spruit MA, Hopkinson NS, Natanek SA, Man WD, Jackson A, et al. The prevalence of quadriceps weakness in COPD and the relationship with disease severity. Eur Respir J. 2010;36:81–8.CrossRefPubMed
8.
O’Shea SD, Taylor NF, Paratz JD. Progressive resistance exercise improves muscle strength and may improve elements of performance of daily activities for people with COPD: a systematic review. Chest. 2009;136:1269–83.CrossRefPubMed
9.
Van’t Hul A, Harlaar J, Gosselink R, Hollander P, Postmus P, Kwakkel G. Quadriceps muscle endurance in patients with chronic obstructive pulmonary disease. Muscle Nerve. 2004;29:267–74.CrossRef
10.
American College of Sports Medicine position stand. Progression models in resistance training for healthy adults. Med Sci Sports Exerc. 2009;41:687–708.CrossRef
11.
Mador MJ. Exercise training in patients with COPD: one leg is better than two? Chest. 2008;133:337–9.CrossRefPubMed
12.
Goldstein RS, Hill K, Brooks D, Dolmage TE. Pulmonary rehabilitation: a review of the recent literature. Chest. 2012;142:738–49.CrossRefPubMed
13.
Dolmage TE, Goldstein RS. Effects of one-legged exercise training of patients with COPD. Chest. 2008;133:370–6.CrossRefPubMed
14.
Nyberg A, Lindstrom B, Rickenlund A, Wadell K. Low-load/high-repetition elastic band resistance training in patients with COPD: a randomized, controlled, multicenter trial. Clin Respir J. 2014. doi:10.1111/crj.12141.
15.
Bronstad E, Rognmo O, Tjonna AE, Dedichen HH, Kirkeby-Garstad I, Haberg AK, et al. High-intensity knee extensor training restores skeletal muscle function in COPD patients. Eur Respir J. 2012;40:1130–6.CrossRefPubMed
16.
Nyberg A, Lindstrom B, Wadell K. Assessing the effect of high-repetitive single limb exercises (HRSLE) on exercise capacity and quality of life in patients with chronic obstructive pulmonary disease (COPD): study protocol for randomized controlled trial. Trials. 2012;13:114.CrossRefPubMedPubMedCentral
17.
Nyberg A, Lindstrom B, Wadell K. A Cohort Study to Evaluate the Feasibility of Low Load/High Repetition Elastic Band Resistance Training for People with Chronic Obstructive Pulmonary Disease. Novel Physiotherpies. J Nov Physiother. 2014;4:190.CrossRef
18.
Burtin C, Saey D, Saglam M, Langer D, Gosselink R, Janssens W, et al. Effectiveness of exercise training in patients with COPD: the role of muscle fatigue. Eur Respir J. 2012;40:338–44.CrossRefPubMed
19.
Moher D, Hopewell S, Schulz KF, Montori V, Gotzsche PC, Devereaux PJ, et al. CONSORT 2010 Explanation and Elaboration: updated guidelines for reporting parallel group randomised trials. J Clin Epidemiol. 2010;63:e1–e37.CrossRefPubMed
20.
Boutron I, Moher D, Altman DG, Schulz KF, Ravaud P. Extending the CONSORT statement to randomized trials of nonpharmacologic treatment: explanation and elaboration. Ann Intern Med. 2008;148:295–309.CrossRefPubMed
21.
Puhan MA, Siebeling L, Frei A, Zoller M, Bischoff-Ferrari H, Ter Riet G. No association of 25-hydroxyvitamin D with exacerbations in primary care patients with COPD. Chest. 2014;145:37–43.CrossRefPubMed
22.
Rossman MJ, Garten RS, Venturelli M, Amann M, Richardson RS. The role of active muscle mass in determining the magnitude of peripheral fatigue during dynamic exercise. Am J Physiol Regul Integr Comp Physiol. 2014;306:934–40.CrossRef
23.
Voorrips LE, Ravelli AC, Dongelmans PC, Deurenberg P, Van Staveren WA. A physical activity questionnaire for the elderly. Med Sci Sports Exerc. 1991;23:974–9.CrossRefPubMed
24.
Page P, Ellenbecker ST. The scientific and clinical application of elastic resistance. Champaign, IL: Human Kinetics; 2003.
25.
Patterson RM, Stegink Jansen CW, Hogan HA, Nassif MD. Material properties of Thera-Band Tubing. Phys Ther. 2001;81:1437–45.PubMed
26.
ACSM. 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 healthy adults. Med Sci Sports Exerc. 1998;30:975–91.
27.
Janaudis-Ferreira T, Wadell K, Sundelin G, Lindstrom B. Thigh muscle strength and endurance in patients with COPD compared with healthy controls. Respir Med. 2006;100:1451–7.CrossRefPubMed
28.
Borg GA. Psychophysical bases of perceived exertion. Med Sci Sports Exerc. 1982;14:377–81.PubMed
29.
Jensen D, Amjadi K, Harris-McAllister V, Webb KA, O’Donnell DE. Mechanisms of dyspnoea relief and improved exercise endurance after furosemide inhalation in COPD. Thorax. 2008;63:606–13.CrossRefPubMed
30.
Martinez JA, Straccia L, Sobrani E, Silva GA, Vianna EO, Filho JT. Dyspnea scales in the assessment of illiterate patients with chronic obstructive pulmonary disease. Am J Med Sci. 2000;320:240–3.CrossRefPubMed
31.
Coronell C, Orozco-Levi M, Mendez R, Ramirez-Sarmiento A, Galdiz JB, Gea J. Relevance of assessing quadriceps endurance in patients with COPD. Eur Respir J. 2004;24:129–36.CrossRefPubMed
32.
Wise RA, Brown CD. Minimal Clinically Important Differences in the Six-Minute Walk Test and the Incremental Shuttle Walking Test. J Chron Obstruct Pulmon Dis. 2005;2:125–9.CrossRef
33.
ATS. ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med. 2002;166:111–7.CrossRef
34.
Takahashi T, Jenkins SC, Strauss GR, Watson CP, Lake FR. A new unsupported upper limb exercise test for patients with chronic obstructive pulmonary disease. J Cardiopulm Rehabil. 2003;23:430–7.CrossRefPubMed
35.
Vieira L, Bottaro M, Celes R, Viegas CA, E Silva CA. Isokinetic muscle evaluation of quadriceps in patients with chronic obstructive pulmonary disease. Rev Port Pneumol. 2010;16:717–36.CrossRefPubMed
36.
Roy JS, Ma B, Macdermid JC, Woodhouse LJ. Shoulder muscle endurance: the development of a standardized and reliable protocol. Sports Med Arthrosc Rehabil Ther Technol. 2011;3:1.CrossRefPubMedPubMedCentral
37.
Bernard S, LeBlanc P, Whittom F, Carrier G, Jobin J, Belleau R, et al. Peripheral muscle weakness in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 1998;158:629–34.CrossRefPubMed
38.
Man WD, Soliman MG, Gearing J, Radford SG, Rafferty GF, Gray BJ, et al. Symptoms and quadriceps fatigability after walking and cycling in chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2003;168:562–7.CrossRefPubMed
39.
Gosker HR, Lencer NH, Franssen FM, van der Vusse GJ, Wouters EF, Schols AM. Striking similarities in systemic factors contributing to decreased exercise capacity in patients with severe chronic heart failure or COPD. Chest. 2003;123:1416–24.CrossRefPubMed
40.
Neptune RR, Zajac FE, Kautz SA. Muscle force redistributes segmental power for body progression during walking. Gait Posture. 2004;19:194–205.CrossRefPubMed
41.
Thompson WRG, Pescatello NF, Linda S. ACSM’s guidelines for exercise testing and prescription. 8th ed. Philadelphia PA: Lippincott Williams & Wilkins; 2010.
42.
Jones PW, Harding G, Berry P, Wiklund I, Chen WH, Kline LN. Development and first validation of the COPD Assessment Test. Eur Respir J. 2009;34:648–54.CrossRefPubMed
43.
Krleza-Jeric K, Lemmens T. 7th revision of the Declaration of Helsinki: good news for the transparency of clinical trials. Croat Med J. 2009;50:105–10.CrossRefPubMedPubMedCentral
44.
Spruit MA, Singh SJ, Garvey C, ZuWallack R, Nici L, Rochester C, et al. An official American Thoracic Society/European Respiratory Society statement: key concepts and advances in pulmonary rehabilitation. Am J Respir Crit Care Med. 2013;188:13–64.CrossRef
45.
O’Donnell DE, Webb KA. The major limitation to exercise performance in COPD is dynamic hyperinflation. J Appl Physiol. 2008;105:753–7.CrossRefPubMed
46.
Aliverti A, Macklem PT. The major limitation to exercise performance in COPD is inadequate energy supply to the respiratory and locomotor muscles. J Appl Physiol. 2008;105:749–57.CrossRefPubMed
47.
Debigare R, Maltais F. The major limitation to exercise performance in COPD is lower limb muscle dysfunction. J Appl Physiol. 2008;105:751–7.CrossRefPubMed
48.
Gagnon P, Bussieres JS, Ribeiro F, Gagnon SL, Saey D, Gagne N, et al. Influences of spinal anesthesia on exercise tolerance in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2012;186:606–15.CrossRefPubMed
49.
Bjorgen S, Hoff J, Husby VS, Hoydal MA, Tjonna AE, Steinshamn S, et al. Aerobic high intensity one and two legs interval cycling in chronic obstructive pulmonary disease: the sum of the parts is greater than the whole. Eur J Appl Physiol. 2009;106:501–7.CrossRefPubMed
50.
De Angelis C, Drazen JM, Frizelle FA, Haug C, Hoey J, Horton R, et al. Clinical trial registration: a statement from the International Committee of Medical Journal Editors. Am J Phys Med Rehabil. 2005;84:3–4.CrossRefPubMed
Metadata
Title
Muscular and functional effects of partitioning exercising muscle mass in patients with chronic obstructive pulmonary disease - a study protocol for a randomized controlled trial
Authors
Andrè Nyberg
Didier Saey
Mickaël Martin
François Maltais
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Trials / Issue 1/2015
Electronic ISSN: 1745-6215
DOI
https://doi.org/10.1186/s13063-015-0698-x

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