Abstract
Systemic effects of COPD lead to cardiovascular co-morbidities, muscle wasting and osteoporosis that, in turn, lead to inactivity and physical deconditioning. This evolution has a direct influence on the health-related quality of life (HRQoL) of patients suffering from this respiratory disease. Pharmacological therapy leads to improvement in shortness of breath, but it has a limited effect on the physical deconditioning. Pulmonary rehabilitation relieves dyspnoea and fatigue, improves emotional function and enhances the sense of control that individuals have over their condition. These improvements are moderately substantial and clinically significant. Rehabilitation serves as an essential component of the management of COPD and is beneficial in improving health-related quality of life and exercise capacity.
Keywords
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Abbreviations
- 6-MWD:
-
6 minute walking test
- AECOPD:
-
Acute exacerbations of chronic obstructive pulmonary disease
- COPD:
-
Chronic obstructive pulmonary disease,
- CPAP:
-
Continuous positive airway pressure
- DW:
-
Downhill walking
- HRQOL:
-
Health-related quality of life
- HX:
-
Heliox
- IMT:
-
Inspiratory muscle training
- LFF:
-
Low-frequency fatigue
- MTL:
-
Mechanical threshold loading
- NIV:
-
Non-invasive ventilation
- NMES:
-
Neuromuscular electrical stimulation
- PImax:
-
Maximal inspiratory pressure
- PR:
-
Pulmonary rehabilitation
- QoL:
-
Quality of life
- RT:
-
Resistance training
- TFRL-IMT:
-
Dynamically controlled tapered flow resistive load
- WBVT:
-
Whole-body vibration training
References
GOLD (2018) Global strategy for the diagnosis, management and prevention of COPD, Global Initiative for Chronic Obstructive Lung Disease (GOLD). https://goldcoped.org/
Gea J, Agusti A, Roca J (2013) Pathophysiology of muscle dysfunction in COPD. J Appl Physiol 114(9):1222–1234
Barreiro E, Rabinovich R, Marin-Corral J, Barberà JA, Gea J, Roca J (2009) Chronic endurance exercise induces quadriceps nitrosative stress in patients with severe COPD. Thorax 64:13–19
Saey D, Michaud A, Couillard A, Cote CH, Mador MJ, LeBlanc P, Jobin J, Maltais F (2005) Contractile fatigue, muscle morphometry, and blood lactate in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 171(10):1109–1115
Nolan CM, Longworth L, Lord J, Canavan JL, Jones SE, Kon SS, Man WD (2016) The EQ-5D-5L health status questionnaire in COPD: validity, responsiveness and minimum important difference. Thorax 71:493–500
Jobin J, Maltais F, Doyon JF, eBlanc P, Simard PM, Simard AA, Simard C (1998) Chronic obstructive pulmonary disease: capillarity and fiber type characteristics of skeletal muscle. J Cardiopulm Rehabil 18(6):432–437
Faisal A, Alghamdi BJ, Ciavaglia CE, Elbehairy AF, Webb KA, Ora J, Neder JA, O’Donnell DE (2016) Common Mechanisms of Dyspnea in Chronic Interstitial and Obstructive Lung Disorders. Am J Respir Crit Care Med 193(3):299–309
Marquis K, Debigaré R, Lacasse Y, LeBlanc P, Jobin J, Carrier G, Maltais F (2002) Midthigh muscle cross-sectional area is a better predictor of mortality than body mass index in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 166(6):809–813
Gosker HR, Zeegers MP, Wouters EF, Schols AM (2007) Muscle fibre type shifting in the vastus lateralis of patients with COPD is associated with disease severity: a systematic review and meta-analysis. Thorax 62(11):944–949
Seymour JM, Ward K, Sidhu PS, Puthucheary Z, Steier J, Jolley CJ, Rafferty G, Polkey MI, Moxham J (2009) Ultrasound measurement of rectus femoris cross-sectional area and the relationship with quadriceps strength in COPD. Thorax 64:418–423
Barreiro E, Jaitovich A (2018) Muscle atrophy in chronic obstructive pulmonary disease: molecular basis and potential therapeutic targets. J Thorac Dis 10(12):S1415–S1424
Maltais F, Decramer M, Casaburi R, Barreiro E, Burelle Y, Debigaré R, Dekhuijzen PN, Franssen F, Gayan-Ramirez G, Gea J, Gosker HR, Gosselink R, Hayot M, Hussain SN, Janssens W, Polkey MI, Roca J, Saey D, Schols AM, Spruit MA, Steiner M, Taivassalo T, Troosters T, Vogiatzis I, Wagner PD, ATS/ERS Ad Hoc Committee on Limb Muscle Dysfunction in COPD (2014) An official American Thoracic Society/European Respiratory Society statement: update on limb muscle dysfunction in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 189(9):e15–e62
Shavlakadze T, Chai J, Maley K, Cozens G, Grounds G, Winn N, Rosenthal N, Grounds MD (2010) A growth stimulus is needed for IGF-1 to induce skeletal muscle hypertrophy in vivo. J Cell Sci 123(Pt 6):960–971
Wang J, Guo S, Zeng M, Yu P, Mo W (2019) Observation of the curative effect of device-guided rehabilitation on respiratory function in stable patients with chronic obstructive pulmonary disease. Medicine (Baltimore) 98(8):e14034
Tieland M, Trouwborst I, Clark BC (2018) Skeletal muscle performance and ageing. J Cachexia Sarcopenia Muscle 9(1):3–19
Jones SE, Maddocks M, Kon SS, Canavan JL, Nolan CM, Clark AL, Polkey MI, Man WD (2015) Sarcopenia in COPD: prevalence, clinical correlates and response to pulmonary rehabilitation. Thorax 70(3):213–218
Hottenrott K, Ludyga S, Schulze S (2012) Effects of high intensity training and continuous endurance training on aerobic capacity and body composition in recreationally active runners. J Sports Sci Med 11(3):483–488
Mangine GT, Hoffman JR, Gonzalez AM, Townsend JR, Wells AJ, Jajtner AR, Beyer KS, Boone CH, Miramonti AA, Wang R, LaMonica MB, Fukuda DH, Ratamess NA, Stout JR (2015) The effect of training volume and intensity on improvements in muscular strength and size in resistance-trained men. Physiol Rep 3(8):pii: e12472
Garber CE, Blissmer B, Deschenes MR, Franklin BA, Lamonte MJ, Lee IM, Nieman DC, Swain DP (2011) American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Med Sci Sports Exerc 43(7):1334–1359
Blackstock FC, Lareau SC, Nici L, ZuWallack R, Bourbeau J, Buckley M, Durning SJ, Effing TW, Egbert E, Goldstein RS, Kelly W, Lee A, Meek PM, Singh S, American Thoracic Society, Thoracic Society of Australia and New Zealand, Canadian Thoracic Society, and British Thoracic Society (2018) Chronic obstructive pulmonary disease education in pulmonary rehabilitation. Ann Am Thorac Soc 15:769
Iepsen UW, Jørgensen KJ, Ringbæk T, Hansen H, Skrubbeltrang C, Lange P (2015) A combination of resistance and endurance training increases leg muscle strength in COPD: an evidence-based recommendation based on systematic review with meta-analyses. Chron Respir Dis 12:132–145
Hortobagyi T, DeVita P (2000) Favorable neuromuscular and cardiovascular responses to 7 days of exercise with an eccentric overload in elderly women. J Gerontol Ser A Biol Sci Med Sci 55(8):B401–B410
Osadnik CR, Rodrigues FM, Camillo CA, Loeckx M, Janssens W, Dooms C, Troosters T (2015) Principles of rehabilitation and reactivation. Respiration 89(1):2–11
Roseguini MH, Roseguini B (2018) Mechanisms for exercise training-induced increases in skeletal muscle blood flow capacity: differences with interval sprint training versus aerobic endurance training. J Physiol Pharmacol 59(Suppl 7):71–88
Guiraud T, Nigam A, Gremeaux V, Meyer P (2012) High-intensity interval training in cardiac rehabilitation. Sports Med 42(7):587–605
Bisca GW, Camillo CA, Cavalheri V, Pitta F, Osadnik CR (2017) Peripheral muscle training in patients with chronic obstructive pulmonary disease: novel approaches and recent advances. Expert Rev Respir Med 11(5):413–423
Strohacker K, Fazzino D, Breslin WL, Xu X (2015) The use of periodization in exercise prescriptions for inactive adults: a systematic review. Prev Med Rep 2:385–396
Alansare A, Alford K, Lee S, Church T, Jung HC (2018) The effects of high intensity interval training vs. moderate intensity continuous training on heart rate variability in physically inactive adults. Int J Environ Res Public Health 15(7):1508
Nyberg A, Lindström B, Wadell K (2012) 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 13:114
Barreiro E, Gea J (2016) Molecular and biological pathways of skeletal muscle dysfunction in chronic obstructive pulmonary disease. Chron Respir Dis 13(3):297–311
Beaumont M, Forget P, Couturaud F, Reychler G (2018) Effects of inspiratory muscle training in COPD patients: a systematic review and meta-analysis. Clin Respir J 12(7):2178–2188
Ambrosino N (2011) The case for inspiratory muscle training in COPD. Eur Respir J 37(2):233–235
Langer D, Charususin N, Jacome C, Hoffman M, McConnell A, Decramer M, Gosselink R (2015) Efficacy of a novel method for inspiratory muscle training in people with chronic obstructive pulmonary disease. J Phys Ther Sci 95(9):1264–1273
Charususin N, Gosselink R, McConnell A, Demeyer H, Topalovic M, Decramer M, Langer D (2016) Inspiratory muscle training improves breathing pattern during exercise in COPD patients. Eur Respir J 47(4):1261–1264
Gosselink R, De Vos J, van den Heuvel SP, Segers J, Decramer M, Kwakkel G (2011) Impact of inspiratory muscle training in patients with COPD: what is the evidence? Eur Respir J 37(2):416–425
Petrovic M, Reiter M, Zipko H, Pohl W, Wanke T (2012) Effects of inspiratory muscle training on dynamic hyperinflation in patients with COPD. Int J Chron Obstruct Pulmon Dis 7:797–805
Moezy A, Erfani A, Mazaherinezhad A, Mousavi SAJ (2018) Downhill walking influence on physical condition and quality of life in patients with COPD: a randomized controlled trial. Med J Islam Repub Iran 14:32–49
Camillo CA, Burtin C, Hornikx M, Demeyer H, De Bent K, van Remoortel H, Osadnik CR, Janssens W, Troosters T (2015) Physiological responses during downhill walking: a new exercise modality for subjects with chronic obstructive pulmonary disease? Chron Respir Dis 12(2):155–164
Maeo S, Yamamoto M, Kanehisa H (2015) Muscular adaptations to short-term low-frequency downhill walking training. Int J Sports Med 36(2):150–156
Burtin C, Saey D, Saglam M, Langer D, Gosselink R, Janssens W, Decramer M, Maltais F, Troosters T (2012) Effectiveness of exercise training in patients with COPD: the role of muscle fatigue. Eur Respir J 40:338–344
Erfani A, Moezy A, Mazaherinezhad A, Mousavi SA (2015) Does downhill walking on treadmill improve physical status and quality of life of a patient with COPD? Asian J Sport Med 6(4):e 25821
Pleguezuelos E, Esquinas C, Moreno E, Guirao L, Ortiz J, Garcia-Alsina J, Merí A, Miravitlles M (2016) Muscular dysfunction in COPD: systemic effect or deconditioning? Lung 194(2):249–257
Hoppeler H (2016) Moderate load eccentric exercise; a distinct novel training modality. Front Physiol 7:483
Lee AL, Holland AE (2014) Time to adapt exercise training regimens in pulmonary rehabilitation—a review of the literature. Int J Chron Obstruct Pulmon Dis 9:1275–1288
Richardson RS, Frank LR, Haseler LJ (1988) Dynamic knee-extensor and cycle exercise: functional MRI of muscular activity. Int J Sports Med 19(3):182–1877
Nyberg A, Saey D, Martin M (2016) Acute effects of low-load/high-repetition single-limb resistance training in COPD. Med Sci Sports Exerc 48(12):2353–2361
Rocha Vieira DS, Baril J, Richard R, Perrault H, Bourbeau J, Taivassalo T (2011) Eccentric cycle exercise in severe COPD: feasibility of application. COPD 8(4):270–274
Abbiss CR, Karagounis LG, Laursen PB, Peiffer JJ, Martin DT, Hawley JA, Fatehee NN, Martin JC (2011) Single-leg cycle training is superior to double-leg cycling in improving the oxidative potential and metabolic profile of trained skeletal muscle. J Appl Physiol 110:1248–1255
Abbiss CR, Levin G, McGuigan MR, Laursen PB (2008) Reliability of power output during dynamic cycling. Int J Sports Med 29:574–578
Lindenthaler JR, Rice AJ, Versey NG, McKune AJ, Welvaert M (2018) Differences in physiological responses during rowing and cycle ergometry in elite male rowers. Front Physiol 9:1010
Jones S, Man WD, Gao W, Higginson IJ, Wilcock A, Maddocks M (2016) Neuromuscular electrical stimulation for muscle weakness in adults with advanced disease. Cochrane Database Syst Rev 10:CD009419
MacMillan NJ, Kapchinsky S, Konokhova Y, Gouspillou G, de Sousa SR, Jagoe RT, Baril J, Carver TE, Andersen RE, Richard R, Perrault H, Bourbeau J, Hepple RT, Taivassalo T (2017) Eccentric ergometer training promotes locomotor muscle strength but not mitochondrial adaptation in patients with severe chronic obstructive pulmonary disease. Front Physiol 8:114
Maddocks M, Nolan CM, Man WD, Polkey MI, Hart N, Gao W, Rafferty GF, Moxham J, Higginson IJ (2016) Neuromuscular electrical stimulation to improve exercise capacity in patients with severe COPD: a randomised double-blind, placebo-controlled trial. Lancet Respir Med 4:27
Abdellaoui A, Préfaut C, Gouzi F, Couillard A, Coisy-Quivy M, Hugon G, Molinari N, Lafontaine T, Jonquet O, Laoudj-Chenivesse D, Hayot M (2011) Skeletal muscle effects of electro stimulation after COPD exacerbation: a pilot study. Eur Respir J 38(4):781–788
Shen J, Nie X, Huang SY, Qin YQ, Pan LL, Wang XT (2019) Neuromuscular electrical stimulation improves muscle atrophy induced by chronic hypoxia-hypercapnia through the MicroRNA-486/PTEN/FoxO1 pathway. Biochem Biophys Res Commun 509(4):1021–1027
Hill K, Cavalheri V, Mathur S, Roig M, Janaudis-Ferreira T, Robles P, Dolmage TE, Goldstein R (2018) Neuromuscular electrostimulation for adults with chronic obstructive pulmonary disease. Cochrane Database Syst Rev 5:CD010821
Giavedoni S, Deans A, McCaughey P, Drost E, MacNee W, Rabinovich RA (2012) Neuromuscular electrical stimulation prevents muscle function deterioration in exacerbated COPD: a pilot study. Respir Med 106(10):1429–1434
Pleguezuelos E, Casarramona P, Guirao L, Samitier B, Ortega P, Vila X, Carmen AD, Ovejero L, Moreno E, Serra N, Gomís M, Garnacho-Castaño MV, Miravitlles M (2018) How whole-body vibration can help our COPD patients. Physiological changes at different vibration frequencies. Int J Chron Obstruct Pulmon Dis 13:3373–3380
Lage VKS, Lacerda ACR, Neves CDC, Chaves MGA, Soares AA, Lima LP, Matos MA, Leite HR, Fernandes JSC, Oliveira VC, Mendonça VA (2019) Cardiorespiratory responses in different types of squats and frequencies of whole body vibration in patients with chronic obstructive pulmonary disease. J Appl Physiol 126(1):23–29
Zhou J, Pang L, Chen N, Wang Z, Wang C, Hai Y, Lyu M, Lai H, Lin F (2018) Whole-body vibration training—better care for COPD patients: a systematic review and meta-analysis. Int J Chron Obstruct Pulmon Dis 13:3243–3254
Neves CDC, Lacerda ACR, Lage VKS, Soares AA, Chaves MGA, Lima LP, Silva TJ, Vieira ÉLM, Teixeira AL, Leite HR, Matos MA, Mendonça VA (2018) Whole body vibration training increases physical measures and quality of life without altering inflammatory-oxidative biomarkers in patients with moderate COPD. J Appl Physiol 125(2):520–522
Spielmanns M, Gloeckl R, Gropp JM, Nell C, Koczulla AR, Boeselt T, Storre JH, Windisch W (2017) Whole-body vibration training during a low frequency outpatient exercise training program in chronic obstructive pulmonary disease patients: a randomized, controlled trial. J Clin Med Res 9(5):396–402
Rauch F, Sievanen H (2010) International Society of Musculoskeletal and Neuronal Interactions. Reporting whole-body vibration intervention studies: recommendations of the International Society of Musculoskeletal and Neuronal Interactions. J Musculoskelet Neuronal Interact 10(3):193–198
Cardim AB, Marinho PE, Nascimento JF Jr, Fuzari HK, Dornelas de Andrade A (2016) Does whole-body vibration improve the functional exercise capacity of subjects with COPD? A meta-analysis. Respir Care 61(11):1552–1559
Cristi-Montero C, Cuevas MJ, Collado PS (2013) Whole-body vibration training as complement to programs aimed at weight loss. Nutr Hosp 28(5):1365–1371
Cristi C, Collado PS, Marquez S, Garatachea N, Cuevas MJ (2014) Whole-body vibration training increases physical fitness measures without alteration of inflammatory markers in older adults. Eur J Sport Sci 14:611–619
Rodriguez-Miguelez P, Fernandez-Gonzalo R, Collado PS, Almar M, Martinez-Florez S, de Paz JA, Gonzalez-Gallego J, Cuevas MJ (2015) Whole-body vibration improves the anti-inflammatory status in elderly subjects through toll-like receptor 2 and 4 signaling pathways. Mech Ageing Dev 150:12–19
Borghi-Silva A, Oliveira CC, Carrascosa C, Maia J, Berton DC, Queiroga F Jr, Ferreira EM, Almeida DR, Nery LE, Neder JA (2008) Respiratory muscle unloading improves leg muscle oxygenation during exercise in patients with COPD. Thorax 63(10):910–915
Troosters T, Probst VS, Crul T, Pitta F, Gayan-Ramirez G, Decramer M, Gosselink R (2010) Resistance training prevents deterioration in quadriceps muscle function during acute exacerbations of chronic obstructive pulmonary disease. Am J Respir Crit Care Med 181(10):1072–1077
Man WD, Hopkinson NS, Harraf F, Nikoletou D, Polkey MI, Moxham J (2005) Abdominal muscle and quadriceps strength in chronic obstructive pulmonary disease. Thorax 60(9):718–722
Ferreira IM, Brooks D, Lacasse Y, Goldstein RS (2000) Nutritional support for individuals with COPD: a meta-analysis. Chest 117(3):672–678
Lakhdar R, Rabinovich RA (2018) Can muscle protein metabolism be specifically targeted by nutritional support and exercise training in chronic obstructive pulmonary disease? J Thorac Dis 10(12):S1377–S1389
Alison JA, McKeough ZJ, Jenkins SC, Holland AE, Hill K, Morris NR, Leung RW, Williamson KA, Spencer LM, Hill CJ, Lee AL, Seale H, Cecins N, McDonald CF (2016) A randomised controlled trial of supplemental oxygen versus medical air during exercise training in people with chronic obstructive pulmonary disease: supplemental oxygen in pulmonary rehabilitation trial (SuppORT) (Protocol). BMC Pulm Med 16:25
Sadaka AS, Montgomery AJ, Mourad SM, Polkey MI, Hopkinson NS (2018) Exercise response to oxygen supplementation is not associated with survival in hypoxemic patients with obstructive lung disease. Int J Chron Obstruct Pulmon Dis 13:1607–1612
Camillo CA, Osadnik CR, van Remoortel H, Burtin C, Janssens W, Troosters T (2016) Effect of “add-on” interventions on exercise training in individuals with COPD: a systematic review. ERJ Open Res 2(1):pii: 00078-2015
Ou YE, Lin ZM, Wu WL, Luo Q, Chen RC (2016) Efficacy of non-invasive ventilation as a rescue therapy for relieving dyspnea in patients with stable severe COPD. Respir Med 121:74–80
Menadue C, Piper AJ, van’t Hul AJ, Wong KK (2014) Non-invasive ventilation during exercise training for people with chronic obstructive pulmonary disease. Cochrane Database Syst Rev (5):CD007714
Palange P, Valli G, Onorati P, Antonucci R, Paoletti P, Rosato A, Manfredi F, Serra P (2004) Effect of heliox on lung dynamic hyperinflation, dyspnea, and exercise endurance capacity in COPD patients. J Appl Physiol 97(5):1637–1642
Laveneziana P, Valli G, Onorati P, Paoletti P, Ferrazza AM, Palange P (2011) Effect of heliox on heart rate kinetics and dynamic hyperinflation during high-intensity exercise in COPD. Eur J Appl Physiol 111(2):225–234
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Ethics declarations
The authors declare no competing financial interests.
Rights and permissions
Copyright information
© 2020 Springer Nature Singapore Pte Ltd.
About this chapter
Cite this chapter
Fiorentino, G., Esquinas, A.M., Annunziata, A. (2020). Exercise and Chronic Obstructive Pulmonary Disease (COPD). In: Xiao, J. (eds) Physical Exercise for Human Health. Advances in Experimental Medicine and Biology, vol 1228. Springer, Singapore. https://doi.org/10.1007/978-981-15-1792-1_24
Download citation
DOI: https://doi.org/10.1007/978-981-15-1792-1_24
Published:
Publisher Name: Springer, Singapore
Print ISBN: 978-981-15-1791-4
Online ISBN: 978-981-15-1792-1
eBook Packages: Biomedical and Life SciencesBiomedical and Life Sciences (R0)