Benefits of High-Intensity Exercise Training to Patients with Chronic Obstructive Pulmonary Disease: A Controlled Study.

Background: Various exercise training programs are used for patients with chronic obstructive pulmonary disease (COPD) of different severity. Objectives: To investigate the impact of individualized high-intensity training on exercise capacity with COPD. Methods: A total of 49 patients agreed to participate. Of these, 31 were assigned to the training group and 18 served as controls. The training group exercised twice a week for 90 min with consecutively increasing loads. At the time of enrollment (T-0), as well as after 3 (T-1) and 6 (T-2) months, a 6-min walk test (6-MWT) was performed and data on health-related quality of life, femoral muscle thickness, and various serum markers were obtained. Results: The training group improved in their 6-MWT results (T-0 = 407 +/- 152 m vs. T-1 = 459 +/- 127 m, p = 0.002, vs. T-2 = 483.2 +/- 130.1 m, p = 0.004), in their cross-sectional area of the musculus rectus femoris (T-0 = 6.2 +/- 1.2 cm(2) vs. T-1 = 6.9 +/- 1.2 cm(2), p = 0.003, vs. 7.5 +/- 1.6 cm(2), p = 0.002), and in their St. George's Respiratory Questionnaire (SGRQ) score (T-0 = 43.3 +/- 18.0 vs. T-1 = 36.0 +/- 18.4, p = 0.001, vs. T-2 = 34.7 +/- 18. 0, p = 0.004). Serum levels of myostatin, irisin, resistin, and a-Klotho did not change significantly within the training period. Of note, the exercise group showed an inverse relationship between serum levels of resistin and those of a-Klotho after 6 months (r = -0.608, p = 0.021). Conclusions: COPD patients undergoing an individualized, structured, high-intensity training program improved their exercise capacity, gained muscle mass, and improved their quality of life. (C) 2017 S. Karger AG, Basel