title: Impact of resistance training in chronic obstructive pulmonary disease patients during periods of acute exacerbation.
abstract: OBJECTIVE
  To evaluate the effects of whole-body resistance training on exercise capacity, health-related quality of life (HRQOL), and muscle strength in patients hospitalized for exacerbation of chronic obstructive pulmonary disease.
  
  
  METHODS
  Randomized controlled trial.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  Patients (N=46) were randomized to either a control group (CG) or training group (TG), and 29 patients completed the study.
  
  
  METHODS
  Training consisted of weight-lifting exercises for 6 muscle groups in the upper and lower limbs (2 sets of 8 repetitions each), and the initial load was set at 80% of the 1-repetition maximum load.
  
  
  METHODS
  Patients were evaluated on the second day of hospitalization, at hospital discharge, and 30 days postdischarge. Patients were evaluated on the basis of the 6-minute walking distance (6MWD), HRQOL, muscle strength, systemic inflammatory markers, and level of physical activity in daily life (PADL).
  
  
  RESULTS
  The CG showed a reduction in the strength of lower-limb muscles (P<.05) but not in the 6MWD (P>.05). In contrast, patients from the TG improved strength in the lower-limb muscles and 6MWD during and 30 days after hospitalization (P<.05). The TG also improved the impact domain in HRQOL after hospitalization. No improvement in PADL was observed in the TG. Finally, a reduction in the blood levels of inflammatory markers was observed only in the TG after hospitalization.
  
  
  CONCLUSIONS
  Our results suggest that resistance training during hospitalization improves the 6MWD, HRQOL, and lower-limb muscle strength, without altering the levels of systemic inflammation. However, future research should explore this intervention in larger randomized trials.
authors.affiliation: Physical Therapy Department, School of Medicine, University of São Paulo, São Paulo, Brazil; University Hospital, University of São Paulo, São Paulo, Brazil. Electronic address: rodrigounopar@yahoo.com.br.
authors.forename: Rodrigo C
authors.initials: RC
authors.lastname: Borges
authors.affiliation: Physical Therapy Department, School of Medicine, University of São Paulo, São Paulo, Brazil.
authors.forename: Celso R
authors.initials: CR
authors.lastname: Carvalho
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D005081:Exercise Therapy; D017079:Exercise Tolerance; D005260:Female; D006801:Humans; D008297:Male; D053580:Muscle Strength; D018482:Muscle, Skeletal / Q000503:physiopathology; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology* / Q000523:psychology / Q000534:rehabilitation*; D011788:Quality of Life; D055070:Resistance Training; D016896:Treatment Outcome
keywords: Hospitalization; Pulmonary disease, chronic obstructive; Quality of life; Rehabilitation; Resistance training