title: Resistance training as a preconditioning strategy for enhancing aerobic exercise training outcomes in COPD.
abstract: OBJECTIVE
  Aerobic exercise training is a recognized approach for improving functional capacity in COPD. People with greater disease severity often have difficulty achieving higher aerobic exercise training intensity. The effects of resistance training prior to aerobic training were examined to determine if this sequential approach was associated with greater gains in functional status than aerobic training alone or concurrent aerobic and resistance training.
  
  
  METHODS
  Patients were randomized to: 1) sequential resistance then aerobic training (RT-then-AT) (8 weeks resistance training followed by 8 weeks aerobic exercise training), 2) control group (CE-then-AT + RT) (8 weeks of 'sham' training followed by 8 weeks concurrent aerobic and resistance training), 3) control group (CE-then-AT) (8 weeks 'sham' training followed by 8 weeks aerobic training). Outcomes were assessed at study entry, after week 8, and after week 16: aerobic exercise performance; muscle strength and endurance.
  
  
  RESULTS
  75 patients completed training: FEV1 %pred 40 ± 10, V˙O(2peak) %predicted, 71 ± 22, fat-free mass index 19.5 ± 3.1. RT-then-AT had greater acquisition of peripheral muscle endurance than CE-then-AT + RT and CE-then-AT, but improvements in aerobic exercise performance were similar. Improvements in muscle strength were similar between RT-then-AT and CE-then-AT + RT. Sarcopenia was associated with poorer attendance, and lower aerobic and resistance training volumes.
  
  
  CONCLUSIONS
  Although the sequential approach to resistance and aerobic training yielded a greater increase in muscle endurance and higher resistance training volume compared to concurrent resistance and aerobic training, other training outcomes were similar between the two groups, thus the sequential approach is not clearly superior to the concurrent approach in severe COPD. ClinicalTrials.gov Identifier: NCT01058213.
authors: Department of Biobehavioral Health Science, University of Illinois at Chicago, Chicago, IL, United States. Electronic address: mkcovey@uic.edu.
authors: Margaret K
authors: MK
authors: Covey
authors: Department of Biobehavioral Health Science, University of Illinois at Chicago, Chicago, IL, United States; Department of Research and Development, Edward Hines Jr Veterans Administration Hospital, Hines, IL, United States.
authors: Eileen G
authors: EG
authors: Collins
authors: Medicine Service Line at Edward Hines Jr Veterans Administration Hospital, Hines, IL, United States; Department of Medicine, Division of Clinical Cardiology, Loyola University, Stritch School of Medicine, Maywood, IL, United States.
authors: Sandra I
authors: SI
authors: Reynertson
authors: Department of Medicine, Division of Pulmonary and Critical Care Medicine, Loyola University, Stritch School of Medicine, Maywood, IL, United States.
authors: Daniel F
authors: DF
authors: Dilling
mesh_terms: D000368:Aged; D015444:Exercise / Q000502:physiology; D005080:Exercise Test; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D008297:Male; D053580:Muscle Strength / Q000502:physiology; D018482:Muscle, Skeletal / Q000502:physiology; D010349:Patient Compliance; D010807:Physical Endurance / Q000502:physiology; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology / Q000534:rehabilitation*; D055070:Resistance Training / Q000379:methods*; D016896:Treatment Outcome
keywords: COPD; Dyspnea; Leg fatigue; Muscle strength; Pulmonary rehabilitation