De Brandt Jana, Spruit Martijn A, Derave Wim, Hansen Dominique, Vanfleteren Lowie E G W, Burtin Chris
a REVAL - Rehabilitation Research Center, BIOMED - Biomedical Research Institute, Faculty of Medicine and Life Sciences , Hasselt University , Diepenbeek , Belgium.
b Department of Research and Education , CIRO, Center of Expertise for Chronic Organ Failure , Horn , The Netherlands.
Expert Rev Respir Med. 2016;10(5):521-45. doi: 10.1586/17476348.2016.1157472. Epub 2016 Apr 6.
Patients with COPD suffer from lower-limb muscle dysfunction characterized by lower muscle oxidative capacity and muscle mass. Exercise-based training is expected to attenuate lower-limb intramuscular characteristics, but a detailed systematic approach to review the available evidence has not been performed yet. PUBMED and PEDro databases were searched. Twenty-five studies that implemented an exercise-based training program (aerobic and/or resistance training, high intensity interval training, electrical or magnetic stimulation) and reported muscle biopsy data of patients with COPD were critically appraised. The coverage of results includes changes in muscle structure, muscle protein turnover regulation, mitochondrial enzyme activity, oxidative and nitrosative stress, and inflammation after exercise-based training interventions. Study design and training modalities varied among studies, which partly explains the observed heterogeneous response in muscle characteristics. Gaps in the current knowledge are identified and recommendations for future research are made to enhance our knowledge on exercise training effects in patients with COPD.
慢性阻塞性肺疾病（COPD）患者存在下肢肌肉功能障碍，其特征为肌肉氧化能力和肌肉质量降低。基于运动的训练有望减轻下肢肌肉内特征，但尚未对现有证据进行详细的系统回顾。检索了PUBMED和PEDro数据库。对25项实施了基于运动的训练计划（有氧运动和/或阻力训练、高强度间歇训练、电刺激或磁刺激）并报告了COPD患者肌肉活检数据的研究进行了严格评估。结果涵盖了基于运动的训练干预后肌肉结构、肌肉蛋白质周转调节、线粒体酶活性、氧化应激和亚硝化应激以及炎症的变化。研究设计和训练方式在各研究中有所不同，这部分解释了观察到的肌肉特征的异质性反应。确定了当前知识中的差距，并对未来研究提出了建议，以增强我们对COPD患者运动训练效果的认识。
