Boeselt Tobias, Nell Christoph, Lütteken Lea, Kehr Katharina, Koepke Janine, Apelt Sandra, Veith Martina, Beutel Björn, Spielmanns Marc, Greulich Timm, Vogelmeier Claus F, Kenn Klaus, Janciauskiene Sabina, Alter Peter, Koczulla A Rembert
Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps-Universität Marburg, Member of the German Center for Lung Research (DZL), Marburg, Germany.
Respiration. 2017;93(5):301-310. doi: 10.1159/000464139. Epub 2017 Mar 23.
Various exercise training programs are used for patients with chronic obstructive pulmonary disease (COPD) of different severity.
To investigate the impact of individualized high-intensity training on exercise capacity with COPD.
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 (T0), as well as after 3 (T1) and 6 (T2) 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.
The training group improved in their 6-MWT results (T0 = 407 ± 152 m vs. T1 = 459 ± 127 m, p = 0.002, vs. T2 = 483.2 ± 130.1 m, p = 0.004), in their cross-sectional area of the musculus rectus femoris (T0 = 6.2 ± 1.2 cm2 vs. T1 = 6.9 ± 1.2 cm2, p = 0.003, vs. 7.5 ± 1.6 cm2, p = 0.002), and in their St. George's Respiratory Questionnaire (SGRQ) score (T0 = 43.3 ± 18.0 vs. T1 = 36.0 ± 18.4, p = 0.001, vs. T2 = 34.7 ± 18. 0, p = 0.004). Serum levels of myostatin, irisin, resistin, and α-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 α-Klotho after 6 months (r = -0.608, p = 0.021).
COPD patients undergoing an individualized, structured, high-intensity training program improved their exercise capacity, gained muscle mass, and improved their quality of life.
各种运动训练方案被用于不同严重程度的慢性阻塞性肺疾病（COPD）患者。
研究个体化高强度训练对COPD患者运动能力的影响。
共有49名患者同意参与。其中，31名被分配到训练组，18名作为对照组。训练组每周锻炼两次，每次90分钟，负荷逐渐增加。在入组时（T0）以及3个月（T1）和6个月（T2）后，进行6分钟步行试验（6-MWT），并获取与健康相关的生活质量、股四头肌厚度和各种血清标志物的数据。
训练组的6-MWT结果有所改善（T0 = 407 ± 152米 vs. T1 = 459 ± 127米，p = 0.002，vs. T2 = 483.2 ± 130.1米，p = 0.004），股直肌横截面积有所增加（T0 = 6.2 ± 1.2平方厘米 vs. T1 = 6.9 ± 1.2平方厘米，p = 0.003，vs. 7.5 ± 1.6平方厘米，p = 0.002），圣乔治呼吸问卷（SGRQ）评分有所改善（T0 = 43.3 ± 18.0 vs. T1 = 36.0 ± 18.4，p = 0.001，vs. T2 = 34.7 ± 18.0，p = 0.004）。在训练期间，血清中肌生长抑制素、鸢尾素、抵抗素和α-klotho水平没有显著变化。值得注意的是，6个月后，运动组血清抵抗素水平与α-klotho水平呈负相关（r = -0.608，p = 0.021）。
接受个体化、结构化、高强度训练方案的COPD患者提高了运动能力，增加了肌肉量，并改善了生活质量。
