Exercise Science Laboratory, School of Kinesiology, Faculty of Medicine, Universidad Finis Terrae, Santiago, Chile.
Department of Kinesiology, Universidad Metropolitana de Ciencias de la Educación, Santiago, Chile.
Eur J Appl Physiol. 2022 Feb;122(2):489-502. doi: 10.1007/s00421-021-04850-x. Epub 2021 Nov 20.
The present study compared the effects of eccentric cycling (ECC) and conventional concentric cycling (CONC) training on muscle function, body composition, functional performance, and quality of life (QOL) of patients with moderate chronic obstructive pulmonary disease (COPD).
Twenty patients (age: 69.6 ± 10.1 years, forced expiratory volume in 1-s: 73.2 ± 11.4% of predicted) were randomly allocated to ECC (n = 10) or CONC (n = 10) group. They performed 12 weeks of ECC or CONC training at similar perceived exertion. The workload, heart rate (HR), blood oxygen saturation (SpO), and dyspnea were monitored during cycling. Outcomes measures included maximal voluntary isometric contraction (MVC) strength of the knee extensors, rate of force development (RFD), lower limb fat-free (LLFFM) and fat (LLFM) mass, 6-min walking test (6MWT), timed up-and-go test (TUG), stairs ascending (SAWT) and descending walking time (SDWT), and QOL assessed by the Saint George's respiratory questionnaire.
ECC produced on average threefold greater (P < 0.001) workload (211.8 ± 106.0 kJ) than CONC (78.1 ± 62.6 kJ) over 34 training sessions. ECC showed 1.5 ± 2.1% greater SpO, 24.7 ± 4.1% lower HR, and 64.4 ± 29.6% lower dyspnea in average than CONC (P < 0.001). ECC increased LLFFM (4.5 ± 6.2%; P = 0.03), while CONC decreased LLFM (3.3 ± 6.4%; P = 0.04) after training. Both ECC and CONC reduced (P < 0.05) SAWT (- 16.1 ± 9.3% vs - 10.1 ± 14.4%) and SDWT (- 12.2 ± 12.6% vs - 14.4 ± 14.7%), and improved (P < 0.05) QOL (33.4 ± 38.8 vs 26.1 ± 36.6%) similarly, but only ECC improved (P < 0.05) RFD (69-199%), TUG (13.6 ± 13.6%), and 6MWT (25.3 ± 27.7%).
These results suggest that ECC training with less cardio-pulmonary demands was more effective in increasing functional performance and muscle mass for COPD patients than CONC training.
本研究比较了离心循环（ECC）和传统向心循环（CONC）训练对中度慢性阻塞性肺疾病（COPD）患者肌肉功能、身体成分、功能表现和生活质量（QOL）的影响。
20 名患者（年龄：69.6±10.1 岁，1 秒用力呼气量：预测值的 73.2±11.4%）被随机分配到 ECC（n=10）或 CONC（n=10）组。他们以相似的感知用力进行 12 周的 ECC 或 CONC 训练。在骑自行车期间监测最大自愿等长收缩（MVC）强度、力发展率（RFD）、下肢去脂（LLFFM）和脂肪（LLFM）质量、6 分钟步行测试（6MWT）、计时起立行走测试（TUG）、上楼梯（SAWT）和下楼梯行走时间（SDWT）以及圣乔治呼吸问卷评估的 QOL。
ECC 在 34 次训练中产生的平均工作量（211.8±106.0 kJ）比 CONC（78.1±62.6 kJ）高出三倍（P<0.001）。ECC 的 SpO 平均高出 1.5±2.1%，HR 平均降低 24.7±4.1%，呼吸困难平均降低 64.4±29.6%（P<0.001）。ECC 增加了 LLFFM（4.5±6.2%；P=0.03），而 CONC 在训练后减少了 LLFM（3.3±6.4%；P=0.04）。ECC 和 CONC 均降低（P<0.05）SAWT（-16.1±9.3%对-10.1±14.4%）和 SDWT（-12.2±12.6%对-14.4±14.7%），并改善（P<0.05）QOL（33.4±38.8%对 26.1±36.6%），但只有 ECC 改善（P<0.05）RFD（69-199%）、TUG（13.6±13.6%）和 6MWT（25.3±27.7%）。
这些结果表明，与 CONC 训练相比，ECC 训练对 COPD 患者的心肺需求较低，更有效地提高了功能表现和肌肉质量。
