Institute of Anatomy and Cell Biology, Paracelsus Medical University of Salzburg, Salzburg, AUSTRIA.
Sports and Exercise Medicine Division, Department of Medicine, University of Padova, Padova, ITALY.
Med Sci Sports Exerc. 2023 Dec 1;55(12):2123-2131. doi: 10.1249/MSS.0000000000003268. Epub 2023 Aug 2.
Exercise training is a cornerstone of the treatment of chronic obstructive pulmonary disease, whereas the related interindividual heterogeneity in skeletal muscle dysfunction and adaptations are not yet fully understood. We set out to investigate the effects of exercise training and supplemental oxygen on functional and structural peripheral muscle adaptation.
In this prospective, randomized, controlled, double-blind study, 28 patients with nonhypoxemic chronic obstructive pulmonary disease (forced expiratory volume in 1 second, 45.92% ± 9.06%) performed 6 wk of combined endurance and strength training, three times a week while breathing either supplemental oxygen or medical air. The impact on exercise capacity, muscle strength, and quadriceps femoris muscle cross-sectional area (CSA) was assessed by maximal cardiopulmonary exercise testing, 10-repetition maximum strength test of knee extension, and magnetic resonance imaging, respectively.
After exercise training, patients demonstrated a significant increase in functional capacity, aerobic capacity, exercise tolerance, quadriceps muscle strength, and bilateral CSA. Supplemental oxygen affected significantly the training impact on peak work rate when compared with medical air (+0.20 ± 0.03 vs +0.12 ± 0.03 W·kg -1 , P = 0.047); a significant increase in CSA (+3.9 ± 1.3 cm 2 , P = 0.013) was only observed in the training group using oxygen. Supplemental oxygen and exercise-induced peripheral desaturation were identified as significant opposing determinants of muscle gain during this exercise training intervention, which led to different adaptations of CSA between the respective subgroups.
The heterogenous functional and structural muscle adaptations seem determined by supplemental oxygen and exercise-induced hypoxia. Indeed, supplemental oxygen may facilitate muscular training adaptations, particularly in limb muscle dysfunction, thereby contributing to the enhanced training responses on maximal aerobic and functional capacity.
运动训练是治疗慢性阻塞性肺疾病的基石，而骨骼肌功能障碍和适应性的个体间差异尚不完全清楚。我们旨在研究运动训练和补充氧气对周围肌肉功能和结构适应性的影响。
在这项前瞻性、随机、对照、双盲研究中，28 名非低氧慢性阻塞性肺疾病患者（第一秒用力呼气量 45.92%±9.06%）进行了 6 周的耐力和力量联合训练，每周 3 次，同时分别吸入补充氧气或医用空气。通过最大心肺运动测试、膝关节伸展 10 次最大重复力量测试和磁共振成像，分别评估运动能力、肌肉力量和股四头肌横截面积（CSA）的变化。
运动训练后，患者的功能能力、有氧能力、运动耐量、股四头肌力量和双侧 CSA 均显著增加。与医用空气相比，补充氧气显著影响峰值工作率的训练影响（+0.20±0.03 对 +0.12±0.03 W·kg -1 ，P=0.047）；仅在使用氧气的训练组中观察到 CSA 显著增加（+3.9±1.3 cm 2 ，P=0.013）。补充氧气和运动诱导的外周缺氧被确定为运动训练干预中肌肉生长的相反决定因素，这导致了各自亚组之间 CSA 的不同适应性。
功能和结构肌肉适应性的异质性似乎由补充氧气和运动诱导的缺氧决定。实际上，补充氧气可能促进肌肉训练适应性，特别是在肢体肌肉功能障碍方面，从而有助于增强最大有氧和功能能力的训练反应。
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