Pulmonary Disease, Chronic Obstructive Clinical Trial
Official title:
Eccentric Training as Novel Rehabilitation for COPD
The main purpose of this project is to establish the additional value of eccentric versus
concentric exercise to optimize muscle function in patients with severe COPD. With this pilot
project the investigators expect that an eccentric endurance training protocol adapted to
severe COPD patients will lead to gains in muscle strength, the primary outcome, and cellular
adaptation (muscle morphology and oxidative capacity, mitochondrial respiratory capacity)
when compared to a concentric training approach.
This information will be essential if the investigators want to design and power a randomized
clinical trial that will allow assessing effectiveness of this novel rehabilitation approach.
Chronic obstructive pulmonary disease (COPD) is a major respiratory illness that is both
preventable and treatable. Dyspnea is the most important symptom that COPD patients
experience and this can have a major impact on their daily live. While COPD is characterized
by a spectrum of disease severity, most patients experience poor exercise intolerance
attributable to ventilatory limitation as well as peripheral muscle fatigue, ultimately
leading to severe disability.
Endurance exercise is an important component of pulmonary rehabilitation and is aimed at
preventing this decline in functional capacity. The effects of pulmonary rehabilitation are
largely attributable to the exercise training component involving concentric muscle
contractions, traditionally trough dynamic, large muscle exercise on a cycle ergometer or
treadmill. However, many patients are unable to partake and benefit from such rehabilitation
because of locomotor muscle weakness and severe ventilatory limitation that prevent them from
exercising at intensities sufficient to provoke improvements in cardioventilatory and
skeletal muscle function. Eccentric exercise is known for its unique physiologically
fundamental characteristics: the lower metabolic demand for a same power output and greater
muscle gains compared to the concentric exercise. For this reason, eccentric endurance
training has been proposed as a novel adjunctive rehabilitative countermeasure for certain
chronic diseases (such as coronary disease and COPD) and can play an important role for
patients with advanced disease.
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