Aerobic Training May Be Key to Pulmonary Rehabilitation for Patients With COPD
Patients with chronic obstructive pulmonary disease (COPD) who participate in supervised aerobic training may experience moderate improvements in their peak oxygen uptake, according to new research.
To assess the effect of aerobic training and exercise prescription on peak oxygen uptake among patients with COPD, the researchers first performed a systematic review of the MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature, and Cochrane databases for all studies that had measured peak oxygen uptake prior to and following supervised lower-limb aerobic training among patients with COPD. The researchers then conducted a random effects meta-analysis only for randomized controlled trials that had compared aerobic training with usual care.
In all, data on 3484 patients from 112 studies were analyzed.
With the intervention of aerobic training, participants had experienced a moderate positive change in peak oxygen uptake.
The change in peak oxygen uptake and the target duration of exercise session were positively associated. And when the researchers excluded studies that lasted for more than 1 year, the change in peak oxygen uptake was also positively associated with greater total volume of exercise training.
After adjusting for participants’ age and gender, programs that lasted more than 12 weeks yielded a greater change in peak oxygen uptake than programs that lasted 6 to 12 weeks.
Reported prescribed exercise intensity, training modality, and mode did not affect the peak oxygen uptake. Furthermore, patients with more severe airflow obstruction did not have as great improvements in peak oxygen uptake.
“There is sufficient evidence to show that programs with greater total exercise volume, including duration of exercise session and program duration, are more effective,” the researchers concluded. “Reduced effects in severe disease suggest alternative aerobic training methods may be needed in this population.”
And according to the researchers, aerobic training should remain a key component of clinical pulmonary rehabilitation programs.
Ward TJC, Plumptre CD, Dolmage TE, et al. Change in VO2peak in response to aerobic exercise training and the relationship with exercise prescription in people with COPD: a systematic review and meta-analysis. CHEST. 2020;158(1):131-144. doi:10.1016/j.chest.2020.01.053