Larger improvements in endurance capacity in fat-free ...

Larger improvements in endurance capacity in fat-free mass depleted COPD patients by non-linear resistance training. Dr. Peter Klijn1, Dr. Anton van Keimpema1,2, Dr. Henk van Stel3, Prof. Dr. Rik Gosselink4

RATIONALE: COPD patients with wasting of f­at-free mass (FFM) are characterized by skeletal muscle weakness. Progressive linear resistance training with

a moderate number of repetitions (8-10) and high intensity 70% 1RM (maximum load) leads to improvements in muscle strength and exercise performance. Non-linear resistance training (NLR) with variation or periodization (i.e. programmed daily variation in the training stimuli) has shown to enhance training effects in healthy subjects. Therefore, we studied the effects of a 6-week ­non-linear resistance training program in FFM ­depleted COPD patients.

Chronic Respiratory Questionnaire

Constant Work Rate cycle Test

Change scores at 6 weeks

75% Wmax

Department of Pulmonology MEREM, Asthma Center Heideheuvel, Hilversum; Department of Pulmonology, Academic Medical Center, ­Amsterdam; 3Julius Center for Health Sciences and P ­ rimary Care, University Medical Center, Utrecht, Netherlands and 4Respiratory Rehabilitation, Katholieke Universiteit Leuven, Leuven, Belgium. 1

1,2

1.000

1,0

CRQ score

0,8 Minimal important difference

0,6 0,4

cycle time (sec)

800

600

400

200

0,2

0

0,0 Non-linear resistance training

Dyspnea

Fatigue

Combined endurance and progressive resistance training

Emotions

Mastery

Non-linear resistance training

Baseline

6 weeks

Combined endurance and progressive resistance training

METHODS: COPD patients (FEV1 20 repetitions, 30-50% 1RM]. NLR EPR Age (year) 59±7.6 60±5.3 FEV1 (%pred) 32±9.4 33±10.3 FFMi (kg FFM/m2) 13.8±1.1 14±1.3 Cycle endurance (sec) 391±177 379±295

p .386 .689 .438 .857

RESULTS: After 6 weeks a significant larger improvement in cycle endurance time (75%Wmax) was found in NLR (391±177 to 858±369sec) compared to EPR (379±295 to 521±346sec), p