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A combination of resistance and endurance training increases leg muscle strength in COPD: An evidence-based recommendation based on systematic review with meta-analyses.

ABSTRACT: Resistance training (RT) is thought to be effective in preventing muscle depletion, whereas endurance training (ET) is known to improve exercise capacity and health-related quality of life (HRQoL) in chronic obstructive pulmonary disease (COPD). Our objectives were to assess the efficiency of combining RT with ET compared with ET alone. We identified eligible studies through a systematic multi-database search. One author checked titles and abstracts for relevance using broad inclusion criteria, whilst two independent authors checked the full-text copies for eligibility. Two authors independently extracted data, and we assessed the risk of bias and quality of evidence according to the Grading of Recommendations Assessment, Development and Evaluation guidelines. We included 11 randomized controlled trials (331 participants) and 2 previous systematic reviews. The meta-analyses showed equal improvements in HRQoL, walking distance and exercise capacity. However, we found moderate quality evidence of a significant increase in leg muscle strength favouring a combination of RT and ET (standardized mean difference of 0.69 (95% confidence interval: 0.39-0.98). In conclusion, we found significantly increased leg muscle strength favouring a combination of RT with ET compared with ET alone. Therefore, we recommend that RT should be incorporated in rehabilitation of COPD together with ET.

SUBMITTER: Iepsen UW

PROVIDER: S-EPMC4412880 | biostudies-other | 2015 May

REPOSITORIES: biostudies-other

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A combination of resistance and endurance training increases leg muscle strength in COPD: An evidence-based recommendation based on systematic review with meta-analyses.

Iepsen Ulrik Winning UW Jørgensen Karsten Juhl KJ Ringbæk Thomas T Hansen Henrik H Skrubbeltrang Conni C Lange Peter P

Chronic respiratory disease 20150312 2

Resistance training (RT) is thought to be effective in preventing muscle depletion, whereas endurance training (ET) is known to improve exercise capacity and health-related quality of life (HRQoL) in chronic obstructive pulmonary disease (COPD). Our objectives were to assess the efficiency of combining RT with ET compared with ET alone. We identified eligible studies through a systematic multi-database search. One author checked titles and abstracts for relevance using broad inclusion criteria, ...[more]

PMID: 25767138

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Project description:Hamstring strains are the most common injury in multiple sprint sports, with inadequate eccentric hamstring strength and fatigue identified as important risk factors. Resistance training interventions aimed at reducing injury risk typically focus on the development of maximum strength, while little is known about the impact of training on hamstring fatigue resistance. The present study compared the effects of strength endurance (SE) with a strength intervention (S) on the eccentric hamstring strength decline induced by a simulated soccer match. Twenty-one female soccer players were randomly assigned to a S group (n = 10) or a SE group (n = 11). Hamstrings and quadriceps isokinetic concentric and eccentric peak torque (PT) were assessed at 120°.s-1 and hamstrings-to-quadriceps ratio (HEcc:QCon) calculated, pre- and immediately post a 90-min simulated match (BEAST90). This was repeated following a 7-week intervention of either three to five sets of 6RM leg curl and stiff-leg deadlift with 3-min inter-set rest (S), or the same exercises performed using three sets of 12-20 RM with 45-90 s inter-set rest (SE). At baseline, the simulated match led to significant declines in hamstrings eccentric peak torque (EccPT) in both groups in both dominant (D) and non-dominant (ND) legs [SE: (D: -15.5, ND: -15.6%), P = 0.001 to 0.016; S: (D: -12.3%, ND: -15.5%), P = 0.001 to 0.018]. After the 7-week intervention, we observed a group?intervention?match interaction such that there was no significant decline in EccPT in the SE group following the simulated match (D: 5.3%, ND: 2.0%), but there remained significant declines in the S group (D: -14.2%, ND: -15.5%, P = 0.018-0.001). Similarly, in the SE group, there was a significant decrease in the HEcc:QCon in D before (-14.2%, P = 0.007), but not after the training intervention, whereas declines were observed in the S group both at baseline, and following the intervention (D: -13.9%, ND: -15.6%, P = 0.045). These results demonstrate that SE training can reduce the magnitude of the EccPT decline observed during soccer competition. As inadequate eccentric strength and fatigue are both risk factors for hamstring injury, SE training should be considered along with the development of peak eccentric strength, as a component of programs aimed at reducing injury risk in multiple-sprint sports.

Project description:IntroductionHip fractures predominantly occur in the geriatric population and results in increased physical inactivity and reduced independency, largely influenced by a downward spiral of ambulatory capacity, related to loss of skeletal muscle strength and postural stability. Thus, effective postoperative treatment, targeting improvements in muscle strength, is sought after.Materials & methodsTwenty-one hip fracture patients (>65 yr) were randomized to 8 weeks of either conventional physiotherapy control group (CG), or leg press and hip abduction maximal strength training (MST) 3 times per week. MST was performed applying heavy loads (85-90% of 1 repetition maximum; 1RM) and 4-5 repetitions in 4 sets. Maximal strength (bi- and unilateral 1RM), postural stability (unipedal stance test; UPS), and DEXA-scan bone mineral content/ density (BMC/BMD) were measured before and after the 8-week rehabilitation.ResultsBoth MST and conventional physiotherapy improved bilateral leg press 1RM by 41 ± 27 kg and 29 ± 17 kg, respectively (both p < 0.01), while unilateral leg press 1RM only increased after MST (within group and between groups difference: both p < 0.05). MST also resulted in an increase in abduction 1RM in both the fractured (5 kg, 95%CI: 2-7; p < 0.01) and healthy limb (6 kg, 95%CI: 3-9; p < 0.01), while no such improvement was apparent in the CG (between groups difference: p < 0.01). Finally, MST improved UPS of the fractured limb (p < 0.05). No differences were observed in BMC or BMD following the 8 weeks.DiscussionEarly postoperative MST improved lower extremities maximal muscle strength more than conventional physiotherapy and was accompanied by improvements in postural stability.ConclusionImplementing MST in early rehabilitation after hip fracture surgery should be considered as a relevant treatment to curtail the downward spiral of reduced ambulatory capacity typical for this patient group, possibly reducing the risk of recuring falls and excess mortality.Trial registrationhttps://clinicaltrials.gov/ct2/show/NCT03030092.

Project description:We determined the effect of concurrent training incorporating either high-intensity interval training (HIT) or moderate-intensity continuous training (MICT) on maximal strength, counter-movement jump (CMJ) performance, and body composition adaptations, compared with single-mode resistance training (RT). Twenty-three recreationally-active males (mean ± SD: age, 29.6 ± 5.5 y; [Formula: see text], 44 ± 11 mL kg-1·min-1) underwent 8 weeks (3 sessions·wk-1) of either: (1) HIT combined with RT (HIT+RT group, n = 8), (2) work-matched MICT combined with RT (MICT+RT group, n = 7), or (3) RT performed alone (RT group, n = 8). Measures of aerobic capacity, maximal (1-RM) strength, CMJ performance and body composition (DXA) were obtained before (PRE), mid-way (MID), and after (POST) training. Maximal (one-repetition maximum [1-RM]) leg press strength was improved from PRE to POST for RT (mean change ± 90% confidence interval; 38.5 ± 8.5%; effect size [ES] ± 90% confidence interval; 1.26 ± 0.24; P < 0.001), HIT+RT (28.7 ± 5.3%; ES, 1.17 ± 0.19; P < 0.001), and MICT+RT (27.5 ± 4.6%, ES, 0.81 ± 0.12; P < 0.001); however, the magnitude of this change was greater for RT vs. both HIT+RT (7.4 ± 8.7%; ES, 0.40 ± 0.40) and MICT+RT (8.2 ± 9.9%; ES, 0.60 ± 0.45). There were no substantial between-group differences in 1-RM bench press strength gain. RT induced greater changes in peak CMJ force vs. HIT+RT (6.8 ± 4.5%; ES, 0.41 ± 0.28) and MICT+RT (9.9 ± 11.2%; ES, 0.54 ± 0.65), and greater improvements in maximal CMJ rate of force development (RFD) vs. HIT+RT (24.1 ± 26.1%; ES, 0.72 ± 0.88). Lower-body lean mass was similarly increased for RT (4.1 ± 2.0%; ES; 0.33 ± 0.16; P = 0.023) and MICT+RT (3.6 ± 2.4%; ES; 0.45 ± 0.30; P = 0.052); however, this change was attenuated for HIT+RT (1.8 ± 1.6%; ES; 0.13 ± 0.12; P = 0.069). We conclude that concurrent training incorporating either HIT or work-matched MICT similarly attenuates improvements in maximal lower-body strength and indices of CMJ performance compared with RT performed alone. This suggests endurance training intensity is not a critical mediator of interference to maximal strength gain during short-term concurrent training.

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A combination of resistance and endurance training increases leg muscle strength in COPD: An evidence-based recommendation based on systematic review with meta-analyses.

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A combination of resistance and endurance training increases leg muscle strength in COPD: An evidence-based recommendation based on systematic review with meta-analyses.

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