Tailored exercise needed for COPD patients

Exercise training is a key component in COPD management and can lead to multiple physiological and clinically relevant adaptations and improvements. Different exercise modalities are (likely) needed to manage the disease as it is clear that one-size-does-not-fit-all when it comes to COPD management.

Prof. Andre Nyberg (Umea University, Sweden) discussed various aspects of exercise training for patients with COPD. He stated that low muscle mass in patients with COPD holds a 4-fold increase in mortality risk [1]. “However, we do not really know what happens within the muscle tissue, so we still need to learn which type of exercise is suitable for which patient,” he commented. “It is clear though, that exercise training is a cornerstone of COPD management,” Prof. Nyberg stated. “Exercise is effective independent of the GOLD stage, symptom severity, or disease control.” Referring to the type of exercise, aerobic and resistance training are very effective [2]. “In addition, the type and level of exercise need to be customised for the individual patient according to the disease manifestations and its imposed limitations as well as harmonised with lifestyle adjustments.” To this end, new targets have been set by the guidelines, focusing not only on patients who experience reduced strength, but also reduced muscle power, and endurance [3,4]. Prof. Nyberg warned that the response may differ at individual level, and that patients with even mild COPD can experience difficulties in progressing exercise workloads which calls for alternative strategies. Besides, variation is very important to prevent stagnation [5]. “So, though exercise training in patients with COPD is effective, there is still room for improvement at the individual level [6].”

1. Marquis K, et al. Am J Respir Crit Care Med. 2002;166(6):809–13.
2. Nolan CM, et al. COPD. 2019;16(5-6):378–389.
3. Spruit MA, et al. Am J Respir Crit Care Med. 2013;188(8):e13–64.
4. Evans RA, et al. Chest. 2015;147(3):673-684.
5. Klijn P, et al. Am J Respir Crit Care Med. 2013;188(2):193–200.
6. Nyberg A. Exercise adaptations and -prescription in COPD. Nordic Lung Congress 2022, 01–03 June, Copenhagen, Denmark

 

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Posted on 17 August, 202217 August, 2022