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Effects of low and high resistance training intensities on clinical outcomes in patients with COPD -- a randomized trial
Gianjoppe-Santos J, Barusso-Gruninger M, Pires Di Lorenzo VA
Physiotherapy Theory and Practice 2022;38:2471-2482
clinical trial
5/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

To compare the effects of two different intensities of combined resistance and aerobic training on physical-functional aspects and perceptual aspects of health status in patients with Chronic Obstructive Pulmonary Disease (COPD). This was a randomized parallel group trial. Thirty-one patients were assessed regarding: symptoms (COPD Assessment Test: CAT), quality of life (Saint George's Respiratory Questionnaire: SGRQ); exercise capacity (six-minute walk test and constant-workload resistance test -- CWRT); and muscle strength (one-repetition maximum test and isometric muscle strength for knee extensors: Kext and elbow flexors: EFlex). Patients were randomized in two groups to perform a combined training: (1) LL/HR = Low-load/high-repetition resistance training (n = 16; 68 +/- 9.3 years; FEV1 = 50.0 +/- 15.7%pred); and (2) HL/LR = High-load/low-repetition resistance training (n = 15; 70 +/- 6.5 years; FEV1 = 46.8 +/- 14.5%pred), and underwent 36 sessions. Symptoms, quality of life and exercise capacity presented significant improvement (p < 0.05) in both groups. Both intensities of resistance training improved symptoms (deltaCAT: LL/HR = -3.9; HL/LR = -2.8) and exercise capacity (delta tolerance time in CWRT: LL/HR = +450.9s; HL/LR = +583.4s) above minimal clinically important difference value. Nevertheless, improvement in quality of life (deltaSGRQ: LL/HR = -3.8; HL/LR = -10) and in isometric muscle strength (deltaKExt: LL/HR = +15.8 N; HL/LR = +37.7 N and (deltaEFlex: LL/HR = +9.5 N; HL/LR = +29.9 N) was observed only in the HL/LR group, which also presented a larger number of responders considering isometric muscle strength. High-intensity resistance training in a combined training was more effective in ameliorating several aspects of patients with COPD, responding more and better to physical-functional aspects and perceptual aspects of health status.

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