Exercise as it relates to Disease/Resistance Training and Chronic Obstructive Pulmonary Disease

What is COPD & How is it Treated?
Chronic Obstructive Pulmonary Disease (COPD), often referred to as Chronic Obstructive Lung Disease (COLD) or Chronic Obstructive Airway Disease (COAD), is a degenerative disease of the lung characterised by chronic airflow problems. The most common cause of COPD is tobacco smoking while environmental exposure to noxious gases; air pollution and childhood infections all contribute to an increased risk. Symptoms include coughing, shortness of breath and mucus production.

The most widely used pharmacological treatment for patients with COPD is the inhalation of short and long term acting Bronchodilators. Long term oxygen therapy (LTOT) is the most effective non-pharmacological treatment for increasing survival rates in severe cases.

Exercise Capacity & COPD
COPD sufferers often experience a reduced exercise capacity due to the restricted airflow to the lungs. Reduced exercise tolerance will also increase the difficulty in performing daily tasks and participating in events and lead to a higher utilisation of health care resources.

Peripheral muscle weakness is a common occurrence amongst COPD patients and contributes to a reduced exercise capacity. Debate continues over the root cause of the peripheral muscle weakness though the two main causes are thought to be the systemic impact of the disease (oxidative stress, systemic inflammation, hypoxia, malnutrition) and treatment (oral corticosteriods) or the sedentary life style that most patients live. Some evidence exists that higher levels of muscular strength are correlated with increased health-related quality of life (HRQL).

Resistance Training for COPD Patients
The most effective way to combat muscle weakness in COPD patients is through a well planned resistance training program using either free or machine based weights. Subjects should be thoroughly screened by an accredited Exercise Physiologist for other health conditions prior to commencing any resistance training program to ensure that any comorbidities that may exist are accounted for in the program design.

The table below summarises the training protocols used in a variety of studies that looked at the effect of resistance training on COPD patients.

Based upon the training protocols shown above and taking into consideration individual fitness levels and the principle of overload a training program for a COPD sufferer should initially consist of: As the exercise capacity of the individual increases the number of days, number of exercises, sets/reps and intensity can all increase incrementally. Correct technique should be emphasised especially in the initial phase of training. This will reduce the risk of injury while increasing the effectiveness of the exercise program.
 * 2–3 days per week of resistance training
 * 2-4 exercises per day
 * 2-3 sets of 8-10 repetitions of each exercise
 * ~60% of a 1RM (actual or calculated)