Progressive Resistance Exercise Improves Muscle Strength and May Improve Elements of Performance of Daily Activities for People With COPD

Background Skeletal muscle weakness and its impact on exercise tolerance in many people with COPD provide a rationale for the intervention of progressive resistance exercise during pulmonary rehabilitation. To optimize rehabilitation outcomes, clinicians prescribing resistance programs require up-to-date information on effectiveness, safety, and feasibility. Therefore, the review aimed to update the current evidence for progressive resistance exercise for people with COPD. Methods Using the keywords of "COPD" and "strength/resistance/weight training," controlled trials relating to progressive resistance exercise for people with COPD were identified through electronic database searches and citation tracking. Data from the identified trials were extracted and assessed by two independent reviewers. Standardized mean differences (effect sizes) with 95% CIs were determined, and overall effects were calculated using metaanalysis. Main results Eighteen controlled trials (including 10 trials published in the last 5 years) demonstrated moderate effects for increases in muscle strength after short-term progressive resistance exercise. Despite effects favoring progressive resistance exercise for cycling tests when compared with no intervention, and daily tasks such as sit-to-stand and stair climbing, trials reporting these outcomes had a higher risk of bias. Conclusions Short-term progressive resistance exercise can lead to appreciable increases in muscle strength for people with COPD, which may carry over to the performance of some daily activities. Future research should place emphasis on activity and participation level outcomes, and focus on determining the longer term outcomes and optimal methods for maintaining outcomes in this population. Skeletal muscle weakness and its impact on exercise tolerance in many people with COPD provide a rationale for the intervention of progressive resistance exercise during pulmonary rehabilitation. To optimize rehabilitation outcomes, clinicians prescribing resistance programs require up-to-date information on effectiveness, safety, and feasibility. Therefore, the review aimed to update the current evidence for progressive resistance exercise for people with COPD. Using the keywords of "COPD" and "strength/resistance/weight training," controlled trials relating to progressive resistance exercise for people with COPD were identified through electronic database searches and citation tracking. Data from the identified trials were extracted and assessed by two independent reviewers. Standardized mean differences (effect sizes) with 95% CIs were determined, and overall effects were calculated using metaanalysis. Eighteen controlled trials (including 10 trials published in the last 5 years) demonstrated moderate effects for increases in muscle strength after short-term progressive resistance exercise. Despite effects favoring progressive resistance exercise for cycling tests when compared with no intervention, and daily tasks such as sit-to-stand and stair climbing, trials reporting these outcomes had a higher risk of bias. Short-term progressive resistance exercise can lead to appreciable increases in muscle strength for people with COPD, which may carry over to the performance of some daily activities. Future research should place emphasis on activity and participation level outcomes, and focus on determining the longer term outcomes and optimal methods for maintaining outcomes in this population.