Title:Effect of Rehabilitative Exercise Training on Peripheral Muscle Remodelling in Patients with COPD: Targeting Beyond the Lungs
VOLUME: 14 ISSUE: 2
Author(s):Ioannis Nasis, Eleni A. Kortianou, Enrico Clini, Nikolaos G. Koulouris and Ioannis Vogiatzis
Affiliation:Thorax Foundation, 3 Ploutarhou Str, 10675, Kolonaki, Athens, Greece.
Keywords:Chronic obstructive pulmonary disease, muscle remodelling, rehabilitative exercise training
Abstract:Locomotor muscle dysfunction and weakness are frequently observed in patients with Chronic Obstructive
Pulmonary Disease (COPD). In addition to intolerable sensations of dyspnoea which importantly contribute to exercise
limitation, intrinsic muscle abnormalities have also been implicated in inducing leg muscle fatigue/discomfort during exercise
in these patients. It is, however, uncertain whether these intrinsic muscle abnormalities are linked to a specific 'myopathy'
or they constitute a consequence of the disease. Besides muscle disuse, other factors which may contribute to peripheral
muscle dysfunction include systemic inflammation, oxidative and nitrosative stress, chronic hypoxia, corticosteroid
use and malnutrition. There is clear evidence that rehabilitative exercise training induces significant skeletal muscle
fibre remodelling and improvements in functionality in the absence of changes in lung function. The ultimate purpose of
this review is to identify and summarize the results of studies implementing diverse types of exercise training on peripheral
muscle fibre phenotypic and genotypic modifications in patients with COPD.