The objective of this study was to summarize and determine the effectiveness of resistance training on exercise capacity in patients with chronic obstructive pulmonary disease (COPD).
We searched PubMed, EMBASE, Cochrane Library, and two Chinese databases (China National Knowledge Infrastructure and Wanfang Data) to identify articles written in English or Chinese and published from January 2000 to January 2019. Randomized controlled trials were included if they evaluated the effects of resistance training on exercise capacity in COPD patients. We assessed the quality of the trials using the Physiotherapy Evidence Database Scale. Data from these studies were pooled to calculate weighted mean difference (WMD) or standardized mean difference (SMD) with 95% confidence intervals (CI).
Eleven studies with a total of 405 participants met the inclusion criteria. Compared with the non-exercise control group, resistance training significantly improved 6-min walking distance (WMD, 54.52; 95% CI 25.47–83.56; I2 = 43%; P = 0.14), transfer numbers for the 6-min pegboard and ring test (WMD, 25.17; 95% CI 10.17–40.16; I2 = 0%; P = 0.55), and tolerance time for the unsupported upper-limb exercise test (SMD, 0.41; 95% CI 0.03–0.79; I2 = 0%; P = 0.83). There were no significant differences in constant work rate endurance test results or in peak oxygen uptake between the two groups.
Resistance training was an effective approach to improve functional exercise capacity, endurance exercise capacity, and peak exercise capacity in COPD patients.
This is a preview of subscription content,to check access.
Access this article
Similar content being viewed by others
Global Initiative for Chronic Obstructive Pulmonary Disease [homepage on the Internet] (2018) Global strategy for the Diagnosis, Management and Prevention of chronic obstructive pulmonary disease (2019 report). https://goldcopd.org/wp-content/uploads/2018/11/GOLD-2019-v1.7-FINAL-14Nov2018-WMS.pdf. Accessed Apr 25 2018
Wang C, Xu J, Yang L et al (2018) Prevalence and risk factors of chronic obstructive pulmonary disease in China (the China Pulmonary Health [CPH] study): a national cross-sectional study. Lancet 391:1706–1717
Ramon MA, Gimeno-Santos E, Ferrer J et al (2014) Hospital admissions and exercise capacity decline in patients with COPD. Eur Respir J 43:1018–1027
Oga T, Nishimura K, Tsukino M et al (2003) Analysis of the factors related to mortality in chronic obstructive pulmonary disease: role of exercise capacity and health status. Am J Respir Crit Care Med 167:544–549
Oga T, Nishimura K, Tsukino M et al (2005) Exercise capacity deterioration in patients with COPD: longitudinal evaluation over 5 years. Chest 128:62–69
McCarthy B, Casey D, Devane D et al (2015) Pulmonary rehabilitation for chronic obstructive pulmonary disease. Cochrane Database Syst Rev 2:D3793
Spruit MA, Singh SJ, Garvey C et al (2013) An official American Thoracic Society/European Respiratory Society statement: key concepts and advances in pulmonary rehabilitation. Am J Respir Crit Care Med 188:e13–e64
Wu W, Liu X, Li P et al (2018) Effect of Liuzijue exercise combined with elastic band resistance exercise on patients with COPD: a randomized controlled trial. Evid Based Complement Alternat Med 2018:2361962
Strasser B, Siebert U, Schobersberger W (2013) Effects of resistance training on respiratory function in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis. Sleep Breath 17:217–226
O’Shea SD, Taylor NF, Paratz JD (2009) Progressive resistance exercise improves muscle strength and may improve elements of performance of daily activities for people with COPD: a systematic review. Chest 136:1269–1283
Liao WH, Chen JW, Chen X et al (2015) Impact of resistance training in subjects with COPD: a systematic review and meta-analysis. Respir Care 60:1130–1145
McKeough ZJ, Velloso M, Lima VP et al (2016) Upper limb exercise training for COPD. Cochrane Database Syst Rev 11:011434
Kongsgaard M, Backer V, Jorgensen K et al (2004) Heavy resistance training increases muscle size, strength and physical function in elderly male COPD-patients–a pilot study. Respir Med 98:1000–1007
Santiworakul A, Jarungjitaree S, Jalayondeja W et al (2009) Effect of lower extremity exercise on muscle strength and physical capacity in COPD patients. J Med Assoc Thai 92:556–563
Wright PR, Heck H, Langenkamp H et al (2002) Influence of a resistance training on pulmonary function and performance measures of patients with COPD. Pneumologie 56:413–417
McNamara RJ, Houben-Wilke S, Franssen F et al (2018) Determinants of functional, peak and endurance exercise capacity in people with chronic obstructive pulmonary disease. Respir Med 138:81–87
Oga T, Nishimura K, Tsukino M et al (2002) Relationship between different indices of exercise capacity and clinical measures in patients with chronic obstructive pulmonary disease. Heart Lung 31:374–381
Singh SJ, Puhan MA, Andrianopoulos V et al (2014) An official systematic review of the European Respiratory Society/American Thoracic Society: measurement properties of field walking tests in chronic respiratory disease. Eur Respir J 44:1447–1478
Puente-Maestu L, Palange P, Casaburi R et al (2016) Use of exercise testing in the evaluation of interventional efficacy: an official ERS statement. Eur Respir J 47:429–460
Maher CG, Sherrington C, Herbert RD et al (2003) Reliability of the PEDro scale for rating quality of randomized controlled trials. Phys Ther 83:713–721
Chen Y, Niu M, Zhang X et al (2018) Effects of home-based lower limb resistance training on muscle strength and functional status in stable chronic obstructive pulmonary disease patients. J Clin Nurs 27:e1022–e1037
Hoff J, Tjonna AE, Steinshamn S et al (2007) Maximal strength training of the legs in COPD: a therapy for mechanical inefficiency. Med Sci Sports Exerc 39:220–226
Silva C, Gomes NM, Saquetto MB et al (2018) Effects of upper limb resistance exercise on aerobic capacity, muscle strength, and quality of life in COPD patients: a randomized controlled trial. Clin Rehabil 32:1636–1644
Li YJ, Shi TY, Liu QG (2016) Effect of unsupported arm exercise on patients with chronic obstructive pulmonary disease. Zhongguo kang fu li lun yu shi jian 6:719–723 (in Chinese)
Calik-Kutukcu E, Arikan H, Saglam M et al (2017) Arm strength training improves activities of daily living and occupational performance in patients with COPD. Clin Respir J 11:820–832
Casaburi R, Bhasin S, Cosentino L et al (2004) Effects of testosterone and resistance training in men with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 170:870–878
O’Shea SD, Taylor NF, Paratz JD (2007) A predominantly home-based progressive resistance exercise program increases knee extensor strength in the short-term in people with chronic obstructive pulmonary disease: a randomised controlled trial. Aust J Physiother 53:229–237
Zambom-Ferraresi F, Cebollero P, Gorostiaga EM et al (2015) Effects of combined resistance and endurance training versus resistance training alone on strength, exercise capacity, and quality of life in patients with COPD. J Cardiopulm Rehabil Prev 35:446–453
McKeough ZJ, Bye PT, Alison JA (2012) Arm exercise training in chronic obstructive pulmonary disease: a randomised controlled trial. Chron Respir Dis 9:153–162
Nyberg A, Lindstrom B, Rickenlund A et al (2015) Low-load/high-repetition elastic band resistance training in patients with COPD: a randomized, controlled, multicenter trial. Clin Respir J 9:278–288
Janaudis-Ferreira T, Hill K, Goldstein RS et al (2011) Resistance arm training in patients with COPD: a Randomized Controlled Trial. Chest 139:151–158
Durr S, Zogg S, Miedinger D et al (2014) Daily physical activity, functional capacity and quality of life in patients with COPD. COPD 11:689–696
De Brandt J, Spruit MA, Hansen D et al (2018) Changes in lower limb muscle function and muscle mass following exercise-based interventions in patients with chronic obstructive pulmonary disease: a review of the English-language literature. Chron Respir Dis 15:182–219
Diaz AA, Pinto-Plata V, Hernandez C et al (2015) Emphysema and DLCO predict a clinically important difference for 6MWD decline in COPD. Respir Med 109:882–889
Felisberto RM, de Barros CF, Nucci K et al (2018) Is the 6-minute pegboard and ring test valid to evaluate upper limb function in hospitalized patients with acute exacerbation of COPD? Int J Chron Obstruct Pulmon Dis 13:1663–1673
Ries AL, Ellis B, Hawkins RW (1988) Upper extremity exercise training in chronic obstructive pulmonary disease. Chest 93:688–692
Takeda K, Kawasaki Y, Yoshida K et al (2013) The 6-minute pegboard and ring test is correlated with upper extremity activity of daily living in chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis 8:347–351
Wang YN, Xu JL, Song HL et al (2017) The effects of unsupported arm exercise in patients with chronic obstructive pulmonary disease: a metaanalysis of randomized controlled trails. Zhonghua Hu Li Za Zhi 9:1077–1081 (in Chinese)
O’Donnell DE, Guenette JA, Maltais F et al (2012) Decline of resting inspiratory capacity in COPD: the impact on breathing pattern, dyspnea, and ventilatory capacity during exercise. Chest 141:753–762
Porszasz J, Emtner M, Goto S et al (2005) Exercise training decreases ventilatory requirements and exercise-induced hyperinflation at submaximal intensities in patients with COPD. Chest 128:2025–2034
Porszasz J, Cao R, Morishige R et al (2013) Physiologic effects of an ambulatory ventilation system in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 188:334–342
Janaudis-Ferreira T, Hill K, Goldstein RS et al (2013) Relationship and responsiveness of three upper-limb tests in patients with chronic obstructive pulmonary disease. Physiother Can 65:40–43
Janaudis-Ferreira T, Beauchamp MK, Goldstein RS et al (2012) How should we measure arm exercise capacity in patients with COPD? A systematic review. Chest 141:111–120
Spruit MA, Gosselink R, Troosters T et al (2002) Resistance versus endurance training in patients with COPD and peripheral muscle weakness. Eur Respir J 19:1072–1078
This systematic review was funded by national fitness project of General Administration of Sport of China (No. 2017B021), the “Qi Kang” young innovative talents project of School of Rehabilitation Medicine in Shanghai University of Traditional Chinese Medicine, the directed research grants from Science and Technology Commission of Shanghai Municipality (No. 18DZ1200600), and National Natural Science Foundation of China (No. 81902307).
Conflict of interests
The authors declare that they have no conflict of interest.
Statement of human and animal rights
This review does not contain any experiments involving human participants or animals performed by any authors.
For this review, informed consent forms were not required.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
About this article
Cite this article
Li, N., Li, P., Lu, Y. et al. Effects of resistance training on exercise capacity in elderly patients with chronic obstructive pulmonary disease: a meta-analysis and systematic review. Aging Clin Exp Res 32, 1911–1922 (2020). https://doi.org/10.1007/s40520-019-01339-8