Optimizing strategies for assessment and treatment of limb muscle dysfunction among people with COPD
The clinical and prognostic relevance of limb muscle dysfunction, i.e. reduced strength and endurance of skeletal muscles in among COPD highlights the importance of continued research on finding clinically relevant measurement methods and effective and feasible treatment modalities
A frequently neglected aspect of chronic obstructive pulmonary disease (COPD) is that the disease is strongly associated with manifestations even outside the lungs that have a direct and significant impact on both the quality of life and survival of the individual person with COPD. For example, limb muscle dysfunction is very common in COPD and, independent of the patient's lung function, related to reduced quality of life, greater health care use, reduced physical ability and even increased mortality. However, despite its clinical and prognostic relevance, there are currently inadequate strategies for assessing and optimal treatment of limb muscle dysfunction in COPD.
The clinical and prognostic relevance of limb muscle dysfunction in COPD highlight the importance of continued research on finding clinically relevant methods for examination and effective and practicable training methods. Before this can become a reality in clinical practice, important knowledge gaps must still be filled.
This is what we intend to achieve by 1) determining the test-retest reliability, feasibility and minimum clinically relevant difference of quadriceps muscle endurance in patients with COPD, 2) examine the correlation between strength and endurance of the quadriceps muscles, functional performance and daily physical activity, 3) develop predictive equations to produce normal values for muscle function, and 4) validate these normal values among people with COPD.
In the project, we will also randomise people with COPD to 8 weeks of resistance training performed according to current recommendations or to an innovative resistance training scheme created with clinical experts in COPD, consisting of Individualized, non-linear, periodized resistance training which will be compared to 5) muscle function, 6) functional performance, quality of life, dyspnea and number of responders (persons receiving noticeable effect of the exercise), 7) feasibility and 8) intramuscular adaptations (metabolic and structural changes within the quadriceps muscle). We will also 9) examine the link between dyspnea, functional performance, limb muscle function, and structural and metabolic properties of the skeletal muscle