Concurrent Training and Pulmonary Function in Smokers

Abstract

This study compared the effects of aerobic, resistance and concurrent aerobic and resistance training on pulmonary function and cardiorespiratory endurance in at-risk smokers. 50 sedentary, male smokers with pulmonary function impairments at risk for developing chronic lung diseases were randomly assigned to an aerobic (AerG;n=12), resistance (ResG;n=13), concurrent (ConG;n=13) or non-exercising control (NexG;n=12) group for 16 weeks. AerG subjects performed 45 min of aerobic exercise at 60%HR_max, ResG subjects performed 8 resistance exercises at 60%1-RM for 3 sets, 15 repetitions while ConG subjects performed both aerobic and resistance exercises. ANOVA revealed no significant difference between the groups in their pre-/post-test changes for FEV₁/FVC ratio (AerG:−4.13%; ResG:−2.13%; ConG:−0.56%); FEF-50 (AerG:−4.59%; ResG:−7.62%; ConG:5.76%), FEF-75 (AerG:−2.36%; ResG:−7.62%; ConG:10.71%) and FEF 25–75 (AerG:−3.53%; ResG:−6.43%; ConG:7.63%). Significant differences were found between the groups in their pre-/post-test changes for FVC (AerG:8.05%; ResG:7.22%; ConG:11.55%), FEV₁ (Aer:9.60%;ResG:5.13%; ConG:12.10%), PEF (AerG: 11.29%; ResG:7.49%; ConG:20.18%), PIF (AerG:24.80%; ResG:19.41%; ConG:28.15%), IVC (AerG: 9.04%; ResG: 6.21%; ConG:16.35%), FEF-25 (AerG:5.88%; ResG:5.37%; ConG:11.88%) and cardiorespiratory fitness (AerG:25.44%; ResG:11.59%; ConG:22.83%). Post-hoc analysis revealed concurrent and aerobic training were equally effective at improving PIF and cardiorespiratory fitness with concurrent training most effective at improving FVC, FEV₁, PEF, IVC and FEF-25. This suggests synergy between aerobic and resistance exercise in preventing or reducing the detrimental effects of smoking while gaining the unique benefits of each mode of exercise.

Key words

aerobic endurance - endurance training - exercise - lung function - weight training

References

• 1 Alfaro V, Torras R, Prats MT, Palacios L, Ibanez J. Improvement in exercise tolerance and spirometric values in stable obstructive pulmonary disease patients after an individualized outpatient rehabilitation programme.  J Sports Med Phys Fitness. 1996;  36 195-203
• 2 American College of Chest Physicians/American Association of Cardiovascular and Pulmonary Rehabilitation (ACCP/AACVPR) . Pulmonary rehabilitation: joint ACCP/AACVPR evidence-based guidelines special report.  Chest. 1997;  112 1363-1396
• 3 Bernard S, Whittom F, LeBlanc P, Jobin J, Belleau R, Bérubé C, Carrier C, Maltais F. Aerobic and strength training in patients with chronic obstructive pulmonary disease.  Am J Respir Crit Care Med. 1999;  159 896-901
• 4 Bourjeily G, Rochester CL. Exercise training in chronic obstructive pulmonary disease.  Clin Chest Med. 2000;  21 763-781
• 5 Boutellier U, Buchel R, Kundert A, Spengler C. The respiratory system as an exercise limiting factor in normal trained subjects.  Eur J Appl Physiol. 1992;  63 347-353
• 6 Carter R, Nicotra B, Calrk L, Zinkgraf S, Williams J, Peavler M, Fields S, Berry J. Exercise conditioning in the rehabilitation of patients with chronic obstructive pulmonary disease.  Arch Phys Med Rehabil. 1988;  69 118-122
• 7 Clini E, Costi S, Romagnoli M, Florini F. Rehabilitation of COPD patients: which training modality.  Monaldi Arch Chest Dis. 2004;  61 167-173
• 8 Cooper CB. Exercise in chronic pulmonary disease: limitations and rehabilitation.  Med Sci Sports Exerc. 2001;  33 ((7 Suppl)) S643-S646
• 9 Crystal GR, West JB, Weibel ER, Barnes PJ. The Lung: Scientific Foundations.. 2nd ed Philadelphia, New York: Lippincott-Raven; 1997
• 10 Dourado VZ, Tanni SE, Antunes LC, Paiva SA, Campana AO, Renno AC, Godoy I. Effect of three exercise programs on patients with chronic obstructive pulmonary disease.  Braz J Med Biol Res. 2009;  42 263-271
• 11 Franssen FM, Broekhuizen R, Jansen PP, Wouters EF, Schols AM. Effects of whole-body exercise training on body composition and functional capacity in normal-weight patients with COPD.  Chest. 2004;  125 2021-2028
• 12 Hakala K, Stenius-Aarniala B, Sovijärvi A. Effects of weight loss on peak flow variability, airways obstruction, and lung volumes in obese patients with asthma.  Chest. 2000;  118 1315-1321
• 13 Hallstrand TS, Bates PW, Schoene RB. Aerobic conditioning in mild asthma decreases the hypernea of exercise and ventilatory capacity.  Chest. 2000;  18 1460-1469
• 14 Harriss DJ, Atkinson G. International Journal of Sports Medicine – Ethical Standards in Sport and Exercise Science Research.  Int J Sports Med. 2009;  30 701-702
• 15 Heyward VH. Advanced Fitness Assessment and Exercise Prescription.. Champaign, IL: Human Kinetics; 1997
• 16 Hsieh MJ, Lan CC, Chen NH, Huang CC, Wu YK, Cho HY, Tsai YH. Effects of high-intensity exercise training in a pulmonary rehabilitation programme for patients with chronic obstructive pulmonary disease.  Respirology. 2007;  12 381-388
• 17 Hudgel DW. Bronchial asthma.. In: Textbook of Pulmonary Diseases Volume 1 (4th ed). Boston/Toronto: Little, Brown and Company; 1989
• 18 Jardins TD. Cardiopulmonary Anatomy and Physiology: Essentials for Respiratory Care.. (2nd ed). Albany, New York: Delmar Publishers; 1993
• 19 Johnson BD, Aaron EA, Babcock MA, Dempsey JA. Respiratory muscle fatigue during exercise: implications for performance.  Med Sci Sports Exerc. 1996;  28 1129-1137
• 20 Kongsgaard M, Backer V, Jørgensen K, Kjaer M, Beyer N. Heavy resistance training increases muscle size, strength and physical function in elderly male COPD-patients – a pilot study.  Respir Med. 2004;  98 1000-1007
• 21 Mador MJ, Bozkanat E, Aggarwal A, Shaffer M, Kufel TJ. Endurance and strength training in patients with COPD.  Chest. 2004;  125 2036-2045
• 22 Manning JM, Dooly-Manning CR, White K, Kampa I, Silas S, Kesselhaut M, Ruoff M. Effects of a resistive training programme on lipoprotein-lipid levels in obese women.  Med Sci Sports Exerc. 1991;  3 1222-1223
• 23 Marciniuk D, McKim D, Sanii R, Younes M. Role of central respiratory muscle fatigue in endurance exercise in normal subjects.  J Appl Physiol. 1994;  76 236-241
• 24 Martin BJ, Stager JM. Ventilatory endurance in athletes and non-athletes.  Med Sci Sports Exerc. 1981;  13 21-26
• 25 Miller MR, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A, Crapo R, Enright P, van der Grinten CP, Gustafsson P, Jensen R, Johnson DC, MacIntyre N, McKay R, Navajas D, Pedersen OF, Pellegrino R, Viegi G, Wanger J. ATS/ERS Task Force: Standardisation of spirometry.  Eur Respir J. 2005;  26 319-338
• 26 Morrow JR, Van Handel PJ, Bradley PW. Development of valid pulmonary function equations for trained athletes.  Int J Sports Med. 1989;  10 43-47
• 27 Nakamura Y, Tanaka K, Shigematsu R, Nakagaichi M, Inoue M, Homma T. Effects of aerobic training and recreational activities in patients with chronic obstructive pulmonary disease.  Int J Rehabil Res. 2008;  31 275-283
• 28 Nava S, Zanotti E, Rampulla C, Rossi A. Respiratory muscle fatigue does not limit exercise performance during moderate endurance run.  J Sports Med Physical Fitness. 1992;  32 39-44
• 29 Norton K, Olds T. Anthropometrica: A Textbook of Body Measurement for Sports and Health Courses.. Marrickville, NSW: Southwood Press; 1996
• 30 Ortega F, Toral J, Cejudo P, Villagomez R, Sanchez H, Castillo J, Montemayor T. Comparison of effects of strength and endurance training in patients with chronic obstructive pulmonary disease.  Am J Respir Crit Care Med. 2002;  166 669-674
• 31 Panton LB, Golden J, Broeder CE, Browder KD, Cestaro-Seifer DJ, Seifer FD. The effects of resistance training on functional outcomes in patients with chronic obstructive pulmonary disease.  Eur J Appl Physiol. 2004;  91 443-449
• 32 Pierson LM, Herbert WG, Norton J, Kiebzak GM, Griffith P, Fedor JM, Ramp WK, Cook JW. Effects of combined aerobic and resistance training versus aerobic training alone in cardiac rehabilitation.  J Cardiopulm Rehabil. 2001;  21 101-110
• 33 Puhan MA, Schünemann HJ, Frey M, Scharplatz M, Bachman LM. How should COPD patients exercise during respiratory rehabilitation? Comparison of exercise modalities and intensities to treat skeletal muscle function.  Thorax. 2005;  60 367-375
• 34 Simpson K, Killian K, McCartney N, Stubbing DG, Jones NL. Randomised controlled trial of weightlifting exercise in patients with chronic airflow limitation.  Thorax. 1992;  47 70-75
• 35 Spruit MA, Gosselink R, Troosters T, De Paepe C, Decramer M. Resistance versus endurance training in patients with COPD and peripheral muscle weakness.  Eur Respir J. 2002;  19 1072-1078
• 36 Tantisira KG, Litonjua AA, Weiss ST, Fuhlbrigge AL. Childhood Asthma Management Program Research Group . Association of body mass with pulmonary function in the Childhood Asthma Management Program (CAMP).  Thorax. 2003;  58 1036-1041
• 37 Troosters T. Endurance versus strength training in chronic obstructive disease 2) Resistance training.  Chron Respir Dis. 2004;  1 40-41
• 38 Troosters T, Casaburi R, Gosselink R, Decramer M. Pulmonary rehabilitation in chronic obstructive pulmonary disease.  Am J Respir Crit Care Med. 2005;  172 19-38
• 39 Wilmore JH, Costill DL. Physiology of Sport and Exercise.. (2nd ed.). Champaign, IL: Human Kinetics; 1999: 226

Correspondence