Pulmonary rehabilitation (PR) including exercise training is highly effective by improving health-related quality of life, exercise capacity and symptoms in patients with chronic obstructive pulmonary disease (COPD). Therefore, PR is a main component in the management of COPD. In a former study patients with Alpha-1 Antitrypsin deficiency (A1ATD)-related COPD (genotype PiZZ) have been found to show smaller improvements in exercise capacity after a 3-week inpatient PR program compared to COPD patients without A1ATD (genotype PiMM)\[1\]. These between-group differences were mirrored by missing adaptations of the fatigue-resistant skeletal muscle fibre type I in A1ATD patients. This was in contrast to COPD patients without A1ATD who increased the proportion of this fibre type after PR. Myofibre type I is crucial because it enables patients for physical endurance activities (walking, cycling etc.) during their daily life. The aim of this study is to compare the effects of an exercise Training program with high vs. moderate Training intensity in order to find a Training modality which improves Training effects in A1ATD patients.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
30
Patients perform an exercise Training program of 3 weeks Duration including endurance Training, resistance Training and squat Training. This program is part of an inpatient pulmonary Rehabilitation.
Schoen Klinik Berchtesgadener Land
Schönau am Königssee, Germany
RECRUITINGEndurance shuttle walk test (ESWT)
The ESWT is performed at 85% of the Peak gate Speed, measured during the Initial incremental shuttle walk test.
Time frame: Change in the duration of the ESWT from day 1 to day 21
Oxygen saturation
Outcome will be assessed at the the time Point of the end of the shortest ESWT ("isotime").
Time frame: Change in the oxygen saturation at isotime from day 1 to day 21
Heart rate
Outcome will be assessed at the the time Point of the end of the shortest ESWT ("isotime").
Time frame: Change in the heart rate at isotime from day 1 to day 21
Partial pressure of carbon dioxide (CO2)
Parameter will be measured by Sentec (R) device. Outcome will be assessed at the the time Point of the end of the shortest ESWT ("isotime").
Time frame: Change in the partial pressure of CO2 at isotime from day 1 to day 21
Lactate concentration
Outcome will be assessed at the the time Point of the end of the shortest ESWT ("isotime").
Time frame: Change in lactate concentration at isotime from day 1 to day 21
Perceived Dyspnea
Dyspnea will be rated on a 0 to 10-point BORG scale where lower values represent less dyspnea and vice versa. The total score will be assessed at the the time Point of the end of the shortest ESWT ("isotime").
Time frame: Change in perceived dyspnea at isotime from day 1 to day 21
Strength capacity in knee extension
Strength will be measured by a Hand Held Dynamometer (Microfet (R)).
Time frame: Change in strength from day 1 to day 21
Balance performance
absolute path length will be measured on a force plate (Leonardo (R)) during the Tandem stance
Time frame: Change in balance performance from day 1 to day 21
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