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Publications (10 of 15) Show all publications
Frykholm, E., Simonsson, E., Levik Sandström, S., Hedlund, M., Holmberg, H., Johansson, B., . . . Rosendahl, E. (2024). Applicability of a supramaximal high-intensity interval training program for older adults previously not engaged in regular exercise: analyses of secondary outcomes from the Umeå HIT Study. Psychology of Sport And Exercise, 73, Article ID 102647.
Open this publication in new window or tab >>Applicability of a supramaximal high-intensity interval training program for older adults previously not engaged in regular exercise: analyses of secondary outcomes from the Umeå HIT Study
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2024 (English)In: Psychology of Sport And Exercise, ISSN 1469-0292, E-ISSN 1878-5476, Vol. 73, article id 102647Article in journal (Refereed) Published
Abstract [en]

This analysis of secondary outcomes investigated the applicability of supramaximal high-intensity interval training (HIT) with individually prescribed external intensity performed on stationary bicycles. Sixty-eight participants with a median (min; max) age of 69 (66; 79), at the time not engaged in regular exercise were randomized to 25 twice-weekly sessions of supramaximal HIT (20-min session with 10 × 6-s intervals) or moderate-intensity training (MIT, 40-min session with 3 × 8-min intervals). The primary aim was outcomes on applicability regarding; adherence to prescribed external interval intensity, participant reported positive and negative events, ratings of perceived exertion (RPE 6–20), and affective state (Feeling Scale, FS -5–5). A secondary aim was to investigate change in exercise-related self-efficacy (Exercise Self-Efficacy Scale) and motivation (Behavioural Regulations in Exercise Questionnaire-2). Total adherence to the prescribed external interval intensity was [median (min; max)] 89 % (56; 100 %) in supramaximal HIT, and 100 % (95; 100 %) in MIT. The supramaximal HIT group reported 60 % of the positive (112 of 186) and 36 % of the negative (52 of 146) events. At the end of the training period, the median (min; max) session RPE was 15 (12; 17) for supramaximal HIT and 14 (9; 15) for MIT. As for FS, the median last within-session rating was 3 (−1; 5) for supramaximal HIT and 3 (1; 5) for MIT. Exercise-related motivation increased (mean difference in Relative Autonomy Index score = 1.54, 95 % CI [0.69; 2.40]), while self-efficacy did not change (mean difference = 0.55, 95 % CI [-0.75; 1.82]), regardless of group. This study provide support for supramaximal HIT in supervised group settings for older adults.

Place, publisher, year, edition, pages
Elsevier, 2024
Keywords
Feasibility, HIIT, Randomized controlled trial, SIT, Sprint interval training
National Category
Sport and Fitness Sciences
Identifiers
urn:nbn:se:umu:diva-223607 (URN)10.1016/j.psychsport.2024.102647 (DOI)38604572 (PubMedID)2-s2.0-85190305065 (Scopus ID)
Funder
Swedish Research Council, 2017–00912Forte, Swedish Research Council for Health, Working Life and Welfare, 2020–00159The Kamprad Family FoundationThe Dementia Association - The National Association for the Rights of the DementedFoundation for the Memory of Ragnhild and Einar LundströmThe Kempe Foundations
Available from: 2024-05-02 Created: 2024-05-02 Last updated: 2024-05-02Bibliographically approved
Ekström, M., Sundh, J., Andersson, A., Angerås, O., Blomberg, A., Börjesson, M., . . . Carlhäll, C.-J. (2024). Exertional breathlessness related to medical conditions in middle-aged people: the population-based SCAPIS study of more than 25,000 men and women. Respiratory Research, 25(1), Article ID 127.
Open this publication in new window or tab >>Exertional breathlessness related to medical conditions in middle-aged people: the population-based SCAPIS study of more than 25,000 men and women
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2024 (English)In: Respiratory Research, ISSN 1465-9921, E-ISSN 1465-993X, Vol. 25, no 1, article id 127Article in journal (Refereed) Published
Abstract [en]

Background: Breathlessness is common in the population and can be related to a range of medical conditions. We aimed to evaluate the burden of breathlessness related to different medical conditions in a middle-aged population.

Methods: Cross-sectional analysis of the population-based Swedish CArdioPulmonary bioImage Study of adults aged 50–64 years. Breathlessness (modified Medical Research Council [mMRC] ≥ 2) was evaluated in relation to self-reported symptoms, stress, depression; physician-diagnosed conditions; measured body mass index (BMI), spirometry, venous haemoglobin concentration, coronary artery calcification and stenosis [computer tomography (CT) angiography], and pulmonary emphysema (high-resolution CT). For each condition, the prevalence and breathlessness population attributable fraction (PAF) were calculated, overall and by sex, smoking history, and presence/absence of self-reported cardiorespiratory disease.

Results: We included 25,948 people aged 57.5 ± [SD] 4.4; 51% women; 37% former and 12% current smokers; 43% overweight (BMI 25.0–29.9), 21% obese (BMI ≥ 30); 25% with respiratory disease, 14% depression, 9% cardiac disease, and 3% anemia. Breathlessness was present in 3.7%. Medical conditions most strongly related to the breathlessness prevalence were (PAF 95%CI): overweight and obesity (59.6–66.0%), stress (31.6–76.8%), respiratory disease (20.1–37.1%), depression (17.1–26.6%), cardiac disease (6.3–12.7%), anemia (0.8–3.3%), and peripheral arterial disease (0.3–0.8%). Stress was the main factor in women and current smokers.

Conclusion: Breathlessness mainly relates to overweight/obesity and stress and to a lesser extent to comorbidities like respiratory, depressive, and cardiac disorders among middle-aged people in a high-income setting—supporting the importance of lifestyle interventions to reduce the burden of breathlessness in the population.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2024
Keywords
Diseases, Dyspnea, Epidemiology, Obesity
National Category
Public Health, Global Health, Social Medicine and Epidemiology Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:umu:diva-223242 (URN)10.1186/s12931-024-02766-6 (DOI)001186201900001 ()38493081 (PubMedID)2-s2.0-85187930690 (Scopus ID)
Funder
Swedish Heart Lung FoundationKnut and Alice Wallenberg FoundationSwedish Research Council, 2019–02081Swedish Research CouncilVinnovaUniversity of GothenburgKarolinska InstituteRegion StockholmLinköpings universitetLund UniversityUmeå UniversityUppsala University
Available from: 2024-04-18 Created: 2024-04-18 Last updated: 2024-04-18Bibliographically approved
Tanguay, S., Saey, D., Marklund, S., Nyberg, A., Gephine, S., Frykholm, E., . . . Maltais, F. (2023). Reference equations for quadriceps strength, endurance and power: a multicentre study. ERJ Open Research, 9(4), Article ID 00313-2023.
Open this publication in new window or tab >>Reference equations for quadriceps strength, endurance and power: a multicentre study
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2023 (English)In: ERJ Open Research, E-ISSN 2312-0541, Vol. 9, no 4, article id 00313-2023Article in journal (Refereed) Published
Abstract [en]

Introduction: The lack of reference values of lower-limb muscle function hinders the clinical recommendations of its measurement in patients with COPD. Therefore, this study aimed to develop reference equations to predict reference values for quadriceps strength, endurance and power and evaluate their construct validity in patients with COPD.

Methods: Quadriceps strength, endurance and power were assessed in 158 healthy individuals and 87 patients with COPD. In addition, patients with COPD performed a 6-min walk test (6MWT) and a 1-min sit-to-stand test (1STS). Multiple linear regressions were performed to develop reference equations. The proportion of patients with COPD with reduced quadriceps function was determined, and correlations between quadriceps strength, endurance and power expressed in percentage of predicted values and 6MWT and 1STS performance were used to document the construct validity of the reference equation.

Results: Except for quadriceps isometric endurance, the proposed reference equations explained 50-70% of the variance of the quadriceps properties in healthy individuals. All quadriceps properties were systematically reduced in a large proportion of patients with COPD compared to healthy individuals. Correlation coefficients between quadriceps properties expressed in percentage of predicted values and 6MWT and 1STS performance ranged between 0.28 and 0.49 (all p<0.05).

Conclusion: In healthy individuals, age, sex, height and body mass index explained 50-70% of the variance of quadriceps strength, endurance and power. When expressed in percentage of predicted values, these quadriceps properties correlated with 6MWT and 1STS performance, suggesting construct validity of the reference values in patients with COPD.

Place, publisher, year, edition, pages
European Respiratory Society, 2023
National Category
Physiotherapy
Research subject
physiotherapy
Identifiers
urn:nbn:se:umu:diva-204241 (URN)10.1183/23120541.00313-2023 (DOI)001055103800011 ()37650093 (PubMedID)2-s2.0-85171791271 (Scopus ID)
Note

Originally included in thesis in manuscript form.

Available from: 2023-01-31 Created: 2023-01-31 Last updated: 2024-03-22Bibliographically approved
Frykholm, E., Gephine, S., Saey, D., Lemson, A., Klijn, P., bij de Vaate, E., . . . Nyberg, A. (2021). Isotonic quadriceps endurance is better associated with daily physical activity than quadriceps strength and power in COPD: an international multicentre cross-sectional trial. Scientific Reports, 11(1), Article ID 11557.
Open this publication in new window or tab >>Isotonic quadriceps endurance is better associated with daily physical activity than quadriceps strength and power in COPD: an international multicentre cross-sectional trial
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2021 (English)In: Scientific Reports, E-ISSN 2045-2322, Vol. 11, no 1, article id 11557Article in journal (Refereed) Published
Abstract [en]

Knowledge about modifiable determinants of daily physical activity (PA) in patients with chronic obstructive pulmonary disease (COPD) is crucial to design effective PA interventions. The present study aimed to determine the contribution of quadriceps strength, power and endurance to daily PA in COPD. Additionally, for quadriceps endurance, we also aimed to determine to what extent the association varies according to the mode of movement (isotonic, isometric, or isokinetic). Using a multicentre cross-sectional trial design we determined the contribution of quadriceps function to daily PA (steps, sedentary time and time spent doing moderate-to-very-vigorous physical activity [MVPA]) using bivariate and partial Pearson correlation analysis (r) and multiple linear regression models (ΔR2). Pre-determined controlling factors were sex, age, body mass index (BMI), COPD-assessment test, forced expiratory volume in one second in percent of the predicted value (FEV1pred), and distance walked on the 6-minute walk test. Eighty-one patients with COPD (mean ± SD: age 67 ± 8 years, FEV1pred 57 ± 19%, daily steps 4968 ± 3319, daily sedentary time 1016 ± 305 min, and MVPA time 83 ± 45 min) were included. Small to moderate bivariate correlations (r =.225 to.452, p <.05) were found between quadriceps function and measures of PA. The best multiple linear regression models explained 38–49% of the variance in the data. Isotonic endurance was the only muscle contributor that improved all PA models; daily steps (ΔR2 =.04 [relative improvement 13%] p =.026), daily sedentary time (ΔR2 =.07 [23%], p =.005) and MVPA-minutes (ΔR2 =.08 [20%], p =.001). Isotonic endurance was also independently associated with most PA variables, even when controlling for strength, power or isometric-isokinetic endurance properties of the muscle (r =.246 to.384, p <.05). In contrast, neither strength, power, isometric-or isokinetic endurance properties of the muscle was independently associated with PA measures when controlling for isotonic endurance (r =.037 to.219, p >.05). To conclude, strength, power, and endurance properties of the quadriceps were low to moderately associated with PA in patients with COPD. Isotonic quadriceps endurance was the only quadriceps property that was independently associated with the different measures of PA after controlling for a basic set of known determinants of PA, quadriceps strength or power, or isometric or isokinetic quadriceps endurance. Future longitudinal studies should investigate its potential as a modifiable determinant of PA.

Place, publisher, year, edition, pages
Nature Publishing Group, 2021
National Category
Physiotherapy
Identifiers
urn:nbn:se:umu:diva-184443 (URN)10.1038/s41598-021-90758-7 (DOI)000687322500085 ()2-s2.0-85107223137 (Scopus ID)
Available from: 2021-06-14 Created: 2021-06-14 Last updated: 2024-03-22Bibliographically approved
Gephine, S., Frykholm, E., Nyberg, A., Mucci, P., Van Hees, H. W., Lemson, A., . . . Saey, D. (2021). Specific contribution of quadriceps muscle strength, endurance, and power to functional exercise capacity in people with chronic obstructive pulmonary disease: a multicenter study. Physical Therapy, 101(6), 1-8
Open this publication in new window or tab >>Specific contribution of quadriceps muscle strength, endurance, and power to functional exercise capacity in people with chronic obstructive pulmonary disease: a multicenter study
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2021 (English)In: Physical Therapy, ISSN 0031-9023, E-ISSN 1538-6724, Vol. 101, no 6, p. 1-8Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: Various functional muscle properties affect different aspects of functional exercise capacity in people with COPD. The purpose of this study was to investigate the contribution of quadriceps muscle strength, endurance, and power to the 6-minute walking distance (6MWD) and the 1-minute sit-to-stand test (1STS) performance in people with COPD.

METHODS: The study was a prospective, multicenter cross-sectional study. Anthropometrics, Medical Research Council (MRC) dyspnea scale, lung function, 6MWD and the 1STS number of repetitions were assessed. Isometric quadriceps strength (Strength-ISOM) and endurance (Endurance-ISOM), isotonic quadriceps endurance (Endurance-ISOT), isokinetic quadriceps strength (Strength-ISOKIN), and power (Power-ISOKIN) were assessed on a computerized dynamometer while functional quadriceps power was determined during 5 sit-to-stand repetitions (Power-5STS). Univariate and multivariate analyses were performed to determine the contribution of functional muscle properties on the 6MWD and the 1STS number of repetitions.

RESULTS: The study included 70 people with COPD (mean % predicted FEV1 = 58.9 [SD = 18.2]). The 6MWD correlated with each functional muscle property, except the Endurance-ISOM. The number of repetitions during the 1STS correlated with each functional muscle property except isometric measurements. Multivariate models explained respectively 60% and 39% of the variance in the 6MWD and 1STS number of repetitions, with Power-5STS being the muscle functional property with the strongest contribution to the models.

CONCLUSION: Except for isometric endurance, quadriceps strength, endurance, and power were associated with functional exercise capacity in people with moderate COPD. Among these functional muscle properties, muscle power contributed the most to the 6MWD and 1STS number of repetitions, suggesting that muscle power is more relevant to functional exercise capacity than muscle strength or endurance in people with COPD.

IMPACT: Understanding the individual contribution of muscle properties to functional status is important to designing interventions. This study provides the guidance that muscle power may be more important to functional exercise capacity than muscle strength or endurance in people with COPD.

Place, publisher, year, edition, pages
Oxford University Press, 2021
Keywords
endurance, isokinetic, power, sit-to-stand, strength
National Category
Physiotherapy
Identifiers
urn:nbn:se:umu:diva-183742 (URN)10.1093/ptj/pzab052 (DOI)000732786500005 ()33594431 (PubMedID)2-s2.0-85107228731 (Scopus ID)
Available from: 2021-05-31 Created: 2021-05-31 Last updated: 2024-03-22Bibliographically approved
Frykholm, E. (2021). The relevance and assessment of limb muscle function in individuals with chronic obstructive pulmonary disease. (Doctoral dissertation). Umeå: Umeå universitet
Open this publication in new window or tab >>The relevance and assessment of limb muscle function in individuals with chronic obstructive pulmonary disease
2021 (English)Doctoral thesis, comprehensive summary (Other academic)
Alternative title[sv]
Relevans och bedömning av muskelfunktion hos personer med kroniskt obstruktiv lungsjukdom
Abstract [en]

Chronic obstructive pulmonary disease (COPD) is a disease that is characterised by persistent respiratory symptoms and airflow limitation. Consequences beyond the airways and lungs are common, and include limb muscle dysfunction. Limb muscle dysfunction is treated with exercise training, and should be preceded by assessments to individualise prescriptions. Guidelines recommend assessment of quadriceps strength, but limb muscle dysfunction affects more than strength. Other less investigated assessments may be of interest. During training, direct physiological (cardiorespiratory, metabolic, and biomechanical) and symptomatic responses are important, since they can affect training effectivity, and they may differ depending on whether arms or legs are used. The main aims of this thesis were to investigate the relevance of assessments of quadriceps function, feasibility and reliability of methods to assess quadriceps endurance, and to compare the direct physiological and symptomatic responses during arm and leg activities in people with COPD.

Method: This thesis is based on four papers. These include one systematic review with a meta-analysis of studies comparing direct physiological and symptomatic responses to activities performed with the arms versus the legs, and three papers based on an international cross-sectional multicentre study investigating reliability, feasibility, and relevance of three leg extension assessments of quadriceps endurance. Relative and absolute reliability were determined via interclass correlation coefficient (ICC), coefficient of variation (CV %), and limits of agreement (LoA %) for measures of isokinetic total work, isokinetic fatigue index, isometric time to exhaustion, and isotonic repetitions to exhaustion. The relevance of the measures of quadriceps endurance and other quadriceps functions were determined by the association to functional capacity and physical activity with Pearson correlation analyses (r) and multiple linear regression models (R2, adjusted R2, Δ R2, and Δ adjusted R2).

Results: Results from the meta-analyses show that leg-cycle ergometer resulted in greater tidal volume (137 mL), minute ventilation (4.8 L/min), and oxygen consumption (164 mL/min) compared to arm cycle ergometer, while symptomatic responses were similar. Physiological responses (e.g., minute ventilation and oxygen consumption) during arm compared to leg resistance training exercises were similar. Results from studies on functional activities depend on the type and intensity of the activity performed. Isokinetic total work was the measurement with the highest relative reliability (ICC = 0.98) and the smallest absolute reliability (e.g., CV% = 6.5). Isokinetic fatigue index, isometric, and isotonic measures demonstrated low-to-high relative reliability (ICC = 0.64, 0.88, 0.91), and absolute reliability was larger (e.g., CV% = 20.3, 14.9, and 15.8%). Participants performed better on the retest for isokinetic total work and isometric measurements (4.8 and 10%, p < 0.001). The feasibility was similar across protocols, with an average time consumption of< 7.5 minutes, limited perceived dyspnoea compared to leg fatigue, and no major adverse advents. The measures of quadriceps function had mostly similar (r = +/- 0.07–0.45) levels of correlations to the functional capacity and physical activity. In multiple regression analyses improved quadriceps power the models to predict functional capacity the most (Δ adjusted R2= 0.10, 0.15, adjusted R2 = 0.60, 0.39). Isotonic endurance was the only muscle function that improved all physical activity models (ΔR2 = 0.04–0.07, p < 0.05, R2 = 0.38–0.49).

Conclusions: The results indicate that if the goal of an activity is to maximise physiological responses such as minute ventilation and oxygen consumption, activities involving the legs should be preferred. Symptomatic responses seems task and intensity dependent, which suggest that strategies used to reduce symptoms should be based on relative intensity. In the assessment of quadriceps endurance, isokinetic, isometric and isotonic protocols present low to very high relative reliability. Differences in reliability and the better performance at retest might reflect differences in ability to detect true change. Quadriceps power seems to be more relevant to functional capacity, and isotonic quadriceps endurance seems to be more relevant to physical activity.

Place, publisher, year, edition, pages
Umeå: Umeå universitet, 2021. p. 93
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 2145
Keywords
COPD, lower and upper limb activities, quadriceps function, reliability, association
National Category
Physiotherapy Respiratory Medicine and Allergy
Research subject
physiotherapy
Identifiers
urn:nbn:se:umu:diva-186741 (URN)978-91-7855-594-9 (ISBN)978-91-7855-595-6 (ISBN)
Public defence
2021-09-17, Triple Helix, Universitetsledningshuset, Umeå, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2021-08-27 Created: 2021-08-20 Last updated: 2023-03-07Bibliographically approved
Nyberg, A., Desroches, L., Frykholm, E., Saey, D., Martin, M. & Maltais, F. (2020). Oxygen consumption (V?O2) kinetics during recovery after resistance exercises in COPD and matched controls. European Respiratory Journal, 56
Open this publication in new window or tab >>Oxygen consumption (V?O2) kinetics during recovery after resistance exercises in COPD and matched controls
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2020 (English)In: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 56Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
European Respiratory Society, 2020
Keywords
COPD, COPD - management, COPD - mechanism
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:umu:diva-180186 (URN)10.1183/13993003.congress-2020.4745 (DOI)000606501408024 ()
Note

Supplement: 64

Meeting Abstract: 4745

Available from: 2021-02-22 Created: 2021-02-22 Last updated: 2024-03-22Bibliographically approved
Bergqvist, M., Lindahl, M., Frykholm, E. & Nyberg, A. (2019). Dynamic and static quadriceps muscle endurance in people with COPD and healthy age and gender-matched controls. European Respiratory Journal, 54(suppl 63)
Open this publication in new window or tab >>Dynamic and static quadriceps muscle endurance in people with COPD and healthy age and gender-matched controls
2019 (English)In: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 54, no suppl 63Article in journal, Meeting abstract (Refereed) Published
Abstract [en]

Introduction: It is commonly known that quadriceps muscle endurance is decreased among people with COPD, however, whether static and dynamic quadriceps muscle endurance is affected to the same extent, remains to be determined. The latter of importance for the design of exercise modalities targeting quadriceps endurance in COPD.Methods: Static (isometric) and dynamic (isokinetic, isotonic) measurements of quadriceps muscle endurance was performed using a computerized dynamometer on 30 of individuals with COPD (FEV1 63% predicted) and 30 healthy age and gender-matched controls. Test order was randomized, separated by 30 min of rest. Comparisons between groups included both relative (seconds/repetitions) and absolute (total work [Nm]) measures of quadriceps endurance. Between-group results are presented as percentage difference (%) and effect sizes (ES).Results: When compared to healthy age and gender matched controls, people with COPD had significantly lower absolute measures of quadriceps endurance (isometric -32%, ES 0.66 [moderate]; isokinetic -29%, ES 0.94 [large], isotonic -38%, ES 0.89 [large], all p &lt;0.05) as well as lower relative measures of dynamic quadriceps endurance (isotonic [repetitions] -20%, ES 0.50 [moderate], p = 0.02) while static quadriceps endurance did not differ between groups (isometric [seconds] -3%, ES 0.06 [trivial], p = 0.617).Conclusion: As evident by larger ES, dynamic quadriceps endurance seems to be reduced to a larger extent than static quadriceps endurance in people with COPD. Thus, exercise modalities that aim to improve quadriceps endurance should preferably be designed to increase dynamic quadriceps muscle enduranceFootnotesCite this article as: European Respiratory Journal 2019; 54: Suppl. 63, OA3814.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).

Place, publisher, year, edition, pages
European Respiratory Society, 2019
National Category
Physiotherapy
Identifiers
urn:nbn:se:umu:diva-166661 (URN)10.1183/13993003.congress-2019.OA3814 (DOI)
Available from: 2019-12-19 Created: 2019-12-19 Last updated: 2024-03-22Bibliographically approved
Frykholm, E., Klijn, P., Saey, D., van Hees, H. W. H., Stål, P., Sandström, T., . . . Nyberg, A. (2019). Effect and feasibility of non-linear periodized resistance training in people with COPD: study protocol for a randomized controlled trial. Trials, 20(1), Article ID 6.
Open this publication in new window or tab >>Effect and feasibility of non-linear periodized resistance training in people with COPD: study protocol for a randomized controlled trial
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2019 (English)In: Trials, E-ISSN 1745-6215, Vol. 20, no 1, article id 6Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: In people with chronic obstructive pulmonary disease (COPD), limb-muscle dysfunction is one of the most troublesome systemic manifestations of the disease, which at the functional level is evidenced by reduced strength and endurance of limb muscles. Improving limb-muscle function is an important therapeutic goal of COPD management, for which resistance training is recommended. However, current guidelines for resistance training in COPD mainly focus on improving muscle strength which only reflects one aspect of limb-muscle function and does not address the issue of reduced muscle endurance. The latter is of importance considering that the reduction in limb-muscle endurance often is greater than that of muscle weakness, and also, limb-muscle endurance seems to be closer related to walking capacity as well as arm function than to limb-muscle strength within this group of people. Thus, strategies targeting multiple aspects of the decreased muscle function are warranted to increase the possibility for an optimal effect for the individual patient. Periodized resistance training, which represents a planned variation of resistance training variables (i.e., volume, intensity, frequency, etc.), is one strategy that could be used to target limb-muscle strength as well as limb-muscle endurance within the same exercise regimen.

METHODS: This is an international, multicenter, randomized controlled trial comparing the effect and feasibility of non-linear periodized resistance training to traditional non-periodized resistance training in people with COPD. Primary outcomes are dynamic limb-muscle strength and endurance. Secondary outcomes include static limb-muscle strength and endurance, functional performance, quality of life, dyspnea, intramuscular adaptations as well as the proportion of responders. Feasibility of the training programs will be assessed and compared on attendance rate, duration, satisfaction, drop-outs as well as occurrence and severity of any adverse events.

DISCUSSION: The proposed trial will provide new knowledge to this research area by investigating and comparing the feasibility and effects of non-linear periodized resistance training compared to traditional non-periodized resistance training. If the former strategy produces larger physiological adaptations than non-periodized resistance training, this project may influence the prescription of resistance training in people with COPD.

TRIAL REGISTRATION: ClinicalTrials.gov, ID: NCT03518723 . Registered on 13 April 2018.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2019
Keywords
Functional performance, Limb-muscle endurance, Limb-muscle strength, Pulmonary disease, chronic obstructive
National Category
Physiotherapy
Research subject
physiotherapy
Identifiers
urn:nbn:se:umu:diva-154980 (URN)10.1186/s13063-018-3129-y (DOI)000454906600006 ()30606240 (PubMedID)2-s2.0-85059495067 (Scopus ID)
Funder
Swedish Research Council, 2016-01802Swedish Heart Lung Foundation, E 127/16
Available from: 2019-01-07 Created: 2019-01-07 Last updated: 2024-03-22Bibliographically approved
Frykholm, E., Pereira Lima, V., Selander, H.-V., Nyberg, A. & Janaudis-Ferreira, T. (2019). Physiological and Symptomatic Responses to Arm versus Leg Activities in People with Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis. COPD: Journal of Chronic Obstructive Pulmonary Disease, 16(5-6), 390-405
Open this publication in new window or tab >>Physiological and Symptomatic Responses to Arm versus Leg Activities in People with Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis
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2019 (English)In: COPD: Journal of Chronic Obstructive Pulmonary Disease, ISSN 1541-2555, E-ISSN 1541-2563, Vol. 16, no 5-6, p. 390-405Article in journal (Refereed) Published
Abstract [en]

While the mechanisms underlying exercise limitations and symptoms during leg activities have been investigated in detail, knowledge of potential differences between leg and arm activities are not well understood and results from individual studies are contradictory. Thus, the aim of the present study was to synthesize physiological and symptomatic responses during activities involving the arms relative to activities involving the legs in people with Chronic Obstructive Pulmonary Disease (COPD). Any study with a cross-sectional comparison of acute physiological (cardiorespiratory, metabolic) and symptomatic responses to activities performed with the arms versus the legs were included. Studies were sub-grouped based on the type of activity performed (cycle ergometer, resistance exercises, or functional test/activities). Eighteen studies with 423 individuals with COPD were included. Leg cycle ergometer resulted in greater tidal volume (137?mL), minute ventilation (4.8?L/min), and oxygen consumption (164?mL/min) than arm cycle ergometer, while symptomatic responses were similar. Resistance exercises resulted in similar physiological and symptomatic responses irrespective of whether the legs or the arms were involved while studies on functional activities report different results depending on the type and intensity of the activity performed. With the exception of cycle ergometer activities, physiological and symptomatic responses do not seem to depend on whether the arms or the legs are used, but rather seem to be task and intensity dependent. These novel findings suggest, for example, that strategies used to increase exercise tolerance should not be dependent on whether the arms or the legs are used, but rather the intensity of specific activity performed.

Place, publisher, year, edition, pages
Taylor & Francis, 2019
Keywords
Peripheral muscle, physiological responses, systematic review, COPD, symptoms
National Category
Physiotherapy
Identifiers
urn:nbn:se:umu:diva-165109 (URN)10.1080/15412555.2019.1674269 (DOI)000491786300001 ()31631711 (PubMedID)2-s2.0-85075605400 (Scopus ID)
Funder
Swedish Research Council, 201601802Swedish Heart Lung Foundation
Available from: 2019-11-13 Created: 2019-11-13 Last updated: 2021-12-15Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-3212-4708

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