Meta- analysis revealed few clinical ly relevant and statistically significant benefits of " add-on " therapies on exercise performance compared with exercise training .
The aim of this review was to identify the effectiveness of therapies added on to conventional exercise training to maximise exercise capacity in patients with chronic obstructive pulmonary disease ( COPD ) .
Effects of nutritional supplementation combined with conventional pulmonary rehabilitation in muscle-wasted chronic obstructive pulmonary disease: a prospective, randomized and controlled study.
BACKGROUND AND OBJECTIVE Nutritional depletion in chronic obstructive pulmonary disease ( COPD ) adversely affects health status and mortality . We aim ed to evaluate the effects of nutritional supplementation ( NS ) with pulmonary rehabilitation ( PR ) on body composition , mid-thigh cross-sectional area ( CSA ) , dyspnoea , exercise capacity , health-related quality of life , anxiety and depression in advanced COPD patients . METHODS Forty-six patients were r and omized to PR and nutritional support ( PRNS ) , PR or the control group .  Dyspnoea was measured with Medical Research Council and BORG scales . Exercise capacity was measured through 6-min walk test and shuttle tests ; health-related quality of life was assessed with St. George 's Respiratory Question naire . Psychological status was measured with Hospital Anxiety and Depression Scale . Body weight and body mass indexes ( BMI ) were also evaluated . Fat-free mass was measured through bioelectrical impedance analyser . The CSA of quadriceps was calculated in mid-level of the thigh with magnetic resonance imaging . RESULTS Dyspnoea and total scores of St. George 's Respiratory Question naire improved in both groups ( P < 0.05 ) . Six-minute walk test and incremental shuttle walk test distances in PRNS and PR patients increased significantly as ( 62.6 ± 42.4 m , 43.3 ± 59.2 m , both P = 0.001 ; and 63.3 ± 70.1 m and 69.3 ± 69.7 m , both P = 0.001 ) . Although anxiety improved in both groups ( P < 0.05 ) , there was no change in depression . Body weight , BMI and fat-free mass index ( FFMI ) ( 1.1 ± 0.9 kg , 0.2 ± 1.4 kg/m(2 ) and 0.6 ± 0.5 kg/m(2 ) , P < 0.05 ) in PRNS , whereas body weight and FFMI ( 0.6 ± 0.7 kg , 0.1 ± 0.6 kg/m(2 ) P < 0.05 ) increased in PR after the intervention . There was a significant increase in mid-thigh CSA ( 2.5 ± 4.1 cm(2 ) ) only in PRNS ( P = 0.04 ) . CONCLUSION The combination of NS with PR result ed in improvements particularly in lean body mass and mid-thigh CSA . This study suggests combining NS with PR in reversing weight loss and muscle wasting in COPD
Meta- analysis revealed few clinical ly relevant and statistically significant benefits of " add-on " therapies on exercise performance compared with exercise training .
The aim of this review was to identify the effectiveness of therapies added on to conventional exercise training to maximise exercise capacity in patients with chronic obstructive pulmonary disease ( COPD ) .