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 Ghrelin Treatment on Exercise Capacity in Underweight COPD Patients: a substudy of a multicenter, randomized, double-blind, placebo-controlled trial of ghrelin treatment
Background The aim of this sub study of the ghrelin treatment , multicenter , r and omized , double-blind , placebo-controlled trial was to investigate the effects of ghrelin administration on exercise capacity and the underlying mechanisms in underweight patients with chronic obstructive pulmonary disease ( COPD ) using cardiopulmonary exercise testing . Methods Twenty underweight COPD patients were r and omized to pulmonary rehabilitation with intravenous ghrelin ( 2 μg/kg , n = 10 ) or placebo ( n = 10 ) twice daily for 3 weeks in a double-blind fashion . The primary outcome was changes in peak oxygen uptake V•o2 . Secondary outcomes included changes in exertional cardio-respiratory functions : O2-pulse , physiologic dead space/tidal volume-ratio ( VD/VT ) , ventilatory equivalent for oxygen V•E/V•o2 , and ventilatory equivalent for carbon dioxide V•E/V•co2 . Results With incremental exercise , at peak exercise , there was a significant difference in the mean difference ( ghrelin minus placebo ) , i.e. , treatment effect in : i ) peak V•o2 ( 1.2 mL/kg/min , 95 % CI : 0.2 - 2.3 mL/kg/min , between-group p = 0.025 ) ; ii ) V•E/V•o2 ( -4.2 , 95 % CI : -7.9 to -0.5 , between-group p = 0.030 ) ; iii ) V•E/V•co2 ( -4.1 , 95 % CI : -8.2 to -0.1 , between-group p = 0.045 ) ; iv ) VD/VT ( -0.04 , 95 % CI : -0.08 to -0.00 , between-group p = 0.041 ) ; and v ) O2-pulse ( 0.7 mL/beat , 95 % CI : 0.3 to 1.2 mL/beat , between-group p = 0.003 ) . Additionally , repeated- measures analysis of variance ( ANOVA ) indicated a significant time-course effect of ghrelin versus placebo in the peak V•o2 ( p = 0.025 ) . Conclusion Ghrelin administration was associated with improved exertional capacity and improvements in ventilatory-cardiac parameters . Trial registration UMIN ( University Hospital Medical Information Network in Japan )
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 ) .