Eccentric Exercise Training as Novel Rehabilitation for Chronic Obstructive Pulmonary Disease (COPD)
Condition: Pulmonary Disease, Chronic Obstructive; Bronchitis, Chronic; Emphysema
MeSH terms: Bronchitis; Bronchitis, Chronic; Lung Diseases; Pulmonary Disease, Chronic Obstructive; Emphysema
Study type: Interventional

Summary: 
      The main purpose of this project is to establish the additional value of eccentric versus
      concentric exercise to optimize muscle function in patients with severe COPD. With this pilot
      project the investigators expect that an eccentric endurance training protocol adapted to
      severe COPD patients will lead to gains in muscle strength, the primary outcome, and cellular
      adaptation (muscle morphology and oxidative capacity, mitochondrial respiratory capacity)
      when compared to a concentric training approach.

      This information will be essential if the investigators want to design and power a randomized
      clinical trial that will allow assessing effectiveness of this novel rehabilitation approach.
    

Detailed description: 
      Chronic obstructive pulmonary disease (COPD) is a major respiratory illness that is both
      preventable and treatable. Dyspnea is the most important symptom that COPD patients
      experience and this can have a major impact on their daily live. While COPD is characterized
      by a spectrum of disease severity, most patients experience poor exercise intolerance
      attributable to ventilatory limitation as well as peripheral muscle fatigue, ultimately
      leading to severe disability.

      Endurance exercise is an important component of pulmonary rehabilitation and is aimed at
      preventing this decline in functional capacity. The effects of pulmonary rehabilitation are
      largely attributable to the exercise training component involving concentric muscle
      contractions, traditionally trough dynamic, large muscle exercise on a cycle ergometer or
      treadmill. However, many patients are unable to partake and benefit from such rehabilitation
      because of locomotor muscle weakness and severe ventilatory limitation that prevent them from
      exercising at intensities sufficient to provoke improvements in cardioventilatory and
      skeletal muscle function. Eccentric exercise is known for its unique physiologically
      fundamental characteristics: the lower metabolic demand for a same power output and greater
      muscle gains compared to the concentric exercise. For this reason, eccentric endurance
      training has been proposed as a novel adjunctive rehabilitative countermeasure for certain
      chronic diseases (such as coronary disease and COPD) and can play an important role for
      patients with advanced disease.
    

Intervention name(s): Eccentric exercise training
Intervention type(s): Other
Intervention description(s): The eccentric exercise training will be performed using a specially built cycle ergo meter where the pedals are driven in backward direction by an electric motor, which has to overcome the adjustable resistance of the electromagnetic brake. During eccentric cycle ergometry patients have to resist the turning pedals.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: COPD; eccentric exercise training; cycle ergometer; muscle function