People with chronic lung disease like emphysema or bronchitis can strengthen their arms and legs with resistance training, and this strength may help them perform everyday tasks more easily, a new review of 18 studies confirms.

Rehabilitation programs are intended to help people with chronic obstructive pulmonary disease (COPD), who often experience loss of muscle strength and fatigue, learn to exercise safely, Dr. Simone D. O’Shea of Charles Sturt University in Albury, New South Wales, Australia and her colleagues note in their report in the medical journal Chest.

There has been a growing emphasis in such programs on progressive resistance training, in which a person moves increasingly heavy weights to improve their strength, the researchers add. They undertook a review of the literature on resistance training for COPD patients to update current understanding of the benefits and risks.

Small but significant increases in strength of arm and leg muscles were seen after short-term progressive resistance training, O’Shea and her colleagues report, but the two trials evaluating whether patients added muscle mass and reduced their body fat were inconclusive.

Five of the studies included in their analysis looked at cycling endurance. When compared to no exercise at all, cycling offered some endurance benefit, but aerobic training was more beneficial, and it wasn’t clear whether combining the two types of exercise offered additional benefit.

The four trials that looked at measures of daily function showed benefits for stair climbing and the speed at which a person was able to rise from a chair, and these benefits were greater than those seen with aerobic training. But the design of these trials meant they could have overestimated the benefits of exercise, O’Shea and her colleagues say.

Often, the researchers note, COPD patients don’t have access to weight machines, so it’s important to determine if home exercises with resistance bands, free weights, and other simple equipment could be helpful.

“Long-term strategies for maintaining health in COPD patients are essential; therefore, an examination of longer-term outcomes, suitable maintenance dose exercise prescriptions, and long-term adherence is warranted,” they conclude.

SOURCE: CHEST, November 2009.