ORIGINAL ARTICLE Lynn B. Panton Æ Jamie Golden Æ Craig E. Broeder Kathy D. Browder Æ Deborah J. Cestaro-Seifer Frederic D. Seifer The effects of resistance training on functional outcomes in patients with chronic obstructive pulmonary disease Accepted: 9 October 2003 / Published online: 25 November 2003 Ó Springer-Verlag 2003 Abstract Aerobic exercise training is used for rehabili- tation in patients with chronic obstructive pulmonary disease (COPD), although it has little effect on muscle weakness and atrophy. Resistance training may be a useful addition to aerobic programs for these patients. The purpose of the present study was to investigate the effects of resistance training in addition to aerobic training on functional outcomes in patients with COPD. Seventeen COPD patients enrolled in an aerobic-based program that met twice a week were assigned to a 12-week control/aerobic [CON: n=8; 63 (8) years; mean (SD)] or a resistance/aerobic group [RES: n=9; 61 (7) years]. RES trained an additional twice a week on 12 resistance machines, performing three sets of 8–12 repetitions at 32–64% of their one-repetition maximum (1-RM) lifts. RES (P<0.05) increased upper (36%) and lower (36%) body strength, as well as lean body mass (5%), while CON showed little to no change. The 12- min walk distance increased (P<0.05) in only the RES [676 (219) to 875 (172) m]. Measurements of three of the eight tasks of activities of daily living improved in RES (P<0.05) compared to CON. This study demonstrated that progressive resistance training was well tolerated and improved functional outcomes in COPD patients that were currently involved in an aerobic training program. Keywords Activities of daily living Æ Body composition Æ Bone density Æ Cholesterol Æ Strength Introduction Due to chronic steroid medication, reduced physical activity levels, and cigarette smoking, patients with chronic obstructive pulmonary disease (COPD) face a decline in total body strength, muscle mass, bone den- sity, and a decrease in performance of activities of daily living (ADL; e.g., ability to climb stairs or do household chores; Wuyam et al. 1992; Gosselink et al. 1996; Bernard et al.1998; Engelen et al. 1998; Lau et al. 1998; McEvoy et al. 1998; Casaburi 2001). Using a multidis- ciplinary treatment approach, accredited pulmonary rehabilitation programs for COPD-related diseases fo- cus on reducing declines in pulmonary function, reduc- ing the use of health care resources, and enhancing each patientÕs quality of life (Ries 1990; American Thoracic Society statement 1995; Ries et al. 1997; Cooper 2001). Evidence-based analysis identifies exercise training as the most effective component for improving physical and social performance and autonomy (Ries 1990; Ries et al. 1997). Aerobic-based activities are the primary form of exercise in many rehabilitation settings (Cooper 2001). The adaptations to aerobic training in COPD patients include improvements in cardiovascular and metabolically related functions (Casaburi et al. 1991, 1997; Maltais et al. 1996; OÕDonnell et al. 1998; Gimenez et al. 2000). However, this type of training has little ef- fect on muscle weakness and atrophy (Hamilton et al. 1995; Gosselink et al. 1996). An alternative Eur J Appl Physiol (2004) 91: 443–449 DOI 10.1007/s00421-003-1008-y L. B. Panton (&) Department of Nutrition, Food and Exercise Sciences, Florida State University, 436 Sandels Building, Tallahassee, FL 32306, USA E-mail: lpanton@mailer.fsu.edu Tel.: +1-850-6444685 Fax: +1-850-6455000 J. Golden Department of Physical Education, Exercise and Sport Sciences, East Tennessee State University, Johnson City, Tennessee, USA C. E. Broeder Department of Biological Sciences, Benedictine University, Lisle, Illinois, USA K. D. Browder Division of Health, Physical Education, Recreation and Dance, University of Idaho, Moscow, Idaho, USA D. J. Cestaro-Seifer Æ F. D. Seifer Pulmonary Rehabilitation Program, Johnson City Medical Center, Johnson City, Tennessee, USA