[Exercise training in chronic obstructive pulmonary disease. Comparative study of aerobic training of lower limbs vs. combination with upper limbs]. / Entrenamiento muscular en la enfermedad pulmonar obstructiva crónica severa. Estudio comparativo del entrenamiento aerobico de miembros inferiores vs. combinacion con miembros superiores.

A prospective, randomized and controlled study has been performed in 28 patients with severe COPD. A group of 14 has been trained with their lower limbs (LL), while another similar group of 14 patients was also trained with their upper limbs (UL). Results showed improvement in both groups in the endurance test for LL, dyspnea scale, efficiency and muscular working capacity. A considerable improvement was observed in the oxygen uptake at the anerobic threshold (VO2AT) which suggests a training effect, expressed through an improvement in exercise tolerance. Only the group who trained UL showed a remarkable improvement in the dyspnea scale, endurance test and maximal static mouth pressure, showing a better intrinsic working capacity and participation of the UL muscles producing those manoeuvres. At the end of training, quality of life was significantly increased and the hospitalization rate was lower in both groups. According to these findings, it is suggested that patients with severe COPD included in training programmes add UL exercises to the LL usually carried out.

Effect of moderate physical training on left ventricular mass in mild hypertensive persons.

Exercise might reduce blood pressure in mild essential hypertensive individuals, but it could raise left ventricular mass, counteracting the beneficial effects induced by a decrease in blood pressure. Seventeen (group 1) of 25 mild hypertensive patients, nonresponders to a 3-month low sodium diet (2 g/day), were admitted into a physical training program consisting of three weekly sessions of aerobics (20 minutes), bicycling at prefixed loads (20 minutes), and induced muscular relaxation (10 minutes). They were compared with 15 mild hypertensive patients (group 2), nonresponders to the low sodium diet who remained untrained. The follow-up lasted 15.7 +/- 5.8 months. There were significant blood pressure decreases in group 1 at rest (155 +/- 9.8/101 +/- 3.3 vs. 136 +/- 8.1/86 +/- 6.6 mm Hg, p less than 0.001) and at maximal effort (219 +/- 27.4/119 +/- 14.4 vs. 196 +/- 21.8/101 +/- 10.5 mm Hg, p less than 0.001). Maximal work capacity increased from 758.8 +/- 256.7 to 944.1 +/- 203.8 kpm (p less than 0.001). Echocardiographic left ventricular mass index tended to decrease (137.8 +/- 36.3 vs. 125.4 +/- 29.9 g/m2, p = NS), without any significant modification of either left ventricular volume index or left ventricular shortening fraction. No significant changes occurred in group 2. There was no correlation between blood pressure and left ventricular mass changes and left ventricular shortening fraction and left ventricular mass index changes. According to these results, it seems prudent to prescribe physical training to mild hypertensive patients because it does not induce left ventricular mass increases.(ABSTRACT TRUNCATED AT 250 WORDS)