Effects of combined training vs aerobic training on cognitive functions in COPD: a randomized controlled trial

Figures & data

Figure 1 Flow-chart of the study.

Note: Combined training is aerobic and resistence training.
Abbreviations: AT, aerobic training; CT, combined training; FEV₁, forced expiratory volume in the first second.

Table 1 Sample characteristics

	Mean ± SD
	Both groups (n=28)	CT group (n=14)	AT group (n=14)
Age (years)	67.21±7.87	65.00±8.26	69.42±7.39
Instruction level (years)	9.21±5.13	9.85±2.96	8.57±6.87
FEV1 %	68.42±11.54	67.71±11.77	69.14±10.38
FEV1/FVC%	62.07±8.16	63.28±6.96	60.85±9.61
MRC score	2.70±0.95	2.57±0.97	2.85±0.69
	Number of patients (%)
Comorbidities
Hypertension	26 (92)	13 (92)	13 (92)
Diabetes	2 (7)	1 (7)	1 (7)
Obesity	3 (10)	1 (7)	2 (14)
Medication
Diuretics	13 (46)	7 (50)	6 (43)
Antihypertensive	12 (42)	7 (50)	5 (36)
Insulin therapy	1 (3)	1 (7)	0 (0)

Note: Combined training is aerobic and resistence training.

Abbreviations: AT, aerobic training; CT, combined training; FEV₁, forced expiratory volume in the first second; FVC, forced vital capacity; MRC, Medical Research Council Scale.

Table 2 Description of two protocols of training

	CT group	AT group
Duration of training	4 weeks	4 weeks
Session per week	Ten sessions (five morning sessions and five afternoon sessions)	Ten sessions (five morning sessions and five afternoon sessions)
Session duration	30 minutes	30 minutes
	+5 minutes of warm-up	+5 minutes of warm-up
	+5 minutes of cooldown	+5 minutes of cooldown
Exercises performed in morning session	30 minutes of treadmill exercises	30 minutes of treadmill exercises with the following progression
	1 week	1 week
	70% HRmax	70% HRmax
	2 weeks	2 weeks
	80% HRmax	80% HRmax
	3 weeks	3 weeks
	85% HRmax	85% HRmax
	4 weeks	4 weeks
	90% HRmax	90% HRmax
Exercises performed in afternoon session	30 minutes of resistance exercises for deltoids, quadriceps, biceps, and dorsal muscles, with the following progression	Same physical activity performed in the morning sessions
	1 week
	70% 1-RM three sets × ten repetitions
	2 weeks
	80% 1-RM three sets × eight repetitions
	3 weeks
	85% 1-RM three sets × six repetitions
	4 weeks
	90% 1-RM three sets × four repetitions

Note: Combined training is aerobic and resistence training.

Abbreviations: 1-RM, one-repetition maximum; AT, aerobic training; CT, combined training; HRmax, heart rate maximum.

Table 3 Physical assessment results

	CT group, mean ± SD		AT group, mean ± SD
	Pre	Post	Pre	Post
Aerobic capacity
VO2 max (mL/kg/min)	7.48±2.79	12.26±3.20	7.63±3.00	12.64±2.25
Muscle strength (kg)
Quadriceps	25.57±8.94	37.29±13.34	26.29±8.11	37.36±13.21
Arms	8.43±2.47	12.86±3.25	8.29±2.40	11.14±2.77

Note: Combined training is aerobic and resistence training.

Abbreviations: AT, aerobic training; CT, combined training; VO₂max, maximal oxygen consumption.

Table 4 Results obtained by the two groups in the cognitive tests

	Both groups, mean ± SD	CT group, mean ± SD	AT group, mean ± SD
Attentive matrices
Pre	61.93±7.2	62.14±9.4	61.71±4.36
Post	64.71±6.77*	64.57±8.32*	64.86±5.1*
Rey-IR
Pre	39±9.5	41.86±10.46	36.14±7.77
Post	38.86±8.78	41.57±9.03	36.14±7.91
Rey-DR
Pre	7.64±2.36	8.29±2.7	7±1.84
Post	8.64±2.57*	9.64±2.76*,#	7.64±1.98**
Raven test
Pre	26.79±4.65	27.71±4.6	25.86±4.69
Post	27.96±4.08*	29.43±3.37*,#	26.5±4.31**
Verbal fluency
Pre	34.79±11.82	35.71±13.53	33.86±10.26
Post	39.29±12.68*	40.71±14.65*	37.86±10.72*
Drawing test I
Pre	5.86±1.08	5.86±1.51	5.86±0.36
Post	6.07±1.3	6.43±1.55	5.71±0.91
Drawing test II
Pre	48.36±11.53	47.36±11.28	49.36±12.12
Post	52.82±9.27*	53.07±9.29*,#	52.57±9.59**

Notes:

* P<0.01 and

** P<0.05 in the comparison of pre vs post.

# P<0.05 in the comparison of CT group vs AT group. Combined training is aerobic and resistence training.

Abbreviations: AT, aerobic training; CT, combined training; DR, delayed recall; IR, immediate recall.