Table 1

 Characteristics of randomised controlled trials comparing strength and endurance exercise

StudyPopulationExercise programmesRehabilitation programmeOutcomes
Wmax, maximum exercise capacity; IET, incremental exercise test; CWRT, constant work rate test; 6MWT and 12MWT, 6 and 12 minute walk test; SWT, shuttle walk test; Edu, education; BE, breathing exercises; Psy, psychological support; Rel, relaxation exercises; CRQ, Chronic Respiratory Questionnaire; BDI and TDI, baseline and transitional dyspnoea index.
Normandin3640 COPD patients (53% men, mean FEV1 49.5% predicted, mean age 68 years)Group 1: Continuous ergometer cycling at 80% of Wmax Group 2: Low intensity calisthenics for peripheral muscles (29 stretching and strength exercises, 8–10 repetitions for each exercise)Sessions of 10–30 min, 3×/week for 10 weeks, EduIET, CWRT, CRQ, TDI, PFSS
Ortega3747 COPD patients (87% men, mean FEV1 38.8% predicted, mean age 64 years)Group 1: Continuous ergometer cycling at 60% of Wmax (40 min); Group 2: Upper and lower extremity strength exercise, 6–8 weight lifting repetitions at 70–85% of one repetition maximum; Group 3: Combined endurance and strength exercise (half of programme of group 1 and 2)Sessions of 40 min, 3×/week for 12 weeks, EduIET, CWRT, SWT, CRQ, BDI
Spruit3430 COPD patients (80% men, mean FEV1 40.5% predicted, mean age 63 years)Group 1: Continuous ergometer cycling at 30–75% of Wmax (10–25 minutes), treadmill walking at 60% of average speed in 6MWT (10–25 minutes) and arm cranking (4–9 minutes); Group 2: Upper and lower extremity strength exercise, 3×8 repetitions at ⩾70% of one repetition maximumSessions of 90 min, 3×/week for 12 weeksIET, 6MWT, CRQ, BDI,
Wurttemberger3869 COPD patients (64% men, mean FEV1 57.2% and 38.5% predicted for non- and for exercise desaturating patients, mean age 65 years)Group 1: Continuous ergometer cycling at 70% of Wmax (20 min); Group 2: Upper and lower extremity strength exercise, 2–4×20–25 repetitions at 40% of one repetition maximum; Group 3: Continuous ergometer cycling as group 1 and strength training as group 2Sessions of 20–45 min, 3×/week for 3 weeks, Psy, RelIET, 6MWT, functional test for daily activities
Bernard3936 COPD patients (78% men, mean FEV1 42.5% predicted, mean age 65 years)Group 1: Continuous ergometer cycling at 80% of Wmax (30 min); Group 2: Continuous ergometer cycling as group 1 + upper and lower extremity strength exercise with 10–30 repetitions at 60–80% of one repetition maximumSessions of 30–60 min, 3×/week for 12 weeks, BE, RelIET, 6MWT, CRQ, muscle strength, muscle mass (CT scan)
Mador4024 COPD patients (% men not stated, mean FEV1 41.8% predicted, mean age 71 years)Group 1: Continuous ergometer cycling at ⩾50% of Wmax (20 min) + treadmill walking at 1.1–2 miles per hour (15 min); Group 2: Continuous ergometer cycling as group 1 + upper and lower extremity strength exercise with 10 repetitions at 60% of one repetition maximumSessions of 60–90 min, 3×/week for 8 weeks, EduIET, CWRT, 6MWT, muscle strength, CRQ
Ries4128 COPD patients (% men not stated, mean FEV1 35.3% predicted, mean age not stated)Group 1: Treadmill walking, intensity set during CWRT for 15 minutes, but no further details; Group 2: Walking training as group 1 + low resistance high repetition exercises for upper extremities (gravity resistance); Group 3: Walking training as groups 1 + low frequency progressive resistance training for upper extremities (proprioceptive neuromuscular facilitation)Sessions of 15–30 min, unclear number/week for 6 weeks, Edu, BE, Psy,IET, Borg scale, Activities of Daily Living test, muscle strength
Sivori4243 COPD patients (89% men, mean FEV1 36.1% predicted, mean age 65 years)Group 1: Continuous ergometer cycling at 75% of Wmax (duration unclear); Group 2: Continuous ergometer cycling as group 1 + five upper extremities strength exercises with five repetitions of 45 sSessions of 45 min, 3×/week for 8 weeksIET, 12MWT, CRQ