Innovative exercise for extrapulmonary benefits in COPD: feasibility, effects & mechanisms of supramaximal high-intensity training: an international multidisciplinary and translational research project

BACKGROUND

The rationale behind this translational research project is that the course of chronic obstructive pulmonary disease (COPD) is intimately linked to extrapulmonary manifestations (muscle, brain and cardiorespiratory dysfunction) that are currently not dealt with optimally, but that has a direct and substantial impact on the disease. To target these manifestations, we have developed a truly novel concept of supramaximal High-Intensity Training (supramaximal HIT), and are after extensive pilot testing ready to determine the feasibility, effect, and mechanisms among people with COPD.

For this project to be feasible, we have gathered an international multidisciplinary research alliance with experts in physiotherapy, neuroscience, cell- and molecular biology, and pulmonology. OBJECTIVE

The objectives are to determine the feasibility and effect of supramaximal HIT versus continuous endurance training on 1) cardiorespiratory-, 2) muscle-, 3) brain-, and 4) psychological function.

Feasibility measures include the ability to reach supramaximal intensities, physiological and symptomatic responses, adverse events as well as the experiences of HIT. We also aim to explore and compare the mechanisms of exercise adaptations between people with COPD and healthy matched controls and to explore how COPD, limb muscles, brain, and cardiorespiratory function and adaptations are linked to exercise intensity

WORKPLAN

152 individuals, including an equal amount of people with COPD & matched controls, will be enrolled in a series of high-quality randomized controlled cross-sectional and interventional trials. The former will evaluate the feasibility and acute responses of supramaximal HIT while the latter will investigate and compare the effects and mechanisms of supramaximal HIT versus continuous exercise. We will also investigate signaling pathways of supramaximal and continuous loading regimes in-vitro.

SIGNIFICANCE

Our project will provide novel scientific evidence on the feasibility and effect of a genuinely unique therapeutic modality that can improve several important health outcomes of the disease, including muscle, brain and cardiovascular function.

Ultimately, our results will change the way one of the most common and deadliest societal diseases of the 21st century are being dealt with, moving from a silo approach toward a global approach where all components of COPD are taken into consideration — improving prognosis and reducing health care cost.