STRENGTH TRAINING IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE (REACT)

该子项目是利用 由NIH/NCRR资助的中心赠款提供的资源。子项目和 研究者（PI）可能从另一个NIH来源获得主要资金， 因此可以在其他CRISP条目中表示。列出的机构是 中心，不一定是研究者的机构。 慢性阻塞性肺疾病（COPD）是美国第四大死亡原因，与残疾风险高出10倍有关。它在老年人中普遍存在，严重加剧了与年龄相关的身体功能下降，并加剧了身体残疾。运动作为COPD患者残疾预防和康复的基石;然而，改善的机制尚不清楚，并且对于COPD患者的最佳运动方式存在争议。在老年健康成年人中，我们发现那些报告高水平活动的ACE基因D等位基因的人，特别是那些报告参加力量训练的人，与II型基因型的人相比，不太可能发展为活动受限。在COPD患者中，D等位基因已被证明与更大的力量相关。由于COPD患者的最佳运动计划尚未确定，再加上ACE基因型可能在患者中发挥作用的概念，为了确定基因型对运动训练的反应，需要一个充分的、随机的临床试验来检验基因型对有氧和力量训练反应的影响。这项试点调查的主要目的是评估具有II和DD ACE基因型的COPD患者进行4个月力量训练干预的可行性、干预的依从性、退出研究以及力量测量变化的变异性。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death in the U.S. and is associated with a 10-fold higher risk of disability. It is prevalent among older adults and severely compounds the age related declines in physical function and exacerbates physical disability. Exercise as a cornerstone in the prevention and rehabilitation of disability in COPD patients; however, the mechanisms of improvement are not well understood, and there is controversy as to the optimal exercise modality for COPD patients. In older healthy adults, we have found that those with the D allele of the ACE gene who report high levels of activity, especially those who report participating in strength training, are less likely to develop a mobility limitation as compared to those with the II genotype. In COPD patients, the D allele has been shown to be associated with greater strength. Due to the fact that the optimal exercise program for COPD patients has yet to be identified coupled with the notion that ACE genotype may play a role in patients¿¿?? responses to exercise training, a fully powered, randomized clinical trial is needed to examine the effect of genotype on the responses to both aerobic and strength training. The primary aim of this pilot investigation is to evaluate the feasibility of a 4-month strength training intervention, adherence to the intervention, drop-out from the study and variability in the change in strength measurements in COPD patients with the II and DD ACE genotypes.