Changes in Exercise Capacity After Physical Training in Individuals With COPD and Different Body Composition Phenotypes

Background: Individuals with COPD may present extra-pulmonary features such as body composition abnormalities. These patients benefit from exercise training, especially in improving their exercise capacity. However, it is unknown whether the magnitude of improvement in exercise capacity is equally proportional in the different body composition phenotypes. We sought to investigate whether individuals with COPD classified in different body composition phenotypes present differences in the magnitude of improvement of exercise capacity after an exercise training program. Methods: Individuals with COPD were assessed before and after a 3-month high intensity exercise training program regarding their body composition (electrical bioimpedance) and functional exercise capacity (6-min walk test [6MWT]). The individuals were classified in four phenotypes of body composition: normal, sarcopenic, obese, and obese-sarcopenic. Results: Fifty-one subjects (26 men, 66 ± 8 years, body mass index 27 ± 6 kg/m²; FEV₁ 50 [34-64] %predicted) were assessed. After the training program there was significant interaction among body composition phenotypes and variation of fat mass (P = .05) and its respective index (P = .05). There was no interaction between improvement in the 6MWT and the body composition phenotypes; however, sarcopenic and obese-sarcopenic individuals improved significantly their 6MWT, both in distance (30 ± 50 m and 46 ± 48 m, respectively) and in %predicted (4 ± 10 and 7 ± 9, respectively), which did not occur in the two other phenotypes.Conclusions: There was interaction of body composition phenotype and variation of fat mass after exercise training. However, the presence of sarcopenia (associated or not with obesity) indicated significant and clinically relevant improvements in the 6MWT.