***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: PURPOSE To determine ( 1 ) the relationship among three common upper-limb tests for patients with chronic obstructive pulmonary disease ( COPD ):  unsupported upper limb exercise test ( UULEX ) , 6-minute pegboard and ring test ( 6PBRT ) , and a muscle-strength test using a h and -held dynamometer ; and ( 2 ) the responsiveness of these three tests to changes after pulmonary rehabilitation that included a resistance arm-training programme . METHODS The study was a secondary analysis of a r and omized controlled trial ( RCT ) . The UULEX and the 6PBRT were used to measure peak arm exercise capacity and arm function , respectively . A h and held dynamometer was used to measure elbow and shoulder flexion force . We analyzed baseline data for all participants in the RCT , as well as baseline and post-PR data for those who completed 6-week follow-up testing . RESULTS 36 patients with COPD ( mean forced expiratory volume in 1 second [FEV1]=35 % [ SD 15 % ] predicted ; age 66 [ 9 ] y ) participated , of whom 13 completed an arm-training programme . The correlations among the test results ranged from 0.41 to 0.81 ( p<0.0001 ) . St and ardized response means were 1.0 for muscle force of elbow flexion , 1.2 for shoulder flexion , and 1.8 for the 6PBRT and UULEX . CONCLUSIONS Although the three tests ( UULEX , 6PBRT , and muscle-strength test using a h and -held dynamometer ) are intended to measure different constructs , they were moderately to highly correlated with one another . The 6PBRT , UULEX , and muscle-strength test were demonstrated to be responsive to the resistance arm-training programme BACKGROUND The study aim ed to evaluate the effect of upper extremity resistance training for patients with COPD on dyspnea during activity of daily living ( ADL ) , arm function , arm exercise capacity , muscle strength , and health-related quality of life ( HRQL ) . METHODS Patients were r and omly assigned to an intervention or control group . The intervention group underwent arm resistance training . The control group performed a sham . Both groups exercised three times a week for 6 weeks . Dyspnea during ADL and HRQL were measured using the Chronic Respiratory Disease Question naire ( CRDQ ) . Arm function and exercise capacity were measured using the 6-min pegboard and ring test ( 6PBRT ) and the unsupported upper limb exercise test ( UULEX ) , respectively . Muscle strength for the biceps , triceps , and anterior and middle deltoids was obtained using an isometric dynamometer . RESULTS Thirty-six patients with COPD ( 66 ± 9 years ) participated in the study . Compared with the control group , the magnitude of change in the intervention group was greater for the 6PBRT ( P = .03 ) , UULEX ( P = .01 ) , elbow flexion force ( P = .01 ) , elbow extension force ( P = .02 ) , shoulder flexion force ( P = .029 ) , and shoulder abduction force ( P = .01 ) . There was no between-group difference in dyspnea during ADL , HRQL , or symptoms during the 6PBRT or UULEX ( all P values > .08 ) . CONCLUSIONS Resistance-based arm training  improved arm function , arm exercise capacity , and muscle strength  in patients with COPD .  No improvement in dyspnea during ADL , HRQL , or symptoms was demonstrated STUDY OBJECTIVES We hypothesized that endurance exercise training would reduce the degree of hyperinflation for a given level of exercise and thereby improve submaximal exercise endurance . METHODS Twenty-four patients with COPD ( mean FEV(1 ) , 36.4 + /- 8.5 % of predicted [ + /- SD ] ) undertook a high-intensity cycle ergometer exercise training program for 45 min , three times a week for 7 weeks . Before and after training , the patients performed both an incremental exercise test to maximum and a constant work rate ( CWR ) test on a cycle ergometer at 75 % of the peak work rate obtained in the pretraining incremental test . Ventilatory variables were measured breath-by-breath , and inspiratory capacity ( IC ) was measured every 2 min to assess changes in end-expiratory lung volume . RESULTS After training , the increase in peak oxygen uptake was not statistically significant ; however , the peak work rate increased by 12.9 + /- 10.3 W ( p < 0.01 ) . For the CWR test performed at the same work rate both before and after training , ventilation and breathing frequency ( f ) were lower after training ( average , 1.97 L/min and 3.2 breaths/min , respectively ; p < 0.01 ) and IC was greater ( by an average of 133 mL , p < 0.05 ) , signifying decreased hyperinflation . The increase in IC at the point of termination in the shortest CWR test for each individual ( defined as isotime ) correlated well with both the decreased f ( r = 0.63 , p = 0.001 ) and with the increase in CWR exercise endurance ( average , 13.1 min , r = 0.46 , p = 0.023 ) . CONCLUSIONS  Exercise training in patients with severe COPD dramatically improves submaximal exercise endurance . Decreased dynamic hyperinflation may , in part , mediate the improvement in exercise endurance by delaying the attainment of a critically high inspiratory lung volume The effects of endurance training on exercise capacity and health-related quality of life ( HRQL ) in chronic obstructive pulmonary disease ( COPD ) patients have been studied thoroughly , while resistance training has been rarely evaluated . This study investigated the effects of resistance training in comparison with endurance training in patients with moderate to severe COPD and peripheral muscle weakness ( isometric knee extension peak torque < 75 % predicted ) . Forty-eight patients ( age 64±8 yrs , forced expiratory volume in one second 38±17 % pred ) were r and omly assigned to resistance training ( RT , n=24 ) or endurance training ( ET , n=24 ) . The former consisted of dynamic strengthening exercises . The latter consisted of walking , cycling and arm cranking .  Respiratory and peripheral muscle force , exercise capacity , and HRQL were re-evaluated in all patients who completed the 12-week rehabilitation ( RT n=14 , ET n=16 ) . Statistically significant increases in knee extension peak torque ( RT 20±21 % , ET 42±21 % ) , maximal knee flexion force ( RT 31±39 % , ET 28±37 % ) , elbow flexion force ( RT 24±19 % , ET 33±25 % ) , 6-min walking distance ( 6MWD ) ( RT 79±74 m , ET 95±57 m ) , maximum workload ( RT 15±16 Watt , ET 14±13 Watt ) and HRQL ( RT 16±25 points , ET 16±15 points ) were observed . No significant differences in changes in HRQL and 6MWD were seen between the two treatments . Resistance training and endurance training have similar effects on peripheral muscle force , exercise capacity and health-related quality of life in chronic obstructive pulmonary disease patients with peripheral muscle weakness Dysfunction of the muscles of ambulation contributes to exercise intolerance in chronic obstructive pulmonary disease ( COPD ) . Men with COPD have high prevalence of low testosterone levels , which may contribute to muscle weakness . We determined effects of testosterone supplementation ( 100 mg of testosterone enanthate injected weekly ) with or without resistance training ( 45 minutes three times weekly ) on body composition and muscle function in 47 men with COPD ( mean FEV(1 ) = 40 % predicted ) and low testosterone levels ( mean = 320 ng/dl ) . Subjects were r and omized to 10 weeks of placebo injections + no training , testosterone injections + no training , placebo injections + resistance training , or testosterone injections + resistance training . Testosterone injections yielded a mean increase of 271 ng/dl in the nadir serum testosterone concentration ( to the middle of the normal range for young men ) . The lean body mass ( by dual-energy X-ray absorptiometry ) increase averaged 2.3 kg with testosterone alone and 3.3 kg with combined testosterone and resistance training ( p < 0.001 ) . Increase in one-repetition maximum leg press strength averaged 17.2 % with testosterone alone , 17.4 % with resistance training alone , and 26.8 % with testosterone + resistance training ( p < 0.001 ) . Interventions were well tolerated with no abnormalities in safety measures . Further studies are required to determine long-term benefits of adding testosterone supplementation and resistance training to rehabilitative programs for carefully screened men with COPD and low testosterone levels PURPOSE A diminished mechanical efficiency ( work/O2 consumed ) accompanies chronic obstructive pulmonary disease ( COPD ) , and increased mechanical efficiency has been attained by maximal strength training ( MST ) with an emphasis on the maximal rate of force mobilization in the concentric phase in healthy subjects . This study combined these observations and evaluated the impact of short-term MST on patients with COPD . METHODS Twelve patients with COPD ( FEV1 = 1.1 + /- 0.1 ) were pretested and then r and omly assigned to either an MST group ( N = 6 ) or a normal activity control group ( N = 6 ) . Within each MST training session ( three times per week for 8 wk ) , patients performed four sets of seated leg presses with a focus on the rate of force development at an intensity that only allowed the performance of five repetitions . RESULTS Patients who performed MST significantly improved their rate of force development ( 105 + /- 22.8 % ) , mechanical efficiency ( 32 + /- 7 % ) , and FEV1 ( 21.5 + /- 6.8 % ) , whereas these variables were unchanged in the controls . Neither group changed either peak oxygen consumption ( VO2peak ) or body mass . CONCLUSION In combination with the observed improvement in FEV1 , these data certainly support the therapeutic role for MST in the treatment of COPD BACKGROUND Training therapy with its manifold effects should be part of a modern and multi modular treatment of the COPD . Because of the specific symptoms ( e. g. muscle atrophy , dyspnea , low testosterone levels ) and the deconditioning of these patients , a resistance training might meet the dem and s of a COPD -exercise-therapy rather than an endurance training . The aim of this research project was to evaluate the efficiency of a hypertrophic maximal strength training on various COPD relevant parameters . METHODS 28 patients with moderate to severe COPD ( m12/f16 ) were r and omized and divided in a treatment and a control group . The patients in the treatment group underwent a resistance training ( hypertrophic maximal strength training ) for 12 weeks , initially two times , then three times a week . RESULTS Considering the results of the daily Peak-Flow-Measurement , there was no significant change in both groups , but a trend towards an improvement could be found in the treatment group . There was no difference in the change of FEV 1 . The performance on the ergo cycle showed a highly significant improvement ( p < 0.001 ) in the treatment group of 18.7 % ( 21.9 Watt ) . The results of the SGRQ showed a significant improvement ( p < 0.05 ) of the HRQL in the treatment group . A change of the HRQL in the control group was not found . CONCLUSIONS These data support the hypotheses that a short term high intensity strength training programme is suitable to improve performance measures of patients with moderate to severe COPD and it might also improve pulmonary function . The conclusion can be drawn , that this kind of resistance training can be prefered as COPD -specific training therapy and offers new treatment perspectives This study investigated the effects of heavy resistance training in elderly males with chronic obstructive pulmonary disease ( COPD ) . 18 Home-dwelling male patients ( age range : 65 - 80 years ) , with a mean forced expiratory volume in the first second ( FEV1 ) of 46 + /- 3.4 % of predicted value , were recruited . Baseline and post-training assessment s included : Cross-sectional area ( CSA ) of quadriceps assessed by MRI , isometric and isokinetic knee extension strength , isometric trunk strength , leg extension power , normal and maximal gait-speed on a 30 m track , stair climbing time , number of chair st and s in 30 s , lung function ( FEV1 ) and self-reported health . Subjects were r and omized to a resistance training group ( RE , n = 9 ) or a control group conducting breathing exercises ( CON , n = 9 ) . RE performed heavy progressive resistance training twice a week for 12 weeks . 6 RE and 7 CON completed the study . In RE the following improved ( P < 0.05 ) : Quadriceps CSA : 4 % , isometric knee extension strength : 14 % , isokinetic knee extension strength at 60 degrees /s . : 18 % , leg extension power : 19 % , maximal gait speed : 14 % , stair climbing time : 17 % , isometric trunk flexion : 5 % and self-reported health . In CON no changes were found . In conclusion , 12 weeks of heavy resistance training twice a week result ed in significant improvements in muscle size , knee extension strength , leg extension power , functional performance and self-reported health in elderly male COPD 
    Output:
    
There were no significant differences in constant work rate endurance test results or in peak oxygen uptake between the two groups .
Resistance training was an effective approach to improve functional exercise capacity , endurance exercise capacity , and peak exercise capacity in COPD patients