Enhancement of cellular adaption to physical training in chronic obstructive pulmonary disease : a randomised placebo controlled trial of creatine supplementation

Dietary creatine supplementation (CrS) has been shown to augment high-intensity exercise training in athletes and healthy elderly, thereby increasing muscle mass. Uptake is increased by exercise and is likely to be most beneficial when combined with training. Previous small studies looking at the effects of CrS during pulmonary rehabilitation in subjects with COPD have shown conflicting results.;Hypothesis: CrS in association with aerobic exercise and resistance training will usefully augment the benefits of pulmonary rehabilitation.;Methods: This hypothesis was tested by a randomised double blind, placebo-controlled, parallel group trial of CrS during PR in patients with COPD. One hundred subjects with COPD (mean (SD) age 68.2 (8.2) years, FEV1 44.0 (19.6) percent predicted) were randomised to receive creatine (22g/day loading for 5-days, maintenance 3.76g/d throughout PR) or placebo (lactose) supplements during 7-weeks of PR encompassing aerobic and resistance exercises. Baseline, post-loading and post-rehabilitation measurements included pulmonary function, body composition, peripheral muscle strength and functional performance (shuttle walking tests and cycle ergometry).;A protocol was developed for testing isokinetic strength in subjects with COPD, using a Cybex II dynamometer.