Randomized controlled trial of dietary creatine as an adjunct therapy to physical training in chronic obstructive pulmonary disease

S.J. Deacon, E.E. Vincent, P.L. Greenhaff, J. Fox, M.C. Steiner, Sally J. Singh, M.D. Morgan

    Research output: Contribution to journalArticle

    49 Citations (Scopus)

    Abstract

    Rationale: Skeletal muscle strength and bulk are reduced in patients with chronic obstructive pulmonary disease (COPD) and influence quality of life, survival, and utilization of health care resources. Exercise training during pulmonary rehabilitation (PR) can reverse some of these effects. In athletes and healthy elderly individuals, dietary creatine supplementation (CrS) has been shown to augment high-intensity exercise training, thereby increasing muscle mass. Objectives: This article examines the effect of CrS on functional exercise capacity and muscle performance in people with COPD. Methods: One hundred subjects with COPD (mean [SD] age, 68.2 [8.2] yr; FEV1, 44.0 [19.6] %predicted) were randomized to a double-blind, placebo-controlled, parallel group trial of CrS during 7 weeks of PR encompassing aerobic and resistance exercises. Subjects ingested creatine (22 g/d loading for 5 d; maintenance, 3.76 g/d throughout PR) or placebo. Baseline, postloading, and postrehabilitation measurements included pulmonary function, body composition, peripheral muscle strength, and functional performance (shuttle walking tests). A volunteer subgroup (n = 44) had pre- and postloading quadriceps muscle biopsies. Measurements and Main Results: Eighty subjects completed the trial (38 creatine, 42 placebo). All outcome measures significantly improved after PR. There were no significant differences between groups post-PR (mean [SD] change in incremental shuttle walk distance, 84 [79] m in the creatine group vs. 83.8 [60] m in the placebo group; P = 1.0; knee extensor work, 19.2 [16] Nm [Newton meters] in the creatine group vs. 19.5 [17] Nm in the placebo group; P = 0.9). Muscle biopsies showed evidence of creatine uptake. Conclusions: This adequately powered, randomized, placebo-controlled trial shows that CrS does not augment the substantial training effect of multidisciplinary PR for patients with COPD.
    Original languageEnglish
    Pages (from-to)233-239
    JournalAmerican Journal of Respiratory and Critical Care Medicine
    Volume178
    DOIs
    Publication statusPublished - 2008

    Fingerprint

    Creatine
    Chronic Obstructive Pulmonary Disease
    Randomized Controlled Trials
    Rehabilitation
    Placebos
    Lung
    Exercise
    Therapeutics
    Muscle Strength
    Muscles
    Biopsy
    Health Resources
    Quadriceps Muscle
    Dietary Supplements
    Body Composition
    Athletes
    Walking
    Volunteers
    Knee
    Skeletal Muscle

    Bibliographical note

    The full text is available free from the link given.

    Keywords

    • pulmonary rehabilitation
    • strength
    • dietary supplementation

    Cite this

    Randomized controlled trial of dietary creatine as an adjunct therapy to physical training in chronic obstructive pulmonary disease. / Deacon, S.J.; Vincent, E.E.; Greenhaff, P.L.; Fox, J.; Steiner, M.C.; Singh, Sally J.; Morgan, M.D.

    In: American Journal of Respiratory and Critical Care Medicine, Vol. 178, 2008, p. 233-239.

    Research output: Contribution to journalArticle

    Deacon, S.J. ; Vincent, E.E. ; Greenhaff, P.L. ; Fox, J. ; Steiner, M.C. ; Singh, Sally J. ; Morgan, M.D. / Randomized controlled trial of dietary creatine as an adjunct therapy to physical training in chronic obstructive pulmonary disease. In: American Journal of Respiratory and Critical Care Medicine. 2008 ; Vol. 178. pp. 233-239.
    @article{6db18a01f93f4bfdb098a2475095df33,
    title = "Randomized controlled trial of dietary creatine as an adjunct therapy to physical training in chronic obstructive pulmonary disease",
    abstract = "Rationale: Skeletal muscle strength and bulk are reduced in patients with chronic obstructive pulmonary disease (COPD) and influence quality of life, survival, and utilization of health care resources. Exercise training during pulmonary rehabilitation (PR) can reverse some of these effects. In athletes and healthy elderly individuals, dietary creatine supplementation (CrS) has been shown to augment high-intensity exercise training, thereby increasing muscle mass. Objectives: This article examines the effect of CrS on functional exercise capacity and muscle performance in people with COPD. Methods: One hundred subjects with COPD (mean [SD] age, 68.2 [8.2] yr; FEV1, 44.0 [19.6] {\%}predicted) were randomized to a double-blind, placebo-controlled, parallel group trial of CrS during 7 weeks of PR encompassing aerobic and resistance exercises. Subjects ingested creatine (22 g/d loading for 5 d; maintenance, 3.76 g/d throughout PR) or placebo. Baseline, postloading, and postrehabilitation measurements included pulmonary function, body composition, peripheral muscle strength, and functional performance (shuttle walking tests). A volunteer subgroup (n = 44) had pre- and postloading quadriceps muscle biopsies. Measurements and Main Results: Eighty subjects completed the trial (38 creatine, 42 placebo). All outcome measures significantly improved after PR. There were no significant differences between groups post-PR (mean [SD] change in incremental shuttle walk distance, 84 [79] m in the creatine group vs. 83.8 [60] m in the placebo group; P = 1.0; knee extensor work, 19.2 [16] Nm [Newton meters] in the creatine group vs. 19.5 [17] Nm in the placebo group; P = 0.9). Muscle biopsies showed evidence of creatine uptake. Conclusions: This adequately powered, randomized, placebo-controlled trial shows that CrS does not augment the substantial training effect of multidisciplinary PR for patients with COPD.",
    keywords = "pulmonary rehabilitation, strength, dietary supplementation",
    author = "S.J. Deacon and E.E. Vincent and P.L. Greenhaff and J. Fox and M.C. Steiner and Singh, {Sally J.} and M.D. Morgan",
    note = "The full text is available free from the link given.",
    year = "2008",
    doi = "10.1164/rccm.200710-1508OC",
    language = "English",
    volume = "178",
    pages = "233--239",
    journal = "American Journal of Respiratory and Critical Care Medicine",
    issn = "1073-449X",
    publisher = "American Thoracic Society",

    }

    TY - JOUR

    T1 - Randomized controlled trial of dietary creatine as an adjunct therapy to physical training in chronic obstructive pulmonary disease

    AU - Deacon, S.J.

    AU - Vincent, E.E.

    AU - Greenhaff, P.L.

    AU - Fox, J.

    AU - Steiner, M.C.

    AU - Singh, Sally J.

    AU - Morgan, M.D.

    N1 - The full text is available free from the link given.

    PY - 2008

    Y1 - 2008

    N2 - Rationale: Skeletal muscle strength and bulk are reduced in patients with chronic obstructive pulmonary disease (COPD) and influence quality of life, survival, and utilization of health care resources. Exercise training during pulmonary rehabilitation (PR) can reverse some of these effects. In athletes and healthy elderly individuals, dietary creatine supplementation (CrS) has been shown to augment high-intensity exercise training, thereby increasing muscle mass. Objectives: This article examines the effect of CrS on functional exercise capacity and muscle performance in people with COPD. Methods: One hundred subjects with COPD (mean [SD] age, 68.2 [8.2] yr; FEV1, 44.0 [19.6] %predicted) were randomized to a double-blind, placebo-controlled, parallel group trial of CrS during 7 weeks of PR encompassing aerobic and resistance exercises. Subjects ingested creatine (22 g/d loading for 5 d; maintenance, 3.76 g/d throughout PR) or placebo. Baseline, postloading, and postrehabilitation measurements included pulmonary function, body composition, peripheral muscle strength, and functional performance (shuttle walking tests). A volunteer subgroup (n = 44) had pre- and postloading quadriceps muscle biopsies. Measurements and Main Results: Eighty subjects completed the trial (38 creatine, 42 placebo). All outcome measures significantly improved after PR. There were no significant differences between groups post-PR (mean [SD] change in incremental shuttle walk distance, 84 [79] m in the creatine group vs. 83.8 [60] m in the placebo group; P = 1.0; knee extensor work, 19.2 [16] Nm [Newton meters] in the creatine group vs. 19.5 [17] Nm in the placebo group; P = 0.9). Muscle biopsies showed evidence of creatine uptake. Conclusions: This adequately powered, randomized, placebo-controlled trial shows that CrS does not augment the substantial training effect of multidisciplinary PR for patients with COPD.

    AB - Rationale: Skeletal muscle strength and bulk are reduced in patients with chronic obstructive pulmonary disease (COPD) and influence quality of life, survival, and utilization of health care resources. Exercise training during pulmonary rehabilitation (PR) can reverse some of these effects. In athletes and healthy elderly individuals, dietary creatine supplementation (CrS) has been shown to augment high-intensity exercise training, thereby increasing muscle mass. Objectives: This article examines the effect of CrS on functional exercise capacity and muscle performance in people with COPD. Methods: One hundred subjects with COPD (mean [SD] age, 68.2 [8.2] yr; FEV1, 44.0 [19.6] %predicted) were randomized to a double-blind, placebo-controlled, parallel group trial of CrS during 7 weeks of PR encompassing aerobic and resistance exercises. Subjects ingested creatine (22 g/d loading for 5 d; maintenance, 3.76 g/d throughout PR) or placebo. Baseline, postloading, and postrehabilitation measurements included pulmonary function, body composition, peripheral muscle strength, and functional performance (shuttle walking tests). A volunteer subgroup (n = 44) had pre- and postloading quadriceps muscle biopsies. Measurements and Main Results: Eighty subjects completed the trial (38 creatine, 42 placebo). All outcome measures significantly improved after PR. There were no significant differences between groups post-PR (mean [SD] change in incremental shuttle walk distance, 84 [79] m in the creatine group vs. 83.8 [60] m in the placebo group; P = 1.0; knee extensor work, 19.2 [16] Nm [Newton meters] in the creatine group vs. 19.5 [17] Nm in the placebo group; P = 0.9). Muscle biopsies showed evidence of creatine uptake. Conclusions: This adequately powered, randomized, placebo-controlled trial shows that CrS does not augment the substantial training effect of multidisciplinary PR for patients with COPD.

    KW - pulmonary rehabilitation

    KW - strength

    KW - dietary supplementation

    U2 - 10.1164/rccm.200710-1508OC

    DO - 10.1164/rccm.200710-1508OC

    M3 - Article

    VL - 178

    SP - 233

    EP - 239

    JO - American Journal of Respiratory and Critical Care Medicine

    JF - American Journal of Respiratory and Critical Care Medicine

    SN - 1073-449X

    ER -