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. 2022 Oct 31;3:987356. doi: 10.3389/fresc.2022.987356

Table 1.

Description of the studies included in this review.

Study (Ref. #) Design Cohort characteristics Intervention Cognitive Function Instruments
Pereira et al. 2011 (43) Prospective observational study Two groups:
  • •
    34 COPD (GOLD 1/2/3/4 = 0/11/15/8) patients:
    • -
      Age: 65.2 ± 7.0 years
    • -
      50% female
  • •
    18 healthy age and sex-matched individuals from community senior center:
    • -
      Age: 62.7 ± 4.0 years
    • -
      50% female
  • •

    Multidisciplinary outpatient PR. Program components: exercise training, educational, psychosocial sessions

  • •

    3 times/week, 3 months, 36 sessions total

  • •

    Neuropsychological evaluation administered at baseline and 3 months following PR
  • •

    The Stroop test

  • •

    F-A-S Test

  • •

    The Digit Span test

  • •

    RAVLT test
Aquino et al. 2015 (44) Randomized control trial
  • •
    28 former smokers, Caucasian male COPD:
    • -
      Age: 67.2 ± 7.9 years
    • -
      FEV1/FVC: 62.1 ± 8.2
    • -
      FEV1%pred: 68.4 ± 11.5
  • •

    Randomized in 2 groups:

    • (1)

      Combined group (aerobic and resistance training); n = 14

    • (2)

      Aerobic Training (AT); n = 14
  • •

    Two 30-min training sessions per day (AM and PM), 5 days/week, 4 weeks

  • •

    Resistance training (30 min): 3 sets, 12 repetitions, from 70% 1-RM (week 1) to 90% 1-RM (week 4) for deltoids, biceps, dorsal muscles, quadriceps. Work rate increase based on a progressive reduction from 10 to 4 repetitions/set, while maintaining 3 sets/exercise

  • •

    Endurance training (40 min): 5 min warm up (walking on treadmill at 35% V˙O2max based on CPET done at intake), 30 min training (on treadmill), 5 min cooldown (stretching). Work rate intensity for training phase progressed from 70% HRmax (week 1) up to 90% HRmax (week 4). Tolerance to effort was constantly monitored using HR monitors and RPE (Borg scale).
  • •

    Rey 15-item memory test

  • •

    Drawing copy test

  • •

    Attentive matrices test

  • •

    Raven's progressive matrices test

  • •

    Verbal fluency test
Bonnevie et al. 2020 (45) Prospective observational study
  • •
    56 COPD patients referred to PR:
    • -
      Age: 62.0 ± 9.0 years
    • -
      54% female
    • -
      FEV1 (L): 0.9 (0.7−1.1)
    • -
      FEV1/FVC: 41.0 ± 10.0
    • -
      FEV1%pred: 36.0 (28–44)
    • -
      73% with diagnosis of CI
  • •

    Multidisciplinary outpatient PR: 3 times/week, 8 weeks, 24 sessions total. Program components: respiratory physiotherapy, muscle strengthening, endurance training, self-management, nutrition

  • •

    Resistance training: 3 sets, 12 repetitions, at 70% 1-RM. Use of free weights and elastic bands

  • •

    Endurance training: 5 min warm-up, progressive exercise (from 15-to-45 min), 5 min cooldown. Work rate initially calculated on anaerobic threshold determined during CPET done at intake. Work rate and exercise duration progression was based on individual RPE (Borg scale).
  • •

    MoCA (three versions of the test were used to prevent learning effects, in a cross-over randomized order)
France et al. 2021 (46) Prospective, observational study
  • •
    67 stable COPD:
    • -
      Age: 68.5 ± 6.4
    • -
      45% female
    • -
      26% current smokers
    • -
      FEV1/FVC: 55.0 ± 18.0
    • -
      FEV1%pred: 54.0 (38.5-72.5)
    • -
      57% with diagnosis of CI (n = 36 mild CI; n = 2 moderate CI)
  • •
    Multidisciplinary outpatient PR: 2 times/week, 6 weeks, 12 supervised sessions:
    • -
      1 h aerobic and resistance exercise training (based on British Thoracic Society guidelines)
  • •

    MoCA
Andrianopoulos et al. 2021 (13) Prospective, observational study
  • •
    60 stable COPD:
    • -
      Age: 67.7 ± 8.4
    • -
      25% female
    • -
      8% current smokers
    • -
      FVC %pred: 69.7 ± 18.0
    • -
      FEV1%pred: 46.7 ± 15.4
    • -
      42% with diagnosis of CI
  • •

    Multidisciplinary inpatient, supervised PR: 4 times/week, 3 weeks, 12 sessions total. Program components: exercise training (80 min), education on COPD self-management, physical activity counseling

  • •
    Exercise training (50 min):
    • -
      Endurance training: 20 min bike/treadmill, 60%–70% peak work rate. Work rate initially calculated during CPET done at 75% of individual estimated peak work rate, on a cycle ergometer at intake. Work rate and exercise duration progression was based on individual RPE for dyspnea and leg fatigue symptoms (Borg scale).
    • -
      Resistance training: 3 sets, 15 repetitions, 6 exercises (leg press, knee extension, hip abduction/adduction, shoulder pull down, rowing, abdominal), individual load (aim to reach momentary muscle fatigue by end of set evaluated by 0-10 Borg RPE scale)
  • •
    Physical activity (30 min):
    • -
      low-to-moderate individual exertion
    • -
      walking and/or calisthenics exercises using body weight, small dumb-bells, rubber tubes
  • •

    SMMSE

  • •

    ACE-R (v.2007)

  • •

    MoCA

  • •

    T-ICS

Data are reported as mean ± SD, or median(IQR range). COPD, Chronic Obstructive Pulmonary Disease; GOLD, Global Initiative for Chronic Obstructive Lung Disease; FEV1, forced expiratory volume within 1 s; FVC, forced vital capacity; CI, cognitive impairment; PR, Pulmonary Rehabilitation; F-A-S test, Verbal Fluency Test; RAVLT, The Rey Auditory Verbal Learning Test; CT, Combined training; AT, Aerobic training; 1-RM, 1-Repetition Maximum; V˙O2max, maximal oxygen consumption; HRmax, maximal heart rate; HR, heart rate; RPE, Borg's Ratings of Perceived Exertion; CPET, cardiopulmonary exercise test; MoCA, Montreal Cognitive Assessment; SMMSE, Standardized Mini-Mental Status Examination; ACE-R, Addenbrooke's Cognitive Examination-Revised; T-ICS, Interview for Cognitive Status (administered face-to-face).