Enhancing muscle function after exacerbations of COPD to limit their impact on physical activity decline.

Lung attacks (exacerbations, AE) mark the progress of Chronic Obstructive Pulmonary Disease (COPD). They lead to loss skeletal muscle function. After lung attacks patients have prolonged reductions in physical activity (PA) leading to comorbidity. Exercise training, aimed at enhancing skeletal muscle function, through dedicated resistance training reverses this process. Outpatient programs are unfortunately not accessible for most patients after AE and the impact of these programs on PA is unknown. We will investigate whether a resistance and functional training program deployed in primary care (easily accessible) after AE of COPD enhances muscle function, exercise tolerance and quality of life and PA in the short and long (1year) term. Two University Centers will recruit in their network 150 patients after an index AE. Patients will be allocated to receive a PA coaching program or a primary care based exercise training program to enhance skeletal muscle function and exercise tolerance, on top of the PA coaching program (intervention group). We expect less impact of the AE(s) in the latter group so they deteriorate less in muscle function, exercise tolerance and physical activity over the one year follow-up. In addition the impact of AEs and their treatment with the training program will be studied on skeletal muscle morphometry as well as function providing further insight is promissing (non-) pharmacologic avenues to further enhance skeletal muscle function after AEs.