18th, September, 2009Literature Review1. IntroductionPulmonary rehabilitation programs have different ways of providing therapy to patients. The programs for example utilize the multidisciplinary intervention therapy or pure exercise training among others to help find solutions to patients with pulmonary diseases and COPD patients in particular. A multidisciplinary intervention consists of several modalities one of which is exercise training. Several research works have been done to help find ways of improving the modalities of the pulmonary programs. Nutritional supplementation is one of the ways used to improve such modalities and are always used to improve or stimulate muscle growth for the purposes of enhancing exercise performance in patients in pulmonary rehabilitation programs.
Examples of nutritional supplements that are always used are creatine and amino acids (L-carnitine and glutamate). Several research findings have revealed that creatine could be used as a nutritional supplement to help enhance muscle activity in the treatment of other patient groups but this is different with chronic obstructive pulmonary disease patients. Pulmonary rehabilitation programs may have adopted this and used this substance as a supplement to help improve the physical exercise of the patients (Hamid et al. , 2005).
Latest scientific research however reveals that this substance, which was thought that could be very important for patients with COPD in the pulmonary rehabilitation process, does not improve the patients’ exercise activity as expected. This paper aims to describe the controversy in the intervention style used to improve the exercise performance and muscle strength in pulmonary rehabilitation programs involving creatine as well as the controversy in the use of creatine in COPD patients in pulmonary rehabilitation programs. 2. MethodResearch scientists’ findings introduced the use of creatine as a nutritional supplement in the pulmonary rehabilitation programs, but currently, this substance does not improve exercise performance in COPD patients.
This paper aims to explain this by giving information about the use of creatine as a supplement, its use in the COPD programs and its ineffectiveness as compared to the “hard work” (exercise training alone)that it replaced. According to the Science Daily report, creatine has always been used as a substitute for exercise training (Science Daily report, 2008). 3. DiscussionAs noted earlier, exercise training is a very important component of pulmonary rehabilitation.
Improving this component means improving the effectiveness of the pulmonary rehabilitation programs therefore the management of the diseases handled in such programs. Intervention strategies have been based on either making the patients to train at higher intensity or changing the functioning of the underlying skeletal muscles (Hamid et al, 2005). The intervention strategy based on altering the muscle function has sub-interventions such as the use of anabolic steroids, the use of growth hormones and creatine as nutritional supplements. The use of creatine supplementation is one approach that was suggested to improve physical training in patients with COPD especially those who had low baseline exercise capacity and reduced muscle bulk under nutritional supplements.
This strategy has also been found to be ineffective in some areas in the rehabilitation program (Kohlstadt, 2009). Therapeutic Importance of Creatine Supplementation