Creatine supplementation and physical training in patients with COPD: A double blind, placebo-controlled study

Gun Faager¹, Karin Söderlund², Carl Magnus Sköld³, Siw Rundgren³, Anna Tollbäck¹, Per Jakobsson⁴

¹Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Department of Physiotherapy, Karolinska University Hospital, Solna; ²Department of Physiology and Pharmacology, Department of Sport and Health Sciences, The Swedish School of Sport and Health Sciences, Stockholm; ³Department of Medicine, Division of Respiratory Medicine, Karolinska Institutet, Karolinska University Hospital, Solna; ⁴Department of Medicine and Care, Faculty of Health Sciences, Linköping University, Department of Respiratory Medicine, University Hospital, Linköping, Sweden

Study objectives: Patients with chronic obstructive pulmonary disease (COPD) have low exercise capacity and low content of high energetic phosphates in their skeletal muscles. The aim of the present study was to investigate whether creatine supplementation together with exercise training may increase physical performance compared with exercise training in patients with COPD.

Design: In a randomized, double-blind, placebo-controlled study, 23 patients with COPD (forced expiratory volume in one second [FEV₁] < 70% of predicted) were randomized to oral creatine (n = 13) or placebo (n = 10) supplementation during an 8-week rehabilitation programme including exercise training. Physical performance was assessed by Endurance Shuttle Walking Test (ESWT), dyspnea and leg fatigue with Borg CR-10, quality of life with St George’s Respiratory Questionnaire (SGRQ). In addition, lung function test, artery blood gases, grip strength test, muscle strength and fatigue in knee extensors were measured.

Results: COPD patients receiving creatine supplementation increased their average walking time by 61% (ESWT) (p < 0.05) after the training period compared with 48% (p = 0.07) in the placebo group. Rated dyspnea directly after the ESWT decreased significantly from 7 to 5 (p < 0.05) in the creatine group. However, the difference between the groups was not statistically significant neither in walking time nor in rated dyspnea. Creatine supplementation did not increase the health related quality of life, lung function, artery blood gases, grip strength and knee extensor strength/fatigue.

Conclusions: Oral creatine supplementation in combination with exercise training showed no significant improvement in physical performance, measured as ESWT, in patients with COPD compared with exercise training alone.

Keywords: COPD, oral creatine supplementation, physical training