Acute and Chronic Effect of Resistance Training on Cardiac Autonomic Function in Patients with Chronic Obstructive Pulmonary Disease: A Systematic Review.

This systematic review aimed to evaluate the acute and chronic effects of resistance training (RT) on cardiac autonomic function in patients with chronic obstructive pulmonary disease (COPD). Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, this review was registered in PROSPERO (CRD4202127541). A systematic search was conducted across PubMed, Web of Science, and Scopus using predefined search criteria. Studies were included if RT was the primary intervention and autonomic markers were assessed in COPD patients. Research involving other exercise types or significant comorbidities was excluded. From 5,159 records, five studies comprising 129 participants met the criteria. Interventions varied from single acute RT sessions to training programs lasting up to eight weeks. All studies measured heart rate variability (HRV), with most reporting significant improvements in time-domain measures and mixed results for frequency-domain parameters. Risk of bias was assessed with the Risk of Bias in Non-randomized Studies of Interventions tool, and evidence quality was appraised using Grading of Recommendations Assessment, Development, and Evaluation approach. Acute RT produced immediate but short-lived changes in autonomic function, while chronic RT consistently improved HRV time-domain indices. RT appears to beneficially influence cardiac autonomic regulation in COPD patients, as reflected by enhanced HRV parameters. These results support RT's role in addressing both muscular and cardiovascular health in this population. However, the limited number of studies, methodological differences, and serious risk of bias highlight the need for larger, well-designed randomized controlled trials to strengthen the evidence base.