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Ulrik Winning Iepsen,1 Gregers Druedal Wibe Munch,1 Mette Rugbjerg,1 Anders Rasmussen Rinnov,1 Morten Zacho,1 Stefan Peter Mortensen,1,2 Niels H Secher,3 Thomas Ringbaek,4 Bente Klarlund Pedersen,1 Ylva Hellsten,5 Peter Lange,1,4,6 Pia Thaning1,4 1The Centre of Inflammation and Metabolism and the Centre for Physical Activity Research, Rigshospitalet, University of Copenhagen, Denmark, 2Department of Cardiovascular and Renal Research, University of Southern Denmark, Odense, 3Department of Anesthesiology, University of Copenhagen, Rigshospitalet, Copenhagen, 4Department of Respiratory Medicine, University Hospital Hvidovre, Hvidovre, 5Department of Nutrition, Exercise and Sports, University of Copenhagen, 6Department of Public Health, Section of Social Medicine, University of Copenhagen, Copenhagen, Denmark Introduction: Exercise is an important countermeasure to limb muscle dysfunction in COPD. The two major training modalities in COPD rehabilitation, endurance training (ET) and resistance training (RT), may both be efficient in improving muscle strength, exercise capacity, and health-related quality of life, but the effects on quadriceps muscle characteristics have not been thoroughly described.Methods: Thirty COPD patients (forced expiratory volume in 1 second: 56% of predicted, standard deviation [SD] 14) were randomized to 8 weeks of ET or RT. Vastus lateralis muscle biopsies were obtained before and after the training intervention to assess muscle morphology and metabolic and angiogenic factors. Symptom burden, exercise capacity (6-minute walking and cycle ergometer tests), and vascular function were also assessed.Results: Both training modalities improved symptom burden and exercise capacity with no difference between the two groups. The mean (SD) proportion of glycolytic type IIa muscle fibers was reduced after ET (from 48% [SD 11] to 42% [SD 10], P