None listed
Conditions
Brief summary
The interstitial lung diseases (ILDs) are a debilitating group of over 200 chronic lung conditions characterised by scarring of the lungs, progressive decline in lung function and few treatment options. Exercise-induced hypoxaemia and dyspnoea on exertion are key features of the ILDs. Pulmonary rehabilitation is a recommended treatment for the ILDs, providing short-term improvements in exercised capacity, symptoms and quality of life following pulmonary rehabilitation. Despite this robust evidence for pulmonary rehabilitation at a group level, only one third of individuals with ILD who undertake PR appear to experience a clinically significant benefit. In our RCT of PR in ILD, thirty-three percent of participants with ILD achieved improvement in 6MWD that exceeded the minimal important difference at the end of PR. The proportion of participants who achieved a clinically significant benefit was slightly greater for those with IPF (42%) and more so for those with asbestosis (55%). Therefore, it appears traditional exercise prescription in PR is inadequate in at least 50% people with ILD. Alternative training strategies may prove more effective in both minimising symptoms and improving exercise tolerance in people with ILD. Interval training (IT) consists of periods of relative high intensity exercise interspersed with periods of low intensity exercise and/or rest. In healthy, interval training induces similar or even superior physiological changes to traditional endurance training. In COPD, interval training delivers equivalent improvements in exercise capacity and quality of life with less dyspnoea and leg discomfort. Whether interval training is tolerable and feasible in patients with ILD is not known. The ideal length of the interval is also unknown. This is a prospective, randomised, crossover trial will investigate the acute physiological effects of high intensity interval cycle training compared to lower intensity interval training and standard continuous training in people with ILD participating in pulmonary rehabilitation.
Interventions
1. A single High-intensity interval training session: 30-second intervals of cycle exercise at 100% of Wpeak alternating with 30-seconds of unloaded pedalling until volitional exhaustion, symptom limitation or desaturation (SpO2 < 80%) or a maximum duration of 45 minutes.
2. A single Moderate-intensity interval training session: 2-minute intervals of cycle exercise at 80% of Wpeak alternating with 2-minute at 40% of Wpeak until volitional exhaustion, symptom limitation or desaturation (SpO2 <
1. A single High-intensity interval training session: 30-second intervals of cycle exercise at 100% of Wpeak alternating with 30-seconds of unloaded pedalling until volitional exhaustion, symptom limitation or desaturation (SpO2 < 80%) or a maximum duration of 45 minutes. 2. A single Moderate-intensity interval training session: 2-minute intervals of cycle exercise at 80% of Wpeak alternating with 2-minute at 40% of Wpeak until volitional exhaustion, symptom limitation or desaturation (SpO2 < 80%) or a maximum duration of 45 minutes. The cycle training sessions were administered by a physiotherapist and an exercise physiologist. The cycle training sessions were separated by 2-5 days.
Sponsors
La Trobe University
Study design
Allocation
Randomised controlled trial
Intervention model
Crossover
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
- A diagnosis of ILD - Oxygen desaturation <90% during 6-minute walk test on room air - Clinically stable ILD during the 4 preceding weeks as indicated by no history of exacerbation. - Ability to provide informed consent
Exclusion criteria
- Clinical instability eg syncope or myocardial infarction within the previous 4 weeks - Comorbidities that limit ability to participate in exercise training or physical activity - Resting oxygen saturation (SpO2) less than 85% on room air, as supplemental oxygen will not be used during measurement of gas exchange during exercise.
Outcome results
None listed