Eccentric Exercise Training
Conditions
Keywords
Eccentric cycling exercise, Pulmonary rehabilitation
Brief summary
Eccentric cycling exercise (ECC) allows training at low metabolic costs and may therefore be valuable for patients with pulmonary vascular disease (PVD). For these patients, regular exercise training has an evidence level 1A recommendation in the current guidelines. Exercise training during longer and regular periods provides chronic adaptation, for which ECC was recently found to have a greater effectiveness than CON by increasing muscle strength, hypertrophy, six-minute walking distance and furthermore, by increasing maximum oxygen uptake (V'O2max) especially in patients with chronic obstructive pulmonary disease (COPD), chronic left heart failure or coronary heart disease. Furthermore, we conducted an RCT in which we exposed patients with PVD to ECC and concluded that ECC is a feasible and well-tolerated exercise modality for PVD patients with severely lower O2 demand and load to the right ventricle. The study in patients with PVD was started (EccRehab), and the great potential was recognized. Therefore there was an indication to open the inclusion criteria to all cardiopulmonary patients with indication for pulmonary rehabilitation (EccRehab2). For this purpose, the aim of this project is to investigate whether ECC improves exercise capacity and possibly hemodynamics during prolonged rehabilitation programs in patients with cardiopulmonary diseases.
Interventions
OTHEREccentric cycling exercise
Patients perform eccentric cycling exercise instead of normal cycling exercise in addition to standard car during a cardiopulmonary rehabilitation
OTHERStandard Care Arm
Patients perform cardiopulmonary rehabilitation according to standard care
Sponsors
Klinik Barmelweid
Silvia Ulrich Somaini
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
Intervention: Eccentric cycling (instead of usual cycling) + standard care Control: Standard care
Eligibility
Sex/Gender
ALL
Age
18 Years to 85 Years
Healthy volunteers
No
Inclusion criteria
* Diagnosed with PVD, either PAH or CTEPH via right heart catheterization, according to recent guidelines \[9\] * Diagnosed with a cardiopulmonary disease as indication for a pulmonary rehabilitation * Stable medication for at least 1 month * Age 18years to 85 years * No resting hypoxemia (PaO2 \>7.3 kPa) * Medical indication to prescibe a pulmonary rehabilitation
Exclusion criteria
* Any co-morbidity that limits the patient to participate the full rehabilitation * Enrollments in other trials with active treatments * Language barriers that limits the patient to participate in the rehabilitation
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Peak exercise performance [Watts] | At baseline pre-intervention and immediately after three weeks of rehabilitation | Peak exercise performance is measured during cardiopulmonary exercise tests on a cycle ergometer. The Unit of the measurement is watts. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Total pulmonary reistance [Wood units] | At baseline pre-intervention and immediately after three weeks of rehabilitation | The total pulmonary resistance is measured by echocardiography by dividing the systolic pulmonary arterial pressure by the cardiac output. The unit of the measurement is woos units. |
| Peak oxygen uptake [L/min] | At baseline pre-intervention and immediately after three weeks of rehabilitation | Peak oxygen uptake is measured during cardiopulmonary exercise tests on a cycle ergometer. The Unit of the measurement is liters per minute. |
| Ventilatory equivalents for carbon dioxide (Minute ventilation / carbon dioxide output) | At baseline pre-intervention and immediately after three weeks of rehabilitation | Ventilatory equivalents for carbon dioxide is measured during cardiopulmonary exercise tests on a cycle ergometer. The measurement is a ratio without a unit (VE/VCO2). |
| Six minute walk distance [meters] | At baseline pre-intervention and immediately after three weeks of rehabilitation | The maximal distance that a patient is able to walk within six minutes. The unit of the measurement is meters. |
| Knee extension test [repetitions] | At baseline pre-intervention and immediately after three weeks of rehabilitation | The patients has to stad up from a chair and sit down as often the patient is able to do this within 1 minute. The unit of the measurement is repetitions. |
| Right ventricular to arterial coupling [mm/mmHg] | At baseline pre-intervention and immediately after three weeks of rehabilitation | The right ventricular arterial coupling is measured by echocardiography dividing the tricuspid annular plane systolic excursion by the systolic arterial pressure. the unit is mm/mmHg. |
| Systolic pulmonary arterial pressure [mmHg] | At baseline pre-intervention and immediately after three weeks of rehabilitation | The sytolic pulmonary arterial pressure is measured by echocardiography using continuous wave doppler at the tricuspid valve. The unit of the measurement is mmHg. |
| Arterial partial pressure for oxygen [kPa] | At baseline pre-intervention and immediately after three weeks of rehabilitation | The arterial partial pressure for oxygen is measured by taking a arterial blood sample from the arteria radialis at peak exercise and analyze it in a radiometer. The unit of the measurement is kPa. |
| Arterial partial pressure for carbon dioxide [kPa] | At baseline pre-intervention and immediately after three weeks of rehabilitation | The arterial partial pressure for carbon dioxide is measured by taking a arterial blood sample from the arteria radialis at peak exercise and analyze it in a radiometer. The unit of the measurement is kPa. |
| Arterial oxygen saturation [%] | At baseline pre-intervention and immediately after three weeks of rehabilitation | The arterial oxygen saturation is measured by taking a arterial blood sample from the arteria radialis at peak exercise and analyze it in a radiometer. The unit of the measurement is %. |
| Patient reported leg fatigue [scale from 1 to 10] | At baseline pre-intervention and immediately after three weeks of rehabilitation | Patients perceived leg fatigue is assessed at peak exercise on the Borg CR 10 scale. The unit of the measurement is a scale from 1 to 10. |
| Patient reported dyspnea [scale from 1 to 10] | At baseline pre-intervention and immediately after three weeks of rehabilitation | Patients perceived dyspnea is assessed at peak exercise on the Borg CR 10 scale. The unit of the measurement is a scale from 1 to 10. |
| Patient reported quality of life [cm] | At baseline pre-intervention and immediately after three weeks of rehabilitation | The patient reported quality of life is assessed by the visual analogue scale, where the patient has to draw on a 10 cm long line where left is bad and right is very good. The unit of the measurement is cm. |
| Cardiac output [L/min] | At baseline pre-intervention and immediately after three weeks of rehabilitation | The cardiac output is measured by echocardiography using the left ventricular outflow tract velocity time integral assessed by pulse wave doppler. The unit of the measurement is L/min. |
Countries
Switzerland
Contacts
Primary ContactSilvia Ulrich, Prof. dr. med.
Backup ContactJulian Müller, Dr. sc. med.
Outcome results
None listed