Short-Term Improvement in Exercise Capacity and Symptoms Following Exercise Training in Interstitial Lung Disease

Abstract

Background: Interstitial lung disease (ILD) is characterised by exertional dyspnoea, exercise limitation and reduced quality of life. The role of exercise training in this diverse patient group is unclear. The aims of this study were to establish the safety of exercise training in ILD; its effects on exercise capacity, dyspnoea and quality of life; and whether patients with idiopathic pulmonary fibrosis (IPF) had similar responses to those with other types of ILD. Methods: 57 subjects with ILD (34 IPF) were randomised to receive 8 weeks of supervised exercise training or weekly telephone support. The 6 min walk distance (6MWD), incremental exercise test, modified Medical Research Council (MRC) dyspnoea score and Chronic Respiratory Disease Questionnaire (CRDQ) were performed at baseline, following intervention and at 6 months. Results: 80% of subjects completed the exercise programme and no adverse events were recorded. The 6MWD increased following training (mean difference to control 35 m, 95% CI 6 to 64 m). A significant reduction in MRC score was observed (0.7 points, 95% CI 0.1 to 1.3) along with improvements in dyspnoea (p = 0.04) and fatigue (p,0.01) on the CRDQ. There was no change in peak oxygen uptake; however, exercise training reduced heart rate at maximum isoworkload (p = 0.01). There were no significant differences in response between those with and without IPF. After 6 months there were no differences between the training and control group for any outcome variable. Conclusions: Exercise training improves exercise capacity and symptoms in patients with ILD, but these benefits are not sustained 6 months following intervention. Trial registration number: NCT00168285The interstitial lung diseases (ILDs) are a diverse group of chronic lung conditions characterised by dyspnoea on exertion and poor health related quality of life.

Nordic walking for geriatric rehabilitation: a randomized pilot trial

“…Nevertheless, in those studies the intervention was longer and more frequent. Despite having smaller changes than what was observed in other studies [44][45][46][47], the change of 41 and 45 m in the 6MWT was greater than we initially expected. Perera et al [38] estimated 20 m being the small meaningful change for 6MWT performed by seniors.…”

“…In other studies [44][45][46][47], however, changes in walking distance are similar, or a little superior, to the 41 and 45 m obtained here. Nevertheless, in those studies the intervention was longer and more frequent.…”

British Thoracic Society guideline on pulmonary rehabilitation in adults: accredited by NICE

“…This was not pulmonary rehabilitation and discussion ensued as to whether it should be included, given the paucity of literature otherwise. This study demonstrated modest improvements in functional exercise tolerance, dyspnoea and quality of life compared with telephone support 186. Importantly it was safe and feasible.…”

The evidence of benefits of exercise training in interstitial lung disease: a randomised controlled trial

“…Based on effects seen in our previous study,24 22 participants with dust-related ILD and 22 with CTD-ILD were required to detect a mean (SD) difference in 6MWD with 80% power between groups of 52 (40) m and 38 (30) m respectively 24 25. For participants with IPF, to detect differences of 29 or 34 m (SD 43 m) with 80% power, representing the upper and lower limits of the MID in IPF25 required 72 and 54 participants respectively.…”

“…Analysis of the other ILD subgroup was not performed as it represented a heterogeneous group of disease entities and not a distinct ILD subtype. Two per-protocol analyses were defined a priori including (1) those who completed the programme (attendance at 12 out of 16 sessions)24 and (2) those whose exercise training prescription was progressed according to the protocol. Categorical data were analysed using the Pearson χ 2 test.…”