Exercise training in interstitial lung disease: lumping or splitting?

Abstract Background Interstitial lung disease is a debilitating condition associated with significant dyspnoea, fatigue, and poor exercise tolerance. Pulmonary rehabilitation is an effective and key intervention in people with interstitial lung disease. However, despite the best efforts of patients and clinicians, many of those who participate are not achieving clinically meaningful benefits. This assessor-blinded, multi-centre, randomised controlled trial aims to compare the clinical benefits of high intensity interval exercise training versus the standard pulmonary rehabilitation method of continuous training at moderate intensity in people with fibrotic interstitial lung disease. Methods Eligible participants will be randomised to either a standard pulmonary rehabilitation group using moderate intensity continuous exercise training or high intensity interval exercise training. Participants in both groups will undertake an 8-week pulmonary rehabilitation program of twice-weekly supervised exercise training including aerobic (cycling) and strengthening exercises. In addition, participants in both groups will be prescribed a home exercise program. Outcomes will be assessed at baseline, upon completion of the intervention and at six months following the intervention by a blinded assessor. The primary outcome is endurance time on a constant work rate test. Secondary outcomes are functional capacity (6-min walk distance), health-related quality of life (Chronic Respiratory Disease Questionnaire (CRQ), St George’s Respiratory Questionnaire idiopathic pulmonary fibrosis specific version (SGRQ-I), breathlessness (Dyspnoea 12, Modified Medical Research Council Dyspnoea Scale), fatigue (fatigue severity scale), anxiety (Hospital Anxiety and Depression Scale), physical activity level (GeneActiv), skeletal muscle changes (ultrasonography) and completion and adherence to pulmonary rehabilitation. Discussion The standard exercise training strategies used in pulmonary rehabilitation may not provide an optimal exercise training stimulus for people with interstitial lung disease. This study will determine whether high intensity interval training can produce equivalent or even superior changes in exercise performance and symptoms. If high intensity interval training proves effective, it will provide an exercise training strategy that can readily be implemented into clinical practice for people with interstitial lung disease. Trial registration ClinicalTrials.gov Registry (NCT03800914). Registered 11 January 2019, https://clinicaltrials.gov/ct2/show/NCT03800914 Australian New Zealand Clinical Trials Registry ACTRN12619000019101. Registered 9 January 2019, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=376050&isReview=true

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Impact of supervised exercise training on pulmonary function parameters, exercise capacity and Irisin Biomarker in Interstitial lung disease patients

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.36.5.1795 ◽

2020 ◽

Vol 36 (5) ◽

Author(s):

Rahma Mohammad Alyami ◽

Abdulrahman Mohammed Alhwaikan ◽

Abdullah Rashed Alharbi ◽

Ghada AL-Nafisah

Keyword(s):

Interstitial Lung Disease ◽

Exercise Training ◽

Pulmonary Function ◽

Lung Disease ◽

Exercise Capacity ◽

University Hospital ◽

Enzyme Linked Immunosorbent Assay ◽

Supervised Exercise ◽

Before And After ◽

The Impact

Objectives: To assess the impact of supervised exercise training (SET) on pulmonary function Parameters, exercise capacity and Irisin biomarker in Interstitial Lung Disease (ILD) patients. Methods: Ten (10) patients with ILD and 18 healthy controls of age between 30-40+ years were selected for 8-weekSET program. Before and after SET all subjects performedexercise capacity six minutes’ walk test (6MWT), heart rate (HR) changes were recorded, shortness of Breath Respiratory Questionnaire (SOBQ) was obtained and Irisin levels were measuredby Enzyme-Linked Immunosorbent Assay (ELISA).This interventional study was carried out atDepartment of Physiology, Faculty of Medicine, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia, from October 2018 to February 2019. Results: Mean six minutes’ walk distance (6MWD) was 395±68.4 m at 1st visit increased significantly (p=0.001) to 458.8±87.1 mat 15 visit. However, 6MWD values found significantly higher in controls (517.4±84.1 m; 561.7±81.6 m; p=0.013) thanILD patients. Overall change (difference between post and pre exercise) in HRvalue was recorded lower in ILD patients (30-35 bpm) as compared to controls (40-45 bpm). Moreover, ILD patients had overall higher SOBQ score than controls. Pre SET Irisin levelsofILD patients (4.24 ± 1.73 pg/ml) and controls (3.43±1.04pg/ml) werefound unchangedafter SET (4.48±2.02pg/ml, 3.39 ±1.41pg/ml,p=0.677, p=0.093) respectively. However, patients Irisin values were foundhigher as compared to controls before and after SET. Conclusion: Exercise capacity and Dyspneain patients with ILD were improved after 8-week of SET program. No major changes in Irisin levels among patients with ILD and controls were observed. Additional research requires to be carried out on large number of subjects to deterMinutese the advantages of exercise in ILD. doi: https://doi.org/10.12669/pjms.36.5.1795 How to cite this:Alyami RM, Alhwaikan AM, Alharbi AR, AL-Nafisah G. Impact of supervised exercise training on pulmonary function parameters, exercise capacity and Irisin Biomarker in Interstitial lung disease patients. Pak J Med Sci. 2020;36(5):1089-1095. doi: https://doi.org/10.12669/pjms.36.5.1795 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Effect of supervised exercise training on exercise capacity, pulmonary function and growth differentiation factor 15 levels in patients with interstitial lung disease: A preliminary study

Isokinetics and Exercise Science ◽

10.3233/ies-210123 ◽

2021 ◽

pp. 1-9

Author(s):

Rahmah Mohammad Alyami ◽

Abdulrahman Mohammed Alhowikan

Keyword(s):

Interstitial Lung Disease ◽

Exercise Training ◽

Pulmonary Function ◽

Lung Disease ◽

Exercise Capacity ◽

Shortness Of Breath ◽

Post Exercise ◽

Growth Differentiation Factor 15 ◽

Supervised Exercise ◽

Exercise Training Program

BACKGROUND: Interstitial lung disease is characterized by exertion dyspnea, exercise limitation and reduced quality of life. The role of exercise training in this diverse patient group is unclear. The growth differentiation factor 15 (GDF15) is a stress-sensitive circulating factor that regulates systemic energy balance and could be a possible biomarker in interstitial lung disease. OBJECTIVE: To evaluate the effect of supervised exercise (endurance and resistance) training (SET) on exercise capacity, pulmonary function parameters and GDF15 levels in patients with interstitial lung disease (PwILD). METHODS: In this non-randomized case-control trial, the experimental group comprised of 10 PwILD (7 women and 3 men) while the control group consisted of of 18 apparently healthy participants s 11 women and 7 men). All subjects completed an 8-week supervised exercise training program, at a rate of twice a week. Dyspnea was evaluated using the Shortness of Breath Respiratory Questionnaire. Exercise capacity was measured using the 6-min walk test while the heart rate (HR) was monitored before and after the exercise training. GDF15 levels were measured by Enzyme-Linked Immunosorbent Assay (ELISA). RESULTS: PwILD had significantly shorter 6-min walk distance than the control subjects at both the 1st and the 15th visit. However, both groups improved significantly in this test. The change (pre to post-exercise) in HR value was smaller in PwILD compared to the controls. Moreover, PwILD had higher Shortness of Breath Respiratory Questionnaire score than controls. While the mean pre-post GDF15 change values in both groups remained statistically unchanged the GDF15 values of the PwILD patients were significantly higher compared to the controls with respect to pre-post exercise training respectively. CONCLUSION: Supervised exercise training did not affect GDF15 levels in both patient and control groups but its values in PwILD were significantly higher compared to those of controls (p⩽0.05). The exercise capacity and dyspnea in these patients improved after exercise training program.

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Best Practice Approach for Interstitial Lung Disease in the Rehabilitation Setting

Journal of Clinical Exercise Physiology ◽

10.31189/2165-7629-9.2.67 ◽

2020 ◽

Vol 9 (2) ◽

pp. 67-82

Author(s):

Leona M. Dowman ◽

Anthony K. May

Keyword(s):

Interstitial Lung Disease ◽

Exercise Training ◽

Lung Disease ◽

Exercise Tolerance ◽

Best Practice ◽

Future Research ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Related Quality ◽

Practice Approach

ABSTRACT Interstitial lung disease (ILD) is a disabling group of chronic lung conditions comprising over 200 different disease entities that are typically associated with interstitial inflammation and fibrosis. People with ILD almost invariably experience dyspnea, fatigue, anxiety, depression, cough, poor health-related quality of life, and reduced exercise tolerance. Pulmonary rehabilitation (PR) is a comprehensive intervention that includes exercise training as a core and essential component and that aims to improve exercise tolerance and exertional symptoms in people with chronic lung disease. PR is a cornerstone of care for people with chronic obstructive pulmonary disease, where its role and benefits have been well defined. PR offers increasing promise as an equally effective therapy for people with ILD. This review discusses the evidence of PR for ILD, outlines the current exercise training approach for people with ILD, and discusses important areas for future research.

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Exercise training in patients with interstitial lung disease (ILD): Can reponders be distinguished from non-responders

10.1183/13993003.congress-2015.pa3530 ◽

2015 ◽

Author(s):

Veronica Barbier ◽

Carlos A. Camillo ◽

Heleen Demeyer ◽

Wim Janssens ◽

Wim Wuyts ◽

...

Keyword(s):

Interstitial Lung Disease ◽

Exercise Training ◽

Lung Disease

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