Exercise Training in Patients With Chronic Respiratory Failure Due to Kyphoscoliosis: A Randomized Controlled Trial

Abstract

BACKGROUND: Research has provided evidence for the safety, feasibility, and efficacy of exercise training in patients with COPD. However, little is known about the impact of exercise training in patients with chronic respiratory failure due to kyphoscoliosis. We evaluated the effect of an exercise training program on exercise capacity, muscle strength, dyspnea, and quality-of-life indices in subjects with chronic respiratory failure due to kyphoscoliosis. METHODS: The 34 subjects were clinically stable, had been receiving nighttime home mechanical ventilation for > 6 months, and were randomly assigned to the exercise group (n ‫؍‬ 17) or the control group (n ‫؍‬ 17). The exercise group conducted cycle and strength training on 3 non-consecutive days per week for 12 weeks. We measured pulmonary function, exercise capacity, peripheral muscle strength, dyspnea scores, and quality of life. RESULTS: Statistical analysis was carried out on the data from 16 subjects in the exercise group and in 11 subjects in the control group. Three of the lung-function parameters in the exercise group significantly changed: P aCO 2 (P ‫؍‬ .04), inspiratory pressure (P ‫؍‬ .03), and expiratory pressure (P ‫؍‬ .04); and endurance time (P ‫؍‬ .002) and shuttle walk distance (P ‫؍‬ .001) increased significantly. The exercise group had significantly greater improvements in peripheral muscle strength, dyspnea, and quality of life. CONCLUSIONS: In patients with chronic respiratory failure due to kyphoscoliosis, exercise training improved exercise capacity, peripheral muscle strength, dyspnea, and quality of life. (Deutschen Register Klinischer Studien DRKS00000443)

Kyphoscoliosis—What Can We Do for Respiration besides NIV?

“…The authors www.journals.viamedica.pl reported significant decrease in PaCO 2 , while maximum inspiratory and expiratory pressures, as well as endurance time and shuttle walk distance increased significantly. The exercise group had also significantly greater improvements in peripheral muscle strength, dyspnoea, and quality of life [13].…”

“…Cejudo et al [13] have recommended this kind of exercise programme for the treatment of chronic respiratory failure due to kyphoscoliosis in patients receiving NHMV.…”

“…A randomised control trial by Cejudo et al [13] examined the influence of exercise on endurance and strength. A group of 34 KS patients receiving night time home mechanical ventilation (NHMV) were divided randomly into two equally-sized groups: an exercise group and a control group.…”

Pulmonary Rehabilitation Improves Exercise Capacity in Subjects with Kyphoscoliosis and Severe Respiratory Impairment

“…29 One potential explanation for the observed difference between the two studies is the duration of the pulmonary rehabilitation program: 4 -6 weeks in our study and 12 weeks in the Cejudo study. 28 In fact, significantly greater improvements in exercise tolerance and dyspnea have been reported in subjects with restrictive lung diseases following a 24-week pulmonary rehabilitation program compared with a 12-week program. 11 In this study, the benefit of pulmonary rehabilitation in terms of improved exercise capacity was completely lost at the 12-month follow-up visit.…”

“…In a recent study of a group of subjects with chronic respiratory failure due to kyphoscoliosis, Cejudo et al 28 reported that exercise training improved exercise capacity, peripheral muscle strength, and HRQOL. The mean 67.2 m increase in shuttle walk distance they reported was far greater than the mean 38 m increase reported by us, despite the similar functional characteristics presented by the two study populations and the significant relationship existing between 6MWD ϭ 6-min walk distance 6MWT ϭ 6-min walk test T0 ϭ at baseline T1 ϭ after rehabilitation T2 ϭ 1 y later the 6MWT and shuttle walk test results.…”