Interval versus continuous training in lung transplant candidates: A randomized trial

Gloeckl, Rainer; Halle, Martin; Kenn, Klaus

doi:10.1016/j.healun.2012.06.004

Cited by 92 publications

(120 citation statements)

References 30 publications

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“…16 In several studies, PR has been found to be helpful in minimizing physical and psychologic losses of patients. 17,18 In the present study, we also examined the effects of preoperative physiotherapy on lung transplant candidates. This study is the first and most comprehensive study conducted in Turkey on PR in lung transplant patients.…”

Section: Discussionmentioning

confidence: 99%

Untitled

Pehlivan

Balcı²,

Kılıç³

et al. 2018

Exp Clin Transplant

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Objectives: The frequency and success rates of lung transplant in patients with end-stage lung disease are increasing. In our study, we investigated the effects of preoperative pulmonary rehabilitation on pulmonary function, exercise capacity, and quality of life in patients who are candidates for lung transplant. Materials and Methods: This prospective study included 39 consecutive patients who were candidates for lung transplant. All patients underwent preoperative pulmonary rehabilitation for at least 3 weeks. Results: Our patient group included 25 male and 14 female patients with a mean age of 36 years (range, 15 -68 y). Although no significant improvement was shown in the forced expiratory volume in 1 second after pulmonary rehabilitation, significant improvements were observed in the Modified Medical Research Council dyspnea scores (P = .001) and 6-minute walk distance (P = .001). We also observed statistically significant improvements in the ShortForm 36 Quality of Life Questionnaire's physical function (P = .01) and emotional role (P = .02) subparameters. We also found a significant improvement in the Beck Depression Inventory score (P = .004). There was no correlation between Beck Depression Inventory scores before and after rehabilitation and 6-minute walk distance, Short-Form 36, and Modified Medical Research Council dyspnea scores. Conclusions: Our results suggest that preoperative pulmonary rehabilitation improves exercise capacity, reduces the sensation of dyspnea and muscle strength loss, and has a positive effect on the psychologic state of patients who are candidates for lung transplant. Key words: Dyspnea, Muscle loss, Psychologic assessment IntroductionLung transplant is the last treatment option for endstage lung disease patients for whom conservative treatments have failed. 1 A pulmonary rehabilitation (PR) program has an important role in this group of patients who have chronic lung diseases and complex medical histories. 2 Studies have shown positive effects of PR programs in patients who are on wait lists for transplant and have shown that postoperative outcomes are improved in patients who can obtain higher preoperative exercise capacity. 3 In chronic pulmonary diseases such as chronic obstructive pulmonary disease, bronchiectasis, and interstitial lung disease, the efficacy and reliability of exercise have been well-documented. [4][5][6] However, data are still scarce on the safety and efficacy of exercise in patients with end-stage lung disease who are transplant candidates. Evidence-based exercise training programs for pre-and postoperative stages of transplant have not yet been developed. Considering the exercise principles and recom mendations in the guidelines for the care of adults with chronic pulmonary disease, exercise training programs should be established to offer optimal health benefits for transplant candidates on wait lists. 7 Patients prepared for lung transplant are a select patient population with advanced chronic lung disease. These patients typically have ven...

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Section: Discussionmentioning

confidence: 99%

Untitled

Pehlivan

Balcı²,

Kılıç³

et al. 2018

Exp Clin Transplant

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“…This is similar to the findings of another trial in which the authors showed that interval training was associated with a lower intensity of dyspnea during exercise and fewer unintended breaks, achieving similar improvements in exercise capacity compared with continuous training in pre-lung transplant subjects with COPD. 22 However, with respect to training adherence, both forms should be offered to patients, and the choice should be made by the patients themselves.…”

Section: Discussionmentioning

confidence: 99%

Effects of Oxygen Supply During Training on Subjects With COPD Who Are Normoxemic at Rest and During Exercise: A Blinded Randomized Controlled Trial

et al. 2014

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BACKGROUND: It is well established that physical training enhances functionality and quality of life in patients with COPD. However, little data exist concerning the effects of the usefulness of oxygen supply during exercise training for > 3 months in patients with COPD who are normoxemic at rest and during exercise. We hypothesized that oxygen supply during training sessions enables higher training intensity and thus optimizes training results in patients with COPD. METHODS: In this blinded randomized controlled study, we carried out a 24-week training program with progressively increasing loads involving large muscle groups. In addition, we compared the influences of oxygen supplementation. Thirty-six subjects with moderate-to-severe COPD who were not dependent on long-term oxygen therapy trained under supervision for 24 weeks (3 times/week at 30 min/session). Subjects were randomized into 2 groups: oxygen supply via nasal cannula at a flow of 4 L/min and compressed air at the same flow throughout the training program. Lung function tests at rest (inspiratory vital capacity, FEV 1 , Tiffeneau index), cycle spiroergometry (peak ventilation, peak oxygen uptake, peak respiratory exchange rate, submaximal and peak lactic acid concentrations), 6-min walk tests, and quality-of-life assessments (Medical Outcomes Study 36-Item Short Form questionnaire) were conducted before and after 12 and 24 weeks. RESULTS: Independent of oxygen supplementation, statistically significant improvements occurred in quality of life, maximal tolerated load during cycling, peak oxygen uptake, and 6-min walk test after 12 weeks of training. Notably, there were no further improvements from 12 to 24 weeks despite progressively increased training loads. CONCLUSIONS: Endurance training 3 times/week resulted in significant improvements in quality of life and exercise capacity in subjects with moderate-to-severe COPD within the initial 12 weeks, followed by a stable period over the following 12 weeks with no further benefits of supplemental oxygen.

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“…Nevertheless, in patients with very severe COPD there is evidence that interval training is associated with fewer symptoms of dyspnoea during exercise and fewer unintended breaks [26,27]. Therefore patients with severe COPD may markedly increase the total exercise duration with significantly lower metabolic and ventilatory stress, as well as lower rates of dynamic hyperinflation when performing interval training compared to continuous training [28].…”

Section: Continuous Versus Interval Trainingmentioning

confidence: 99%

Practical recommendations for exercise training in patients with COPD

Gloeckl

Marinov

Pitta

2013

European Respiratory Review

211

131

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The aim of this article was to provide practical recommendations to healthcare professionals interested in offering a pulmonary rehabilitation programme for patients with chronic obstructive pulmonary disease (COPD). The latest research findings were brought together and translated into clinical practice. These recommendations focus on the description of useful assessment tests and of the most common exercise modalities for patients with COPD. We provide specific details on the rationale of why and especially how to implement exercise training in patients with COPD, including the prescription of training mode, intensity and duration, as well as suggestions of guidelines for training progression.

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Interval versus continuous training in lung transplant candidates: A randomized trial

Cited by 92 publications

References 30 publications

Untitled

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Effects of Oxygen Supply During Training on Subjects With COPD Who Are Normoxemic at Rest and During Exercise: A Blinded Randomized Controlled Trial

Practical recommendations for exercise training in patients with COPD

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