The evidence of benefits of exercise training in interstitial lung disease: a randomised controlled trial
Top Cited Papers
Open Access
- 17 February 2017
- Vol. 72 (7), 610-619
- https://doi.org/10.1136/thoraxjnl-2016-208638
Abstract
Background Uncertainty exists regarding the clinical relevance of exercise training across the range of interstitial lung diseases (ILDs). Objective To establish the impact of exercise training in patients with ILDs of differing aetiology and severity. Methods 142 participants with ILD (61 idiopathic pulmonary fibrosis (IPF), 22 asbestosis, 23 connective tissue disease-related ILD (CTD-ILD) and 36 with other aetiologies) were randomised to either 8 weeks of supervised exercise training or usual care. Six-minute walk distance (6MWD), Chronic Respiratory Disease Questionnaire (CRDQ), St George Respiratory Questionnaire IPF-specific version (SGRQ-I) and modified Medical Research Council dyspnoea score were measured at baseline, 9 weeks and 6 months. Measurements and main results Exercise training significantly increased 6MWD (25 m, 95% CI 2 to 47 m) and health-related quality of life (CRDQ and SGRQ-I) in people with ILD. Larger improvements in 6MWD, CRDQ, SGRQ-I and dyspnoea occurred in asbestosis and IPF compared with CTD-ILD, but with few significant differences between subgroups. Benefits declined at 6 months except in CTD-ILD. Lower baseline 6MWD and worse baseline symptoms were associated with greater benefit in 6MWD and symptoms following training. Greater gains were seen in those whose exercise prescription was successfully progressed according to the protocol. At 6 months, sustained improvements in 6MWD and symptoms were associated with better baseline lung function and less pulmonary hypertension. Conclusions Exercise training is effective in patients across the range of ILDs, with clinically meaningful benefits in asbestosis and IPF. Successful exercise progression maximises improvements and sustained treatment effects favour those with milder disease. Trial registration number Results, ACTRN12611000416998.This publication has 38 references indexed in Scilit:
- Skeletal muscle atrophy in advanced interstitial lung diseaseRespirology, 2015
- Exercise Training-Based Pulmonary Rehabilitation Program Is Clinically Beneficial for Idiopathic Pulmonary FibrosisRespiration, 2014
- New Therapeutic Targets in Idiopathic Pulmonary Fibrosis. Aiming to Rein in Runaway Wound-Healing ResponsesAmerican Journal of Respiratory and Critical Care Medicine, 2014
- Diagnosis and management of interstitial lung diseaseTranslational Respiratory Medicine, 2014
- An Official ATS/ERS/JRS/ALAT Statement: Idiopathic Pulmonary Fibrosis: Evidence-based Guidelines for Diagnosis and ManagementAmerican Journal of Respiratory and Critical Care Medicine, 2011
- Review Series: Aspects of Interstitial lung disease: Connective tissue disease-associated interstitial lung disease: How does it differ from IPF? How should the clinical approach differ?Chronic Respiratory Disease, 2011
- Review series: Aspects of interstitial lung disease: Exercise limitation in interstitial lung disease - mechanisms, significance and therapeutic optionsChronic Respiratory Disease, 2010
- Interstitial lung disease guidelineThorax, 2008
- Pulmonary hypertension in interstitial lung diseaseEuropean Respiratory Journal, 2008
- Assessment of Health-Related Quality of Life in Patients With Interstitial Lung DiseaseSocial psychiatry. Sozialpsychiatrie. Psychiatrie sociale, 1999