Eccentric Cycling Exercise During Pulmonary Rehabilitation in Patients With Cardiopulmonary Diseases

Eccentric Cycling Exercise During Pulmonary Rehabilitation in Patients With Cardiopulmonary Diseases

Eccentric cycling exercise (ECC) allows training at low metabolic costs and may therefore be valuable for patients with pulmonary vascular disease (PVD). For these patients, regular exercise training has an evidence level 1A recommendation in the current guidelines. Exercise training during longer and regular periods provides chronic adaptation, for which ECC was recently found to have a greater effectiveness than CON by increasing muscle strength, hypertrophy, six-minute walking distance and furthermore, by increasing maximum oxygen uptake (V'O2max) especially in patients with chronic obstructive pulmonary disease (COPD), chronic left heart failure or coronary heart disease. Furthermore, we conducted an RCT in which we exposed patients with PVD to ECC and concluded that ECC is a feasible and well-tolerated exercise modality for PVD patients with severely lower O2 demand and load to the right ventricle. The study in patients with PVD was started (EccRehab), and the great potential was recognized. Therefore there was an indication to open the inclusion criteria to all cardiopulmonary patients with indication for pulmonary rehabilitation (EccRehab2).

For this purpose, the aim of this project is to investigate whether ECC improves exercise capacity and possibly hemodynamics during prolonged rehabilitation programs in patients with cardiopulmonary diseases.

Inclusion Criteria:

• Diagnosed with PVD, either PAH or CTEPH via right heart catheterization, according to recent guidelines [9]
• Diagnosed with a cardiopulmonary disease as indication for a pulmonary rehabilitation
• Stable medication for at least 1 month
• Age 18years to 85 years
• No resting hypoxemia (PaO2 >7.3 kPa)
• Medical indication to prescibe a pulmonary rehabilitation

Exclusion Criteria:

• Any co-morbidity that limits the patient to participate the full rehabilitation
• Enrollments in other trials with active treatments
• Language barriers that limits the patient to participate in the rehabilitation