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.
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
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
Parallel
Eccentric cycling exercise
Other interventionPatients perform eccentric cycling exercise instead of normal cycling exercise in addition to standard car during a cardiopulmonary rehabilitation
Standard Care Arm
Other interventionPatients perform cardiopulmonary rehabilitation according to standard care
Peak exercise performance [Watts]
Peak exercise performance is measured during cardiopulmonary exercise tests on a cycle ergometer. The Unit of the measurement is watts.
Peak oxygen uptake [L/min]
Peak oxygen uptake is measured during cardiopulmonary exercise tests on a cycle ergometer. The Unit of the measurement is liters per minute.
Ventilatory equivalents for carbon dioxide (Minute ventilation / carbon dioxide output)
Ventilatory equivalents for carbon dioxide is measured during cardiopulmonary exercise tests on a cycle ergometer. The measurement is a ratio without a unit (VE/VCO2).
Six minute walk distance [meters]
The maximal distance that a patient is able to walk within six minutes. The unit of the measurement is meters.
Knee extension test [repetitions]
The patients has to stad up from a chair and sit down as often the patient is able to do this within 1 minute. The unit of the measurement is repetitions.
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Silvia Ulrich Somaini
Lead sponsor
University of Zurich
Sponsor institution
Klinik Barmelweid
Collaborator
