Changes in fatigability following intense aerobic exercise training in patients with interstitial lung disease - 17/02/15

Doi : 10.1016/j.rmed.2015.01.021

Randall E. Keyser ^a,^b,^⁎ , Eric J. Christensen ^b, Lisa M.K. Chin ^a,^b, Joshua G. Woolstenhulme ^a,^b, Bart Drinkard ^b, Anne Quinn ^b, Gerilynn Connors ^d, Nargues A. Weir ^c, Steven D. Nathan ^c, Leighton E. Chan ^b
^a Department of Rehabilitation Science, College of Health and Human Services, George Mason University, 4400 University Drive, Fairfax, VA 22030, USA
^b Rehabilitation Medicine Department, National Institutes of Health Clinical Center, 10 Center Drive, Bethesda, MD 20892, USA
^c Advanced Lung Disease and Transplant Program, Inova Fairfax Hospital, 3300 Gallows Road, Falls Church, VA 22046, USA
^d Pulmonary Rehabilitation Center, Inova Farifax Hospital, Falls Church, VA 22046, USA

^∗Corresponding author. George Mason University, College of Health and Human Services, Department of Rehabilitation Science, 4400 University Dr. MS 2G7, Fairfax, VA 22030, USA. Tel.: +1 703 993 9708.

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Tuesday 17 February 2015

Summary

Objective

To determine if, in patients with interstitial lung disease (ILD), fatigue might be lessened after vigorous aerobic exercise.

Methods

13 physically inactive patients (5 men and 8 women; age 57.2 ± 9.1 years, BMI 28.2 ± 4.6 kgm⁻²) with ILD of heterogeneous etiology and able to walk on a motor driven treadmill without physical limitation were enrolled. Subjects underwent cardiopulmonary exercise (CPET) and 6-min walk (6MWT) tests and completed Fatigue Severity Scale and Human Activity Profile questionnaires before and after an aerobic exercise-training regimen. The training regimen required participation in at least 24 of 30 prescribed aerobic exercise training sessions at a target heart rate of 70–80% of the heart rate reserve, 30 min per session, 3 times per week for 10 weeks.

Results

After training, a 55% (p < 0.001) increase in time to anaerobic threshold on the CPET, and an 11% (p = 0.045) reduction in performance fatigability index (PFI), calculated from the performance on the 6MWT were observed. Distance walked on the 6MWT (6MWD) increased by 49.7 ± 46.9 m (p = 0.002). Significant improvements in scores on the Fatigue Severity Scale (p = 0.046) and Human Activity Profile (AAS p = 0.024; MAS p = 0.029) were also observed. No adverse events related to the training regimen were noted.

Conclusion

After training, the decrease in fatigability appeared to result in increased 6MWD and was associated with physical activity. Since significant declines in 6MWD may be a marker for impending mortality in ILD, a better understanding of the etiological state of fatigue in patients with ILD and its reversal might provide fundamental insight into disease progression and even survival. [ClinicalTrials.gov identifier NCT00678821].

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Keywords : Interstitial lung disease, Fatigability, Pulmonary rehabilitation, Aerobic exercise physical activity, Fatigue severity