Interval versus continuous training in lung transplant candidates: A randomized trial.
Gloeckl R, Halle M, et al.The Journal of Heart and Lung Transplantation 2012; 31(9): 934-941.
Aims
Using a non-inferiority design the primary aim was to assess whether interval training (IT) was equally effective as continuous training (CT). The secondary aim was to assess whether the feasibility of the IT protocol was superior to that of the CT protocol in patients with end-stage chronic obstructive pulmonary disease (COPD) listed for lung transplantation.
Interventions
IT versus CT protocols. All patients followed a multidisciplinary 3-week inpatient rehabilitation programme that included exercise units on 5 to 6 days/week. Apart from the type of endurance training, the rehabilitation program was identical for both groups and consisted of medical care, breathing therapy, education and psychological support. IT consisted of 30-second bouts of cycling at 100% of peak work rate (PWR) alternating with 30 seconds of rest (0% of PWR). The target work rate for patients in the CT group was 60% of peak work rate (PWR). The total amount of exercise time per session in
Participants
71 COPD patients listed for lung transplantation
Outcomes
The primary outcome was the change in 6-minute walking distance. Other outcomes included PWR, lung function, feasibility of the exercise protocols and quality of life (Short-Form 36)
Follow-up
3 weeks
CET Conclusions
Interval training (IT) was compared with continuous training (CT) in patients with COPD awaiting a lung transplant. Although IT was associated with a lower intensity of dyspnea during exercise the improvement in exercise capacity was similar with the two protocols. However there are a considerable number of limitations to this study (outlined very clearly by the authors), the major one being the relatively small sample size. These findings do support the evidence of previous trials suggesting that there is no difference between the effects of interval training and continuous training on improving exercise capacity.
Data analysis
Modified intention-to-treat analysis
Trial registration
ClinicalTrials.gov - NCT00962078