Effects of Treadmill Versus Cycling Endurance Training in Patients With COPD

Study Overview
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Brief Summary
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Aim of this study is to investigate the effects of treadmill versus cycling endurance training on Balance, gait performance and exercise capacity in patients with severe chronic obstructive pulmonary disease. Patients will be recruited during a 3-week inpatient pulmonary rehabilitation program and will be randomized into one of two intervention groups. Walking intensity in the treadmill group will be set at 80 percent of the average speed of the 6-minute walking test. The cycling group will exercise at an intensity of 60 percent according to an Initial incremental cycling test. Patients will perform 5 to 6 training sessions per week. The total exercise duration will be progressively increased from 10 to 30 minutes. Walking or cycling intensity will also be progressively increased if perceived exertion during exercise is rated below 3 on the modified 10-point Borg scale.

Official Title
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Effects of a Three Week Treadmill Versus Cycling Endurance Training on Balance, Gait Performance and Exercise Capacity in Patients With Chronic Obstructive Pulmonary Disease - a Pilot Study

Conditions
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Chronic Obstructive Pulmonary Disease

Intervention / Treatment
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* Other: treadmill endurance training
* Other: cycling endurance training


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: COPD Stage III or IV according to the global initiative for chronic obstructive lung disease impaired exercise capacity (6 Minute walk distance of less than 70% of the reference values from Troosters et al.) Exclusion Criteria: acute, severe exacerbation of COPD carbon dioxide of more than 45 mmHg at rest any disabilities that prevent patient form walking or cycling Patient is not able to walk 20 meters without any aid (for example rollator)

Ages Eligible for Study
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Minimum Age: 50 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: treadmill endurance training<br> | Other: treadmill endurance training<br>* n = 15 patients with COPD. Walking intensity will be initially set at 80 percent of 6-minute Walking test Speed with progressive increase in Duration and intensity.<br>|
| Active Comparator: cycling endurance training<br> | Other: cycling endurance training<br>* n=15 patients with COPD. Cycling intensity will initially be set at 60 percent of Peak work rate with progressive increase in Duration and intensity<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in step symmetry during 20m walking | Patients walk 20m while wearing the Mc Roberts move test device (triaxial accelerometer) which performs a gait analysis | measurement on day 1 and 21 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in balance performance during semi-tandem stance | patients stand still for 10 seconds on a force platform that measures absolute path length of the center of force. | measurement on day 1 and 21 | 
| Change in balance performance during Romberg stance | patients stand still for 10 seconds on a force platform that measures absolute path length of the center of force. | measurement on day 1 and 21 | 
| Change in balance performance during single leg stance | patients stand still for 10 seconds on a force platform that measures absolute path length of the center of force. | measurement on day 1 and 21 | 
| Change in muscle power during counter movement jump | patients jump on a force platform as high as possible. The Outcome is Watt per Kilogram Body weight | measurement on day 1 and 21 | 
| Change in 1 Minute sit to stand test | Patients try to perform as many repetitions as possible of standing up and sitting down from a chair with crossed arms on a force platform during 1 minute | measurement on day 1 and 21 | 
| Change in 5 Repetition sit to stand test | Patients try to perform 5 repetitions of standing up and sitting down from a chair with crossed arms on a force platform as quick as possible | measurement on day 1 and 21 | 
| Change in peak muscle strength | isometric peak torque of the knee extensor muscles are measured in 90° knee angle | measurement on day 1 and 21 | 
| Change in 4 meter gait Speed test | patients have to walk 4 meters at their usual Speed. Outcome is the average Speed during the 4m walk. | measurement on day 1 and 21 | 
| Change in 6-minute Walk test | the best out of two 6- Minute Walk Tests will be used for analysis | measurement on day 1 and 21 | 
| Change in Hospital anxiety and Depression scale | the Hospital anxiety and Depression scale is a questionnaire that evaluates signs of anxiety or depression | measurement on day 1 and 21 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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COPD, exercise, training, cycling, treadmill, walking, pulmonary rehabilitation