Although uncommon, interstitial lung diseases (ILDs), and particularly idiopathic pulmonary fibrosis (IPF), are progressive, irreversible, and ultimately fatal without treatment. Pharmacological therapies can slow the decline in forced vital capacity (FVC) and six-minute walk distance (6MWD), but they do not improve exercise-related respiratory limitations or quality of life. Therefore, pulmonary rehabilitation (PR) is recommended for patients with a confirmed diagnosis of ILD/IPF who experience exercise limitation and significant functional impairment. However, the benefits of PR remain modest, and the optimal rehabilitation strategies for these patients have yet to be defined, particularly given the severe dyspnea and often profound exertional hypoxemia that characterize the disease. To optimize the effects of PR, especially exercise training, the use of high-flow nasal oxygen (HFNO) during exercise has been proposed in certain respiratory conditions such as chronic obstructive pulmonary disease (COPD). By improving oxygenation and exercise tolerance, HFNO applied during exercise training sessions may enhance the effectiveness of pulmonary rehabilitation.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
60
Participants will undergo a standardized 4-week pulmonary rehabilitation program consisting of respiratory therapy exercises (20min), cycle ergometer endurance training, outdoor walking, calisthenics, and muscle strengthening exercises, performed 5 days per week for a total of 20 sessions. During cycle ergometer endurance training, participants will receive NHFO2.
Participants will undergo a standardized 4-week pulmonary rehabilitation program consisting of respiratory therapy exercises (20min), cycle ergometer endurance training, outdoor walking, calisthenics, and muscle strengthening exercises, performed 5 days per week for a total of 20 sessions. During cycle ergometer endurance training, participants will receive conventional O2 therapy.
Association Dieulefit Santé
Dieulefit, Auvergne-Rhône-Alpes, France
Constant Work Rate Endurance Time (CWRET)
Endurance time measured during a constant-load exercise test performed at 70% of peak work rate (PWR) in room air determined during baseline incremental cardiopulmonary exercise testing.
Time frame: Baseline and end of the 4-week PR program.
Six-Minute Walk Distance
Distance walked during the 6-Minute Walk Test.
Time frame: Baseline and end of the 4-week pulmonary rehabilitation.
Dyspnea, Leg Discomfort and Rate of Percieved Exertion (RPE)
Using the modified CR10 Borg scale (ranging from 0 \[nothing at all\] to 10 \[maximal\]) for dyspnea and leg discomfort; using the 6 (no exertion at all) - 20 (maximum exertion) Borg scale for RPE.
Time frame: Dyspnea and Leg Discomfort : during constant-load exercise test and 6-min walk test, at baseline and end of 4-week PR. Dyspnea and RPE : during each of the 20 exercise training sessions on a bicycle ergometer.
Pulmonary responses to exercise
Pulmonary exercise parameters, including ventilation (VE, L/min), gas exchange (VO2, VCO2, L/min), assessed during a cardiopulmonary exercise test (CPET) and during constant-load cycle ergometer endurance tests.
Time frame: Baseline and end of the 4-week pulmonary rehabilitation.
Oxygen saturation
By pulse oximetry
Time frame: During each of the 20 exercise training sessions on a bicycle ergometer.
Heart Rate
Using electrocardiogram, in beats/min
Time frame: Continuous monitoring throughout the cardiopulmonary test and during each of the 20 exercise training sessions on a bicycle ergometer.
Power
Time frame: During each of the 20 exercise training sessions on a bicycle ergometer. During the CPET, baseline and end of the 4-week pulmonary rehabilitation
Near Infrared Spetroscopy
Of the Vastus Lateralis, used during the CPET and CWRET.
Time frame: Baseline and end of the 4-week PR
King's Brief Interstitial Lung Disease (K-BILD)
Ranging from 0 (worst) to 100 (better)
Time frame: Baseline and end of the 4-week pulmonary rehabilitation
modified Medical Research Council (mMRC)
Ranging from 0 (better) to 4 (worst)
Time frame: Baseline and end of the 4-week pulmonary rehabilitation
Hospital Anxiety and Depression Scale (HADS)
Ranging from 0 (better) to 21 (worst)
Time frame: Baseline and end of the 4-week pulmonary rehabilitation
Pichot Fatigue Scale
Ranging from 0 (better) to 32 (worst)
Time frame: Baseline and end of the 4-week pulmonary rehabilitation
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