Table 1.
Characteristics of included randomised controlled studies.
| Author, Year | CRD | Setting | Sample | Age (year), | FEV1 (L) | Intervention | Comparator | Duration (wks) | Outcomes |
|---|---|---|---|---|---|---|---|---|---|
| Size (n) | Gender(M/F) | (% pred) | (IET) parameters | (CET) parameters | Frequency (times × per wk) | 1) Exercise capacity2) Cardiorespiratory fitness3) Symptoms (dyspnoea and leg discomfort) | |||
| Coppoolse 18 | COPD | Netherlands, supervised inpatient programme | 21 | 62 year for IET, 67 year for CET, 100%M | 37±15% | 60 s (90% WR peak) cycling alternating with 120 s (45% WR peak) for 30 min | Cycling (65% WR peak) for 30 min | 8 wks, 3 × wk for IET, 2 × wk for CET |
1) Incremental and CWR: WRpeak and VO2peak 2) VEpeak, HRpeak and LAT 3) Visual analogue scale (VAS) |
| Vogiatzis 4 | COPD | Greece, supervised outpatient PR |
36 | 68 year, 83%M |
45 ± 4% | 30 s cycling (100% WR peak) alternating with 30 s rest period for 20 min per session, 40 min total | Cycling (50% WR peak) for 40 min per session | 12 wks, 2× wk, education, instruction in the use of medication, dietary advice, psychological Support, breathing exercises |
1) Ramp incremental: WRpeak and VO2peak 2) VEpeak, HRpeak and LAT 3) Borg’s scale (0–10) for dyspnoea |
| Vogiatzis 16 | COPD | Greece, supervised outpatient PR |
19 | 65 year, 84%M | 40 ± 4% | 30 s cycling (100% WR peak) alternating with 30 s rest period for 45 min per session | Cycling (60% WR peak) for 30 min | 10 wks, 3 × wk, plus breathing, education, relaxation, secretion clearance techniques, Psychosocial support, progression monthly equal in magnitude in both groups |
1) Incremental: WRpeak and VO2peak, 2) VEpeak, HRpeak and LAT 3) Modified Borg’s scale |
| Puhan 19 | COPD | Switzerland, supervised inpatient PR | 86 | 69 year, 29% M for IET, 36%M for CET | 34% | 20 s cycling (100% WR peak) alternating with 40 s (20 % WR peak) for 20 min session | Cycling (60% WR peak) for 20 min | 3 × wks (included 12 to 15 sessions), 4 × wk, 24 min session, total duration 5 weeks of PR, progression: WR increased by 10% of baseline for each group | 1) Incremental, steep ramp test: WRpeak 2) Not assessed 3) CRQ - all domains |
| Arnardottir 23 | COPD | Sweden, supervised outpatient PR |
60 | 43 to 80 year, 13%M | 14% To 59% |
180 s cycling (80% WR peak) alternating with 180 s (40% WR peak) for 27 min | Cycling (65% WR peak) for 27 min | 16 wks, 2 × wk (1 day/week) calisthenics, 1 day/week resistance training and relaxation, progression performed but not explicitly explained |
1) Incremental cycle test, semi-steady state cardiopulmonary test: WRpeak and VO2peak 2) VEpeak and HRpeak 3) Borg dyspnoea (CR-10) and RPE |
| Varga 22 | COPD | Hungary, supervised outpatient PR | 79 (only 39 randomised in groups) | 64 year, 77%M | 57% | 120 s (90% WR peak) cycling alternating with 60 s active rest (50% WR peak) for 30 min | Cycling (80% WR peak) for 30 min or self-paced training: Unsupervised self-paced group on cycle, walk and climb stairs in own environment |
8 wks, 3 × wk, 45 min per session, progression of exercise duration targeted to 45 min, but proportion and Frequency of progression not explicitly explained |
1) Incremental: PWR and VO2peak 2) VEpeak, HRpeak and LAT 3) Borg (CR-10) scores of dyspnoea and RPE |
| Mador 24 | COPD | New York, Veterans Affairs New York healthcare, supervised outpatient PR |
41 | 72 year, 80%M |
45% | Cycling and treadmill: 60 s (150% WR peak) alternating with 120 s (75% WR peak) for 21 min, total training duration 42 min/session | Cycling (50% WR peak) for 20 min and treadmill at 80% of average speed in 6MWT and 0% elevation (20 min), total training duration 40 min | Cycle and treadmill: 8 wks, 3 × wk, stretching, calisthenics, 1-h/wk education, 21 min duration, 24 sessions, progression in both groups: Cycling WR increased by 10% and treadmill speed increased by 5%–10% | 1) Incremental: WRpeak and VO2peak 2) VEpeak and HRpeak 3) CRQ - all domains |
| Nasis 21 | COPD | Greece, supervised outpatient PR | 42 | 66 year, 78%M | 42% | 30 s cycling at (100% WR peak) alternated with 30 s rest for 40 min per session | Cycling (60% WR peak) for 30 min per session | 10 wks, 3 × wk plus education and breathing exercises weekly increase of total work rate for each group not explicitly explained | 1) Incremental: WR peak 3) Borg (CR-10) dyspnoea and RPE (leg fatigue) |
| Gloeckl 17 | LT candidates | Germany, supervised inpatient PR | 60 | 53 ± 6 year, 47%M | 25 ± 8% | 30 s cycling alternating with 30 s rest. Resistance exercises | Cycling (60 % WR peak), resistance exercises | 3 × wks, 5–6 × wk | 1) Incremental: WRpeak 2) Not assessed 3) Modified Borg’s scale (0–10) |
| Bronstad 26 | COPD | Norway, supervised outpatient PR |
20 | 64 year, 70%M | 52,8 ± 11% | Uphill treadmill walking: 90% HR peak, 38 min (intervals of 4 min: 4 min) | Treadmill uphill walking (70% HR peak) for 47 min | 10 wks, 3 × wk | 1) Ramp protocol: VO2peak 2) VEpeak, HRpeak and LAT 3) Not assessed |
| Rizk 20 | COPD | Canada, supervised inpatient programme | 35 | 68 year, 35%M | 60.2 ± 15.8% | 30 s intervals at the 100% WR peak alternating with 30 s | Cycling HR (equivalent to HR reached at 80% WR peak) for 25 min | 12 wks, 3 × wk, 3 groups of exercise, continuous, high intensity, continuous ventilatory threshold, interval. 10 min warm up (5 min unloaded pedalling + 5 min progressively increasing load) + 5 min cool down |
1) Incremental: WR peak and VO2peak 2) VEpeak and HRpeak 3) Borg’s scale (0–10) |
| Kaltsakas 15 | CF | Greece, structured, outpatient hospital-based PR programme | 24 | 32 year, 54%M | 46% | 30 min high intensity IET (100% WR peak for 30 s alternated with 40% WR peak for 30 s | Cycling (70% WR peak) for 30 min | 12 wks, 3 × wk | 1) Incremental: WRpeak and VO2peak 2) VEpeak and HRpeak 3 Modified Borg’s scale |
| Ercin 25 | COPD | Turkey, supervised outpatient PR | 69 | 60 year, 78% | 55 ± 11% | wk 1–2: Cycling for 30 s at 100% WR peak alternating with 30 s rest, wk 3–8: 30 s at 120 % WR peak progressively to 140% WR peak alternating with 30 s rest | wk 1–2: 50% WR peak, wk 3–4: 60% WR peak, wk 5–8: 70% WR peak cycling for 3 min | 8 × wks, 3 × wk, 30 min sessions | 1) Incremental: WRpeak and VO2peak 2) VEpeak and HRpeak 3) Borg’s scale |
F: female, M: male, IET: Interval exercise training, CET: continuous exercise training, wks: weeks, CWR: constant work rate, WR peak: peak work rate CRQ: chronic respiratory disease questionnaire, RPE: ratings for perceived exertion, LAT: lactate threshold, PR: pulmonary rehabilitation programme, RCT: randomised control trial.