Eccentric cycling for chronic respiratory disease: Does helmet ventilation add value? A randomized controlled trial

Background Chronic respiratory diseases frequently cause a decrease in physical activity and lower exercise tolerance. Eccentric Cycling Training (ECT) offers a potential rehabilitation strategy. However, its effectiveness when combined with Helmet Ventilation (HV) is not fully established. Methods This nonblinded randomized controlled trial (RCT) investigated the effects of ECT with or without HV in individuals with chronic respiratory diseases. Participants were randomly assigned to the ECT, ECT-HV, or control group and underwent graded exercise testing. The ECT sessions spanned 9 weeks with gradually increasing intensity. The primary outcome was peak oxygen consumption (VO 2peak ). Secondary outcomes included functional tests and symptom scores. Results Forty-four patients with chronic respiratory diseases were enrolled and divided among the ECT (n = 13), ECT-HV (n = 15), and control (n = 13) groups. After 9 weeks, significant improvements in the 6-min walk test (6MWT) distance, energy expenditure index during the 6MWT, and timed up and go test were observed in both the ECT and ECT-HV groups compared to the control group. Reductions in initially high Borg leg fatigue were noted over time in these groups. VO 2peak at follow-up was 17.6 ± 2.9 ml/min/kg in the control group, 17.2 ± 4.5 ml/min/kg in the ECT group, and 18.2 ± 3.9 ml/min/kg in the ECT-HV group, with no significant differences among groups. No significant differences in achieving the targeted exercise intensity were found between the ECT and ECT-HV groups. Conclusions Over a 9-week period, eccentric cycling training improved functional capacity and mobility in patients with chronic respiratory diseases, although no significant changes were observed in peak oxygen consumption or overall cardiopulmonary fitness.