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Completed

NCT Number: NCT07042750

Eccentric Cycling Exercise During Pulmonary Rehabilitation in Patients With Cardiopulmonary Diseases

Eccentric cycling exercise (ECC) allows training at low metabolic costs and may therefore be valuable for patients with pulmonary vascular disease (PVD). For these patients, regular exercise training has an evidence level 1A recommendation in the current guidelines. Exercise training during longer and regular periods provides chronic adaptation, for which ECC was recently found to have a greater effectiveness than CON by increasing muscle strength, hypertrophy, six-minute walking distance and furthermore, by increasing maximum oxygen uptake (V'O2max) especially in patients with chronic obstructive pulmonary disease (COPD), chronic left heart failure or coronary heart disease. Furthermore, we conducted an RCT in which we exposed patients with PVD to ECC and concluded that ECC is a feasible and well-tolerated exercise modality for PVD patients with severely lower O2 demand and load to the right ventricle. The study in patients with PVD was started (EccRehab), and the great potential was recognized. Therefore there was an indication to open the inclusion criteria to all cardiopulmonary patients with indication for pulmonary rehabilitation (EccRehab2).

For this purpose, the aim of this project is to investigate whether ECC improves exercise capacity and possibly hemodynamics during prolonged rehabilitation programs in patients with cardiopulmonary diseases.

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Key information

Conditions

Eccentric Exercise Training

Age range

18 year–85 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Klinik Barmelweid, Barmelweid, Switzerland

Loading trial locations.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Diagnosed with PVD, either PAH or CTEPH via right heart catheterization, according to recent guidelines [9]
  • Diagnosed with a cardiopulmonary disease as indication for a pulmonary rehabilitation
  • Stable medication for at least 1 month
  • Age 18years to 85 years
  • No resting hypoxemia (PaO2 >7.3 kPa)
  • Medical indication to prescibe a pulmonary rehabilitation

Exclusion criteria

  • Any co-morbidity that limits the patient to participate the full rehabilitation
  • Enrollments in other trials with active treatments
  • Language barriers that limits the patient to participate in the rehabilitation

Treatment and study plan

Eccentric cycling exercise

Other

Patients perform eccentric cycling exercise instead of normal cycling exercise in addition to standard car during a cardiopulmonary rehabilitation

Standard Care Arm

Other

Patients perform cardiopulmonary rehabilitation according to standard care

Primary outcomes

  1. Peak exercise performance [Watts]

    Time frame: At baseline pre-intervention and immediately after three weeks of rehabilitation

    Peak exercise performance is measured during cardiopulmonary exercise tests on a cycle ergometer. The Unit of the measurement is watts.

Secondary outcomes

  1. Peak oxygen uptake [L/min]

    Time frame: At baseline pre-intervention and immediately after three weeks of rehabilitation

    Peak oxygen uptake is measured during cardiopulmonary exercise tests on a cycle ergometer. The Unit of the measurement is liters per minute.

  2. Ventilatory equivalents for carbon dioxide (Minute ventilation / carbon dioxide output)

    Time frame: At baseline pre-intervention and immediately after three weeks of rehabilitation

    Ventilatory equivalents for carbon dioxide is measured during cardiopulmonary exercise tests on a cycle ergometer. The measurement is a ratio without a unit (VE/VCO2).

  3. Six minute walk distance [meters]

    Time frame: At baseline pre-intervention and immediately after three weeks of rehabilitation

    The maximal distance that a patient is able to walk within six minutes. The unit of the measurement is meters.

  4. Knee extension test [repetitions]

    Time frame: At baseline pre-intervention and immediately after three weeks of rehabilitation

    The patients has to stad up from a chair and sit down as often the patient is able to do this within 1 minute. The unit of the measurement is repetitions.

  5. Systolic pulmonary arterial pressure [mmHg]

    Time frame: At baseline pre-intervention and immediately after three weeks of rehabilitation

    The sytolic pulmonary arterial pressure is measured by echocardiography using continuous wave doppler at the tricuspid valve. The unit of the measurement is mmHg.

  6. Total pulmonary reistance [Wood units]

    Time frame: At baseline pre-intervention and immediately after three weeks of rehabilitation

    The total pulmonary resistance is measured by echocardiography by dividing the systolic pulmonary arterial pressure by the cardiac output. The unit of the measurement is woos units.

  7. Right ventricular to arterial coupling [mm/mmHg]

    Time frame: At baseline pre-intervention and immediately after three weeks of rehabilitation

    The right ventricular arterial coupling is measured by echocardiography dividing the tricuspid annular plane systolic excursion by the systolic arterial pressure. the unit is mm/mmHg.

  8. Cardiac output [L/min]

    Time frame: At baseline pre-intervention and immediately after three weeks of rehabilitation

    The cardiac output is measured by echocardiography using the left ventricular outflow tract velocity time integral assessed by pulse wave doppler. The unit of the measurement is L/min.

  9. Arterial partial pressure for oxygen [kPa]

    Time frame: At baseline pre-intervention and immediately after three weeks of rehabilitation

    The arterial partial pressure for oxygen is measured by taking a arterial blood sample from the arteria radialis at peak exercise and analyze it in a radiometer. The unit of the measurement is kPa.

  10. Arterial partial pressure for carbon dioxide [kPa]

    Time frame: At baseline pre-intervention and immediately after three weeks of rehabilitation

    The arterial partial pressure for carbon dioxide is measured by taking a arterial blood sample from the arteria radialis at peak exercise and analyze it in a radiometer. The unit of the measurement is kPa.

  11. Arterial oxygen saturation [%]

    Time frame: At baseline pre-intervention and immediately after three weeks of rehabilitation

    The arterial oxygen saturation is measured by taking a arterial blood sample from the arteria radialis at peak exercise and analyze it in a radiometer. The unit of the measurement is %.

  12. Patient reported leg fatigue [scale from 1 to 10]

    Time frame: At baseline pre-intervention and immediately after three weeks of rehabilitation

    Patients perceived leg fatigue is assessed at peak exercise on the Borg CR 10 scale. The unit of the measurement is a scale from 1 to 10.

  13. Patient reported dyspnea [scale from 1 to 10]

    Time frame: At baseline pre-intervention and immediately after three weeks of rehabilitation

    Patients perceived dyspnea is assessed at peak exercise on the Borg CR 10 scale. The unit of the measurement is a scale from 1 to 10.

  14. Patient reported quality of life [cm]

    Time frame: At baseline pre-intervention and immediately after three weeks of rehabilitation

    The patient reported quality of life is assessed by the visual analogue scale, where the patient has to draw on a 10 cm long line where left is "bad" and right is "very good". The unit of the measurement is cm.

Sponsors and collaborators

Lead sponsor

Silvia Ulrich Somaini

Other

Collaborators

  • Klinik Barmelweid

Registry information

Important dates

Study start
2025
Primary completion
2026
Study completion
2026
First posted
Jun 29, 2025
Registry last updated
Jul 7, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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