To review studies comparing the effects of high-intensity and moderate-intensity training on interstitial lung disease and to identify differences in effectiveness.
Following the PRISMA guidelines for scoping reviews, we systematically searched databases including MEDLINE (PubMed), CENTRAL (Cochrane Library), Ichushi, and AI search engines (Perplexity AI, Elicit, ResearchRabbit, Scite.AI). The search terms used were "interstitial lung disease" as the patient condition and "high-intensity training" and "high-intensity interval training" as concepts.
Preliminary searches identified 439 articles. After screening titles, abstracts, and full texts, three studies were selected.
Nikoletou D et al randomized 58 subjects with interstitial lung disease to high-intensity interval training (HIIT: 80% of maximal heart rate) or moderate interval training (MICT:60% of maximal heart rate). Results showed no difference between HIIT and MICT in terms of exercise tolerance, respiration, and physical function, but MICT was superior in terms of sustained effect.
Leona M et al. studied nine ILD patients using a crossover design involving HIIT (100% workload (Wpeak) with rest), MICT (80% Wpeak and 40% Wpeak with 2-minute intervals), and moderate continuous exercise (60% Wpeak). No significant differences were observed in total workload, exercise time, or oxygen saturation, although HIIT tended to have less decrease in oxygen saturation. Approximately 70% of participants preferred HIIT.
Wickerson L et al. examined nine ILD patients awaiting lung transplantation using a crossover design comparing HIIT (100% Wpeak for 30 seconds with 30 seconds rest for 20 minutes) and moderate continuous exercise (50% Wpeak for 20 minutes). HIIT resulted in significantly lower maximum heart rates and tended to have less oxygen saturation decline, dyspnea, perceived exertion, and lower limb fatigue, with most participants favoring HIIT.
The scoping review indicates that while high-intensity interval training (HIIT) shows some benefits over moderate-intensity training in terms of patient preference and reduced symptoms, the overall effectiveness in exercise tolerance and long-term outcomes is comparable. Moderate-intensity training may offer better sustainability of benefits.
HIIT may be a favorable option for ILD rehabilitation, especially considering patient preference and symptom management. However, moderate-intensity training should not be overlooked, as it may offer better long-term effectiveness. Further research is needed to better understand these approaches and to tailor rehabilitation strategies for optimal patient outcomes.
High-Intensity and Moderate-Intensity Exercise
A Scoping Review
