Clinical Research Directory

Effectiveness of Eccentric Cycling Exercise in Ambulatory Rehabilitation for Patients With Cardiopulmonary Diseases: A Pragmatic Randomized Controlled Trial

In eccentric cycling exercise (ECC), the cyclist must oppose backwards moving pedals on a specialized motor-driven ergometer. Throughout this process, the force applied on the pedals exceeds the torque generated by the lengthening muscle (negative work), concurrently generating and storing elastic recoil energy . During ECC the cyclist is able to reach fourfold higher forces compared to conventional concentric cycling exercise (CON). At identical work-rates however, ECC is associated with a lower cardiac output 5 and requires up to 80% less oxygen uptake than CON. Hence, ECC is described as a promising and efficient exercise method with low metabolic costs. ECC exhibits greater effectiveness compared to CON, especially in terms of increasing muscle strength, muscle hypertrophy, six-minute walk distance (6MWD). Acute studies during cycle ergometries have proven that ECC is effective to provide exercise at beneficial levels with low metabolic demand, even at low intensities in patients with chronic cardiopulmonary conditions, such as pulmonary hypertension or COPD. However, whether these benefits can be achieved in a real world setting such as an ambulatory rehabilitation is unknown. Therefore, the rational of the study is to evaluate the effectiveness of ECC vs. standard training in healthy individuals during a three-month time period.