Home-based remotely-supervised high-intensity interval training and cardiorespiratory fitness in children and adolescents with post-infectious bronchiolitis obliterans: a randomized controlled trial.

INTRODUCTION

While high-intensity interval training (HIIT) has shown effectiveness in improving cardiorespiratory fitness (CRF) across various chronic respiratory diseases, its impacts on individuals with post-infectious bronchiolitis obliterans (PIBO) remain unexplored.

AIM: To assess the effects of a home-based remotely-supervised HIIT programme on CRF, clinical and functional variables in patients with PIBO.

METHODS

Participants of this assessor-blinded, multicentre, randomized controlled trial were individuals with PIBO aged 6 to 20 years. An exercise group (EXE) underwent two 40-min sessions of HIIT remotely supervised in real time per week. Sessions were continued for 16 weeks. The control group (CON) adhered to general physical activity recommendations. The primary outcome was peak oxygen consumption (VO2peak), time to ventilatory threshold (VT1), percentage of VO2 at VT1, and ventilatory equivalent for carbon dioxide, determined via cardiopulmonary exercise testing on a treadmill. Secondary outcomes were lung function (spirometry), muscle strength (dynamometry), functional capacity (30-second Sit-To-Stand test), body mass index, and Saint George Respiratory Questionnaire.

RESULTS

Fifty-one PIBO patients were enrolled (EXE=25; CON=26) (mean age 13.3±4.2 years; females 49%; FEV1 -3.56±1.28 (z-score); VO2peak 36.8±8.6 mL.kg-1.min-1). The HIIT intervention resulted in improvements in VO2peak (Δ=3.39; p=0.04), time (min) to VT1 (Δ=1.05; p=0.04), and in the number of repetitions in the 30s-STS (Δ=2.21; p=0.04). No differences were found in the other variables.

CONCLUSIONS

Our real-time, remotely-supervised HIIT intervention was effective at significantly increasing CRF and functional capacity in children and adolescents with PIBO.