Sarcoidosis; fatigue and exercise

Abstract

Fatigue is the most common symptom amongst patients with sarcoidosis. As reduced exercise capacity and muscle strength is highly prevalent as well, exercise training is recommended.

Since the impact of high-intensity exercise training on fatigue in patients with pulmonary sarcoidosis has not been explored, moderate intensity exercise training has commonly been used. But will high-intensity exercise worsen fatigue? The aims of the thesis were to investigate the impact of one single session of high-intensity compared to one single session of moderate-intensity on fatigue, for both endurance and resistance training using a cross-over design. Thereafter, to evaluate the impact on fatigue and exercise capacity (VO2peak) following a 4-week pulmonary rehabilitation program using a one group pre-post design. There was no significantly difference in fatigue following one single session of high-intensity versus moderate-intensity endurance exercise training. A statistically significant increase in fatigue was seen immediately after the moderate-intensity resistance training session compared to the high-intensity session. However, the fatigue development did not reach a clinically relevant level. Four weeks pulmonary rehabilitation improved exercise capacity (p = 0.002) and decreased fatigue (p = 0.009) significantly. Interestingly, patients with a higher level of baseline fatigue showed a larger improvement in exercise capacity following four weeks rehabilitation. Overall, both high-intensity endurance and resistance training appears to be well tolerated by patients with pulmonary sarcoidosis without worsening fatigue. Further, four weeks rehabilitation improved exercise capacity and decreased fatigue, where a high baseline fatigue score was related to a higher improvement in exercise capacity. The results will provide physiotherapists and patients with sarcoidosis reassuring knowledge that exercise training with high-intensity is well tolerated and does not worsen fatigue.