TITLE: Randomized controlled trial of exercise training in chronic respiratory failure due to kyphoscoliosis

Background: Research has provided evidence for the safety, feasibility, and efficacy of exercise training in patients with chronic obstructive pulmonary disease. However, little is known about the impact of exercise training in patients with chronic respiratory failure due to kyphoscoliosis. The objective of the current study was to evaluate the effect of an exercise training program on exercise capacity, muscle strength, dyspnea and quality of life indices, in patients with chronic respiratory failure due to kyphoscoliosis. . Methods: Clinically stable patients with chronic respiratory failure due to kyphoscoliosis (n=34), receiving home mechanical ventilation during the night for the previous six months, were randomly assigned to an exercise (n = 17) or control (n = 17) group. The exercise group trained three nonconsecutive days per week for 12 weeks, including cycle and strength exercises. The study outcomes were changes in pulmonary function, exercise capacity, peripheral muscle strength, dyspnea scores, and quality of life from baseline to post-intervention. Results: Statistical analysis was carried out in 16 patients in the exercise group and in 11 patients in the control group. Lung function parameters did not change from baseline to post-intervention, with the exception of arterial carbon dioxide (p = 0.04), inspiratory (p = 0.025) and expiratory pressures (p = 0.04). In the exercise group, endurance time (p=0.002) and shuttle walking distance (p=0.001) increased significantly. Improvements occurred in the exercise group in peripheral muscle strength, dyspnea, and quality of life were statistically different when compared to the control group. Conclusions: In patients with chronic respiratory failure due to kyphoscoliosis, exercise training had beneficial effects on exercise capacity and peripheral muscle strength, resulting in less dyspnea and better quality of life.