The acute impact of resistance training on fatigue in patients with pulmonary sarcoidosis

Fatigue is the most prevalent symptom among patients with sarcoidosis, and skeletal muscle dysfunction is a common clinical feature, making resistance training (RT) a recommended treatment strategy. Despite lacking knowledge regarding whether high-intensity RT will aggravate fatigue, low to moderate-intensity is routinely used even if the evidence for this protocol to improve muscle strength is inconclusive. This study aimed to investigate whether one single session of high-intensity RT induces a higher increase in fatigue than one single session of moderate-intensity RT. In this randomized crossover study, 41 patients with pulmonary sarcoidosis (age: 53 +/- 11 yr) were recruited. They randomly performed one single session of high-intensity RT, 4 sets x 5 repetitions maximum (5RM), and one single session of moderate-intensity RT, 2 sets x 25 RM. Fatigue was assessed with the Visual Analogue Scale (0-100 mm) immediately before (T0), immediately after (T1) and 24 hours after (T2) each exercise session. Fatigue development from T0 to T1 was significantly lower after 5RM (-3 +/- 18 mm) than after 25RM (5 +/- 15 mm), p = 0.004. No difference was seen from T0 to T2 between 5RM (0 +/- 17 mm) and 25RM (6 +/- 18 mm), p = 0.147. The high-intensity 5RM session did not induce a larger increase in fatigue than the moderate-intensity 25RM session. RT appears feasible and safe in patients with pulmonary sarcoidosis irrespective of the intensity. Thus, the long-term effects of high-intensity RT on fatigue should be explored in a RT programme of longer duration.