Telerehabilitation in cystic fibrosis: a randomized clinical trial protocol for increasing exercise loads and...

Individuals with cystic fibrosis (CF) often face respiratory and gastrointestinal impairments, leading to muscle loss and altered exercise responses. Despite exercise recommendations, this population still lacks structured protocols with progressive load increments, making training adaptation challenging. In this context, telerehabilitation emerges as a promising alternative for remote supervision, improving adherence, and enabling personalized adjustments. Thus, this study aims to develop and test an exercise protocol for progressive load increment and increased exercise difficulty in individuals with CF through telerehabilitation.

This prospective clinical study will compare two randomized groups: a control group receiving general CF outpatient guidance and an experimental group following a structured exercise protocol with progressive load increments. Exercises will be performed for 40 min/day, three times/week for 12 weeks. Primary outcomes include distance covered (6-Minute Walk Test), muscle strength (Handgrip Strength Test), pulmonary function, fatigue levels (FACIT-Fatigue Questionnaire), and quality of life. Inflammatory biomarkers will be quantified from saliva and peripheral blood samples. All outcomes will be assessed before and after the protocol. Participants will receive initial instructions and instructional videos via a messaging app, which will also transmit vital signs and physical effort data. Biweekly online meetings will monitor exercise execution and guide load progression.

Physical exercise promotes airway clearance, improves pulmonary and functional capacity, and enhances the quality of life. With respect to patients with CF, little is known about exercise recommendations and how exercise and load progression should proceed, especially through telerehabilitation. This study provided data about exercise guidance provided remotely (telerehabilitation) to the study participants.

Brazilian Registry of Clinical Trials (REBEC; U1111-1277-5378). Registered on November 9, 2022.