Comparison of the effects of one-legged and two-legged exercisetraining on exercise capacity and fatigue in patients withsarcoidosis

Introduction: Sarcoidosis is a restrictive lung disease within the group of interstitial lung diseases (ILDs) characterized by inflammatory, granulomatous involvement of multiple organs. Objective: This study aims to compare the effects of one-legged and two-legged cycling exercises on exercise capacity, fatigue, muscle strength, and quality of life in patients with stage 2-3-4 pulmonary sarcoidosis. Method: Twenty-six participants diagnosed with stage 2-3-4 pulmonary sarcoidosis were randomly divided into two groups: the one-legged bicycle exercise group (n=13) and the twolegged bicycle exercise group (n=13), and they were included in an 8-week exercise training program. Both groups received bicycle exercise training for 40 minutes, twice a week. Participants were evaluated before and after the exercise training using the 6-Minute Walk Test (6 MWT), Incremental Shuttle Walk Test (ISWT), Endurance Shuttle Walk Test (ESWT), Fatigue Assessment Scale (FAS), Multidimensional Fatigue Inventory (MFI), Leicester Cough Questionnaire (LCQ) blood lactate levels, St. George's Respiratory Questionnaire (SGRQ), Medical Research Council Scale (MRC), and Handheld Dynamometer (quadriceps, tibialis anterior, gastrosoleus). Results: Significant improvements were observed in the one-legged bicycle exercise group after treatment, including in the 6-Minute Walk Test distance (6 MWD), FAS, MFI, quadriceps femoris (right/left), tibialis anterior (right/left), gastrosoleus muscle strength (right/left), SGRQ, and LCQ results (p<0.05). On the other hand, in the two-legged bicycle exercise group, improvements were observed in the FAS, MFI, quadriceps femoris (right/left), tibialis anterior (right/left), gastrosoleus (right/left) muscle strength, and the symptom subscale of the SGRQ (p<0.05). Comparing the results of both groups after the treatment program, a statistically significant difference was found only in the activity subscale and total score of the SGRQ (p=0.012, p=0.043). Conclusion: The study demonstrated that one-legged and two-legged bicycle exercises have similar effects in the management of sarcoidosis. Both exercise methods have positive effects on fatigue, exercise capacity, quality of life, and peripheral muscle strength.