Exercise & Training

Measured and supervised physical exercise for older individuals with asthma, chronic obstructive pulmonary disease and obstructive sleep apnoea (MIOLI): protocol of a randomised controlled trial.

TL;DR

This paper describes the protocol for a single-blinded, parallel-group randomised controlled trial (MIOLI) investigating the effects of a 12-week supervised Nordic walking and resistance/balance/mobility training programme on physical fitness, functional capacity, respiratory health, physical activity, and quality of life in adults aged 55-80 years with asthma, COPD, and/or obstructive sleep apnoea.

Key Findings

The MIOLI trial targets older adults with one or more of three prevalent chronic respiratory diseases: asthma, COPD, and obstructive sleep apnoea (OSA).

  • Asthma, COPD, and OSA are described as 'prevalent chronic respiratory diseases associated with increased comorbidity, mortality and healthcare costs.'
  • The trial will recruit adults aged 55-80 years diagnosed with asthma and/or COPD and/or OSA.
  • Recruitment is based in the Northern Savo region of Finland.
  • The paper notes that 'physical activity and exercise are widely recommended as part of treatment for these conditions, yet the specific effects of Nordic walking (NW) remain underexplored.'

The trial will enrol 100 participants who will be randomly allocated to either an intervention group or a control group in a parallel-group design.

  • Target sample size is 100 adults aged 55-80 years.
  • The design is described as 'single-blinded, parallel-group RCT.'
  • Participants will be randomly allocated to the intervention or control group.
  • The control group will 'continue their usual physical activity and receive physical activity guidance after 12 weeks.'

The intervention consists of a 12-week supervised exercise programme combining progressive Nordic walking twice per week with resistance, balance and mobility training once per week.

  • The programme is 12 weeks (3 months) in duration.
  • Nordic walking (NW) sessions are scheduled twice per week and described as 'progressive.'
  • Resistance, balance and mobility training is scheduled once per week.
  • The intervention is described as 'group-based.'

The primary outcome of the trial is change in cardiorespiratory endurance, with multiple secondary outcomes also assessed.

  • The primary outcome is 'a change in cardiorespiratory endurance.'
  • Secondary outcomes include 'functional capacity, physical activity level, spirometry parameters and quality of life.'
  • Measurements are conducted at three time points: baseline, 3 months, and 9 months.
  • Data will be analysed according to the intention-to-treat principle.
  • Group differences over time will be examined using 'appropriate parametric or non-parametric methods depending on data distribution.'

The trial received ethical approval and has been registered in an international trial registry.

  • Ethical approval was obtained from 'the Regional Medical Research Ethics Committee of Eastern Finland Collaborative Area (892/13.00/2023).'
  • The trial is registered at ISRCTN12097135.
  • Registration date was 7 June 2024.
  • Findings will be disseminated through peer-reviewed journal publications and scientific conference presentations.

What This Means

This paper describes the design and plan (protocol) for a clinical trial called MIOLI, which has not yet reported results. The study aims to test whether a structured, supervised exercise programme—combining Nordic walking (walking with poles, similar to cross-country skiing technique) with strength, balance, and mobility exercises—can benefit older adults who have one or more chronic respiratory conditions: asthma, chronic obstructive pulmonary disease (COPD), or obstructive sleep apnoea (OSA). These conditions are common, often occur together, and are linked to worse health outcomes and higher healthcare costs. While exercise is generally recommended for people with these conditions, the specific benefits of Nordic walking in this population have not been well studied. The trial plans to recruit 100 adults aged 55 to 80 in Finland and randomly assign them to either participate in the 12-week exercise programme (three sessions per week) or continue their usual activities. The main thing researchers will measure is whether cardiorespiratory fitness—essentially how well the heart and lungs work during physical activity—improves. They will also measure functional ability, how physically active participants are day-to-day, lung function, and quality of life. Measurements will be taken at the start, after 3 months, and again at 9 months to see if any benefits are maintained. This research suggests that if proven effective, a structured Nordic walking programme could become a practical, accessible exercise option for older people managing chronic respiratory diseases. Because this paper only describes the study plan and not yet the results, no conclusions about whether the intervention actually works can be drawn at this stage. The results, when published, may help inform exercise recommendations for this growing population of older adults with respiratory conditions.

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Citation

Äijö M, Komulainen P, Lönnroos E, Lindholm H, Hiltunen S, Tikkanen H, et al.. (2026). Measured and supervised physical exercise for older individuals with asthma, chronic obstructive pulmonary disease and obstructive sleep apnoea (MIOLI): protocol of a randomised controlled trial.. BMJ open. https://doi.org/10.1136/bmjopen-2026-118045