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Kohlbrenner D, Kuhn M, Manettas A, Aregger C, Peterer M, Greco N, Sievi NA, Clarenbach C. Low-load blood flow restriction strength training in patients with COPD: a randomised single-blind pilot study. Thorax 2024; 79:340-348. [PMID: 38129116 PMCID: PMC10958309 DOI: 10.1136/thorax-2023-220546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 11/18/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVE The objective of this study is to compare the effectiveness of lower limb low-load blood flow restriction training (LL-BFRT) with high-load strength training (HL-ST) as part of an outpatient pulmonary rehabilitation programme on leg strength in patients with chronic obstructive pulmonary disease (COPD). METHODS Participants were randomised to LL-BFRT or HL-ST (24 sessions). LL-BFRT was done at 30% 1-repetition maximum (1-RM) with 70% arterial occlusion pressure. HL-ST was done at 70% 1-RM. Primary outcome was isometric strength of knee extensors and flexors. Secondary outcomes were 1-RM, functional exercise capacity, physical activity, symptom burden and health-related quality of life. Perceptions of dyspnoea and leg fatigue were recorded after every exercise. We compared groups with t-tests. RESULTS We included 30 participants (13 women, 17 men, 64 (9) years, forced expiratory volume in 1 s 47 (18)% pred.), 24 completed the study. Isometric knee extensor strength improved to a clinically relevant degree in both legs in both groups (LL-BFRT: right leg 9 (20) Nm, left leg 10 (18) Nm; HL-ST: right leg 15 (26) Nm, left leg 16 (30) Nm, data are mean (SD)), without statistically significant or clinically relevant between-group differences (right leg mean difference= -6.4, 95% CI= -13.20 to 25.92 Nm, left leg mean difference= -5.6, 95% CI= -15.44 to 26.55 Nm). 1 min sit-to-stand test performance improved to a clinically relevant degree only in the LL-BFRT group (4 (4) vs 1 (5) repetitions). Interestingly, physical activity improved to a clinically relevant degree only in the LL-BFRT group (1506 (2441) vs -182 (1971) steps/day). LL-BFRT lowered perceived in-exercise dyspnoea and increased leg fatigue compared with HL-ST in the initial 12 trainings. CONCLUSION In patients with stable COPD undergoing outpatient pulmonary rehabilitation, LL-BFRT was not superior to HL-ST in improving leg strength. LL-BFRT led to similar strength gains as HL-ST while reducing perceptions of dyspnoea in the initial training phase. TRIAL REGISTRATION NUMBER NCT04151771.
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Affiliation(s)
- Dario Kohlbrenner
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
- Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland
| | - Manuel Kuhn
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
- Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland
| | - Anastasios Manettas
- Physiotherapy Occupational Therapy, University Hospital Zurich, Zurich, Switzerland
- Biomechanics and Ergonomics, ErgoMech Laboratory, Department of Physical Education and Sport Science, University of Thessaly, Trikala, Greece
| | - Céline Aregger
- Physiotherapy Occupational Therapy, University Hospital Zurich, Zurich, Switzerland
| | - Matthias Peterer
- Physiotherapy Occupational Therapy, University Hospital Zurich, Zurich, Switzerland
| | - Nicola Greco
- Physiotherapy Occupational Therapy, University Hospital Zurich, Zurich, Switzerland
| | - Noriane A Sievi
- Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland
| | - Christian Clarenbach
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
- Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland
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Jo S, Jeon J, Park G, Do HK, Kang J, Ahn KJ, Ma SY, Choi YM, Kim D, Youn B, Ki Y. Aerobic Exercise Improves Radiation Therapy Efficacy in Non-Small Cell Lung Cancer: Preclinical Study Using a Xenograft Mouse Model. Int J Mol Sci 2024; 25:2757. [PMID: 38474004 DOI: 10.3390/ijms25052757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 02/15/2024] [Accepted: 02/22/2024] [Indexed: 03/14/2024] Open
Abstract
The "oxygen effect" improves radiation efficacy; thus, tumor cell oxygen concentration is a crucial factor for improving lung cancer treatment. In the current study, we aimed to identify aerobic exercise-induced changes in oxygen concentrations in non-small cell lung cancer (NSCLC) cells. To this end, an NSCLC xenograft mouse model was established using human A549 cells. Animals were subsequently subjected to aerobic exercise and radiation three times per week for 2 weeks. Aerobic exercise was performed at a speed of 8.0 m/m for 30 min, and the tumor was irradiated with 2 Gy of 6 MV X-rays (total radiation dose 12 Gy). Combined aerobic exercise and radiation reduced NSCLC cell growth. In addition, the positive effect of aerobic exercise on radiation efficacy through oxygenation of tumor cells was confirmed based on hypoxia-inducible factor-1 and carbonic anhydrase IX expression. Finally, whole-transcriptome analysis revealed the key factors that induce oxygenation in NSCLC cells when aerobic exercise was combined with radiation. Taken together, these results indicate that aerobic exercise improves the effectiveness of radiation in the treatment of NSCLC. This preclinical study provides a basis for the clinical application of aerobic exercise to patients with NSCLC undergoing radiation therapy.
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Affiliation(s)
- Sunmi Jo
- Department of Radiation Oncology, Haeundae Paik Hospital, Inje University School of Medicine, Busan 48108, Republic of Korea
| | - Jaewan Jeon
- Department of Radiation Oncology, Haeundae Paik Hospital, Inje University School of Medicine, Busan 48108, Republic of Korea
| | - Geumju Park
- Department of Radiation Oncology, Haeundae Paik Hospital, Inje University School of Medicine, Busan 48108, Republic of Korea
| | - Hwan-Kwon Do
- Department of Physical Medicine and Rehabilitation, Haeundae Paik Hospital, Inje University School of Medicine, Busan 48108, Republic of Korea
| | - JiHoon Kang
- Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Ki Jung Ahn
- Department of Radiation Oncology, Busan Paik Hospital, Inje University School of Medicine, Busan 48108, Republic of Korea
| | - Sun Young Ma
- Department of Radiation Oncology, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan 49267, Republic of Korea
| | - Young Min Choi
- Department of Radiation Oncology, Dong-A University College of Medicine, Busan 49315, Republic of Korea
| | - Donghyun Kim
- Department of Radiation Oncology and Biomedical Research Institute, Pusan National University School of Medicine, Busan 49241, Republic of Korea
| | - BuHyun Youn
- Department of Biological Sciences, Pusan National University, Busan 46241, Republic of Korea
| | - Yongkan Ki
- Department of Radiation Oncology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan 50612, Republic of Korea
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Xu K, Li J, Wen R, Chang B, Cheng Y, Yi X. Role of SIRT3 in bone homeostasis and its application in preventing and treating bone diseases. Front Pharmacol 2023; 14:1248507. [PMID: 38192409 PMCID: PMC10773770 DOI: 10.3389/fphar.2023.1248507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 12/11/2023] [Indexed: 01/10/2024] Open
Abstract
Bone homeostasis refers to the balance between osteoblast-mediated bone formation and osteoclast-mediated bone resorption and the maintenance of stable bone mass. SIRT3 is a class of mitochondrial protein deacetylase that influences various mitochondrial functions and is involved in the mechanisms underlying resistance to aging; regulation of bone marrow mesenchymal stem cells, osteoblasts, and osteoclasts; and development of osteoporosis, osteoarthritis, and other bone diseases. Moreover, exercise affects bones through SIRT3. Thus, studies on SIRT3 may provide insights for the treatment of bone diseases. Although SIRT3 can exert multiple effects on bone, the specific mechanism by which it regulates bone homeostasis remains unclear. By evaluating the relevant literature, this review discusses the structure and function of SIRT3, reveals the role and associated mechanisms of SIRT3 in regulating bone homeostasis and mediating bone health during exercise, and highlights the potential pharmacological value of SIRT3 in treating bone diseases.
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Affiliation(s)
- Ke Xu
- School of Sports Health, Shenyang Sport University, Shenyang, China
| | - Jing Li
- School of Physical Education, Liaoning Normal University, Dalian, China
| | - Ruiming Wen
- School of Sports Health, Shenyang Sport University, Shenyang, China
| | - Bo Chang
- School of Sports Health, Shenyang Sport University, Shenyang, China
| | - Yang Cheng
- School of Sports Health, Shenyang Sport University, Shenyang, China
| | - Xuejie Yi
- School of Sports Health, Shenyang Sport University, Shenyang, China
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Jin F, Li Y, Gao X, Yang X, Li T, Liu S, Wei Z, Li S, Mao N, Liu H, Cai W, Xu H, Zhang H. Exercise training inhibits macrophage-derived IL-17A-CXCL5-CXCR2 inflammatory axis to attenuate pulmonary fibrosis in mice exposed to silica. Sci Total Environ 2023; 902:166443. [PMID: 37611700 DOI: 10.1016/j.scitotenv.2023.166443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 08/12/2023] [Accepted: 08/18/2023] [Indexed: 08/25/2023]
Abstract
Exposure to crystalline silica leads to health effects beyond occupational silicosis. Exercise training's potential benefits on pulmonary diseases yield inconsistent outcomes. In this study, we utilized experimental silicotic mice subjected to exercise training and pharmacological interventions, including interleukin-17A (IL-17A) neutralizing antibody or clodronate liposome for macrophage depletion. Findings reveal exercise training's ability to mitigate silicosis progression in mice by suppressing scavenger receptor B (SRB)/NOD-like receptor thermal protein domain associated protein 3 (NLRP3) and Toll-like receptor 4 (TLR4) pathways. Macrophage-derived IL-17A emerges as primary source and trigger for silica-induced pulmonary inflammation and fibrosis. Exercise training effectively inhibits IL-17A-CXC motif chemokine ligand 5 (CXCL5)-Chemokine (C-X-C motif) Receptor 2 (CXCR2) axis in silicotic mice. Our study evidences exercise training's potential to reduce collagen deposition, preserve elastic fibers, slow pulmonary fibrosis advancement, and enhance pulmonary function post silica exposure by impeding macrophage-derived IL-17A-CXCL5-CXCR2 axis.
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Affiliation(s)
- Fuyu Jin
- School of Public Health, Hebei Key Laboratory for Organ Fibrosis, North China University of Science and Technology, Tangshan, Hebei 063210, China
| | - Yaqian Li
- School of Public Health, Hebei Key Laboratory for Organ Fibrosis, North China University of Science and Technology, Tangshan, Hebei 063210, China
| | - Xuemin Gao
- School of Public Health, Hebei Key Laboratory for Organ Fibrosis, North China University of Science and Technology, Tangshan, Hebei 063210, China
| | - Xinyu Yang
- School of Public Health, Hebei Key Laboratory for Organ Fibrosis, North China University of Science and Technology, Tangshan, Hebei 063210, China
| | - Tian Li
- School of Public Health, Hebei Key Laboratory for Organ Fibrosis, North China University of Science and Technology, Tangshan, Hebei 063210, China
| | - Shupeng Liu
- School of Public Health, Hebei Key Laboratory for Organ Fibrosis, North China University of Science and Technology, Tangshan, Hebei 063210, China
| | - Zhongqiu Wei
- School of Public Health, Hebei Key Laboratory for Organ Fibrosis, North China University of Science and Technology, Tangshan, Hebei 063210, China
| | - Shifeng Li
- School of Public Health, Hebei Key Laboratory for Organ Fibrosis, North China University of Science and Technology, Tangshan, Hebei 063210, China
| | - Na Mao
- School of Public Health, Hebei Key Laboratory for Organ Fibrosis, North China University of Science and Technology, Tangshan, Hebei 063210, China
| | - Heliang Liu
- School of Public Health, Hebei Key Laboratory for Organ Fibrosis, North China University of Science and Technology, Tangshan, Hebei 063210, China.
| | - Wenchen Cai
- School of Public Health, Hebei Key Laboratory for Organ Fibrosis, North China University of Science and Technology, Tangshan, Hebei 063210, China.
| | - Hong Xu
- School of Public Health, Hebei Key Laboratory for Organ Fibrosis, North China University of Science and Technology, Tangshan, Hebei 063210, China; Health Science Center, North China University of Science and Technology, Tangshan, Hebei 063210, China.
| | - Haibo Zhang
- Department of Anesthesiology and Pain Medicine, Department of Physiology, Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada; The Keenan Research Centre for Biomedical Science of St. Michael's Hospital, Toronto, Ontario, Canada
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Donadio MVF, Barbosa MA, Vendrusculo FM, Ramirez TI, Santana-Sosa E, Sanz-Santiago V, Perez-Ruiz M. Mechanisms of ventilatory limitation to maximum exercise in children and adolescents with chronic airway diseases. Pediatr Pulmonol 2023; 58:3293-3302. [PMID: 37671821 DOI: 10.1002/ppul.26659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 08/08/2023] [Accepted: 08/19/2023] [Indexed: 09/07/2023]
Abstract
INTRODUCTION Exercise intolerance is common in chronic airway diseases (CAD), but its mechanisms are still poorly understood. The aim of this study was to evaluate exercise capacity and its association with lung function, ventilatory limitation, and ventilatory efficiency in children and adolescents with cystic fibrosis (CF) and asthma when compared to healthy controls. METHODS Cross-sectional study including patients with mild-to-moderate asthma, CF and healthy children and adolescents. Anthropometric data, lung function (spirometry) and exercise capacity (cardiopulmonary exercise testing) were evaluated. Primary outcomes were peak oxygen consumption (VO2 peak), forced expiratory volume in 1 s (FEV1 ), breathing reserve (BR), ventilatory equivalent for oxygen consumption (VE /VO2 ) and for carbon dioxide production (VE /VCO2 ), both at the ventilatory threshold (VT1 ) and peak exercise. RESULTS Mean age of 147 patients included was 11.8 ± 3.0 years. There were differences between asthmatics and CF children when compared to their healthy peers for anthropometric and lung function measurements. Asthmatics showed lower VO2 peak when compared to both healthy and CF subjects, although no differences were found between healthy and CF patients. A lower BR was found when CF patients were compared to both healthy and asthmatic. Both CF and asthmatic patients presented higher values for VE /VO2 and VE /VCO2 at VT1 when compared to healthy individuals. For both VE /VO2 and VE /VCO2 at peak exercise CF patients presented higher values when compared to their healthy peers. CONCLUSION Patients with CF achieved good exercise capacity despite low ventilatory efficiency, low BR, and reduced lung function. However, asthmatics reported reduced cardiorespiratory capacity and normal ventilatory efficiency at peak exercise. These results demonstrate differences in the mechanisms of ventilatory limitation to maximum exercise testing in children and adolescents with CAD.
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Affiliation(s)
- Márcio Vinícius Fagundes Donadio
- Department of Physiotherapy, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
- Laboratory of Pediatric Physical Activity, Infant Center, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Marta Amor Barbosa
- Department of Physiotherapy, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Fernanda Maria Vendrusculo
- Laboratory of Pediatric Physical Activity, Infant Center, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Tamara Iturriaga Ramirez
- Department of Physiotherapy, Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, Spain
| | - Elena Santana-Sosa
- Department of Physiotherapy, Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, Spain
| | - Veronica Sanz-Santiago
- Department of Pulmonology, Hospital Universitario Infantil Niño Jesús de Madrid, Madrid, Spain
| | - Margarita Perez-Ruiz
- Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences-INEF, Universidad Politécnica de Madrid (UPM), Madrid, Spain
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Fairman CM, Owens OL, Kendall KL, Steele J, Schumpp AR, Latella C, Jones MT, Marcotte L, Dawson JM, Peddle-McIntyre CMJ, McDonnell KK. Hybrid delivery of cluster-set resistance training for individuals previously treated for lung cancer: the results of a single-arm feasibility trial. Pilot Feasibility Stud 2023; 9:177. [PMID: 37848969 PMCID: PMC10580552 DOI: 10.1186/s40814-023-01405-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 10/06/2023] [Indexed: 10/19/2023] Open
Abstract
BACKGROUND Individuals with non-small cell lung cancer (NSCLC) are burdened by long-lasting symptoms (e.g., dyspnea and fatigue) post-treatment. These symptoms often reduce physical activity levels and increase the risk of functional decline. Though we have previously proposed cluster-set resistance training to mitigate symptom burden in lung cancer, there is currently no data on the feasibility or acceptability of this mode of exercise in cancer. Therefore, the purpose of this study was to investigate the feasibility and acceptability of a hybrid-delivery home-based cluster-set resistance training program in individuals with NSCLC stages I-III (i.e., early stage). METHODS This study aimed to recruit individuals with NSCLC stages I-III post-treatment to participate in 8 weeks of home-based resistance training, 3 days per week. The program included supervised sessions in the participants' homes and virtual supervision via videoconferencing. The primary outcome measure of feasibility was evaluated through recruitment, retention, and intervention fidelity (i.e., proportion of exercise completed, relative to what was prescribed). Intervention acceptability (i.e., ease and quality of virtual delivery, level of difficulty, and home-based approach) was assessed using a 4-point Likert-type scale from "strongly disagree" to "strongly agree". RESULTS Fourteen participants were recruited over a 6-month period, with 11 completing the intervention (2 withdrew due to unrelated illness, 1 withdrew due to requiring active treatment), yielding a retention rate of 79%. Characteristics of the participants who completed the intervention (n = 11) were as follows: mean age: 71 ± 10 years, mean BMI: 29.1 ± 6.5, and average time since diagnosis was 62 ± 51 months. Of completers, 27% were male, and 36% were Black; 10 were stage I (91%), and one was stage II (9%). Mean session attendance was 86.4 ± 9.5%. Mean intervention fidelity was 83.1 ± 13.1%. With regard to acceptability, > 90% of participants positively rated all aspects of the intervention delivery. No adverse events related to exercise were recorded. CONCLUSIONS The hybrid delivery of a home-based resistance exercise program for individuals previously treated for early-stage NSCLC was found to be safe and feasible. Adaptations to the program for future interventions are required, particularly surrounding resistance exercise programming, and intervention delivery with home visits. TRIAL REGISTRATION ClinicalTrials.gov: NCT05014035 . Registered January 20, 2021.
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Affiliation(s)
- C M Fairman
- Department of Exercise Science, University of South Carolina, Columbia, USA.
| | - O L Owens
- College of Social Work, University of South Carolina, Columbia, USA
| | - K L Kendall
- Centre for Human Performance, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
| | - J Steele
- Faculty of Sport, Health, and Social Science, Solent University, Southampton, UK
| | - A R Schumpp
- Department of Exercise Science, University of South Carolina, Columbia, USA
| | - C Latella
- Centre for Human Performance, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
| | - M T Jones
- Department of Exercise Science, University of South Carolina, Columbia, USA
- Department of Kinesiology, The University of Alabama, Tuscaloosa, USA
| | - L Marcotte
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - J M Dawson
- Department of Exercise Science, University of South Carolina, Columbia, USA
| | - C M J Peddle-McIntyre
- Exercise Medicine Research Institute, School of Medical and Health Science, Edith Cowan University, Joondalup, Australia
| | - K K McDonnell
- College of Nursing, University of South Carolina, Columbia, USA
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Xiong T, Bai X, Wei X, Wang L, Li F, Shi H, Shi Y. Exercise Rehabilitation and Chronic Respiratory Diseases: Effects, Mechanisms, and Therapeutic Benefits. Int J Chron Obstruct Pulmon Dis 2023; 18:1251-1266. [PMID: 37362621 PMCID: PMC10289097 DOI: 10.2147/copd.s408325] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 06/14/2023] [Indexed: 06/28/2023] Open
Abstract
Chronic respiratory diseases (CRD), is a group of disorders, primarily chronic obstructive pulmonary disease and asthma, which are characterized by high prevalence and disability, recurrent acute exacerbations, and multiple comorbidities, resulting in exercise limitations and reduced health-related quality of life. Exercise training, an important tool in pulmonary rehabilitation, reduces adverse symptoms in patients by relieving respiratory limitations, increasing gas exchange, increasing central and peripheral hemodynamic forces, and enhancing skeletal muscle function. Aerobic, resistance, and high-intensity intermittent exercises, and other emerging forms such as aquatic exercise and Tai Chi effectively improve exercise capacity, physical fitness, and pulmonary function in patients with CRD. The underlying mechanisms include enhancement of the body's immune response, better control of the inflammatory response, and acceleration of the interaction between the vagus and sympathetic nerves to improve gas exchange. Here, we reviewed the new evidence of benefits and mechanisms of exercise intervention in the pulmonary rehabilitation of patients with chronic obstructive pulmonary disease, bronchial asthma, bronchiectasis, interstitial lung disease, and lung cancer.
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Affiliation(s)
- Ting Xiong
- School of Exercise and Health, Shanghai University of Sport, Shanghai, 200438, People’s Republic of China
| | - Xinyue Bai
- School of Exercise and Health, Shanghai University of Sport, Shanghai, 200438, People’s Republic of China
| | - Xingyi Wei
- School of Exercise and Health, Shanghai University of Sport, Shanghai, 200438, People’s Republic of China
| | - Lezheng Wang
- School of Exercise and Health, Shanghai University of Sport, Shanghai, 200438, People’s Republic of China
| | - Fei Li
- School of Athletic Performance, Shanghai University of Sport, Shanghai, 200438, People’s Republic of China
| | - Hui Shi
- Department of Rheumatology and Immunology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People’s Republic of China
| | - Yue Shi
- School of Athletic Performance, Shanghai University of Sport, Shanghai, 200438, People’s Republic of China
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Li J, Qiu H, Li J. Exercise is medicine. Front Aging Neurosci 2023; 15:1129221. [PMID: 36793648 PMCID: PMC9922893 DOI: 10.3389/fnagi.2023.1129221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 01/13/2023] [Indexed: 01/31/2023] Open
Affiliation(s)
- Jiahui Li
- Rehabilitation Medical Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Huaide Qiu
- Faculty of Rehabilitation Science, Nanjing Normal University of Special Education, Nanjing, China
| | - Jianan Li
- Rehabilitation Medical Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
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Kilgore K, Leinfelder J, Campbell J, Wayne PM, Hallowell RW, Barakat A. A Tai Chi Class Collaboratively Developed for Persons With Interstitial and Other Lung Diseases: An Ethnographic Investigation. Glob Adv Integr Med Health 2023; 12:27536130231206122. [PMID: 37901846 PMCID: PMC10605663 DOI: 10.1177/27536130231206122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 09/02/2023] [Accepted: 09/18/2023] [Indexed: 10/31/2023]
Abstract
Background Participating in physical activity (PA) can be challenging for persons with chronic and significant lung disease due to the multifaceted disruptive effects of their symptoms and variable disease course. Objectives Our study investigates a novel approach to increasing PA by collaboratively and adaptively developing a Tai Chi (TC) class for and by persons with lung diseases and explores participants' perceptions of their experiences in the co-developed TC class. Methods We initiated a collaboration between the Interstitial Lung Disease (ILD) Collaborative and the Tai Chi Foundation to develop a TC class appropriate for persons with ILD and other lung diseases. The TC class was offered online, during the early phases of the COVID-19 pandemic, when pulmonary patients were isolated socially. TC class sessions were held twice weekly for 12 weeks with 12 participants. Ethnographic field methods were used to collect observations and conduct interviews with teachers and students. The Social Ecological Model (SEM) for understanding factors in intrapersonal, interpersonal, social, and organizational contexts was used to explore ways in which wellness practices, particularly those involving changes in health behaviors, can be collaboratively conceived, and developed by persons with the lived experience of illness and community organizations that are sensitive to their personal and social contexts. The constant comparative method was used for data analysis. Results Our findings include the importance of (1) creating a supportive class environment, characterized by interactive and reciprocal relationships among students and teachers; (2) alternating segments of movement and meditation to avoid fatigue and breathlessness; (3) cultivating sensory awareness and body trust, resting when needed and rejoining the movements when ready; (4) increasing the capacity to meditate through deepening presence and renewing the vital connection with inner and outer sources of energy; (5) reducing, through meditative movement, the persistent anxiety, isolation, and sense of loss that accompany chronic disease diagnosis and progression. Conclusion We documented a collaboration between the TC and pulmonary communities to design a TC class for persons with chronic and significant lung disease. We employed the SEM to provide insights into how teachers, informed by their students, can use effective pedagogical skills to create core curricula with modifications appropriate for a specific population.
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Affiliation(s)
- Karen Kilgore
- Interstitial Lung Disease Collaborative, Pulmonary Care and Research Collaborative, Boston, MA, USA
- Osher Center for Integrative Medicine, Brigham and Women’s Hospital, Boston, MA, USA
| | | | | | - Peter M. Wayne
- Osher Center for Integrative Medicine, Brigham and Women’s Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Robert W. Hallowell
- Harvard Medical School, Boston, MA, USA
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Aliaa Barakat
- Interstitial Lung Disease Collaborative, Pulmonary Care and Research Collaborative, Boston, MA, USA
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10
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Gao Y, Zhao L, Yang Z, He K, Zhang T, Yi J. Efficacy of exercise in patients with pulmonary fibrosis: A systematic review and meta-analysis. Medicine (Baltimore) 2022; 101:e31789. [PMID: 36482634 PMCID: PMC9726387 DOI: 10.1097/md.0000000000031789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Pulmonary fibrosis (PF) is easily caused by a variety of factors, resulting in dyspnea, exertion and movement intolerance. This systematic review aims to synthesize evidence on exercise training during rehabilitation for PF in order to improve patients' exercise capacity, quality of life, and lung function. METHODS Retrieved from the Cochrane Library, Web of Science, PubMed, Scopus and Embase from inception until April 2022. Participants: patients with PF; Intervention measures: exercise training; Results: exercise ability, quality of life, lung function and cardiopulmonary endurance. Two reviewers independently screen the title, abstract and full text. Finally, quality evaluation and meta-analysis were conducted. RESULTS In this study, 13 randomized controlled studies from 1468 articles were selected. A total of 456 patients with PF were enrolled. Compared with usual care in the control group, the 6-minute walking distance, predicted forced vital capacity, predicted forced expiratory volume at 1 second and maximal rate of oxygen consumption were increased significantly after exercise training, while there was no significant change in quality of life and predicted diffusing capacity of the lung for carbon monoxide. CONCLUSION Exercise training can significantly improve the exercise capacity, lung function and cardiopulmonary endurance of patients with PF, but has no effect on the quality of life. Exercise training is an effective rehabilitation strategy for PF.
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Affiliation(s)
- Yan Gao
- School of Nursing, Jilin University, Changchun, China
| | - Lijing Zhao
- School of Nursing, Jilin University, Changchun, China
| | - Zhaoyun Yang
- School of Nursing, Jilin University, Changchun, China
| | - Kang He
- School of Nursing, Jilin University, Changchun, China
| | - Tingyu Zhang
- School of Nursing, Jilin University, Changchun, China
| | - Jiang Yi
- Department of Rehabilitation, the Second Hospital of Jilin University, Changchun, China
- * Correspondence: Jiang Yi, Department of Rehabilitation, the Second Hospital of Jilin University, Changchun, Jilin 130012, China (e-mail: )
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11
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Denche-Zamorano Á, Pastor-Cisneros R, Moreno-Moreno L, Carlos-Vivas J, Mendoza-Muñoz M, Contreras-Barraza N, Gil-Marín M, Barrios-Fernández S. Physical Activity Frequency and Health-Related Quality of Life in Spanish Children and Adolescents with Asthma: A Cross-Sectional Study. Int J Environ Res Public Health 2022; 19:14611. [PMID: 36361489 PMCID: PMC9658524 DOI: 10.3390/ijerph192114611] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 09/28/2022] [Accepted: 09/30/2022] [Indexed: 06/16/2023]
Abstract
Asthma is considered the most prevalent chronic childhood disease worldwide. Physical activity (PA) represents a tool to improve patients with respiratory diseases' health-related quality of life (HRQoL). A cross-sectional study examining data from the Spanish National Health Survey (ENSE 2017) was carried out to investigate the associations between the PAF (physical activity frequency) and health-related quality of life (HRQoL) in asthmatic children and adolescents from 8 to 14 years old (total 11.29 years ± 1.91, boys 11.28 ± 1.90 and 11.29 ± 1.95 girls). Data were obtained from the Children Questionnaire, which was completed by their families or legal guardians, achieving a final sample composed of 240 participants with asthma. Data were taken from Survey 2017 (ENSE 2017), the last one before the COVID-19 pandemic. The results revealed significant associations between the PAF and the HRQoL, finding no significant differences between genders.
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Affiliation(s)
- Ángel Denche-Zamorano
- Health, Economy, Motricity and Education Research Group (HEME), Faculty of Sport Sciences, University of Extremadura, 10003 Caceres, Spain
| | - Raquel Pastor-Cisneros
- Social Impact and Innovation in Health (InHEALTH), University of Extremadura, 10003 Caceres, Spain
| | - Lara Moreno-Moreno
- Health, Economy, Motricity and Education Research Group (HEME), Faculty of Sport Sciences, University of Extremadura, 10003 Caceres, Spain
| | - Jorge Carlos-Vivas
- Promoting a Healthy Society Research Group (PHeSO), Faculty of Sport Sciences, University of Extremadura, 10003 Caceres, Spain
| | - María Mendoza-Muñoz
- Research Group on Physical and Health Literacy and Health-Related Quality of Life (PHYQOL), Faculty of Sport Sciences, University of Extremadura, 10003 Caceres, Spain
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, 7004-516 Evora, Portugal
| | | | - Miseldra Gil-Marín
- Public Policy Observatory, Universidad Autónoma de Chile, Santiago 7500912, Chile
| | - Sabina Barrios-Fernández
- Social Impact and Innovation in Health (InHEALTH), University of Extremadura, 10003 Caceres, Spain
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12
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Tian J, Zhou F, Zhang XG, Wang HY, Peng SH, Li X, Cao J, Zhang H. Experience of physical activity in patients with COPD: A systematic review and qualitative meta-synthesis. Geriatr Nurs 2022; 47:211-219. [PMID: 35940039 DOI: 10.1016/j.gerinurse.2022.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 07/13/2022] [Accepted: 07/15/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To systematically evaluate and integrate the qualitative research on physical activity (PA) experience of patients with chronic obstructive pulmonary disease (COPD). METHODS Web of Science, Cochrane Library, Embase, CINAHL and other databases were searched, and the qualitative research on PA experience of patients with COPD was collected. The systematic review was conducted in line with Joanna Briggs Institute (JBI) methodology for systematic reviews of qualitative evidence. RESULTS 12 studies were included and 3 themes were summarized, included: COPD patients experience more barriers while participating in physical activities than facilitators; COPD patients experience more positive effects post-physical activities than negative effects; Guaranteeing safety, goal setting, and establishing a professional support group improve compliance in COPD patients. CONCLUSION Health care professionals should help patients overcome the obstacles of PA, pay attention to the PA experience of patients, adopt diversified PA methods, improve PA participation and compliance, and make patients develop good PA habits.
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Affiliation(s)
- Jing Tian
- College of Nursing,Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 610075, China
| | - Fan Zhou
- College of Nursing,Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 610075, China
| | - Xian Geng Zhang
- Sichuan Nursing Vocational College, No.173 Longdu South Road, Longquanyi District, Chengdu, Sichuan 610100, China.
| | - Hong Yan Wang
- Sichuan Nursing Vocational College, No.173 Longdu South Road, Longquanyi District, Chengdu, Sichuan 610100, China
| | - Si Han Peng
- Affiliated hospital of Chengdu University of Traditional Chinese Medicine,Chengdu, Sichuan 610032, China
| | - Xin Li
- College of Nursing,Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 610075, China
| | - Jun Cao
- Sichuan Nursing Vocational College, No.173 Longdu South Road, Longquanyi District, Chengdu, Sichuan 610100, China
| | - Hong Zhang
- College of Nursing,Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 610075, China
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13
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Lippi L, D’Abrosca F, Folli A, Dal Molin A, Moalli S, Maconi A, Ammendolia A, de Sire A, Invernizzi M. Closing the Gap between Inpatient and Outpatient Settings: Integrating Pulmonary Rehabilitation and Technological Advances in the Comprehensive Management of Frail Patients. IJERPH 2022; 19:ijerph19159150. [PMID: 35954506 PMCID: PMC9368185 DOI: 10.3390/ijerph19159150] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 07/21/2022] [Accepted: 07/24/2022] [Indexed: 02/03/2023]
Abstract
Pulmonary rehabilitation (PR) is a well-established intervention supported by strong evidence that is used to treat patients affected by chronic respiratory diseases. However, several barriers still affect its spreading in rehabilitation clinical practices. Although chronic respiratory diseases are common age-related disorders, there is still a gap of knowledge regarding the implementation of sustainable strategies integrating PR in the rehabilitation management of frail patients at high risk of respiratory complications. Therefore, in the present study, we characterized the effects of PR in frail patients, highlighting the evidence supporting its role in improving the complex rehabilitative management of these patients. Moreover, we propose a novel organizational model promoting PR programs for frail patients in both inpatient and outpatient settings. Our model emphasizes the role of interdisciplinary care, specifically tailored to patients and environmental characteristics. In this scenario, cutting-edge technology and telemedicine solutions might be implemented as safe and sustainable strategies filling the gap between inpatient and outpatient settings. Future research should focus on large-scale sustainable interventions to improve the quality of life and global health of frail patients. Moreover, evidence-based therapeutic paths should be promoted and taught in training courses promoting multiprofessional PR knowledge to increase awareness and better address its delivery in frail patients.
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Affiliation(s)
- Lorenzo Lippi
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy; (L.L.); (F.D.); (A.F.); (S.M.)
- Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), Translational Medicine, Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy;
| | - Francesco D’Abrosca
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy; (L.L.); (F.D.); (A.F.); (S.M.)
| | - Arianna Folli
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy; (L.L.); (F.D.); (A.F.); (S.M.)
| | - Alberto Dal Molin
- Department of Translational Medicine, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy;
- Health Professions’ Direction, “Ospedale Maggiore della Carità” University Hospital, 28100 Novara, Italy
| | - Stefano Moalli
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy; (L.L.); (F.D.); (A.F.); (S.M.)
| | - Antonio Maconi
- Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), Translational Medicine, Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy;
| | - Antonio Ammendolia
- Physical and Rehabilitative Medicine Unit, Department of Medical and Surgical Sciences, University of Catanzaro “Magna Graecia”, Viale Europa, 88100 Catanzaro, Italy; (A.A.); (A.d.S.)
| | - Alessandro de Sire
- Physical and Rehabilitative Medicine Unit, Department of Medical and Surgical Sciences, University of Catanzaro “Magna Graecia”, Viale Europa, 88100 Catanzaro, Italy; (A.A.); (A.d.S.)
| | - Marco Invernizzi
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy; (L.L.); (F.D.); (A.F.); (S.M.)
- Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), Translational Medicine, Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy;
- Correspondence: ; Tel.: +39-0131-206111
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14
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Abstract
PURPOSE OF REVIEW Ageing, the accrual of molecular and cellular damage over a lifetime confers progressive physiologic dysfunction of bodily systems, leaving the body in a heightened state of vulnerability to biophysical and psychosocial stressors. The inflection point is frailty which easily leads to disability and death. Interstitial lung disease (ILD) creates biophysical and psychosocial stresses difficult for even optimally fit patients to cope with. With evolving ILD treatment pathways, people with ILD are living longer. RECENT FINDINGS ILD and ageing are bi-directionally influential: ILD, its treatments, complications, and collateral systemic extra-pulmonary damage (hypoxic and oxidative stress) wear on the ageing person and ageing impacts a person's tolerance of ILD. ILD extent may proportionally accelerate age-related vulnerabilities. ILD related to inflammatory systemic diseases, e.g. connective tissue diseases or sarcoidosis, exert an even more complex biophysical impact on the body. SUMMARY The present review stresses goals of preventing frailty in ILD and preserving general health and well being of people living with ILD of any age, from time of diagnosis and as they age. The development of a prediction score is proposed to classify those at risk of frailty and guide interventions that preserve successful ageing for all levels of ILD severity. VIDEO ABSTRACT http://links.lww.com/COPM/A32.
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15
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Hua Y, Yuan X, Wang J, Zeng K, Zhi S, Liu L. Association between air pollution and hospital admissions for chronic respiratory disease in people aged over 65 years: a time series analysis in Ningbo, China, 2015-2017. Int Arch Occup Environ Health 2022; 95:1293-1304. [PMID: 35661917 DOI: 10.1007/s00420-022-01887-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 05/16/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE To provide essential information of environmental triggers leading to CRD. METHODS We investigated the short-term effects of ambient air pollutants on CRD-related hospitalizations in people aged ≥ 65 years in Ningbo. Data on 23,610 cases of CRD requiring hospitalization were collected from January 2015 to August 2017. After adjusting for temporal trends, seasonality, meteorological conditions, day of week (DOW), and public holidays, we used generalized additive Poisson distribution models to calculate the excess risks (ERs) and 95% confidence intervals (95% CIs) of CRD related hospitalizations. RESULTS Our results showed that fine particulate matter (PM2.5), inhalable particulate matter (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), and carbon monoxide (CO) were associated with CRD-related hospitalizations in people aged ≥ 65 years. We observed that each 10 μg/m3 increase (except for each 0.1 mg/m3 increase in CO) in the concentration of air pollutants, the percentage of CRD-related hospitalizations due to PM2.5, PM10, and SO2 exposure at lag 07, NO2 exposure at lag 03, and CO exposure at lag 0 increased by 2.13% (95% CI: 0.55%, 3.74%), 1.76% (95% CI: 0.70%, 2.83%), 8.24% (95% CI: 0.92%, 16.09%), 2.16% (95% CI: 0.26%, 4.05%), and 1.19% (95% CI: 0.26%, 2.12%), respectively. In addition, we found stronger effects of particulate matter in 75-84 years age group, on warmer days, and in asthmatics. CONCLUSION In conclusion, air pollution may have adverse effects on CRD-related hospitalizations among people aged ≥ 65 years in Ningbo. Therefore, public health measures should be taken to improve air quality.
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Affiliation(s)
- Yuzhe Hua
- School of Medicine, Ningbo University, Ningbo, China
| | - Xiaoqi Yuan
- Ningbo Women and Children Hospital, Ningbo, China
| | - Jichao Wang
- The Affiliated Hospital of Medical School, Ningbo, China
| | - Ke Zeng
- The Affiliated Hospital of Medical School, Ningbo, China
| | - Shuai Zhi
- School of Medicine, Ningbo University, Ningbo, China
| | - Liya Liu
- School of Medicine, Ningbo University, Ningbo, China.
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16
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Blanco I, Torres-Castro R, Barberà JA. [Translated article] Exercise Tolerance in Pulmonary Hypertension. Arch Bronconeumol 2022. [PMID: 35513947 DOI: 10.1016/j.arbres.2021.11.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Isabel Blanco
- Servicio de Neumología y Alergia Respiratoria, Hospital Clínic - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universidad de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain.
| | - Rodrigo Torres-Castro
- Servicio de Neumología y Alergia Respiratoria, Hospital Clínic - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universidad de Barcelona, Barcelona, Spain; Departamento de Kinesiología, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Joan Albert Barberà
- Servicio de Neumología y Alergia Respiratoria, Hospital Clínic - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universidad de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
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17
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Xu Y, Gao H, Du Z, Liu H, Cheng Q, Zhang F, Ye J, Wang A, Dou Y, Ma B, Zhao N, Zhu F, Xu X, Shen N, Wu J, Xue B. A new approach for reducing pollutants level: a longitudinal cohort study of physical exercises in young people. BMC Public Health 2022; 22:223. [PMID: 35114971 PMCID: PMC8812347 DOI: 10.1186/s12889-022-12621-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 01/21/2022] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The present study aimed to evaluate the elimination of three common pollutants (dimethoate, benzo(a)pyrene (BaP) and bisphenol A (BPA) by different physical exercises and to assess the possible factors which could affect the pollutants elimination. METHODS A total of 200 individuals who chose different kinds of exercises in accordance to their own wish were recruited. The levels of urinary pollutants were measured using β-glucuronidase hydrolysis followed by a high-performance liquid chromatography tandem mass spectrometry-based method. RESULTS Totally, the levels of dimethoate, BaP and BPA were reduced after physical exercises. However, the elimination of BaP in male was higher than that in female but the elimination of BPA in female was higher than that in male. Multivariate logistic regression showed that the degree of heart rate (HR) change was a protective factor affecting the improvement effect of dimethoate, BaP and BPA while BMI (body mass index) was a risk factor. Nevertheless, sex was a risk factor affecting the improvement of dimethoate and BaP but had a lower efficacy on BPA improvement. CONCLUSION The present findings indicate that physical exercises can be considered as a novel approach to eliminate pollutants level in human body and can also give suggestions for choosing specific physical exercises to male and female individuals. Moreover, those who are with higher BMI need to lose weight before eliminating pollutant level through physical exercises.
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Affiliation(s)
- Yujuan Xu
- Hohai University, Nanjing, 210098, China
| | - Hongliang Gao
- Core Laboratory, Sir Run Run Hospital, Nanjing Medical University, Nanjing, 211166, China
| | - Zhixiang Du
- Department of Infectious Diseases, Taizhou People's Hospital, Taizhou, 225300, China
| | - He Liu
- General surgery department, Sir Run Run Hospital, Nanjing Medical University, Nanjing, 211166, China
| | - Qi Cheng
- Medical School of Nanjing University, Nanjing, 210093, China
| | - Furong Zhang
- Core Laboratory, Sir Run Run Hospital, Nanjing Medical University, Nanjing, 211166, China
| | - Juan Ye
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, 210028, China
| | | | - Yanjun Dou
- Hohai University, Nanjing, 210098, China
| | - Bei Ma
- Hohai University, Nanjing, 210098, China
| | - Ningwei Zhao
- Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, 210029, China
| | - Feng Zhu
- General surgery department, Sir Run Run Hospital, Nanjing Medical University, Nanjing, 211166, China
| | - Xianlin Xu
- Department of Urology, Sir Run Run Hospital, Nanjing Medical University, 109 Longmian Road, Jiangning, Nanjing, 211100, Jiangsu, China
| | - Ning Shen
- China Exposomics Institute (CEI) Precision Medicine Co. Ltd, Shanghai, 200120, China
| | - Jing Wu
- Core Laboratory, Sir Run Run Hospital, Nanjing Medical University, Nanjing, 211166, China
| | - Bin Xue
- Core Laboratory, Sir Run Run Hospital, Nanjing Medical University, Nanjing, 211166, China.
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18
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Bickton FM, Mankhokwe T, Nightingale R, Fombe C, Mitengo M, Mwahimba L, Lipita W, Wilde L, Pina I, Yusuf ZK, Ahmed Z, Kamponda M, Limbani F, Shannon H, Chisati E, Barton A, Free RC, Steiner M, Matheson JA, Manise A, Singh SJ, Rylance J, Orme M. Protocol for a single-centre mixed-method pre-post single-arm feasibility trial of a culturally appropriate 6-week pulmonary rehabilitation programme among adults with functionally limiting chronic respiratory diseases in Malawi. BMJ Open 2022; 12:e057538. [PMID: 35105655 PMCID: PMC8804676 DOI: 10.1136/bmjopen-2021-057538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 12/13/2021] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION Malawi has a substantial burden of chronic respiratory diseases (CRDs) which cause significant morbidity and loss of economic productivity, affecting patients, families and health systems. Pulmonary rehabilitation (PR) is a highly recommended non-pharmacological intervention in the clinical management of people with CRDs. However, Malawi lacks published evidence on the implementation of PR for people with CRDs. This trial will test the feasibility and acceptability of implementing a culturally appropriate hospital-based PR programme among adults with functionally limiting CRDs at Queen Elizabeth Central Hospital in Blantyre, Malawi. METHODS AND ANALYSIS This is a single-centre mixed-methods pre-post single-arm feasibility trial. Ten patients aged ≥18 years, with a spirometry confirmed diagnosis of a CRD and breathlessness of ≥2 on the modified Medical Research Council dyspnoea scale, will be consecutively recruited. Their baseline lung function, exercise tolerance and health status will be assessed; including spirometry, Incremental Shuttle Walk Test and Chronic Obstructive Pulmonary Disease Assessment Test, respectively. Pretrial semistructured in-depth interviews will explore their experiences of living with CRD and potential enablers and barriers to their PR uptake. Along with international PR guidelines, these data will inform culturally appropriate delivery of PR. We initially propose a 6-week, twice-weekly, supervised centre-based PR programme, with an additional weekly home-based non-supervised session. Using combination of researcher observation, interaction with the participants, field notes and informal interviews with the participants, we will assess the feasibility of running the programme in the following areas: participants' recruitment, retention, engagement and protocol adherence. Following programme completion (after 6 weeks), repeat assessments of lung function, exercise tolerance and health status will be conducted. Quantitative changes in clinical outcomes will be described in relation to published minimal clinically important differences. Post-trial semistructured interviews will capture participants' perceived impact of the PR programme on their quality of life, enablers, and barriers to fully engaging with the programme, and allow iteration of its design. ETHICS AND DISSEMINATION Ethical approval for this trial was obtained from University of Malawi College of Medicine Research and Ethics Committee (COMREC), Blantyre, Malawi (protocol number: P.07/19/2752) and University of Leicester Research Ethics Committee, Leicester, UK (ethics reference: 31574). The results of the trial will be disseminated through oral presentations at local and international scientific conferences or seminars and publication in a peer-reviewed journal. We will also engage the participants who complete the PR trial and the Science Communication Department at Malawi-Liverpool-Wellcome Trust Clinical Research Programme to organise community outreach activities within Blantyre to educate communities about CRDs and PR. We will also broadcast our trial results through national radio station programmes such as the weekly "Thanzi la Onse" (Health of All) programme by Times Radio Malawi. We will formally present our trial results to Blantyre District Health Office and Malawi Ministry of Health. TRIAL REGISTRATION NUMBER ISRCTN13836793.
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Affiliation(s)
- Fanuel Meckson Bickton
- Lung Health Research Group, Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Malawi
- UCL GOS Institute of Child Health, University College London, London, UK
| | - Talumba Mankhokwe
- Physiotherapy Department, Queen Elizabeth Central Hospital, Blantyre, Southern Region, Malawi
| | - Rebecca Nightingale
- Lung Health Research Group, Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Malawi
- Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Cashon Fombe
- Physiotherapy Department, Queen Elizabeth Central Hospital, Blantyre, Southern Region, Malawi
| | - Martha Mitengo
- Physiotherapy Department, Queen Elizabeth Central Hospital, Blantyre, Southern Region, Malawi
| | - Langsfield Mwahimba
- Physiotherapy Department, Queen Elizabeth Central Hospital, Blantyre, Southern Region, Malawi
| | - Wilfred Lipita
- Physiotherapy Department, Queen Elizabeth Central Hospital, Blantyre, Southern Region, Malawi
| | - Laura Wilde
- Department of Respiratory Sciences, University of Leicester, Leicester, Leicestershire, UK
- Centre for Exercise and Rehabilitation Science, NIHR Leicester Biomedical Research Centre Respiratory Diseases, Leicester, East Midlands, UK
| | - Ilaria Pina
- Department of Respiratory Sciences, University of Leicester, Leicester, Leicestershire, UK
- Centre for Exercise and Rehabilitation Science, NIHR Leicester Biomedical Research Centre Respiratory Diseases, Leicester, East Midlands, UK
| | - Zainab K Yusuf
- Department of Respiratory Sciences, University of Leicester, Leicester, Leicestershire, UK
- Centre for Exercise and Rehabilitation Science, NIHR Leicester Biomedical Research Centre Respiratory Diseases, Leicester, East Midlands, UK
| | - Zahira Ahmed
- Department of Respiratory Sciences, University of Leicester, Leicester, Leicestershire, UK
- Centre for Exercise and Rehabilitation Science, NIHR Leicester Biomedical Research Centre Respiratory Diseases, Leicester, East Midlands, UK
| | - Martin Kamponda
- Medicine Department, Queen Elizabeth Central Hospital, Blantyre, Southern Region, Malawi
| | - Felix Limbani
- Lung Health Research Group, Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Malawi
| | - Harriet Shannon
- UCL GOS Institute of Child Health, University College London, London, UK
| | - Enock Chisati
- Department of Rehabilitation Sciences, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Andy Barton
- Department of Respiratory Sciences, University of Leicester, Leicester, Leicestershire, UK
| | - Robert C Free
- Department of Respiratory Sciences, University of Leicester, Leicester, Leicestershire, UK
| | - Michael Steiner
- Department of Respiratory Sciences, University of Leicester, Leicester, Leicestershire, UK
- Centre for Exercise and Rehabilitation Science, NIHR Leicester Biomedical Research Centre Respiratory Diseases, Leicester, East Midlands, UK
| | | | - Adrian Manise
- NIHR Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Sally J Singh
- Department of Respiratory Sciences, University of Leicester, Leicester, Leicestershire, UK
- Centre for Exercise and Rehabilitation Science, NIHR Leicester Biomedical Research Centre Respiratory Diseases, Leicester, East Midlands, UK
| | - Jamie Rylance
- Lung Health Research Group, Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Malawi
- Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Mark Orme
- Department of Respiratory Sciences, University of Leicester, Leicester, Leicestershire, UK
- Centre for Exercise and Rehabilitation Science, NIHR Leicester Biomedical Research Centre Respiratory Diseases, Leicester, East Midlands, UK
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19
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Vonbank K, Lehmann A, Bernitzky D, Gysan MR, Simon S, Krotka P, Zwick RH, Idzko M, Burtscher M. Comparison of heart rates at fixed percentages and the ventilatory thresholds in patients with interstitial lung disease. Scand J Med Sci Sports 2021; 32:754-764. [PMID: 34923682 PMCID: PMC9304263 DOI: 10.1111/sms.14117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 12/15/2021] [Accepted: 12/16/2021] [Indexed: 11/27/2022]
Abstract
Heart rate (HR) responses to maximal exercise are commonly used for the prescription of training intensities in pulmonary rehabilitation. Those intensities are usually based on fixed percentages of peak HR (HRpeak), heart rate reserve (HRR), or peak work load (Wpeak), and rarely on HRs at the individual ventilatory thresholds (VT1 and VT2) derived from cardiopulmonary exercise testing (CPET). For patients suffering from interstitial lung disease (ILD), data on cardiorespiratory responses to CPET are scarce. Thus, the aim of this study was to record cardiorespiratory responses to CPET and to compare fixed HR percentages with HRs at VT1 and VT2 in ILD patients. A total of 120 subjects, 80 ILD patients and 40 healthy controls, underwent a symptom‐limited CPET. From the ILD patient, 32 suffered from idiopathic pulmonary fibrosis (IPF), 37 from connective tissue disease (CTD), and 11 from sarcoidosis. HRs at fixed percentages, that is, at 70%HRpeak, at 70%Wpeak, and at 60%HRR were significantly lower in the ILD patients compared with the control group (p‐values: 0.001, 0.044, and 0.011). Large percentages of HR values at 70%Wpeak and 60%HRR ranged between the HRs at VT1 and VT2 in ILD subgroups and controls as well. HRs at 70%HRpeak were lower than HRs at VT1 in 66% of the IPF patients, 54% of the CTD patients, and 55% of patients with sarcoidosis compared with 18% in the control group. Our findings demonstrate a considerable scattering of fixed HR percentages compared with HRs at the individual VTs derived from CPET in ILD patients. These findings may provide valuable information for the prescription of exercise intensity in pulmonary rehabilitation of ILD patients.
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Affiliation(s)
- Karin Vonbank
- Department of Pulmonary Medicine, Medical University of Vienna, Vienna, Austria
| | - Antje Lehmann
- Department of Pulmonary Medicine, Medical University of Vienna, Vienna, Austria
| | - Dominik Bernitzky
- Department of Pulmonary Medicine, Medical University of Vienna, Vienna, Austria
| | | | - Stefan Simon
- Department of Pulmonary Medicine, Medical University of Vienna, Vienna, Austria
| | - Pavla Krotka
- Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria
| | - Ralf-Harun Zwick
- ThermeWienMed, Ludwig Boltzmann Institute for Rehabilitation Research, Vienna, Austria
| | - Marco Idzko
- Department of Pulmonary Medicine, Medical University of Vienna, Vienna, Austria
| | - Martin Burtscher
- Department of Sports Sciences, Medical Section, University of Innsbruck, Innsbruck, Austria
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20
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Blanco I, Torres-Castro R, Barberà JA. Tolerancia al esfuerzo en la hipertensión pulmonar. Arch Bronconeumol 2021; 58:388-389. [DOI: 10.1016/j.arbres.2021.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 11/16/2021] [Indexed: 11/02/2022]
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Curran M, Tierney AC, Button B, Collins L, Kennedy L, McDonnell C, Casserly B, Cahalan R. The effectiveness of exercise interventions to increase physical activity in Cystic Fibrosis: A systematic review. J Cyst Fibros 2021; 21:272-281. [PMID: 34753671 DOI: 10.1016/j.jcf.2021.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 10/10/2021] [Accepted: 10/25/2021] [Indexed: 11/17/2022]
Abstract
Physical activity (PA) and exercise have numerous benefits in Cystic Fibrosis (CF) including improved lung function, exercise capacity and quality of life. Despite these benefits, the effectiveness of interventions to promote PA in this population are still largely unknown. The objective of this review was to synthesise existing research and determine whether exercise interventions are effective in promoting PA in people with CF. Using the PRISMA guidelines, a comprehensive search was conducted. Fifteen studies (463 participants) met the inclusion criteria. Eleven studies demonstrated improvements in PA in both short- and long-term interventions. However, the interventions were variable across the included studies, with a large inconsistency in PA assessment tools used. Aerobic training and activity counselling were the two elements identified in this review which most consistently improved PA. Future research should consider larger sample sizes and the use of accurate instruments to assess and track PA levels longitudinally.
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Affiliation(s)
- M Curran
- School of Allied Health, University of Limerick, Limerick, Ireland; University Hospital Limerick, Limerick, Ireland; Health Research Institute, University of Limerick, Limerick, Ireland.
| | - A C Tierney
- School of Allied Health, University of Limerick, Limerick, Ireland; Health Research Institute, University of Limerick, Limerick, Ireland; Department of Dietetics, Nutrition and Sport, La Trobe University, Melbourne, Australia; Health Implementation Science and Technology Research Group, Health Research Institute, University of Limerick, Limerick, Ireland
| | - B Button
- Departments of Respiratory Medicine and Physiotherapy, The Alfred, Melbourne, Australia; Department of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - L Collins
- University Hospital Limerick, Limerick, Ireland
| | - L Kennedy
- University Hospital Limerick, Limerick, Ireland
| | - C McDonnell
- University Hospital Limerick, Limerick, Ireland
| | - B Casserly
- University Hospital Limerick, Limerick, Ireland
| | - R Cahalan
- School of Allied Health, University of Limerick, Limerick, Ireland; Health Research Institute, University of Limerick, Limerick, Ireland; Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
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22
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Santiworakul A, Piya-Amornphan N, Jianramas N. A Home-Based Multimedia Pulmonary Rehabilitation Program Improves Clinical Symptoms and Physical Performance of Patients with Chronic Obstructive Pulmonary Disease. Int J Environ Res Public Health 2021; 18:11479. [PMID: 34769994 DOI: 10.3390/ijerph182111479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 10/26/2021] [Accepted: 10/29/2021] [Indexed: 11/23/2022]
Abstract
Home-based pulmonary rehabilitation can decrease symptoms in chronic obstructive pulmonary disease (COPD) patients. The purpose of this study was to compare the effects of a home-based pulmonary rehabilitation by instructive multimedia in the form of videos and flip charts on clinical symptoms and exercise performance in COPD patients. An eight-week home-based pulmonary rehabilitation program was performed with twenty COPD patients older than 60 years of age with moderate to severe stages. They were separated into two groups: a multimedia group (n = 10) and a control group, which was only provided with telephone monitoring (n = 10). Clinical symptoms were measured by using the clinical COPD questionnaire (CCQ), and exercise performance was measured using a six-minute walk test (6MWT) and an upper-lower limb muscle strengthening test. After 8 weeks, the results showed that both groups showed a statistically significant decrease in the CCQ (p < 0.05). The multimedia group showed a statistically significant increase in the lower-limb muscle strengthening (p < 0.05), while the control group was not found to show a statistically significant increase in the lower-limb muscle strengthening. Therefore, a pulmonary rehabilitation program using multimedia at home can lessen symptoms and improve exercise performance in COPD patients.
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23
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Pettersson H, Alexanderson H, Poole JL, Varga J, Regardt M, Russell AM, Salam Y, Jensen K, Mansour J, Frech T, Feghali-Bostwick C, Varjú C, Baldwin N, Heenan M, Fligelstone K, Holmner M, Lammi MR, Scholand MB, Shapiro L, Volkmann ER, Saketkoo LA. Exercise as a multi-modal disease-modifying medicine in systemic sclerosis: An introduction by The Global Fellowship on Rehabilitation and Exercise in Systemic Sclerosis (G-FoRSS). Best Pract Res Clin Rheumatol 2021; 35:101695. [PMID: 34217607 PMCID: PMC8478716 DOI: 10.1016/j.berh.2021.101695] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Systemic sclerosis (SSc) is a heterogeneous multisystem autoimmune disease whereby its main pathological drivers of disability and damage are vascular injury, inflammatory cell infiltration, and fibrosis. These mechanisms result in diffuse and diverse impairments arising from ischemic circulatory dysfunction leading to painful skin ulceration and calcinosis, neurovascular aberrations hindering gastrointestinal (GI) motility, progressive painful, incapacitating or immobilizing effects of inflammatory and fibrotic effects on the lungs, skin, articular and periarticular structures, and muscle. SSc-related impairments impede routine activities of daily living (ADLs) and disrupt three critical life areas: work, family, social/leisure, and also impact on psychological well-being. Physical activity and exercise are globally recommended; however, for connective tissue diseases, this guidance carries greater impact on inflammatory disease manifestations, recovery, and cardiovascular health. Exercise, through myogenic and vascular phenomena, naturally targets key pathogenic drivers by downregulating multiple inflammatory and fibrotic pathways in serum and tissue, while increasing circulation and vascular repair. G-FoRSS, The Global Fellowship on Rehabilitation and Exercise in Systemic Sclerosis recognizes the scientific basis of and advocates for education and research of exercise as a systemic and targeted SSc disease-modifying treatment. An overview of biophysiological mechanisms of physical activity and exercise are herein imparted for patients, clinicians, and researchers, and applied to SSc disease mechanisms, manifestations, and impairment. A preliminary guidance on exercise in SSc, a research agenda, and the current state of research and outcome measures are set forth.
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Affiliation(s)
- Henrik Pettersson
- Women's Health and Allied Health Professionals, Medical Unit Occupational Therapy and Physiotherapy, Karolinska University Hospital, Stockholm, Sweden; Division of Rheumatology, Department of Medicin, Solna, Karolinska Institutet, Stockholm, Sweden
| | - Helene Alexanderson
- Women's Health and Allied Health Professionals, Medical Unit Occupational Therapy and Physiotherapy, Karolinska University Hospital, Stockholm, Sweden; Division of Rheumatology, Department of Medicin, Solna, Karolinska Institutet, Stockholm, Sweden
| | - Janet L Poole
- Occupational Therapy Graduate Program, University of New Mexico, Albuquerque, NM, USA
| | - Janos Varga
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - Malin Regardt
- Women's Health and Allied Health Professionals, Medical Unit Occupational Therapy and Physiotherapy, Karolinska University Hospital, Stockholm, Sweden; Department of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden
| | - Anne-Marie Russell
- University of Exeter, College of Medicine and Health, Exeter, UK; National Institute of Health Research, Senior Nurse Research Leader, London, UK
| | - Yasser Salam
- Department of Physical Therapy, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Kelly Jensen
- Oregon Health and Science University, Portland, OR, USA; New Orleans Scleroderma and Sarcoidosis Patient Care and Research Center, New Orleans, USA; Tulane University School of Medicine, New Orleans, USA
| | - Jennifer Mansour
- New Orleans Scleroderma and Sarcoidosis Patient Care and Research Center, New Orleans, USA; Tulane University School of Medicine, New Orleans, USA
| | - Tracy Frech
- Vanderbilt University, Division of Rheumatology, Nashville, TN, USA
| | | | - Cecília Varjú
- Department of Rheumatology and Immunology, University of Pécs Clinical Center, Pecs, Hungary
| | | | - Matty Heenan
- Scleroderma Foundation/Pulmonary Hypertension Association, Tucson, AZ, USA
| | - Kim Fligelstone
- Scleroderma & Raynaud Society UK (SRUK), London, UK; Royal Free Hospital, London, UK
| | - Monica Holmner
- The Swedish Rheumatism Association National Association for Systemic Sclerosis, Sweden
| | - Matthew R Lammi
- New Orleans Scleroderma and Sarcoidosis Patient Care and Research Center, New Orleans, USA; University Medical Center - Comprehensive Pulmonary Hypertension Center and Interstitial Lung Disease Clinic Programs, New Orleans, USA; Louisiana State University School of Medicine, Section of Pulmonary Medicine, New Orleans, USA
| | - Mary Beth Scholand
- University of Utah, Division of Pulmonary Medicine, Pulmonary Fibrosis Center, Salt Lake City, UT, USA
| | - Lee Shapiro
- Division of Rheumatology, Albany Medical Center, Albany, NY, USA; Steffens Scleroderma Foundation, Albany, NY, USA
| | - Elizabeth R Volkmann
- University of California, David Geffen School of Medicine, UCLA Scleroderma Program and UCLA CTD-ILD Program, Division of Rheumatology, Department of Medicine, Los Angeles, CA, USA
| | - Lesley Ann Saketkoo
- New Orleans Scleroderma and Sarcoidosis Patient Care and Research Center, New Orleans, USA; Tulane University School of Medicine, New Orleans, USA; University Medical Center - Comprehensive Pulmonary Hypertension Center and Interstitial Lung Disease Clinic Programs, New Orleans, USA; Louisiana State University School of Medicine, Section of Pulmonary Medicine, New Orleans, USA.
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24
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Netz Y, Yekutieli Z, Arnon M, Argov E, Tchelet K, Benmoha E, Jacobs JM. Personalized Exercise Programs Based upon Remote Assessment of Motor Fitness: A Pilot Study among Healthy People Aged 65 Years and Older. Gerontology 2021; 68:465-479. [PMID: 34515118 DOI: 10.1159/000517918] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 06/15/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The World Health Organization has recently updated exercise guidelines for people aged >65 years, emphasizing the inclusion of multiple fitness components. However, without adequate recognition of individual differences, these guidelines may be applied using an approach that "one-size-fits-all." Within the shifting paradigm toward an increasingly personalized approach to medicine and health, it is apparent that fitness components display a significant age-related increase in variability. Therefore, it is both logical and necessary to perform an accurate individualized assessment of multiple fitness components prior to optimal prescription for a personalized exercise program. OBJECTIVE The aim of the study was to test the feasibility and effectiveness of a novel tool able to remotely assess balance, flexibility, and strength using smartphone sensors (accelerometer/gyroscope), and subsequently deliver personalized exercise programs via the smartphone. METHODS We enrolled 52 healthy volunteers (34 females) aged 65+ years, with normal cognition and low fall risk. Baseline data from remote smartphone fitness assessment were analyzed to generate 42 fitness digital markers (DMs), used to guide personalized exercise programs (×5/week for 6 weeks) delivered via smartphone. Programs included graded exercises for upper/lower body, flexibility, strength, and balance (dynamic, static, and vestibular). Participants were retested after 6 weeks. RESULTS Average age was 74.7 ± 6.4 years; adherence was 3.6 ± 1.7 exercise sessions/week. Significant improvement for pre-/posttesting was observed for 10/12 DMs of strength/flexibility for upper/lower body (sit-to-stand repetitions/duration; arm-lift duration; torso rotation; and arm extension/flexion). Balance improved significantly for 6/10 measures of tandem stance, with consistent (nonsignificant) trends observed across 20 balance DMs of tandem walk and 1 leg stance. Balance tended to improve among the 37 participants exercising ≥3/week. DISCUSSION These preliminary results provide a proof of concept, with high adherence and improved fitness confirming the benefits of remote fitness assessment for guiding home personalized exercise programs among healthy adults aged >65 years. Further examination of the application within a randomized control study is necessary, comparing the personalized exercise program to general guidelines among healthy older adults, as well as specific populations, such as those with frailty, deconditioning, cognitive, or functional impairment. The study tool offers the opportunity to collect big data, including additional variables, with subsequent utilization of artificial intelligence to optimize the personalized exercise program.
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Affiliation(s)
- Yael Netz
- The Academic College at Wingate, Netanya, Israel
| | | | - Michal Arnon
- The Academic College at Wingate, Netanya, Israel
| | - Esther Argov
- The Academic College at Wingate, Netanya, Israel
| | | | - Eti Benmoha
- The Academic College at Wingate, Netanya, Israel
| | - Jeremy M Jacobs
- Department of Geriatric Rehabilitation, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
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25
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Dipla K, Boutou AK, Markopoulou A, Papadopoulos S, Kritikou S, Pitsiou G, Stanopoulos I, Kioumis I, Zafeiridis A. Differences in cerebral oxygenation during exercise in patients with idiopathic pulmonary fibrosis with and without exertional hypoxemia: does exercise intensity matter? Pulmonology 2021; 29:221-229. [PMID: 34274251 DOI: 10.1016/j.pulmoe.2021.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 06/08/2021] [Accepted: 06/15/2021] [Indexed: 10/20/2022] Open
Abstract
INTRODUCTION AND OBJECTIVES Patients with idiopathic pulmonary fibrosis (IPF) present respiratory derangements at rest and during exercise, accompanied by exercise intolerance. Some patients may develop profound exertional desaturation even without resting hypoxemia. Evidence suggests the involvement of reduced cerebral-oxygenation in exercise intolerance. We aimed to examine (i) differences in cerebral-oxygenation during exercise between IPF patients with and without isolated exertional desaturation, (ii) whether the impairments in cerebral-oxygenation are detected at similar exercise intensity, and (iii) correlations between cerebral-oxygenation indices, disease severity, and 6-min walk test (6MWT). MATERIALS AND METHODS Patients with IPF (n = 24; 62.1 ± 9.3 years) without resting hypoxemia underwent cardiopulmonary exercise testing (CPET) with cerebral-oxygenation monitoring via near-infrared-spectroscopy (NIRS). Βased on their pulse-oxymetry saturation (SpO2) during CPET, patients were divided into the "exertional-desaturators" group (SpO2nadir≤89% and ≥6% drop in SpO2) and the "non-exertional-desaturators" group (SpO2nadir≥90% and ≤5% drop). RESULTS During CPET, the "exertional-desaturators" group exhibited lower oxygenated-hemoglobin (-0.67 ± 1.48 vs. 0.69 ± 1.75 μmol/l; p < 0.05) and higher deoxygenated-hemoglobin (1.67 ± 1.13 vs. 0.17 ± 0.62 μmol/l; p < 0.001) than the "non-exertional-desaturators" group. A different pattern (p < 0.01) in cerebral-oxygenation responses was observed in the two groups. In exertional-desaturators oxygenated-hemoglobin declined below baseline even at low/moderate-intensity exercise (p < 0.05), whereas, in non-exertional-desaturators cerebral-oxygenation declined (p < 0.05) at high-intensity exercise. Cerebral-NIRS indices correlated (p < 0.05) with CPET-duration, dyspnea, diffusion capacity, and 6MWT. CONCLUSIONS During incremental exercise, patients with IPF and exertional desaturation present a significant decline in cerebral-oxygenation even during low-intensity exercise. Our findings support the implementation of longer-duration rehabilitation programs in IPF so that lower intensity exercise can be applied at the initial stages. (NCT03683082).
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Affiliation(s)
- Konstantina Dipla
- Exercise Physiology & Biochemistry Laboratory, Dept. of Sport Sciences at Serres, Aristotle University of Thessaloniki, Ippokratous 22, Ag. Ioannis, Serres 621 22, Greece.
| | - Afroditi K Boutou
- Department of Respiratory Medicine, G. Papanikolaou Hospital, Thessaloniki, Greece
| | | | - Stavros Papadopoulos
- Exercise Physiology & Biochemistry Laboratory, Dept. of Sport Sciences at Serres, Aristotle University of Thessaloniki, Ippokratous 22, Ag. Ioannis, Serres 621 22, Greece
| | - Stella Kritikou
- Exercise Physiology & Biochemistry Laboratory, Dept. of Sport Sciences at Serres, Aristotle University of Thessaloniki, Ippokratous 22, Ag. Ioannis, Serres 621 22, Greece
| | - Georgia Pitsiou
- Department of Respiratory Failure, Aristotle University of Thessaloniki, Greece
| | - Ioannis Stanopoulos
- Department of Respiratory Failure, Aristotle University of Thessaloniki, Greece
| | - Ioannis Kioumis
- Department of Respiratory Failure, Aristotle University of Thessaloniki, Greece
| | - Andreas Zafeiridis
- Exercise Physiology & Biochemistry Laboratory, Dept. of Sport Sciences at Serres, Aristotle University of Thessaloniki, Ippokratous 22, Ag. Ioannis, Serres 621 22, Greece
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26
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Latella C, Peddle-McIntyre C, Marcotte L, Steele J, Kendall K, Fairman CM. Strengthening the Case for Cluster Set Resistance Training in Aged and Clinical Settings: Emerging Evidence, Proposed Benefits and Suggestions. Sports Med 2021; 51:1335-51. [PMID: 33983613 DOI: 10.1007/s40279-021-01455-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2021] [Indexed: 12/13/2022]
Abstract
Resistance training (RT) is a fundamental component of exercise prescription aimed at improving overall health and function. RT techniques such as cluster set (CS) configurations, characterized by additional short intra-set or inter-repetition rest intervals, have been shown to maintain acute muscular force, velocity, and 'power' outputs across a RT session, and facilitate positive longer-term neuromuscular adaptations. However, to date CS have mainly been explored from a human performance perspective despite potential for application in health and clinical exercise settings. Therefore, this current opinion piece aims to highlight emerging evidence and provide a rationale for why CS may be an advantageous RT technique for older adults, and across several neurological, neuromuscular, cardiovascular and pulmonary settings. Specifically, CS may minimize acute fatigue and adverse physiologic responses, improve patient tolerance of RT and promote functional adaptations (i.e., force, velocity, and power). Moreover, we propose that CS may be a particularly useful exercise rehabilitation technique where injury or illness, persistent fatigue, weakness and dysfunction exist. We further suggest that CS offer an alternative RT strategy that can be easily implemented alongside existing exercise/rehabilitation programs requiring no extra cost, minimal upskilling and/or time commitment for the patient and professional. In light of the emerging evidence and likely efficacy in clinical exercise practice, future research should move toward further direct investigation of CS-based RT in a variety of adverse health conditions and across the lifespan given the already demonstrated benefits in healthy populations.
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Vogiatzis I, Bouros D. Ergogenic Value of Oxygen Supplementation in Patients with Idiopathic Pulmonary Fibrosis with Isolated Exertional Oxygen Desaturation. Respiration 2021; 100:461-462. [PMID: 33849033 DOI: 10.1159/000515397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 02/17/2021] [Indexed: 11/19/2022] Open
Affiliation(s)
- Ioannis Vogiatzis
- Department of Sport, Exercise and Rehabilitation, Northumbria University Newcastle, Newcastle upon Tyne, United Kingdom
| | - Demosthenes Bouros
- 1st Department of Respiratory Medicine, National and Kapodistrian University of Athens Medical Centre, Athens, Greece
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Cruthirds CL, Deutz NEP, Ligthart-Melis GC, Simbo SY, Engelen MPKJ. Walking exercise alters protein digestion, amino acid absorption, and whole body protein kinetics in older adults with and without COPD. J Appl Physiol (1985) 2021; 130:435-444. [DOI: 10.1152/japplphysiol.00783.2020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Gut function is disturbed in older adults with COPD. As exercise is the cornerstone of pulmonary rehabilitation in COPD, knowledge of the response of the gut to aerobic exercise is of importance.
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Affiliation(s)
- Clayton L. Cruthirds
- Department of Health and Kinesiology, Center for Translational Research in Aging & Longevity, Texas A&M University, College Station, Texas
| | - Nicolaas E. P. Deutz
- Department of Health and Kinesiology, Center for Translational Research in Aging & Longevity, Texas A&M University, College Station, Texas
| | - Gerdien C. Ligthart-Melis
- Department of Health and Kinesiology, Center for Translational Research in Aging & Longevity, Texas A&M University, College Station, Texas
| | - Sunday Y. Simbo
- Department of Health and Kinesiology, Center for Translational Research in Aging & Longevity, Texas A&M University, College Station, Texas
| | - Mariëlle P. K. J. Engelen
- Department of Health and Kinesiology, Center for Translational Research in Aging & Longevity, Texas A&M University, College Station, Texas
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Lo YP, Chiang SL, Lin CH, Liu HC, Chiang LC. Effects of Individualized Aerobic Exercise Training on Physical Activity and Health-Related Physical Fitness among Middle-Aged and Older Adults with Multimorbidity: A Randomized Controlled Trial. Int J Environ Res Public Health 2020; 18:ijerph18010101. [PMID: 33375668 PMCID: PMC7794827 DOI: 10.3390/ijerph18010101] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 12/22/2020] [Accepted: 12/23/2020] [Indexed: 12/21/2022]
Abstract
The presence of multimorbidity in middle-aged and older adults, which reduces their physical activity and quality of life, is a global health challenge. Exercise is one of the most important health behaviors that individuals can engage in. Previous studies have revealed that aerobic exercise training is beneficial for healthy middle-aged and older adults and those with various chronic diseases, but few studies have designed individualized aerobic exercise training for individuals with multimorbidity. Although individuals with multimorbidity are considerably less adherent to physical activity interventions, telephone-based motivational interviewing may help in strengthening motivation and promoting behavioral change for increasing physical activity and health-related physical fitness. This study aimed to examine whether a 12-week individualized aerobic exercise training in a rehabilitation center combined with telephone-based motivational interviewing is effective in promoting physical activity and health-related physical fitness among middle-aged and older adults with multimorbidity. A randomized controlled trial was conducted. Forty-three participants (aged > 40) were recruited and randomly assigned to the intervention group, comparison group, or control group. The participants’ physical activity and health-related physical fitness were assessed at baseline and at 12 weeks. The results indicated that after individualized aerobic exercise training combined with telephone-based motivational interviewing, the participants reported increased total physical activity (Fin = 481.3, p = 0.011), vigorous-intensity physical activity (Fin= 298.9, p = 0.007), dominant and nondominant hand grip (kg) (Fin = 1.96, p = 0.019; Fin = 2.19, p = 0.027, respectively), FEV1/FVC (Fin = 0.045, p = 0.043), VO2 max (ml/kg/min) (Fin = 5.30, p = 0.001), VO2 max predicted (%) (Fin = 21.6, p = 0.001), work (watts) (Fin = 22.5, p = 0.001), and anaerobic threshold (L/min) (Fin = 0.165, p = 0.011). Twelve weeks of individualized aerobic exercise training in the rehabilitation center combined with telephone-based motivational interviewing can increase the total physical activity, vigorous physical activity, and cardiorespiratory fitness of middle-aged and older adults with multimorbidity.
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Affiliation(s)
- Yi-Pang Lo
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei 11490, Taiwan;
- Department of Nursing, Tri-Service General Hospital SongShan Branch, Taipei 10581, Taiwan;
| | - Shang-Lin Chiang
- School of Medicine, National Defense Medical Center, Taipei 11490, Taiwan;
- Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, Taipei 11490, Taiwan;
| | - Chia-Huei Lin
- Department of Nursing, Tri-Service General Hospital SongShan Branch, Taipei 10581, Taiwan;
- School of Nursing, National Defense Medical Center, Taipei 11490, Taiwan
| | - Hung-Chang Liu
- Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, Taipei 11490, Taiwan;
| | - Li-Chi Chiang
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei 11490, Taiwan;
- School of Nursing, National Defense Medical Center, Taipei 11490, Taiwan
- School of Nursing, China Medical University, Taichung 40402, Taiwan
- Correspondence:
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30
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Jayamaha AR, Perera CH, Orme MW, Jones AV, Wijayasiri UKDC, Amarasekara TD, Karunatillake RS, Fernando A, Seneviratne ALP, Barton A, Jones R, Yusuf ZK, Miah RB, Malcolm D, Matheson JA, Free RC, Manise A, Steiner MC, Wimalasekera SW, Singh SJ. Protocol for the cultural adaptation of pulmonary rehabilitation and subsequent testing in a randomised controlled feasibility trial for adults with chronic obstructive pulmonary disease in Sri Lanka. BMJ Open 2020; 10:e041677. [PMID: 33243812 PMCID: PMC7692826 DOI: 10.1136/bmjopen-2020-041677] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 11/05/2020] [Accepted: 11/11/2020] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION International guidelines recommend pulmonary rehabilitation (PR) should be offered to adults living with chronic obstructive pulmonary disease (COPD), but PR availability is limited in Sri Lanka. Culturally appropriate PR needs to be designed and implemented in Sri Lanka. The study aims to adapt PR to the Sri Lankan context and determine the feasibility of conducting a future trial of the adapted PR in Sri Lanka. METHODS AND ANALYSIS Eligible participants will be identified and will be invited to take part in the randomised controlled feasibility trial, which will be conducted in Central Chest Clinic, Colombo, Sri Lanka. A total of 50 participants will be recruited (anticipated from April 2021) to the trial and randomised (1:1) into one of two groups; control group receiving usual care or the intervention group receiving adapted PR. The trial intervention is a Sri Lankan-specific PR programme, which will consist of 12 sessions of exercise and health education, delivered over 6 weeks. Focus groups with adults living with COPD, caregivers and nurses and in-depth interviews with doctors and physiotherapist will be conducted to inform the Sri Lankan specific PR adaptations. After completion of PR, routine measures in both groups will be assessed by a blinded assessor. The primary outcome measure is feasibility, including assessing eligibility, uptake and completion. Qualitative evaluation of the trial using focus groups with participants and in-depth interviews with PR deliverers will be conducted to further determine feasibility and acceptability of PR, as well as the ability to run a larger future trial. ETHICS AND DISSEMINATION Ethical approval was obtained from the ethics review committee of Faculty of Medical Sciences, University of Sri Jayewardenepura, Sri Lanka and University of Leicester, UK. The results of the trial will be disseminated through patient and public involvement events, local and international conference proceedings, and peer-reviewed journals. TRIAL REGISTRATION NUMBER ISRCTN13367735.
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Affiliation(s)
| | | | - Mark W Orme
- Centre for Exercise and Rehabilitation Science, NIHR Leicester Biomedical Research Centre-Respiratory, University Hospitals of Leicester NHS Trust, Leicester, UK
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
| | - Amy V Jones
- Centre for Exercise and Rehabilitation Science, NIHR Leicester Biomedical Research Centre-Respiratory, University Hospitals of Leicester NHS Trust, Leicester, UK
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
| | | | - Thamara D Amarasekara
- Faculty of Allied Health Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
| | | | - Amitha Fernando
- Central Chest Clinic, National Hospital of Sri Lanka, Colombo, Sri Lanka
| | | | - Andy Barton
- Faculty of Health, University of Plymouth, Plymouth, UK
| | - Rupert Jones
- Faculty of Health, University of Plymouth, Plymouth, UK
| | - Zainab K Yusuf
- Centre for Exercise and Rehabilitation Science, NIHR Leicester Biomedical Research Centre-Respiratory, University Hospitals of Leicester NHS Trust, Leicester, UK
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
| | - Ruhme B Miah
- Centre for Exercise and Rehabilitation Science, NIHR Leicester Biomedical Research Centre-Respiratory, University Hospitals of Leicester NHS Trust, Leicester, UK
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
| | - Dominic Malcolm
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | | | - Robert C Free
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
| | - Adrian Manise
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
| | - Michael C Steiner
- Centre for Exercise and Rehabilitation Science, NIHR Leicester Biomedical Research Centre-Respiratory, University Hospitals of Leicester NHS Trust, Leicester, UK
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
| | | | - Sally J Singh
- Centre for Exercise and Rehabilitation Science, NIHR Leicester Biomedical Research Centre-Respiratory, University Hospitals of Leicester NHS Trust, Leicester, UK
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
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Li S, Ma X, Xie J, Yan X, Sun W. MicroRNA-206, IL-4, IL-13, and INF-γ levels in lung tissue and plasma are increased by the stimulation of particulate matter with a diameter of ≤2.5μm, and are associated with the poor prognosis of asthma induced pulmonary arterial hypertension patients. Clin Exp Hypertens 2020; 43:181-188. [PMID: 33086901 DOI: 10.1080/10641963.2020.1836192] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND This study aimed to explore the prognostic value of particulate matter with a diameter of ≤2.5 μm (PM2.5)-related microRNA-206 combined with interleukin (IL)-4, IL-13 and interferon-γ (INF-γ) in asthma induced pulmonary arterial hypertension (PAH). METHODS Fifty SPF BALB/c mice were divided into 5 groups: control group, asthma + PAH group, low-toxic asthma + PAH group, moderately-exposed asthma + PAH group, highly-exposed asthma + PAH group. Differences of microRNA-206, IL-4, IL-13, and INF-γ expression in lung tissue and plasma were detected. A total of 98 patients with asthma induced PAH and 98 healthy persons were collected. Patients were followed up for 12 months. RESULTS Based on microarray analyses, we found that microRNA-206 may be involved in asthma induced PAH stimulated by PM2.5. Compared with healthy people, plasma microRNA-206, IL-4, IL-13, and INF-γ levels in asthma induced PAH patients were significantly higher (P< .05). Compared with survivors, plasma microRNA-206, IL-4, IL-13, and INF-γ levels in non-survivors were significantly higher (P< .05). Survival analyses showed that compared with low microRNA-206, low IL-4, low IL-13 and low INF-γ groups, survival rate of patients in high microRNA-206 (χ2 = 4.864, P= .013), high IL-4 (χ2 = 3.774, P= .038), high IL-13 (χ2 = 8.375, P< .001) and high INF-γ groups (χ2 = 9.007, P< .001) were significantly reduced. Established prognostic evaluation model was built and the estimated probability was 0.473. Compared with estimated probability ≤ 0.473, survival rate of patients in estimated probability> 0.473 was significantly reduced (χ2 = 17.377, P< .001). CONCLUSION Current model combining plasma microRNA-206, IL-4, IL-13, and INF-γ has potential significance for prognosis of asthma induced PAH.
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Affiliation(s)
- Shaohua Li
- Department of Respiratory and Critical Care Medical, The Second Hospital of Hebei Medical University , Shijiazhuang, Hebei, China.,Department of Respiratory and Critical Care Medical, The First Hospital of Hebei Medical University , Shijiazhuang, Hebei, China
| | - Xiaoning Ma
- Intensive Care Unit of Shijiazhuang First Hospital, People's Hospital in Shijiazhuang , Shijiazhuang, Hebei, China
| | - Jianli Xie
- Rheumatology and Immunology Department, The Third Hospital of Hebei Medical University , Shijiazhuang, Hebei, China
| | - Xixin Yan
- Department of Respiratory and Critical Care Medical, The Second Hospital of Hebei Medical University , Shijiazhuang, Hebei, China
| | - Wuzhuang Sun
- Department of Respiratory and Critical Care Medical, The First Hospital of Hebei Medical University , Shijiazhuang, Hebei, China
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Barlow R, Jones B, Rogerson M, Bannister H, Stuart R, Iqbal J, Andrews L, Easton I. An Evaluation of Service Provision and Novel Strength Assessment on Patient Outcomes in a UK-Based Pulmonary Rehabilitation Setting. COPD 2020; 17:280-288. [PMID: 32419522 DOI: 10.1080/15412555.2020.1764519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
This study's purpose was to (i) assess the impact of a 7-week pulmonary rehabilitation (PR) programme upon patient outcomes; incremental shuttle walk test (ISWT), COPD assessment tool (CAT), Clinical COPD Questionnaire (CCQ) and the Hospital Anxiety and Depression Scale (HADS); (ii) assess the impact of COPD severity on ISWT, psychological functioning and quality of life measures following PR; (iii) assess the feasibility of incorporating individually prescribed one repetition maximum (1RM) training loads into the existing strength training programme. Patients were people with COPD enrolled onto one of three versions (locations A, B and C) of a 7-week PR programme, which consisted of group exercise sessions and a social plus education element. Two locations incorporated individually prescribed training loads. Minimal clinically important changes (MCICs) are reported for the ISWT across all locations. Statistically significant changes in both CAT and the CCQ were found, with MCIC's evident for CAT score overall and individually at location B. MCIC's were not found for the CCQ. No statistically significant or MCICs were evident for the HADS. MCIC's were present only in patients with mild to moderate severity for the ISWT. For the CAT, moderate, severe and very severe patients with COPD experienced MCIC's. MCIC's and statistically significant increases in 1RM strength were seen at both locations. These findings evidence an effective PR service. Basic strength exercise programming and assessment are feasible and should be implemented in PR services to maximise patient outcomes.
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Affiliation(s)
| | - Ben Jones
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Colchester, UK
| | - Mike Rogerson
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Colchester, UK
| | | | | | - Jawadh Iqbal
- School of Health and Social Care, University of Essex, Colchester, UK
| | - Leanne Andrews
- School of Health and Social Care, University of Essex, Colchester, UK
| | - Izzie Easton
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Colchester, UK
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Polastri M. Physiotherapeutic regimen in patients with chronic obstructive pulmonary disease: from the intensive care unit to home-based rehabilitation. International Journal of Therapy and Rehabilitation 2020. [DOI: 10.12968/ijtr.2019.0156] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Massimiliano Polastri
- Medical Department of Continuity of Care and Disability, Physical Medicine and Rehabilitation, St Orsola University Hospital, Bologna, Italy
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Machado A, Quadflieg K, Oliveira A, Keytsman C, Marques A, Hansen D, Burtin C. Exercise Training in Patients with Chronic Respiratory Diseases: Are Cardiovascular Comorbidities and Outcomes Taken into Account?-A Systematic Review. J Clin Med 2019; 8:E1458. [PMID: 31540240 PMCID: PMC6780679 DOI: 10.3390/jcm8091458] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 09/06/2019] [Accepted: 09/10/2019] [Indexed: 12/16/2022] Open
Abstract
Patients with chronic obstructive pulmonary disease (COPD), asthma and interstitial lung diseases (ILD) frequently suffer from cardiovascular comorbidities (CVC). Exercise training is a cornerstone intervention for the management of these conditions, however recommendations on tailoring programmes to patients suffering from respiratory diseases and CVC are scarce. This systematic review aimed to identify the eligibility criteria used to select patients with COPD, asthma or ILD and CVC to exercise programmes; assess the impact of exercise on cardiovascular outcomes; and identify how exercise programmes were tailored to CVC. PubMed, Scopus, Web of Science and Cochrane were searched. Three reviewers extracted the data and two reviewers independently assessed the quality of studies with the Quality Assessment Tool for Quantitative Studies. MetaXL 5.3 was used to calculate the individual and pooled effect sizes (ES). Most studies (58.9%) excluded patients with both stable and unstable CVC. In total, 26/42 studies reported cardiovascular outcomes. Resting heart rate was the most reported outcome measure (n = 13) and a small statistically significant effect (ES = -0.23) of exercise training on resting heart rate of patients with COPD was found. No specific adjustments to exercise prescription were described. Few studies have included patients with CVC. There was a lack of tailoring of exercise programmes and limited effects were found. Future studies should explore the effect of tailored exercise programmes on relevant outcome measures in respiratory patients with CVC.
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Affiliation(s)
- Ana Machado
- REVAL-Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium
- Respiratory Research and Rehabilitation Laboratory (Lab3R), School of Health Sciences (ESSUA), University of Aveiro, 3810 Aveiro, Portugal
| | - Kirsten Quadflieg
- REVAL-Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium
| | - Ana Oliveira
- Respiratory Research and Rehabilitation Laboratory (Lab3R), School of Health Sciences (ESSUA), University of Aveiro, 3810 Aveiro, Portugal
- Respiratory Medicine, West Park Healthcare Centre, Toronto, ON M6M 2J5, Canada
- School of Rehabilitation Sciences, Faculty of Health Sciences, McMaster University, Hamilton, ON L8S 4K1, Canada
| | - Charly Keytsman
- REVAL-Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium
- BIOMED-Biomedical Research Institute, Hasselt University, 3590 Diepenbeek, Belgium
| | - Alda Marques
- Respiratory Research and Rehabilitation Laboratory (Lab3R), School of Health Sciences (ESSUA), University of Aveiro, 3810 Aveiro, Portugal
- Institute of Biomedicine (iBiMED), University of Aveiro, 3810 Aveiro, Portugal
| | - Dominique Hansen
- REVAL-Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium
- BIOMED-Biomedical Research Institute, Hasselt University, 3590 Diepenbeek, Belgium
- Jessa hospital, Heart Centre Hasselt, 3500 Hasselt, Belgium
| | - Chris Burtin
- REVAL-Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium.
- BIOMED-Biomedical Research Institute, Hasselt University, 3590 Diepenbeek, Belgium.
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Alison JA, Franssen FM. Optimizing health in chronic lung diseases: What did we learn from the experts in pulmonary rehabilitation? Respirology 2019; 24:916-917. [DOI: 10.1111/resp.13638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Accepted: 05/13/2019] [Indexed: 12/09/2022]
Affiliation(s)
- Jennifer A. Alison
- Faculty of Health SciencesUniversity of Sydney Sydney NSW Australia
- Sydney Local Health District Sydney NSW Australia
| | - Frits M.E. Franssen
- CIRO Horn The Netherlands
- Department of Respiratory MedicineMaastricht University Medical Centre Maastricht The Netherlands
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O'Donnell DE, Neder JA. Chronic respiratory diseases: The dawn of precision rehabilitation. Respirology 2019; 24:826-827. [DOI: 10.1111/resp.13640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 06/10/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Denis E. O'Donnell
- Respiratory Investigation Unit and Laboratory of Clinical Exercise Physiology, Division of Respirology, Department of MedicineQueen's University and Kingston Health Science Center Kingston ON Canada
| | - J. Alberto Neder
- Respiratory Investigation Unit and Laboratory of Clinical Exercise Physiology, Division of Respirology, Department of MedicineQueen's University and Kingston Health Science Center Kingston ON Canada
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