Elastic tubing training had a greater effect on functional exercise capacity than conventional resistance training. Both interventions were equally effective in improving muscle strength and quality of life.

High-intensity exercise training improves HRV at rest and during orthostatic stimulus in patients with COPD. Better baseline total HRV, muscle force and daily physical activity level are predictors of HRV improvements after the training program.

Background: Low-grade inflammation can be present in chronic obstructive pulmonary disease (COPD), which may affect the regulation of muscle protein and body metabolism. Regular exercise show improvement in muscle strength and dyspnea in patients with COPD, however, the response to training on inflammatory and metabolic disorders is unclear. In this study, we compared the effects of resistance training using weight machines and elastic resistance (bands and tubes) on the inflammatory and metabolic responses in patients with COPD.Methods: Patients with COPD were randomized into three groups: elastic band group (EBG), elastic tube group (ETG), and weight machines equipment group (MG). EBG and ETG were analyzed together [elastic group (EG)]. The participants were evaluated for pulmonary function (spirometry), peripheral muscle strength (digital dynamometry), IL-6, TNF-α, IL-10, IL-15 (Immunoassay), glucose, triacylglycerol, total cholesterol, HDL-c, and albumin levels (Enzymatic colorimetric). Blood samples were collected to assess the acute and chronic exercise responses after 12 weeks of training protocol.Results: The patient's mean age was 71.53 ± 6.97 years old. FEV1 (percent predicted) was 50.69 ± 16.67 and 45.40 ± 15.15% for EG and MG, respectively (p = 0.28). All groups increased muscle strength (p < 0.05) with no differences between groups. The acute response to exercise after 12 weeks of training showed improvement of inflammation when compared to baseline. Regarding the chronic effects, it was observed a decrease of all cytokines, except IL-10 (p < 0.05). After 12 weeks of training, the analysis of the metabolic profile presented a reduction in glucose concentration (p < 0.01), with no differences between groups (p = 0.30) and a decrease in triacylglycerol for the EG (p > 0.01).Conclusions: Training with elastic resistances or conventional weight machines showed improvement of inflammation response after 12 weeks of training. Chronically, both training groups showed anti-inflammatory effects, with the EG showing a strong tendency to improve IL-10/TNF-α ratio and IL-10 levels.Trial registration : RBR-6V9SJJ.

Influence of pursed-lip breathing on heart rate variability and cardiorespiratory parameters in subjects with chronic obstructive pulmonary disease (COPD) Influência da respiração freno-labial sobre a variabilidade da frequência cardíaca e parâmetros cardiorrespiratórios em pacientes com doença pulmonar obstrutiva crônica (DPOC) Ramos AbstractObjectives: To assess the effects of pursed-lip breathing (PLB) at rest on the behavior of heart rate (HR) and its variability, and on variations in blood pressure (BP), respiratory rate (RR) and pulse oxygen saturation (SpO 2 ) in subjects with chronic obstructive pulmonary disease (COPD). Methods: Sixteen subjects with COPD (seven in GOLD stage I, three in GOLD stage II and six in GOLD stage III; mean age 64±11 years; mean FEV 1 60±25% of predicted value) were assessed at rest, in a seated position, under the following conditions: ten minutes of normal breathing without PLB (R1), eight minutes with PLB (R2) and ten minutes of normal breathing once more (R3). HR was recorded, beat-to-beat, by means of a Polar S810 heart monitor. The RMSSD index (root mean square of the difference between successive R-R intervals) was determined. BP, RR and SpO 2 were also assessed during the trials. ANOVA for repeated measures followed by the Tukey test and Kruskal-Wallis test were used for data analysis, with a 5% significance level. Results: There was a significant increase in the RMSSD index during R2, in comparison with R1. The HR variation between inspiration and expiration was 8.98 bpm, and the variation between HR at rest and HR with PLB was 8.25 bpm. During R2, RR decreased and SpO 2 increased significantly in comparison with R1 and R3. BP values did not show significant changes. Conclusions: The results showed that PLB produced significant changes in HR, RR and SpO 2 , and did not alter BP in subjects with COPD. Furthermore, analysis of the RMSSD index showed that PLB promoted increased parasympathetic activity in these subjects, thus indicating that this technique influenced the autonomic cardiac modulation.Key words: Chronic obstructive pulmonary disease; pursed-lip breathing; heart rate variability. ResumoObjetivos: Avaliar os efeitos da respiração freno-labial (RFL), em repouso, sobre o comportamento da frequência cardíaca (FC) e sua variabilidade e variações na pressão arterial (PA), frequência respiratória (FR) e saturação parcial de oxigênio (SpO 2 ) em pacientes com doença pulmonar obstrutiva crônica (DPOC). Métodos: Dezesseis pacientes com DPOC (7: estágio GOLD I, 3: estágio GOLD II e 6: estágio GOLD III; média de idade=64±11; média de VEF 1 =60±25% do predito) foram avaliados em repouso, na posição sentada, nas seguintes condições: 10 minutos respirando normalmente sem RFL (R1), 8 minutos com RFL (R2) e 10 minutos respirando novamente normalmente (R3 Os resultados mostraram que a RFL produziu modificações significativas na FC, FR e SpO 2 e não alterou a PA em pacientes com DPOC. Além disso, a análise do índice RMSSD mostrou que a RFL promoveu aumento da atividade para...

Background: Smoking impairs mucociliary clearance and increases respiratory infection frequency and severity in subjects with and without smoking-related chronic lung diseases. Objective: This study evaluated the effects of smoking intensity on mucociliary clearance in active smokers. Methods: Seventy-five active smokers were grouped into light (1-10 cigarettes/day; n = 14), moderate (11-20 cigarettes/day; n = 34) and heavy smokers (≥21 cigarettes/day; n = 27) before starting a smoking cessation programme. Smoking behaviour, nicotine dependence, pulmonary function, carbon monoxide in exhaled air (exCO), carboxyhaemoglobin (COHb) and mucociliary clearance measured by the saccharin transit time (STT) test were all evaluated. An age-matched non-smoker group (n = 24) was assessed using the same tests. Results: Moderate (49 ± 7 years) and heavy smokers (46 ± 8 years) had higher STT (p = 0.0001), exCO (p < 0.0001) and COHb (p < 0.0001) levels compared with light smokers (51 ± 15 years) and non-smokers (50 ± 11 years). A positive correlation was observed between STT and exCO (r = 0.4; p < 0.0001), STT and cigarettes/day (r = 0.3, p = 0.02) and exCO and cigarettes/day (r = 0.3, p < 0.01). Conclusion: Smoking impairs mucociliary clearance and is associated with cigarette smoking intensity.

Background: oropharyngeal dysphagia in patients with chronic obstructive pulmonary disease.

Our findings suggest that patients with severe COPD can exhibit compromised "inflammatory status", characterized by higher IL6, IL-6/IL-10 ratio and lower IL-10 concentration. Furthermore, IL-10 seems to be an interesting cytokine to be investigated in this kind of patients.

Nasal mucociliary system is the first line of defense of the upper airways and may be affected acutely by exposure to particulate matter (PM) from biomass burning. Several epidemiologic studies have demonstrated a consistent association between levels of air pollution from biomass burning with increases in hospitalization for respiratory diseases and mortality. To determine the acute effects of exposure to particulate matter from biomass burning in nasal mucociliary transport by saccharin transit time (STT) test, we studied thirty-three non-smokers and twelve light smokers sugarcane cutters in two periods: pre-harvest season and 4 h after harvest at the first day after biomass burning. Lung function, exhaled carbon monoxide (CO), nasal symptoms questionnaire and mucociliary clearance (MC) were assessed. Exhaled CO was increased in smokers compared to non-smokers but did not change significantly after harvest. In contrast, STT was similar between smokers and non-smokers and decreased significantly after harvest in both groups (p < 0.001). Exposure to PM from biomass burning did not influence nasal symptoms. Our results suggest that acute exposure to particulate matter from sugarcane burned affects mucociliary clearance in smokers and non-smokers workers in the absence of symptoms.