BackgroundLung volume therapy with the Voldyne® device can improve lung volume and has a nonsignificant benefit on respiratory muscle strength via the slow deep-breathing technique (SDBT); whereas respiratory muscle training with a respiratory muscle trainer via the fast deep-breathing technique (FDBT) has produced a significant improvement in people with COPD. Thus, the aim of this study was to compare the efficiency of lung volume therapy with the Voldyne® device with the SDBT and FDBT on pulmonary function, respiratory muscle strength, oxidative stress, cytokines, walking capacity, and quality of life (QoL) in people with COPD.MethodsA total of 30 COPD patient volunteers with mild (stage I) to moderate (stage II) severity were randomized into two groups: SDBT (n=15) and FDBT (n=15). Pulmonary function (FVC, FEV1, and FEV1/FVC), maximal inspiratory mouth pressure (PImax), oxidative stress status (total antioxidant capacity [TAC], glutathione [GSH], malondialdehyde [MDA], and nitric oxide [NO]), inflammatory cytokines (tumor necrosis factor-alpha [TNF-α] and IL-6), 6-minute walking distance (6MWD), and total clinical COPD questionnaire (CCQ) score were evaluated before and after 4 weeks of training.ResultsAll the parameters had no statistical difference between the groups before training. The PImax, TAC, IL-6, total QoL score, and 6MWD changed significantly in the SDBT group after the 4-week experiment as compared to those in the pre-experimental period, whereas FVC, FEV1, FEV1%, FEV1/FVC%, PImax, TAC, MDA, NO, TNF-α, IL-6, 6MWD, and total CCQ score changed significantly in the FDBT group as compared to those in the pre-experimental period. The FEV1%, PImax, TNF-α, IL-6, and total CCQ score differed significantly in the FDBT group in the post-experimental period as compared to those in the SDBT group.ConclusionThis preliminary study concluded that the application of incentive spirometry with the Voldyne® device via fast deep breathing possibly improved respiratory muscle strength and QoL and reduced inflammatory cytokines, MDA, and NO better than that via slow deep breathing among people with COPD.

Background: Star fruit (Averrhoa carambola L.) is a seasonal fruit, which has proven antioxidant and inflammation activities in vitro. However, sweet-type is more available than sour-type. Therefore, developing a new product from sweet-type star fruit, and evaluating its effectiveness on antioxidants and inflammation have been very challenging. Objectives: The aims were to develop a prototype product from sweet-type star fruit and evaluate its effectiveness with or without walking exercise on participants with stable chronic obstructive pulmonary disease (COPD). Methods: The prototype product of sweet-type star fruit was prepared industrially by mixing with honey before nutrients such as L-ascorbic acid (Vit C) and total phenolic compound, and contaminants like chemicals, microbials and oxalic acid were evaluated. Effectiveness of this product on antioxidents, inflammation and physical function was evaluated in participants with stable COPD with and without walking exercise, and compared to walking exercise and control participants. Two spoons of the product (20 g) in sterile warm water (150 mL) were guided and consumed twice daily for 4 weeks, whereas the walking exercise was prescribed with moderate intensity at home for 30 min 3 days per week. Plasma Vit C, total antioxidant capacity (TAC), malondialdehyde (MDA), tumor necrotic factoralpha (TNF-∝) and 6-minutes walking distance (6MWD) were evaluated before and after the 4-week study period. Results: The prototype product composed of star fruit juice with honey (1:1, v:v). Main nutrients were composed of ash (0.4 g), carbohydrate (74.59 g), lipid (2.88 g), protein (0.57 g) and 326.56 kcal of total energy, whereas Vit C and total phenolic compound were equivalent to 0.25 ± 0.11 mg and 144.89 ± 2.51 µg gallic acid equivalent in a 100 gram of product. The results of chemicals and microbials showed safety under food conditions. The results of study compared the ages of stable COPD participants between those of the controls (n=10, 69.20±1.40 years), and those with star fruit juice and honey supplement (n=20, 71.25 ± 6.01 years), walking exercise (n=15, 60.60±3.38 years), and supplement with walking exercise (n=15, 64.40±1.63 years) and no statistical difference was shown in any parameters in the control group. Whereas, the plasma Vit C and TAC levels increased, and MDA and TNF-∝ levels reduced significantly, in the supplement consumption group, which was in contrast to the Vit C, MDA and TNF-∝ levels in the walking exercise group. However, the TAC level increased significantly when the walking exercise was completed. When the prototype product was applied to the walking exercise, the levels of Vit C and TAC increased, and MDA and TNF-∝ levels reduced significantly. Whereas, the supplement levels increased significantly in all of the groups, especially in the 6MWD. Conclusion: This study proposed that sweet-type star fruit can be prepared industrially by mixing with honey, and be developed as a new commercial product with antioxidant and inflammation activities for p...

Sapodilla is one of many fruits that has been consumed in all people in Thailand, especially in the elderly. The aim of this preliminary was to evaluate the antioxidant compounds, radical scavenging and anti-inflammatory activities of ripe sapodilla extracts, and the effects of their consumption on antioxidants, vitamins, lipid profiles, cytokines, and walking distance in healthy elderly volunteers. Vitamin A, E and C, total phenolics, the activity of scavenging Superoxide (O 2 o-), Hydroxyl (OH o ), Hydrogen Peroxide (H 2 O 2 ) and Nitric Oxide (NO), and inhibition of Tumor Necrosis Factor-Alpha (TNF-α) were identified in vitro. Whereas in elderly subjects, Total Antioxidant Capacity (TAC), Glutathione (GSH), Malondialdehyde (MDA), Protein Hydroperoxide (PrOOH), Nitric Oxide (NO), vitamins, lipid profiles (triglyceride, cholesterol, high-density lipoprotein-cholesterol; HDL-C, lowdensity lipoprotein; LDL), glucose, TNF-α, interleukin (IL-23 and IL-2), and 6-Minute Walking Distance (6MWD) were evaluated before and after 4-week consumption of 100 g of fresh sapodilla fruit twice daily.Results specific to in vitro data showed that sapodilla extract contained vitamin C and A, total phenolics, scavenged OH o , O 2 o-, NO, and H 2 O 2 , and inhibited TNF-α in a dose-dependent manner. The results in elderly individuals showed a significant increase of TAC, and vitamin C and A, while the NO level decreased. A significant decrease in cholesterol and increase in glucose with no significant change in all cytokines, were noted after consumption. Finally, the 6MWD improved significantly. This preliminary study demonstrates that ripe sapodilla fruit shows antioxidant and anti-inflammatory activities and benefits for health status among elderly persons.

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Clinical benefits of rehabilitation are very difficult to present because of various factors such as very small sample sizes, no control comparison, or short period of intervention.