Effects of Exercise Training on Cardiopulmonary Function and Quality of Life in Elderly Patients with Pulmonary Fibrosis: A Meta-Analysis

Abstract

(1) Objective: Our objective was to conduct a meta-analysis of randomized controlled trials that have evaluated the benefits of exercise training for elderly pulmonary fibrosis (PF) patients. (2) Methods: Studies in either English or Chinese were retrieved from the China National Knowledge Infrastructure (CNKI) and the Wanfang, PubMed, Web of Science and SPORTDiscus databases from inception until the first week of April 2021. Age, body mass index (BMI), and exercise frequency, intensity, type, and duration were considered for each participant. The specific data recorded were the six-minute walk distance (6MWD), maximal rate of oxygen consumption (peak VO2), predicted forced vital capacity (FVC% pred), predicted diffusing capacity of the lung for carbon monoxide (DLCO% pred), predicted total lung capacity (TLC% pred), St. George’s respiratory questionnaire (SGRQ) total score and a modified medical research council score (mMRC). (3) Results: Thirteen studies comprised this meta-analysis (eleven randomized controlled trials and two prospective studies design), wherein 335 patients were exercised and 334 were controls. The results showed that exercise training increased the 6MWD (Cohen’s d = 0.77, MD = 34.04 (95% CI, 26.50–41.58), p < 0.01), peak VO2 (Cohen’s d = 0.45, MD = 1.13 (95% CI, 0.45–1.82), p = 0.0001) and FVC% pred (Cohen’s d = 0.42, MD = 3.94 (95% CI, 0.91–6.96), p = 0.01). However, exercise training reduced scores for the SGRQ (Cohen’s d = 0.89, MD = −8.79 (95% CI, −10.37 to −7.21), p < 0.01) and the mMRC (Cohen’s d = 0.64, MD = −0.58 (95% CI, −0.79 to −0.36), p < 0.01). In contrast, exercise training could not increase DLCO% pred (Cohen’s d = 0.16, MD = 1.86 (95% CI, −0.37–4.09), p = 0.10) and TLC% pred (Cohen’s d = 0.02, MD = 0.07 (95% CI, −6.53–6.67), p = 0.98). Subgroup analysis showed significant differences in frequency, intensity, type, and age in the 6MWD results (p < 0.05), which were higher with low frequency, moderate intensity, aerobic–resistance–flexibility–breathing exercises and age ≤ 70. Meanwhile, the subgroup analysis showed significant differences in exercise intensity and types in the mMRC results (p < 0.05), which were lower with moderate intensity and aerobic–resistance exercises. (4) Conclusions: Exercise training during pulmonary rehabilitation can improved cardiopulmonary endurance and quality of life in elderly patients with PF. The 6MWDs were more noticeable with moderate exercise intensity, combined aerobic–resistance–flexibility–breathing exercises and in younger patients, which all were not affected by BMI levels or exercise durations. As to pulmonary function, exercise training can improve FVC% pred, but has no effect on DLCO% pred and TLC% pred.

APOE in the bullseye of neurodegenerative diseases: impact of the APOE genotype in Alzheimer’s disease pathology and brain diseases

“…Several robust studies have shown the health benefits of physical activity in cardiopulmonary function, neuroplasticity, cognition, and bone density [582,583]. Interestingly, related to bone density, it was recently reported the discovery of a specialized bone-cell progenitor that supports immune cell generation in response to physical Fernández-Calle et al Molecular Neurodegeneration (2022) 17:62 exercise [584].…”

Effects of a Long-Term Wearable Activity Tracker-Based Exercise Intervention on Cardiac Morphology and Function of Patients with Cystic Fibrosis

“…Apart from the widely acknowledged cardiovascular and musculoskeletal benefits of exercise in chronic disease patients, studies have described specific mechanisms of physical training to maintain respiratory function [29,30]. It was reported that a single bout of moderate-intensity exercise might have an acute bronchodilator effect, increasing both FEV1 and FEF27-75 [31].…”

Effects of Osimertinib Combined With Pulmonary Rehabilitation and Health Care Training on Pulmonary Function, Complications, and Quality of Life in Patients After Radical Resection of Lung Cancer

“…(5) Patients who were not malnourished; (6) Patients who had an expected survival time of more than 6 months; (7) The Karnofsky performance status score was more than 60 points in patients; (8) The age of the patients was more than 18 years old; and (9) Patients who had good tolerance and compliance. In the following circumstances, patients were not included in this study: (1) Patients with some factors such as hearing impairment, language disorders, unconsciousness or mental illness, and patients who could not communicate with others; (2) Patients with a grave organic disease or dysfunction in vital organs; (3) Patients with complications, such as pulmonary infection and respiratory failure; (4) Patients with malnutrition or excessive obesity; (5) Patients with the expected survival period <6 months; and (6) Patients with the training participation rate <80%.…”

“…At present, chemotherapy has an exact effect on SCLC, and about 1% of patients can be cured by chemotherapy (6). However, the effects of chemotherapy in patients with NSCLC are unsatisfactory, and patients can only relieve the clinical symptoms through chemotherapy drugs, which cannot effectively improve pulmonary function (7). For patients with NSCLC with the EGFR gene mutation, the T790M mutation will lead to an increase in chemoresistance, and patients who are insensitive to the conventional pemetrexed often get worse after treatment (8).…”