Home-based pulmonary rehabilitation improves clinical features and systemic inflammation in chronic obstructive pulmonary disease patients

Abstract

Chronic obstructive pulmonary disease (COPD) is a respiratory disease characterized by chronic airflow limitation that leads beyond the pulmonary changes to important systemic effects. COPD is characterized by pulmonary and systemic inflammation. However, increases in the levels of inflammatory cytokines in plasma are found even when the disease is stable. Pulmonary rehabilitation improves physical exercise capacity and quality of life and decreases dyspnea. The aim of this study was to evaluate whether a home-based pulmonary rehabilitation (HBPR) program improves exercise tolerance in COPD patients, as well as health-related quality of life and systemic inflammation. This prospective study was conducted at the Laboratory of Functional Respiratory Evaluation, Nove de Julho University, São Paulo, Brazil. After anamnesis, patients were subjected to evaluations of health-related quality of life and dyspnea, spirometry, respiratory muscle strength, upper limbs incremental test, incremental shuttle walk test, and blood test for quantification of systemic inflammatory markers (interleukin [IL]-6 and IL-8). At the end of the evaluations, patients received a booklet containing the physical exercises to be performed at home, three times per week for 8 consecutive weeks. Around 25 patients were enrolled, and 14 completed the pre- and post-HBPR ratings. There was a significant increase in the walked distance and the maximal inspiratory pressure, improvements on two components from the health-related quality-of-life questionnaire, and a decrease in plasma IL-8 levels after the intervention. The HBPR is an important and viable alternative to pulmonary rehabilitation for the treatment of patients with COPD; it improves exercise tolerance, inspiratory muscle strength, quality of life, and systemic inflammation in COPD patients.

Effects of combined aerobic and resistance training on the glycolipid metabolism and inflammation levels in type 2 diabetes mellitus

“…There was research also demontrated that the home-based exercise improved the metabolic asset and reduced the systemic inflammation of sedentary people 40 ) . Another study proved that home-based exercise could improve clinical features and systemic inflammation of patients with chronic obstructive pulmonary disease 41 ) . In the present study, the intensive intervention program for diabetes patients included a 12-week moderate-intensity workout program consisting of aerobic exercise and resistance training (i.e., the IT group).…”

Association between respiratory variables and exercise capacity in COPD patients

“…In COPD patients, some factors directly contribute to the reduction in exercise capacity, among which nutritional depletion, skeletal muscle dysfunction and respiratory muscle weakness are emphasized. 18 Studies that show the influence of FEV 1 and FVC reduction on exercise capacity used the 6MWT so that the use of ISWT and its association with respiratory muscle strength leads to original results in our study. 19,20 The response required by the 6MWT reflects the efforts made in ADL and the short distance walked in the test reproduces such limitations in daily life, which may also be used as a predictor of exercise capacity and COPD severity.…”

Physical therapy in chronic obstructive pulmonary disease (analysis of the evidence-based medicine)

“…All studies found that pulmonary rehabilitation programs or individual physical therapy programs were effective in improving the quality of life [12][13][14][15][16][17], physical endurance [12][13][14][15][16][18][19][20][21][22][23], respiratory muscle strength [13,18,23], reducing symptoms of CoPd [14,16,19,23], improving the function of external breathing [16,[24][25][26], blood parameters [22,27], cognitive functions [21], functional state of muscles [28], survival rates [29,30], and reducing the number of hospital days [31]. The main part of investigations was devoted to the comparison of therapeutic rehabilitation programs that included several components and referred to stable patients with CoPd.…”