Pulmonary function, inflammation, exercise capacity and quality of life in cystic fibrosis

Bradley, Judy; McAlister, Olibhear; Elborn, J. Stuart

doi:10.1183/09031936.01.17407120

Cited by 66 publications

(47 citation statements)

References 11 publications

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“…The negative association between inflammation and exercise capacity is compatible with the concept that chronic systemic inflammation results in a reduced exercise capacity due to devastating effects on skeletal muscle [32,34], which is not limited to CF disease [20] but is also present in other chronic inflammatory diseases, such as chronic obstructive pulmonary disease [29]. Skeletal muscle mass and function have been shown to be related to exercise capacity in CF [5,35], but were unfortunately not measured in our study.…”

Section: Discussionsupporting

confidence: 71%

“…Although CRP levels were found to be negatively correlated with exercise capacity in patients with CF in a univariate model [20], we did not find an association between CRP levels and longitudinal changes in exercise capacity. CRP is an acute phase reactant that is predominantly elevated during acute infectious diseases and only slightly in patients suffering from chronic infectious diseases.…”

Section: Discussioncontrasting

confidence: 46%

“…A study in adult patients with CF showed that higher Creactive protein (CRP), total and specific immunoglobulin (Ig)G, and total leukocyte levels were significantly associated with decreased pulmonary function [18,19]. Another study showed that a change in CRP level was negatively associated with exercise capacity, but the effect of CRP level on exercise capacity was never investigated in a multivariate model [20].…”

mentioning

confidence: 99%

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Chronic infection and inflammation affect exercise capacity in cystic fibrosis

Leeuwen¹,

Slieker²,

Hulzebos³

et al. 2011

Eur Respir J

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Pulmonary function and nutritional status are important determinants of exercise capacity in patients with cystic fibrosis (CF). Studies investigating the effects of determinants, such as genotype or infection and inflammation, are scarce and have never been analysed in a multivariate longitudinal model.A prospective longitudinal cohort study was performed to evaluate whether genotype, chronic inflammation and infection were associated with changes in exercise capacity. Furthermore, we investigated whether exercise capacity can predict clinical outcome.504 exercise tests of 149 adolescents with CF were evaluated. Maximal oxygen uptake corrected for body mass % predicted declined 20% during adolescence, and was associated with immunoglobulin (Ig)G levels and chronic Pseudomonas aeruginosa infection. A lower exercise capacity was associated with a higher mortality, steeper decline in pulmonary function and greater increase in IgG levels.Since a decline in exercise capacity during adolescence was negatively associated with IgG levels and chronic P. aeruginosa infection, these data emphasise the importance of prevention and treatment of chronic inflammation and infections in patients with CF. Furthermore, a lower exercise capacity was associated with a higher mortality rate, steeper decline in pulmonary function and higher increase in IgG levels with increasing age in adolescents with CF. This stresses the value of regular exercise testing for assessing prognosis in adolescents with CF.

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Section: Discussionsupporting

confidence: 71%

Section: Discussioncontrasting

confidence: 46%

mentioning

confidence: 99%

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Chronic infection and inflammation affect exercise capacity in cystic fibrosis

Leeuwen¹,

Slieker²,

Hulzebos³

et al. 2011

Eur Respir J

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“…In the present study, the 6MWD was an independent predictor for both WHOQOL-BREF and CFQOL scores. Bradley et al 42 demonstrated that the performance in the modified shuttle test was significantly associated with the change in quality of life according to the Chronic Respiratory Disease Questionnaire. 43 The 6-min walk test is a useful measure of functional capacity, and it has been widely used to measure the response to therapeutic interventions for pulmonary disease such as CF.…”

Section: Discussionmentioning

confidence: 99%

Relationship Between Clinical Variables and Health-Related Quality of Life in Young Adult Subjects With Cystic Fibrosis

Forte

Perin

et al. 2015

Respir Care

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BACKGROUND: Health-related quality of life (HRQOL) has received much attention in patients with cystic fibrosis (CF). The goal of this study was to evaluate the association between clinical, lung function, sleep quality, and polysomnographic variables with 2 HRQOL questionnaires, the shorterversion World Health Organization Quality of Life (WHOQOL-BREF) and Cystic Fibrosis Quality of Life (CFQOL) questionnaires, in adult subjects with CF. METHODS: In a cross-sectional study, 51 subjects underwent clinical evaluation and overnight polysomnography and answered WHO-QOL-BREF, CFQOL, Pittsburgh Sleep Quality Index, and Epworth Sleepiness Scale questionnaires. In addition, pulmonary function tests, 6-min walk tests, and echocardiography were performed. RESULTS: For WHOQOL-BREF scores, the sleep quality index was associated with the physical domain; the percent-of-predicted 6-min walk distance (6MWD) and sleepiness scale were associated with the psychological domain; the percent-of-predicted FEV 1 and sleep quality index were associated with the social relationship domain; and the sleep quality index was associated with the environment domain. For CFQOL scores, age at diagnosis, clinical score, and sleep quality index were associated with the physical functioning domain; the percent-of-predicted 6MWD and pulmonary arterial systolic pressure were associated with the role domain; sex and sleep quality index were associated with the vitality domain; the apnea-hypopnea index was associated with the emotional functioning domain; sex and body mass index (BMI) were associated with the body image domain; the percent-of-predicted 6MWD and sleep quality index were associated with the health perception domain; age, sex, BMI, and arousal index were associated with the weight domain; age, sex, percent-of-predicted FEV 1 , percent-of-predicted 6MWD, and pulmonary arterial systolic pressure were associated with the respiratory symptom domain; and the clinical score was associated with the digestive symptom domain. CONCLUSIONS: The sleep quality index score, 6MWD, sleepiness scale score, and FEV 1 were predictors of WHOQOL-BREF scores. Age at diagnosis, clinical score, sleep quality score, 6MWD, sex, apnea-hypopnea index, BMI, current age, arousal index, FEV 1 , and pulmonary arterial systolic pressure were predictors of CFQOL scores.

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“…9,10 However, few properly designed, randomized studies have been conducted to evaluate whether guidelines prepared by health-care professionals as recommendations of physical exercises, modality, frequency, intensity, and stretching are effective and regularly adopted by patients. 11,12 The purpose of this study was to evaluate the effect of an aerobic exercise program based on verbal and written guidelines on maximum exercise capacity using a cardiopulmonary exercise test, quality of life, and the selfreported aerobic exercise practice of children and adolescents with CF.…”

Section: Introductionmentioning

confidence: 99%

Effects of an Educational Intervention of Physical Activity for Children and Adolescents With Cystic Fibrosis: A Randomized Controlled Trial

et al. 2014

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BACKGROUND: Regular aerobic exercise in patients with cystic fibrosis (CF) improves aerobic conditioning and delays disease progression, resulting in better quality of life. The purpose of this study was to evaluate the effect of an aerobic exercise program based on verbal and written guidelines on maximum exercise capacity using a cardiopulmonary exercise test, quality of life, and the self-reported aerobic exercise practice of children and adolescents with CF. METHODS: This randomized controlled trial followed guidelines for physical exercise in a CF center. Subjects were assigned to 2 groups: intervention (group 1), with 17 subjects; and control (group 2), also with 17 subjects. Data were collected from October 2010 to October 2011, and the study population comprised 7-20-y-old children and adolescents with CF. The intervention consisted of handing out a manual with guidelines for aerobic physical exercises and reinforcing recommendations in telephone calls every 2 weeks. RESULTS: Thirty-four subjects were included in the study, 20 of whom were boys (58.5%). The groups were similar at baseline. In group 1, 6 subjects (35.2%) reported practicing physical exercises regularly. The mean age was 13.4 ؎ 2.8 y, the mean percent-ofpredicted FEV 1 was 95.5 ؎ 17.9%, and the mean peak oxygen uptake (V O 2 ) relative to body mass was 34.9 ؎ 9.0 mL/kg/min. In group 2, 4 subjects (23.5%) reported practicing physical exercises regularly. The mean age was 12.7 ؎ 3.3 y, the mean percent-of-predicted FEV 1 was 100.1 ؎ 21.2%, and the mean peak V O 2 was 33.2 ؎ 8.2 mL/kg/min. In group 1, there was a significant increase in physical exercise practice as reported by subjects after 3 months of intervention compared with group 2 (P ‫؍‬ .01). No statistically significant differences were found for the other variables. CONCLUSIONS: Verbal and written guidelines for aerobic exercise, together with supervision over the telephone, had a positive impact on the self-reported regular physical exercise practice of children and adolescents. However, no improvement was found in lung function and maximum exercise capacity or domains of the quality of life questionnaire.

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Pulmonary function, inflammation, exercise capacity and quality of life in cystic fibrosis

Cited by 66 publications

References 11 publications

Chronic infection and inflammation affect exercise capacity in cystic fibrosis

Chronic infection and inflammation affect exercise capacity in cystic fibrosis

Relationship Between Clinical Variables and Health-Related Quality of Life in Young Adult Subjects With Cystic Fibrosis

Effects of an Educational Intervention of Physical Activity for Children and Adolescents With Cystic Fibrosis: A Randomized Controlled Trial

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