Evaluation of biochemical markers and quality of life in different pulmonary rehabilitation exercises for COPD patients

Avaliação de marcadores bioquímicos e qualidade de vida em diferentes treinos na reabilitação pulmonar nos portadores de DPOC

Authors

  • Vivian Taciana Simioni Santana
  • Priscila Kessar Cordoni
  • Selma Denis Squassoni
  • Anete Sevciovic Grumach
  • Elie Fiss

DOI:

https://doi.org/10.34119/bjhrv5n4-260

Keywords:

COPD, rehabilitation, exercise, physical therapy, biochemical markers

Abstract

Background: Chronic obstructive pulmonary disease (COPD) affects millions of people worldwide, causing gradual muscle dysfunction deterioration. Muscle impairment may be controlled after a specific and individualized pulmonary rehabilitation training program, which is essential for the management of COPD. This study aimed to assess indirect biochemical parameters related to muscle behavior and quality of life in patients with COPD in different pulmonary rehabilitation training programs. Methods: Thirty patients (GOLD stages II-IV) were prospectively included in a 12-week multidisciplinary pulmonary rehabilitation program. Patients who performed high-intensity training (n=15) were assigned to Group A and those performing low-intensity training (n=15) were placed in Group B. Besides clinical evaluation, serum creatine kinase, lactate, fibrinogen, and vitamin D levels, cardiopulmonary test and 6-minute walk test results, and quality of life were assessed before and after intervention. Results: There was a significant reduction in fibrinogen (458 vs. 284 mg/dl) (p<0.001) associated with an improvement in quality of life (27.9 vs. 19.3 points) (p=0.024) in group A. Conclusions: Pulmonary rehabilitation with a structured program that included high-intensity training was well tolerated by the patients and was more efficient in reducing fibrinogen as an inflammatory marker, improving quality of life.

References

Mathers CD, Loncar D. Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med. 2006;3:e442. https://doi.org/10.1371/journal.pmed.0030442

Eisner MD, Blanc PD, Yelin EH, et al. COPD as a systemic disease: impact on physical functional limitations. Am J Med. 2008;121:789–796. https://doi.org/10.1016/j.amjmed.2008.04.030

Menezes AM, Perez-Padilha R, Jardim JR, Muiño A, et al. Chronic obstructive pulmonary disease in five Latin American cities (the PLATINO study): a prevalence study. Lancet. 2005;366:1875–1881. https://doi.org/10.1016/s0140-6736(05)67632-5

Reardon J, Casaburi R, Morgan M, Nici L, Rochester C. Pulmonary rehabilitation for COPD. Respir Med. 2005;99(suppl B):19–27. https://doi.org/10.1016/j.rmed.2005.09.012

Halbert RJ, Natoli JL, Gano A, Badamgarav E, Buist AS. Global burden of COPD: systematic review and meta-analysis. Eur Respir J. 2006;28:523–532. https://doi.org/10.1183/09031936.06.00124605

Ries AL, Bauldoff GS, Carlin BW, Casaburi R, Emery CF, Mahler DA, et al. Pulmonary rehabilitation: Joint ACCP/AACVPR Evidence-Based Clinical Practice Guidelines. Chest. 2007;131(suppl.5):4S–42S. https://doi.org/10.1378/chest.06-2418

Nici L, Donner C, Wouters E, et al. American Thoracic Society/European Respiratory Society Statement on Pulmonary Rehabilitation. Am J Respir Crit Care Med. 2006;173:1390–1413. https://doi.org/10.1164/rccm.200508-1211st

Alcazar J, Rodriguez-Lopez C, Alfaro-Acha A, Alegre LM, Ara I. Exercise prescription in patients with chronic obstructive pulmonary disease. Eur J Human Movement. 2018;41:73–102.

Zainuldin R, Mackey MG, Alison J. Optimal intensity and type of leg exercise training for people with chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2011;11:1–89. https://doi.org/10.1002/14651858.CD008008.pub2

McCarthy B, Casey D, Devane D, Murphy K, Murphy E, Lacasse Y. Pulmonary rehabilitation for chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2015:2:CD003793. https://doi.org/10.1002/14651858.CD003793.pub3

Global Initiative for Chronic Obstructive Lung Disease (GOLD). Pocket Guide to COPD Diagnosis, Management, and Prevention 2018 report. https://goldcopd.org/wp-content/uploads/2017/11/GOLD-2018-v6.0-FINAL-revised-20-Nov_WMS.pdf

Jones PW, Quirk FH, Baveystock CM. The St George’s Respiratory Questionnaire. Respir Med. 1991;85:25–31. https://doi.org/10.1016/s0954-6111(06)80166-6

ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories. ATS statements: guidelines for the six-minute walk test. Am J Respir Crit Care Med. 2002;166:111–117. https://doi.org/10.1164/ajrccm.166.1.at1102

Fermont MJ, Masconi KL, Jensen MT, Ferrari R, et al. Biomarkers and clinical outcomes in COPD: a systematic review and meta-analysis. Thorax. 2019,74:439–446. https://doi.org/10.1136/thoraxjnl-2018-211855

Jollife DA, Greenberg L, Hooper RL, Mathyssen C, et al. Vitamin D to prevent exacerbations of COPD: systematic review and meta-analysis of individual participant data from randomised controlled trials. Thorax. 2019;74:337–345. http://dx.doi.org/10.1136/thoraxjnl-2018-212092

Katiriji B, Al Jaberi MM. Creatine kinase revisited. J Clin Neuromusc Dis. 2001;2:158–164. https://doi.org/10.1097/00131402-200103000-00008

Totsuka M, Nakaji S, Suzuki K, Sato K. Break point of serum creatine kinase release after endurance exercise. J Appl Physiol. 2002;93:1280–1286. https://doi.org/10.1152/japplphysiol.01270.2001

Martinez A, Boulaiz H, Pradis J, et al. Release of α-actin into serum after skeletal muscle damage. Br J Sports Med. 2005;39:830–834. http://dx.doi.org/10.1136/bjsm.2004.017566

Maltais F, LeBlanc P, Simard C, et al. Skeletal muscle adaptation to endurance training in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 1996;154:442–447. https://doi.org/10.1164/ajrccm.154.2.8756820

Silva AB, Di’Lorenzo VAP, Sampaio LMM, Jamami M, Costa D, Baldissera V. A influência no treinamento físico (TF) sobre as respostas cardiorrespiratórias e lactacidemia em pacientes com doença pulmonar obstrutiva crônica (DPOC). Rev Bras Ativ Fis Saúde. 2003;8:30–37. https://doi.org/10.12820/rbafs.v.8n1p30-37

Baker JF, Mehta NN, Baker DG, et al. Vitamin D, metabolic dyslipidemia, and metabolic syndrome in rheumatoid arthritis. Am J Med. 2012;125:1036e9–1036e15. https://doi.org/10.1016/j.amjmed.2012.01.025

He C, Handzlik M, Frase WD, et al. Influence of vitamin D status on respiratory infection incidence and immune function during 4 months of winter training in endurance sports athletes. Exerc Immunol Rev. 2013;19:86–101.

Shibata Y, Abe S, Inoue S, et al. Relationship between plasma fibrinogen levels and pulmonary function in the Japanese population: the Takahata Study. Int J Med Sci. 2013;10:1530–1536. https://doi.org/10.7150/ijms.7256

Risoy BA, Raastad T, Hallén J, et al. Delayed leukocytosis after hard strength and endurance exercise: aspects of regulatory mechanisms. BMC Physiol. 2003;14:1–12. https://doi.org/10.1186/1472-6793-3-14

Ronsen O, Kjeldsen-Kragh J, Haug E, Bahr R, Pedersen BK. Recovery time affects immunoendocrine responses to a second bout of endurance exercise. Am J Physiol Cell Physiol. 2002;283:C1612–C1620. https://doi.org/10.1152/ajpcell.00242.2002

Natale VM, Brenner IK, Moldoveanu AL, Vasiliou P, Shek P, Shephard RJ. Effects of three different types of exercise on blood leukocyte count during and following exercise. Sao Paulo Med J. 2003;121:9–14. https://doi.org/10.1590/S1516-31802003000100003

Boeselt T, Nell C, Lutteken L, et al. Benefits of high-intensity exercise training to patients with chronic obstructive pulmonary disease: a controlled study. Respiration. 2017;93:301–310. https://doi.org/10.1159/000464139

Berry MJ, Sheilds KL, Adair NE. Comparison of effects of endurance and strength training programs in patients with COPD. COPD. 2018;15:192–199. https://doi.org/10.1080/15412555.2018.1446926

Aquino G, Luliano E, Di Cagno A, et al. Effects of combined training vs aerobic training on cognitive functions in COPD: a randomized controlled trial. Int J Chron Obstruct Pulmon Dis. 2016;11:711–718. https://doi.org/10.2147/copd.s96663

Dias FD, Sampaio LM, da Silva GA, et al. Home-based pulmonary rehabilitation in patients with chronic obstructive pulmonary disease: a randomized clinical trial. Int J Chron Obstruct Pulmon Dis. 2013;8:537–544. https://doi.org/10.2147/copd.s50213

Hill K, Jenkins SC, Philippe DL, Shepherd KL, Hillman DR, Eastwood PR. High-intensity inspiratory muscle training in COPD. Eur Respir J. 2006;27:1119–1128. https://doi.org/10.1183/09031936.06.00105205

Schaadt L, Christensen R, Kristensen LE, Henriksen M. Increased mortality in patients with severe COPD associated with high-intensity exercise: a preliminary cohort study. Int J Chron Obstruct Pulmon Dis. 2016;11:2329–2334. https://doi.org/10.2147/copd.s114911

Stefanelli F, Meoli I, Cobuccio R, et al. High-intensity training and cardiopulmonary exercise testing in patients with chronic obstructive pulmonary disease and non-small-cell lung cancer undergoing lobectomy. Eur J Cardiothorac Surg. 2013;44:260–265. https://doi.org/10.1093/ejcts/ezt375

Wadell K, Sundelin G, Henriksson-Larsén K, Lundgren R. High-intensity physical group training in water – an effective training modality for patients with COPD. Respir Med. 2004;98:428–438. https://doi.org/10.1016/j.rmed.2003.11.010

Morris NR, Walsh J, Adams L, Alision J. Exercise training in COPD: what is it about intensity? Respirology. 2016;21:1185–1192. https://doi.org/10.1111/resp.12864

Spruit MA, Singh SJ, Garvey C, et al. An official American Thoracic Society/ European Respiratory Society Statement: key concepts and advances in pulmonary rehabilitation. Am J Respir Crit Care Med. 2013;188:e13–e64. https://doi.org/10.1164/rccm.201309-1634st

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Published

08/31/2022

How to Cite

SANTANA, V. T. S.; CORDONI, P. K.; SQUASSONI, S. D.; GRUMACH, A. S.; FISS, E. Evaluation of biochemical markers and quality of life in different pulmonary rehabilitation exercises for COPD patients: Avaliação de marcadores bioquímicos e qualidade de vida em diferentes treinos na reabilitação pulmonar nos portadores de DPOC. Brazilian Journal of Health Review, [S. l.], v. 5, n. 4, p. 17091–17104, 2022. DOI: 10.34119/bjhrv5n4-260. Disponível em: https://ojs.brazilianjournals.com.br/ojs/index.php/BJHR/article/view/51641. Acesso em: 18 oct. 2026.

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Original Papers