Inflammatory and Metabolic Responses to Different Resistance Training on Chronic Obstructive Pulmonary Disease: A Randomized Control Trial

Revisiting Skeletal Muscle Dysfunction and Exercise in Chronic Obstructive Pulmonary Disease: Emerging Significance of Myokines

Skeletal muscle dysfunction (SMD) is the most significant extrapulmonary complication and an independent prognostic indicator in patients with chronic obstructive pulmonary disease (COPD). Myokines, such as interleukin (IL)-6, IL-15, myostatin, irisin, and insulin-like growth factor (IGF)-1, play important roles in skeletal muscle mitochondrial function, protein synthesis and breakdown balance, and regeneration of skeletal muscles in COPD. As the main component of pulmonary rehabilitation, exercise can improve muscle strength, muscle endurance, and exercise capacity in patients with COPD, as well as improve the prognosis of SMD and COPD by regulating the expression levels of myokines. The mechanisms by which exercise regulates myokine levels are related to microRNAs. IGF-1 expression is upregulated by decreasing the expression of miR-1 or miR-29b. Myostatin downregulation and irisin upregulation are associated with increased miR-27a expression and decreased miR-696 expression, respectively. These findings suggest that myokines are potential targets for the prevention and treatment of SMD in COPD. A comprehensive analysis of the role and regulatory mechanisms of myokines can facilitate the development of new exercise-based therapeutic approaches for patients with COPD.

Pulmonary Rehabilitation Using Minimal Equipment for People With Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis

OBJECTIVE

Pulmonary rehabilitation programs that use minimal equipment for exercise training, rather than gymnasium equipment, would enable delivery of pulmonary rehabilitation to a greater number of people with chronic obstructive pulmonary disease (COPD). The effectiveness of minimal equipment programs in people with COPD is unclear. This systematic review and meta-analysis aimed to determine the effects of pulmonary rehabilitation using minimal equipment for aerobic and/or resistance training in people with COPD.

METHODS

Literature databases were searched up to September 2022 for randomized controlled trials (RCTs) comparing the effect of minimal equipment programs with usual care or with exercise equipment-based programs for exercise capacity, health-related quality of life (HRQoL), and strength.

RESULTS

Nineteen RCTs were included in the review and 14 RCTs were included in the meta-analyses, which reported low to moderate certainty of evidence. Compared with usual care, minimal equipment programs increased 6-minute walk distance (6MWD) by 85 m (95% CI = 37 to 132 m). No difference in 6MWD was observed between minimal equipment and exercise equipment-based programs (14 m, 95% CI = -27 to 56 m). Minimal equipment programs were more effective than usual care for improving HRQoL (standardized mean difference = 0.99, 95% CI = 0.31 to 1.67) and were not different from exercise equipment-based programs for improving upper limb strength (6 N, 95% CI = -2 to 13 N) or lower limb strength (20 N, 95% CI = -30 to 71 N).

CONCLUSION

In people with COPD, pulmonary rehabilitation programs using minimal equipment elicit clinically significant improvements in 6MWD and HRQoL and are comparable with exercise equipment-based programs for improving 6MWD and strength.

IMPACT

Pulmonary rehabilitation programs using minimal equipment may be a suitable alternative in settings where access to gymnasium equipment is limited. Delivery of pulmonary rehabilitation programs using minimal equipment may improve access to pulmonary rehabilitation worldwide, particularly in rural and remote areas and in developing countries.

Immunomodulatory Function of Interleukin-15 and Its Role in Exercise, Immunotherapy, and Cancer Outcomes

Exercise has been shown to improve physical and psychosocial outcomes for people across the cancer care continuum. A proposed mechanism underpinning the relationship between exercise and cancer outcomes is exercise-induced immunomodulation via secretion of anti-inflammatory myokines from skeletal muscle tissue. Myokines have the potential to impair cancer growth through modulation of natural killer (NK) cells and CD8+ T cells while improving the effectiveness of cancer therapies. Interleukin-15 (IL-15), one of the most abundant myokines found in skeletal muscle, has a key immunoregulatory role in supporting the proliferation and maturation of T cells and NK cells, which have a key role in the host's immune response to cancer. Furthermore, IL-15 is being explored clinically as an immunotherapy agent with doses similar to the IL-15 concentrations released by skeletal muscle during exercise. Here we review the role of IL-15 within the immune system, examine how IL-15 is produced as a myokine during exercise, and how it may improve outcomes for people with cancer, specifically as an adjuvant or neoadjuvant to immunotherapy. We summarize the available evidence showing changes in IL-15 in response to both acute exercise and training, and the results are inconsistent; higher quality research is needed to advance the understanding of how exercise-mediated increases in IL-15 potentially benefit those who are being treated for, or who have had, cancer.

Vitamin D Supplementation Has No Impact on Cardiorespiratory Fitness, but Improves Inflammatory Status in Vitamin D Deficient Young Men Engaged in Resistance Training

Data on the effect of vitamin D (Vit-D) supplementation on cardiorespiratory fitness (VO2max) are conflicting. A possible source of discrepancies in the literature is the heterogeneity in baseline Vit-D status among participants in previous studies. The main objectives of the present study were to assess the impact of Vit-D supplementation on VO2max and inflammatory status in Vit-D deficient young healthy men. Participants (n = 39, baseline serum Vit-D level < 50 nmol/L) were quasi-randomly assigned to one of the two groups, which, in a double-blind manner, supplemented their diet daily with either Vit-D (8000 IU; VD) or placebo (PLC) and concomitantly performed a 12-week supervised resistance training program. During the 12-week intervention, serum Vit-D concentrations increased 3.9-fold (p < 0.001) in the VD group while no changes occurred in the PLC group. Baseline VO2max did not differ in the two groups and remained unchanged during the intervention. Serum interleukin-10/tumour necrosis factor alpha ratio increased significantly (30%, p = 0.007; effect size 0.399) in VD but not in PLC group. In conclusion, 12-week Vit-D supplementation increases serum 25(OH)D levels and improves inflammatory status, but has no impact on VO2max in Vit-D deficient young men engaged in resistance training.

The effects of ageing, BMI and physical activity on blood IL-15 levels: A systematic review and meta-analyses

AIM

The purpose of the study was to test the effect of ageing, BMI, physical activity and chronic exercise on IL-15 blood concentration by meta-analyses of the literature.

METHODS

The search was performed on PubMed/MEDLINE, Web of Science, ProQuest, Embase and Cochrane databases. First meta-analysis compared blood IL-15 of healthy adults across three age groups (<35 years, 35-65 years, and >65 years), considering BMI as confounding factor; the second compared IL-15 levels between physically active and non-physically active individuals (cross-sectional studies); and the third tested the effect of chronic exercise interventions on blood IL-15 levels on participants of any age, sex, and health condition.

RESULTS

From 2582 studies retrieved, 67 were selected for the three meta-analyses (age effect: 59; physical activity cross-sectional effect: 5; chronic exercise effect: 14). Older adults had lower blood IL-15 than young and middle-aged adults (5.30 pg/ml [4.76; 5.83]; 7.11 pg/ml [6.33; 7.88]; 7.10 pg/ml [5.55; 8.65], respectively). However, the subgroup of overweight older adults had higher IL-15 than young and middle aged overweight adults; Habitual physical activity did not affect blood IL-15 (standardized mean difference [SMD] 0.61 [-0.65; 1.88], p = 0.34); Chronic exercise reduced blood IL-15 in short-term interventions (<16 weeks) (SMD -0.14 [-0.27; -0.01], p = 0.04), but not studies of >16 weeks of intervention (SMD 0.44 [-0.26; 1.15], p = 0.22).

CONCLUSION

The present meta-analyses highlight the complex interaction of age, BMI and physical activity on blood IL-15 and emphasize the need to take these factors into account when considering the role of this myokine in health throughout life.

Mapping the global research landscape and hotspot of exercise therapy and chronic obstructive pulmonary disease: A bibliometric study based on the web of science database from 2011 to 2020

Background: The application of exercise therapy (ET) in chronic obstructive pulmonary disease (COPD) is generating increasing clinical efficacy and social-economic value. In this study, research trends, evolutionary processes and hot topics in this field are detailed, as well as predictions of future development directions.

Methods: Search for literature in the field of COPD and ET and analyze data to generate knowledge graphs using VOSiewer and CiteSpace software. The time frame for the search was from 2011 to January 2021. Then we extracted full-text key information (such as title, journal category, publication date, author, country and institution, abstract, and keyword) and obtained the co-citation analysis. Use hierarchal clustering analysis software developed by VOSviewer to map common citations, and use Citespace software to plot trend networks.

Results: The United States topped the list with 27.91% of the number of articles posted, followed by the UK at 25.44%. Imperial College London was the highest number of article publications in institutions, followed by Maastricht University and the University of Toronto. The Royal Brompton Harefield NHS Foundation Trust was one of many research institutions and currently holds the highest average citations per item (ACI) value, followed by Imperial College London and the University of Leuven. Judging from the number of publications related to ET and COPD, it is mainly published in cell biology, respiratory pulmonary diseases, and rehabilitation experiments study medicine. The European Respiration Journal is the most widely published in this field, followed by the International Journal of Chronic Obstructive Pulmonary Disease and Respiratory Medicine.

Conclusion: COPD combined with ET is widely used in clinical practice and is on the rise. A distinctive feature of the field is multidisciplinary integration. Rehabilitation research for COPD involves multidisciplinary collaboration, tissue engineering, and molecular biology mechanism studies to help patients remodel healthy breathing. Multidisciplinary rehabilitation measures provide a solid foundation for advancing clinical efficacy in the field of COPD.

Effect of physical training on cytokine expression in CD4+ T lymphocytes in subjects with stable COPD

Introduction:

Although evidence suggests that physical exercise reduces systemic inflammation, at the plasma level, there are still contradictions in chronic obstructive pulmonary disease (COPD). In this sense, analysis of intracellular cytokines could clear off the effect of physical exercise on the inflammatory profile of these subjects.

Aim:

The aim was to evaluate the effect of physical training on cytokine expression in CD4+ T lymphocytes from subjects with COPD.

Methods:

This is a randomized controlled trial. Subjects with stable COPD were grouped into two groups, exercise and control. In total, 23 subjects with stable COPD were evaluated, of which 15 underwent aerobic strength training [physical exercise group (PEG)] and 8 underwent breathing exercises [respiratory physiotherapy group (RPG)]. Intracellular cytokines [interleukin (IL)-8, IL-13, IL-17, IL-6, IL-2, IL-10, and tumor necrosis factor alpha (TNF-α)] from CD4+ T lymphocytes were analyzed from peripheral blood through flow cytometry, before and after 8 weeks of intervention.

Results:

The PEG and RPG groups had a mean age of 68 ± 5.96 and 72.25 ± 6.86 years and predicted forced expiratory volume in the first second (FEV₁) of 58.6 ± 15.99% and 39.75 ± 10.39%, respectively. It was possible to detect a significant reduction in IL-8 (p = 0.0125) and an increase in IL-13 (p = 0.0014) and an increase in TNF-α (p < 0.001) in both groups.

Conclusion:

Eight weeks of physical training, both peripheral and respiratory, were able to reduce concentrations of IL-8 and to increase IL-13, and TNF-α in CD4+ T lymphocytes in subjects with stable COPD. The findings reinforce the benefits of interventions in subjects with COPD, revealing data not previously investigated.

Isolated Resistance Training Programs to Improve Peripheral Muscle Function in Outpatients with Chronic Obstructive Pulmonary Diseases: A Systematic Review

This systematic review aims to establish which isolated resistance training (RT) programs have been used in outpatients with chronic obstructive pulmonary disease (COPD) and their impact on all aspects of peripheral skeletal muscle function. Electronic databases were systematically searched up to June 2021. The eligibility criteria were: (1) randomized controlled trials investigating the effects of supervised and isolated RT programs in outpatients with COPD and (2) RT programs lasting 8-12 weeks, (3) including at least one outcome measure related to trainable muscle characteristics. Initially, 6576 studies were identified, whereas 15 trials met the inclusion criteria. All the included trials reported that isolated RT improved both upper and lower limbs' maximal strength. Muscle endurance and power also increased after RT but received less attention in the analysis. Furthermore, few studies assessed the effect of RT on muscle mass and cross-sectional area, reporting only limited improvement. Isolated RT programs carried out 2-3 days a week for 8-12 weeks improved skeletal muscle function in individuals with COPD. The RT program should be specifically focused to the trainable muscle characteristic to be improved. For this reason, we further encourage the introduction of a detailed assessment of muscle function and structure during the pulmonary rehabilitation practice.

New insights into the emerging effects of inflammatory response on HDL particles structure and function

According to the increasing results, it has been well-demonstrated that the chronic inflammatory response, including systemic lupus erythematosus, rheumatoid arthritis, and inflammatory bowel disease are associated with an increased risk of atherosclerotic cardiovascular disease. The mechanism whereby inflammatory response up-regulates the risk of cardio-metabolic disorder disease is multifactorial; furthermore, the alterations in high density lipoprotein (HDL) structure and function which occur under the inflammatory response could play an important modulatory function. On the other hand, the serum concentrations of HDL cholesterol (HDL-C) have been shown to be reduced significantly under inflammatory status with remarked alterations in HDL particles. Nevertheless, the potential mechanism whereby the inflammatory response reduces serum HDL-C levels is not simply defined but reduces apolipoprotein A1 production. The alterations in HDL structure mediated by the inflammatory response has been also confirmed to decrease the ability of HDL particle to play an important role in reverse cholesterol transport and protect the LDL particles from oxidation. Recently, it has been shown that under the inflammatory condition, diverse alterations in HDL structure could be observed which lead to changes in HDL function. In the current review, the emerging effects of inflammatory response on HDL particles structure and function are well-summarized to elucidate the potential mechanism whereby different inflammatory status modulates the pathogenic development of dyslipidemia.

Serum myokine levels after linear and flexible non-linear periodized resistance training in overweight sedentary women

This study compared the capacity of linear-(LP) and non-linear periodized (NLP) resistance training to improve select myokines and metabolic parameters in overweight sedentary women. An additional purpose was to compare these variables between the overweight and lean women. Fitness- and age-matched overweight women between 28 and 43 years old were randomly allocated to LP (body fat [BF]% = 38.7 ± 2.6, n = 10), NLP (BF% = 39.3 ± 2.4, n = 9) and control (BF% = 39.8 ± 2.6, n = 9) groups. Lean women (BF% = 29.1 ± 2.3, n = 16) matched for age and fitness were also included for baseline comparison. Resistance training programmes (12 weeks, 3 d.wk^-1, 9 exercises, 60-90% of 1-repetition maximum [1RM]) were performed with different periodization schemes. Glucose, insulin, interleukin (IL)-7, IL-15, and insulin-like growth factor (IGF)-1 levels were measured at baseline and after training. Overweight subjects had significantly lower IL-15, IGF-1 and higher insulin, glucose, and insulin resistance (homeostasis model assessment, HOMA-IR) than lean subjects at baseline (all, P < .05). IL-15 and VO₂max increased significantly after NLP compared with CON, which was accompanied by a significant decrease in HOMA-IR (all, P < .03). Muscular endurance improved significantly in both models after training compared to CON (all, P < .01), but it increased more in NLP than in LP (P = .01). Both training protocols were equally effective at reducing BF% and increasing IGF-1, IL-7, muscle mass and bench press 1RM (P < .01). It appears that LP and NLP are both effective strategies for improving health markers in overweight women, but LP is not as effective as NLP to improve IL-15, HOMA-IR and aerobic capacity.Highlights Overweight women had a significantly lower IL-15 and IGF-1 compared to lean encounters, but no significant difference was noted for maximal strength, aerobic capacity, muscle mass, IL-7 and neutrophil/lymphocyte ratio.Twelve weeks of either linear or flexible non-linear periodized resistance training resulted in reduction in BF% and neutrophil/lymphocyte ratio, and increased IGF-1, IL-7, muscle mass and bench press 1RM, with no difference between the two training protocols.Linear protocol is not as effective as non-linear protocol to improve IL-15, HOMA-IR and aerobic capacity.

Elastic Resistance Training Produces Benefits Similar to Conventional Resistance Training in People With Chronic Obstructive Pulmonary Disease: Systematic Review and Meta-Analysis

OBJECTIVE

The purpose of this study was to investigate the effectiveness of elastic resistance training on improving muscle strength, functional exercise capacity, health-related quality of life (HRQoL), and dyspnea in people with stable chronic obstructive pulmonary disease (COPD).

METHODS

For this systematic review, PubMed, The Cochrane Library, Embase (OVID), PEDro, SciELO, and CINAHL were searched from inception to November 2019. Included studies were randomized clinical trials in which people with stable COPD were allocated to (1) an experimental group that received lower-limb resistance training, upper-limb resistance training, or both using elastic resistance; or (2) a control group that received no or sham resistance training or conventional resistance training using weight machines. Data extraction was performed by 3 review authors. The methodological quality of the studies was assessed using the PEDro scale. Eight studies on 332 participants were included.

RESULTS

Knee extensor strength was higher in the experimental group (standardized mean difference = 0.52, 95% CI = 0.09-0.95) compared with the non-exercise control group. Compared with the conventional exercise control, the experimental group presented similar effects for muscle strength, functional exercise capacity, HRQoL, and dyspnea (95% CI overlapped the line of no effect for all).

CONCLUSIONS

Elastic resistance training improves muscle strength in people with COPD. The current review suggests elastic resistance as a potential alternative to conventional resistance training using weight machines, as they show similar effects on muscle strength, functional exercise capacity, HRQoL, and dyspnea.

IMPACT

Due to its beneficial effects, including reduced risk of exacerbation-related hospitalizations, exercise training is viewed as the cornerstone of pulmonary rehabilitation in people with COPD. This study shows that elastic resistance training can be an effective, portable, practical, and low-cost alternative to conventional weight resistance training.

LAY SUMMARY

Training with elastic resistance tubes or bands-which are easy to carry, easy to use, and relatively low cost-can be an effective way to improve strength for people with COPD and promote similar benefits to those achieved with weight machines.

Inflammatory responses to acute exercise during pulmonary rehabilitation in patients with COPD

Objective

Pulmonary rehabilitation is a cornerstone treatment in the management of chronic obstructive pulmonary disease (COPD). Acute bouts of exercise can lead to short bursts of inflammation in healthy individuals. However, it is unclear how COPD patients respond to acute bouts of exercise. This study assessed inflammatory responses to exercise in COPD patients at the start (phase 1) and end (phase 2) of pulmonary rehabilitation.

Methods

Blood samples were collected before and after an acute exercise bout at the start (phase 1, n = 40) and end (phase 2, n = 27) of pulmonary rehabilitation. The primary outcome was change in fibrinogen concentrations. Secondary outcomes were changes in CRP concentrations, total/differential leukocyte counts, markers of neutrophil activation (CD11b, CD62L and CD66b), and neutrophil subsets (mature, suppressive, immature, progenitor).

Results

Acute exercise (phase 1) did not induce significant changes in fibrinogen (p = 0.242) or CRP (p = 0.476). Total leukocyte count [mean difference (MD), 0.5 ± 1.1 (10⁹ L⁻¹); p = 0.004], neutrophil count [MD, 0.4 ± 0.8 (10⁹ L⁻¹); p < 0.001], and immature neutrophils (MD, 0.6 ± 0.8%; p < 0.001) increased post-exercise. Neutrophil activation markers, CD11b (p = 0.470), CD66b (p = 0.334), and CD62L (p = 0.352) were not significantly altered post-exercise. In comparison to the start of pulmonary rehabilitation (phase 2), acute exercise at the end of pulmonary rehabilitation led to a greater fibrinogen response (MD, 84 mg/dL (95% CI − 14, 182); p = 0.045).

Conclusion

An acute bout of exercise does not appear to induce significant alterations in the concentrations of inflammatory mediators but can increase white blood cell subsets post-exercise. A greater fibrinogen response to acute exercise is seen at the end of pulmonary rehabilitation when compared to the start. Further research is required to understand the clinical context of these acute inflammatory responses to exercise.

Schisandra A ameliorates cigarette smoke extract and lipopolysaccharide-induced oxidative stress in lung epithelial cells

Background

The previous studies reported the antioxidant and anti-inflammatory properties of Schisandrin A (Sch A). This study aimed to investigate the ability of Sch A to protect against lung oxidative stress induced by the combination of cigarette smoke extract and lipopolysaccharide (LPS) in an in vitro model of chronic obstructive pulmonary disease (COPD).

Methods

The cell viability was determined by using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. Colorimetry was used to detect the changes in antioxidant markers. Quantitative real-time polymerase chain reaction (RT-PCR) was used to examine the mRNA levels of interleukin-8 (IL-8) and heme oxygenase-1 (HO-1). The levels of IL-8 and HO-1 in the supernatant were determined by enzyme-linked immunosorbent assay, and Western blot analysis was performed to measure the phosphorylation and protein expression levels of nuclear factor-κB.

Results

Sch A inhibited the excessive proliferation of pulmonary epithelial cells, decreased malondialdehyde content, and increased the expression levels of superoxide dismutase and glutathione after the combined treatment of cigarette smoke extract and LPS. Also, Sch A downregulated the expression of IL-8 and upregulated the expression of HO-1 mRNA in lung epithelial cells and cell supernatants, and resulted in the downregulation of the protein expression level of phosphorylated nuclear factor-κB.

Conclusions

Sch A inhibited the oxidative stress of lung epithelial cells induced by the combination of cigarette smoke extract and LPS. Sch A may be a potential therapeutic medication for COPD.

CYP1B1, VEGFA, BCL2, and CDKN1A Affect the Development of Chronic Obstructive Pulmonary Disease

Purpose

Chronic obstructive pulmonary disease (COPD) is a progressive lung disease characterized by poor airflow. The purpose of this study was to explore the mechanisms involved in the development of COPD.

Patients and Methods

The mRNA expression profile GSE100281, consisting of 79 COPD and 16 healthy samples, was acquired from the Gene Expression Omnibus database. The differentially expressed genes (DEGs) between COPD samples and healthy samples were analyzed using the limma package. Functional enrichment analysis for the DEGs was carried out using the Database for Annotation, Visualization, and Integrated Discovery (DAVID) tool. Furthermore, DEG-compound pairs were predicted using the Comparative Toxicogenomics Database. The KEGG metabolite IDs corresponding to the compounds were also obtained through the MetaboAnalyst pipeline. Based on the diffusion algorithm, the metabolite network was constructed. Finally, the expression levels of key genes were determined using quantitative PCR (qPCR).

Results

There were 594 DEGs identified between the COPD and healthy samples, including 242 upregulated and 352 downregulated genes. A total of 696 DEG-compound pairs, such as BCL2-C00469 (ethanol) and BCL2-C00389 (quercetin) pairs, were predicted. CYP1B1, VEGFA, BCL2, and CDKN1A were included in the top 10 DEG-compound pairs. Additionally, 57 metabolites were obtained. In particular, hsa04750 (inflammatory mediator regulation of TRP channels)-C00469 (ethanol) and hsa04152 (AMPK signaling pathway)-C00389 (quercetin) pairs were found in the metabolite network. The results of qPCR showed that the expression of CYP1B1, VEGFA, BCL2, and CDKN1A was consistent with that predicted using bioinformatic analysis.

Conclusion

CYP1B1, VEGFA, BCL2, and CDKN1A may play important functions in the development and progression of COPD.

Exercise Training in Patients with Chronic Respiratory Diseases: Are Cardiovascular Comorbidities and Outcomes Taken into Account?-A Systematic Review

Patients with chronic obstructive pulmonary disease (COPD), asthma and interstitial lung diseases (ILD) frequently suffer from cardiovascular comorbidities (CVC). Exercise training is a cornerstone intervention for the management of these conditions, however recommendations on tailoring programmes to patients suffering from respiratory diseases and CVC are scarce. This systematic review aimed to identify the eligibility criteria used to select patients with COPD, asthma or ILD and CVC to exercise programmes; assess the impact of exercise on cardiovascular outcomes; and identify how exercise programmes were tailored to CVC. PubMed, Scopus, Web of Science and Cochrane were searched. Three reviewers extracted the data and two reviewers independently assessed the quality of studies with the Quality Assessment Tool for Quantitative Studies. MetaXL 5.3 was used to calculate the individual and pooled effect sizes (ES). Most studies (58.9%) excluded patients with both stable and unstable CVC. In total, 26/42 studies reported cardiovascular outcomes. Resting heart rate was the most reported outcome measure (n = 13) and a small statistically significant effect (ES = -0.23) of exercise training on resting heart rate of patients with COPD was found. No specific adjustments to exercise prescription were described. Few studies have included patients with CVC. There was a lack of tailoring of exercise programmes and limited effects were found. Future studies should explore the effect of tailored exercise programmes on relevant outcome measures in respiratory patients with CVC.

Resistance exercise training improves mucociliary clearance in subjects with COPD: A randomized clinical trial

INTRODUCTION

Elastic tubing was recently investigated as an alternative to the conventional resistance training (RT) in chronic obstructive pulmonary disease (COPD). The effects of RT on the mucociliary system have not yet been reported in the literature.

OBJECTIVE

The aim of this study was to evaluate the effects of two RT programs on mucociliary clearance in subjects with COPD.

METHODS

Twentyeight subjects with COPD were randomly allocated by strata, according to individual strength of lower limbs, to defined groups: conventional resistance training (GCT) or resistance training using elastic tubing (GET). Nineteen subjects (GET: n=9; GCT: n=10) completed the study and were included in the analysis. The measurement of vital signs (blood pressure, heart rate and respiratory rate), lung function (spirometry) and the primary outcome mucociliary clearance analysis (saccharin transit time test (STT)) were performed before and after the 12 weeks of RT.

RESULTS

In relation to the mucociliary transportability analysis, no differences were observed between the baseline evaluations of the training groups (p=0.05). There was a significant reduction in the STT values in both training groups, GET (10.64±5.06 to 6.01±4.91) and GCT (12.07±5.10 to 7.36±2.54) with p=0.03. However, no differences between groups were observed on the magnitude of SST changes after interventions (GET: -43.51%; GCT: -38.94%; p=0.97).

CONCLUSION

The present study demonstrated that both RT with elastic tubing and conventional training with weights promoted similar gains in the mucociliary transportability of subjects with COPD.

Oxidative stress and anti-oxidant responses to regular resistance training in young and older adult women

AIM

The aging process is associated with increased production of free radicals, but regular exercise training might create a balance between oxidative stress and the anti-oxidant system. The aim of the present study was to investigate the effect of resistance training (RT) on the serum levels of tumor necrosis factor-α, malondialdehyde, total anti-oxidant capacity and nuclear factor-κB in young and older adult women.

METHODS

A total of 44 women were divided into four groups: older-training, older-control, young-training and young-control. The experimental groups carried out 12 weeks of RT with an intensity of 75% one repetition maximum.

RESULTS

After finishing the RT program, total anti-oxidant capacity and nuclear factor-κB in both the young and older adult training groups were significantly increased, whereas malondialdehyde in the young and the older exercising groups decreased. In addition, malondialdehyde in both the older and young groups, and total anti-oxidant capacity in only the young group, were respectively lower and higher compared with their inactive counterparts. No significant changes in tumor necrosis factor-α occurred in training groups after the 12-week intervention, but the older and younger training groups had a significant difference with the young control group in the post-test.

CONCLUSIONS

It seems that the strengthening of the anti-oxidant system resulting from regular RT in older adults is similar to those of young people. Geriatr Gerontol Int 2019; 19: 419-422.