Long-Term Effects of a 12-Week Exercise Training Program on Clinical Outcomes in Idiopathic Pulmonary Fibrosis

Vainshelboim, Baruch; Oliveira, José; Fox, Benjamin D.; Soreck, Yafit; Fruchter, Oren; Kramer, Mordechai R.

doi:10.1007/s00408-015-9703-0

Cited by 98 publications

(144 citation statements)

References 42 publications

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“…We also found that non-survivor subjects were characterized by a higher prevalence of pulmonary hypertension, a lower level of exercise capacity, more severe desaturation, and higher dyspnea levels with evident breathing inefficiency compared with survivors (Table 4). Consistent with our previous report, 38 the current study did not show benefits in survival following exercise training intervention at 40-month follow-up (see Fig. 1), although this study was underpowered to detect such differences.…”

Section: Discussionsupporting

confidence: 92%

“…42 It could be argued that an additional limitation of the study is related to the subjects' group assignments for exercise training or usual care, which could have some impact on the results and potential bias. This hypothesis was rebutted in our previous 38 and current reports (see Fig. 1), showing no significant differences in survival between exercise training and the control group; however, the studies were underpowered to detect survival differences.…”

Section: Discussionmentioning

confidence: 77%

“…We have reported previously that at 30-month follow-up, group allocation does not affect survival or hospitalization in this group of subjects. 38 However, that study was underpowered to detect such changes. 38 There was no significant difference between the exercise training and the control groups in the number of subjects who continued or started a 12-week pulmonary rehabilitation program during the follow-up period (P ϭ .56).…”

Section: Resultsmentioning

confidence: 99%

“…38 However, that study was underpowered to detect such changes. 38 There was no significant difference between the exercise training and the control groups in the number of subjects who continued or started a 12-week pulmonary rehabilitation program during the follow-up period (P ϭ .56). In the current study, consistent with our previous report, no significant difference was found between the exercise training and control groups in survival at 40-month follow-up (P ϭ .20) (Fig.…”

Section: Resultsmentioning

confidence: 99%

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The Prognostic Role of Ventilatory Inefficiency and Exercise Capacity in Idiopathic Pulmonary Fibrosis

et al. 2016

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BACKGROUND: Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive, and fatal interstitial lung disease associated with poor prognosis and limited effective treatment options. Reliable predictors of outcome in daily clinical practice are needed to determine high-risk patients for urgent lung transplantation referral. This study aimed to identify practical prognostic predictors of mortality using cardiopulmonary exercise testing (CPET) in IPF subjects. METHODS: Thirty-four subjects with IPF (22 men and 12 women), median age 68 (range 50 -81) y were prospectively studied. At baseline, all subjects were assessed with CPET and were followed up for 40 months from baseline. Receiver operating characteristic curve analysis was conducted to determine cut-off points of CPET variables for mortality, Cox regression analysis for survival using a log-rank test, and hazard ratio for death using a Wald test. RESULTS: Peak work rate <62 watts (P ‫؍‬ .005), peak V O 2 <13.8 mL/kg/min (P ‫؍‬ .031), tidal volume reserve <0.48 L/breath (P ‫؍‬ .010), minute ventilation to carbon dioxide (V E )/V CO 2 ) ratio at the anaerobic threshold >34 (P ‫؍‬ .02), and V E )/V O 2 nadir >34 (P ‫؍‬ .002) were detected as cut-off points associated with mortality. Non-survivor subjects were characterized by higher dyspnea levels, the presence of pulmonary hypertension assessed by echocardiography, pronounced inefficient ventilatory pattern, lower exercise capacity, and more severe desaturation during physical exertion. By the end of the study, 11 subjects (7 women and 4 men) died. Overall mean survival was 60%, 33.7 months (95% CI 30.2-37.2). CONCLUSIONS: This study provides simple, practical, and novel cut-off points for CPET as predictors of prognosis to identify high-risk IPF subjects. Impairment in exercise capacity and abnormal ventilatory responses during CPET were associated with poorer survival in IPF subjects. The findings suggest considering the use of CPET for IPF risk stratification and prediction of prognosis. (ClinicalTrials.gov registration NCT01499745.) Key words: cardiopulmonary exercise testing, survival, prognostic predictors, ventilatory response, exercise intolerance. [Respir Care 2016;61(8):1100 -1109.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 77%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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The Prognostic Role of Ventilatory Inefficiency and Exercise Capacity in Idiopathic Pulmonary Fibrosis

et al. 2016

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“…[17][18][19] These studies show the importance of the pulmonary rehabilitation program to patients with ILD. The pulmonary rehabilitation program, which includes physical exercise, has positive results in endurance capacity 20,21 and improves the symptoms and life quality of these patients. 22 Exercise physiology has used laboratory animals to simulate conditions of physical stress observed in humans and its purpose is to better monitor the systemic, cellular, and molecular changes resulted from physical activity.…”

Section: Introductionmentioning

confidence: 99%

Original Research: ACE2 activator associated with physical exercise potentiates the reduction of pulmonary fibrosis

Prata

Rodrigues

Martins

et al. 2016

Exp Biol Med (Maywood)

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The interstitial lung diseases are poorly understood and there are currently no studies evaluating the association of physical exercise with an ACE2 activator (DIZE) as a possible treatment for this group of diseases. We evaluate the effects of pharmacological treatment with an angiotensin-converting enzyme 2 activator drug, associated with exercise, on the pulmonary lesions induced by bleomycin. From the 96 male Balb/c mice used in the experiment, only 49 received 8 U/kg of bleomycin (BLM, intratracheally). The mice were divided into control (C) and bleomycin (BLM) groups, sedentary and trained (C-SED, C-EXE, BLM-SED, BLM-EXE), control and bleomycin and also sedentary and trained treated with diminazene (C-SED/E, C-EXE/E, BLM-SED/E, BLM-EXE/E). The animals were trained five days/week, 1 h/day with 60% of the maximum load obtained in a functional capacity test, for four weeks. Diminazene groups were treated (1 mg/kg, by gavage) daily until the end of the experiment. The lungs were collected 48 h after the training program, set in buffered formalin and investigated by Gomori's trichrome, immunohistochemistry of collagen type I, TGF-b 1 , beta-prolyl-4-hydroxylase, MMP-1 and -2. The BLM-EXE/E group obtained a significant increase in functional capacity, reduced amount of fibrosis and type I collagen, decreased expression of TGF-b 1 and beta-prolyl-4-hydroxylase and an increase of metalloproteinase À1, À2 when compared with the other groups. The present research shows, for the first time, that exercise training associated with the activation of ACE2 potentially reduces pulmonary fibrosis.

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Pulmonary rehabilitation for interstitial lung disease

Dowman

Hill

May

et al. 2021

Cochrane Database of Systematic Reviews

145

152

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Long-Term Effects of a 12-Week Exercise Training Program on Clinical Outcomes in Idiopathic Pulmonary Fibrosis

Cited by 98 publications

References 42 publications

The Prognostic Role of Ventilatory Inefficiency and Exercise Capacity in Idiopathic Pulmonary Fibrosis

The Prognostic Role of Ventilatory Inefficiency and Exercise Capacity in Idiopathic Pulmonary Fibrosis

Original Research: ACE2 activator associated with physical exercise potentiates the reduction of pulmonary fibrosis

Pulmonary rehabilitation for interstitial lung disease

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