Individualized supervised resistance training during nebulization in adults with cystic fibrosis.

Ina Shaw,Janine E Kinsey,Brandon S Shaw,Roxanne Richards

doi:10.12669/pjms.325.9960

Abstract

Background & Objective:Since dyspnea limits exercise adherence and intensity in cystic fibrosis (CF) patients, engaging in resistance training (RT), which causes less dyspnea than other exercise modalities, while using nebulizers could not only overcome this barrier, but also enhance long-term adaptations to treatment. The objective of this study was to examine the effects of RT during nebulization on spirometry, anthropometry, chest wall excursion, respiratory muscle strength and health-related quality of life (HRQOL).Methods:Fourteen male and female CF patients were assigned to a four-week, 20-minute, 5-day per week proof-of-concept RT group (RTG) (n=7) or non-exercising control group (CON) (n=7), with 3 CON patients later dropping out of the study. Patients performed whole body exercises for 3 sets of 10 reps using resistance bands, since such bands have previously demonstrated a greater effect on functional exercise capacity than conventional RT in lung patients.Results:The RTG displayed significant (p≤0.05) increases in FEV1, FEV1/FVC, latissimusdorsi strength, pectoralis major clavicular portion strength, pectoralis major sternocostal portion strength and emotional and digestion HRQOL domains, while decreasing pectoralis minor strength on the left and social, body image and respiration HRQOL domains.Conclusion:This small scale proof-of-concept investigation demonstrates the multiple and simultaneous benefits of RT during nebulization in CF patients. The improvements in pulmonary measures are particularly promising especially since this study only made use of a four-week experimental period. This study provides an important alternative, time-saving treatment for the CF patient that does not add to the treatment burden of CF patients.

Highlights

Cystic fibrosis (CF) is a multi system disease that primarily affects the pulmonary system and pancreas
Results indicated that FEV1 (p=0.041), FEV1/ FVC (p=0.032), latissimusdorsi strength on the left (p=0.047), pectoralis major: sternocostal portion on the right (p=0.025), pectoralis minor strength on the left (p=0.011) and right (p=0.020), seven-stage abdominal test (p=0.001) and emotional (p
The concomitant use resistance training (RT) during nebulization times may result in improvements in both the efficacy of the nebulization, since RT may increase the dwell time of the inhaled submicronic particles as a result of Valsalva maneuvers, and the enhanced efficacy of the nebulized medications may reduce exerciseinduced hypoxemia and increase exercise tolerance, oxygen supply and adaptations and overcome the primary reason that many cystic fibrosis (CF) patients abstain from exercise and enhance long-term adaptations

Summary

Introduction

Cystic fibrosis (CF) is a multi system disease that primarily affects the pulmonary system and pancreas. Since dyspnea limits exercise adherence and intensity in cystic fibrosis (CF) patients, engaging in resistance training (RT), which causes less dyspnea than other exercise modalities, while using nebulizers could overcome this barrier, and enhance long-term adaptations to treatment. Methods: Fourteen male and female CF patients were assigned to a four-week, 20-minute, 5-day per week proof-of-concept RT group (RTG) (n=7) or non-exercising control group (CON) (n=7), with 3 CON patients later dropping out of the study. Patients performed whole body exercises for 3 sets of 10 reps using resistance bands, since such bands have previously demonstrated a greater effect on functional exercise capacity than conventional RT in lung patients. This study provides an important alternative, time-saving treatment for the CF patient that does not add to the treatment burden of CF patients

Objectives

Methods

Discussion

Conclusion