title: Home-based pulmonary rehabilitation improves clinical features and systemic inflammation in chronic obstructive pulmonary disease patients.
abstract: Chronic obstructive pulmonary disease (COPD) is a respiratory disease characterized by chronic airflow limitation that leads beyond the pulmonary changes to important systemic effects. COPD is characterized by pulmonary and systemic inflammation. However, increases in the levels of inflammatory cytokines in plasma are found even when the disease is stable. Pulmonary rehabilitation improves physical exercise capacity and quality of life and decreases dyspnea. The aim of this study was to evaluate whether a home-based pulmonary rehabilitation (HBPR) program improves exercise tolerance in COPD patients, as well as health-related quality of life and systemic inflammation. This prospective study was conducted at the Laboratory of Functional Respiratory Evaluation, Nove de Julho University, São Paulo, Brazil. After anamnesis, patients were subjected to evaluations of health-related quality of life and dyspnea, spirometry, respiratory muscle strength, upper limbs incremental test, incremental shuttle walk test, and blood test for quantification of systemic inflammatory markers (interleukin [IL]-6 and IL-8). At the end of the evaluations, patients received a booklet containing the physical exercises to be performed at home, three times per week for 8 consecutive weeks. Around 25 patients were enrolled, and 14 completed the pre- and post-HBPR ratings. There was a significant increase in the walked distance and the maximal inspiratory pressure, improvements on two components from the health-related quality-of-life questionnaire, and a decrease in plasma IL-8 levels after the intervention. The HBPR is an important and viable alternative to pulmonary rehabilitation for the treatment of patients with COPD; it improves exercise tolerance, inspiratory muscle strength, quality of life, and systemic inflammation in COPD patients.
authors.affiliation: Laboratory of Functional Respiratory Evaluation (LARESP), Nove de Julho University (UNINOVE), São Paulo, SP, Brazil.
authors.forename: Eloisa Sanches Pereira
authors.initials: ES
authors.lastname: do Nascimento
authors.affiliation: Laboratory of Functional Respiratory Evaluation (LARESP), Nove de Julho University (UNINOVE), São Paulo, SP, Brazil.
authors.forename: Luciana Maria Malosá
authors.initials: LM
authors.lastname: Sampaio
authors.affiliation: Laboratory of Functional Respiratory Evaluation (LARESP), Nove de Julho University (UNINOVE), São Paulo, SP, Brazil.
authors.forename: Fabiana Sobral
authors.initials: FS
authors.lastname: Peixoto-Souza
authors.affiliation: Laboratory of Functional Respiratory Evaluation (LARESP), Nove de Julho University (UNINOVE), São Paulo, SP, Brazil.
authors.forename: Fernanda Dultra
authors.initials: FD
authors.lastname: Dias
authors.affiliation: Laboratory of Functional Respiratory Evaluation (LARESP), Nove de Julho University (UNINOVE), São Paulo, SP, Brazil.
authors.forename: Evelim Leal Freitas Dantas
authors.initials: EL
authors.lastname: Gomes
authors.affiliation: Laboratory of Pulmonary and Exercise Immunology (LABPEI), Nove de Julho University (UNINOVE), São Paulo, SP, Brazil.
authors.forename: Flavia Regina
authors.initials: FR
authors.lastname: Greiffo
authors.affiliation: Laboratory of Pulmonary and Exercise Immunology (LABPEI), Nove de Julho University (UNINOVE), São Paulo, SP, Brazil.
authors.forename: Ana Paula
authors.initials: AP
authors.lastname: Ligeiro de Oliveira
authors.affiliation: Department of Pneumology, Santa Casa University Hospital, São Paulo, SP, Brazil.
authors.forename: Roberto
authors.initials: R
authors.lastname: Stirbulov
authors.affiliation: Laboratory of Pulmonary and Exercise Immunology (LABPEI), Nove de Julho University (UNINOVE), São Paulo, SP, Brazil.
authors.forename: Rodolfo Paula
authors.initials: RP
authors.lastname: Vieira
authors.affiliation: Laboratory of Functional Respiratory Evaluation (LARESP), Nove de Julho University (UNINOVE), São Paulo, SP, Brazil.
authors.forename: Dirceu
authors.initials: D
authors.lastname: Costa
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D001938:Brazil; D016207:Cytokines / Q000097:blood; D005080:Exercise Test; D005081:Exercise Therapy; D017079:Exercise Tolerance; D005260:Female; D018575:Home Care Services, Hospital-Based; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology / Q000534:rehabilitation*; D018836:Inflammation Mediators / Q000097:blood; D008168:Lung / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology / Q000534:rehabilitation*; D011788:Quality of Life; D020127:Recovery of Function; D012132:Respiratory Muscles / Q000503:physiopathology; D012138:Respiratory Therapy / Q000379:methods*; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D016207:Cytokines; D018836:Inflammation Mediators
keywords: chronic obstructive pulmonary disease; health-related quality of life; home-based pulmonary rehabilitation; inflammation; interleukin; physical exercise
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