Acute effects of combined exercise and oscillatory positive expiratory pressure therapy on sputum properties and lung diffusing capacity in cystic fibrosis: a randomized, controlled, crossover trial
Abstract Background Regular airway clearance by chest physiotherapy and/or exercise is critical to lung health in cystic fibrosis (CF). Combination of cycling exercise and chest physiotherapy using the Flutter® device on sputum properties has not yet been investigated. Methods This prospective, rand...
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| Format: | Article |
| Language: | English |
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BMC
2018-06-01
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| Series: | BMC Pulmonary Medicine |
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| Online Access: | http://link.springer.com/article/10.1186/s12890-018-0661-1 |
| _version_ | 1818910433049837568 |
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| author | Thomas Radtke Lukas Böni Peter Bohnacker Marion Maggi-Beba Peter Fischer Susi Kriemler Christian Benden Holger Dressel |
| author_facet | Thomas Radtke Lukas Böni Peter Bohnacker Marion Maggi-Beba Peter Fischer Susi Kriemler Christian Benden Holger Dressel |
| author_sort | Thomas Radtke |
| collection | DOAJ |
| description | Abstract Background Regular airway clearance by chest physiotherapy and/or exercise is critical to lung health in cystic fibrosis (CF). Combination of cycling exercise and chest physiotherapy using the Flutter® device on sputum properties has not yet been investigated. Methods This prospective, randomized crossover study compared a single bout of continuous cycling exercise at moderate intensity (experiment A, control condition) vs a combination of interval cycling exercise plus Flutter® (experiment B). Sputum properties (viscoelasticity, yield stress, solids content, spinnability, and ease of sputum expectoration), pulmonary diffusing capacity for nitric oxide (DLNO) and carbon monoxide (DLCO) were assessed at rest, directly and 45 min post-exercise (recovery) at 2 consecutive visits. Primary outcome was change in sputum viscoelasticity (G’, storage modulus; G”, loss modulus) over a broad frequency range (0.1–100 rad.s− 1). Results 15 adults with CF (FEV1range 24–94% predicted) completed all experiments. No consistent differences between experiments were observed for G’ and G” and other sputum properties, except for ease of sputum expectoration during recovery favoring experiment A. DLNO, DLCO, alveolar volume (VA) and pulmonary capillary blood volume (Vcap) increased during experiment A, while DLCO and Vcap increased during experiment B (all P < 0.05). We found no differences in absolute changes in pulmonary diffusing capacity and its components between experiments, except a higher VA immediately post-exercise favoring experiment A (P = 0.032). Conclusions The additional use of the Flutter® to moderate intensity interval cycling exercise has no measurable effect on the viscoelastic properties of sputum compared to moderate intensity continuous cycling alone. Elevations in diffusing capacity represent an acute exercise-induced effect not sustained post-exercise. Trial registration ClinicalTrials.gov; No.: NCT02750722; URL: clinical.trials.gov; Registration date: April 25th, 2016. |
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| format | Article |
| id | doaj.art-6a37e61e4eac4c4ab2037fee2ebc9adf |
| institution | Directory Open Access Journal |
| issn | 1471-2466 |
| language | English |
| last_indexed | 2024-12-19T22:42:43Z |
| publishDate | 2018-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pulmonary Medicine |
| spelling | doaj.art-6a37e61e4eac4c4ab2037fee2ebc9adf2022-12-21T20:03:01ZengBMCBMC Pulmonary Medicine1471-24662018-06-0118111210.1186/s12890-018-0661-1Acute effects of combined exercise and oscillatory positive expiratory pressure therapy on sputum properties and lung diffusing capacity in cystic fibrosis: a randomized, controlled, crossover trialThomas Radtke0Lukas Böni1Peter Bohnacker2Marion Maggi-Beba3Peter Fischer4Susi Kriemler5Christian Benden6Holger Dressel7Epidemiology, Biostatistics and Prevention Institute (EBPI), University of ZurichDepartment of Health Science and Technology, ETH ZurichDepartment of Health Science and Technology, ETH ZurichDivision of Occupational and Environmental Medicine, University of Zurich and University Hospital ZurichDepartment of Health Science and Technology, ETH ZurichEpidemiology, Biostatistics and Prevention Institute (EBPI), University of ZurichDivision of Pulmonology, University Hospital of ZurichDivision of Occupational and Environmental Medicine, University of Zurich and University Hospital ZurichAbstract Background Regular airway clearance by chest physiotherapy and/or exercise is critical to lung health in cystic fibrosis (CF). Combination of cycling exercise and chest physiotherapy using the Flutter® device on sputum properties has not yet been investigated. Methods This prospective, randomized crossover study compared a single bout of continuous cycling exercise at moderate intensity (experiment A, control condition) vs a combination of interval cycling exercise plus Flutter® (experiment B). Sputum properties (viscoelasticity, yield stress, solids content, spinnability, and ease of sputum expectoration), pulmonary diffusing capacity for nitric oxide (DLNO) and carbon monoxide (DLCO) were assessed at rest, directly and 45 min post-exercise (recovery) at 2 consecutive visits. Primary outcome was change in sputum viscoelasticity (G’, storage modulus; G”, loss modulus) over a broad frequency range (0.1–100 rad.s− 1). Results 15 adults with CF (FEV1range 24–94% predicted) completed all experiments. No consistent differences between experiments were observed for G’ and G” and other sputum properties, except for ease of sputum expectoration during recovery favoring experiment A. DLNO, DLCO, alveolar volume (VA) and pulmonary capillary blood volume (Vcap) increased during experiment A, while DLCO and Vcap increased during experiment B (all P < 0.05). We found no differences in absolute changes in pulmonary diffusing capacity and its components between experiments, except a higher VA immediately post-exercise favoring experiment A (P = 0.032). Conclusions The additional use of the Flutter® to moderate intensity interval cycling exercise has no measurable effect on the viscoelastic properties of sputum compared to moderate intensity continuous cycling alone. Elevations in diffusing capacity represent an acute exercise-induced effect not sustained post-exercise. Trial registration ClinicalTrials.gov; No.: NCT02750722; URL: clinical.trials.gov; Registration date: April 25th, 2016.http://link.springer.com/article/10.1186/s12890-018-0661-1Lung diseaseSputum viscoelasticityDiffusing capacity for nitric oxideExerciseAirway clearanceMucus |
| spellingShingle | Thomas Radtke Lukas Böni Peter Bohnacker Marion Maggi-Beba Peter Fischer Susi Kriemler Christian Benden Holger Dressel Acute effects of combined exercise and oscillatory positive expiratory pressure therapy on sputum properties and lung diffusing capacity in cystic fibrosis: a randomized, controlled, crossover trial BMC Pulmonary Medicine Lung disease Sputum viscoelasticity Diffusing capacity for nitric oxide Exercise Airway clearance Mucus |
| title | Acute effects of combined exercise and oscillatory positive expiratory pressure therapy on sputum properties and lung diffusing capacity in cystic fibrosis: a randomized, controlled, crossover trial |
| title_full | Acute effects of combined exercise and oscillatory positive expiratory pressure therapy on sputum properties and lung diffusing capacity in cystic fibrosis: a randomized, controlled, crossover trial |
| title_fullStr | Acute effects of combined exercise and oscillatory positive expiratory pressure therapy on sputum properties and lung diffusing capacity in cystic fibrosis: a randomized, controlled, crossover trial |
| title_full_unstemmed | Acute effects of combined exercise and oscillatory positive expiratory pressure therapy on sputum properties and lung diffusing capacity in cystic fibrosis: a randomized, controlled, crossover trial |
| title_short | Acute effects of combined exercise and oscillatory positive expiratory pressure therapy on sputum properties and lung diffusing capacity in cystic fibrosis: a randomized, controlled, crossover trial |
| title_sort | acute effects of combined exercise and oscillatory positive expiratory pressure therapy on sputum properties and lung diffusing capacity in cystic fibrosis a randomized controlled crossover trial |
| topic | Lung disease Sputum viscoelasticity Diffusing capacity for nitric oxide Exercise Airway clearance Mucus |
| url | http://link.springer.com/article/10.1186/s12890-018-0661-1 |
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