Courtney M Wheatley1, Sarah E Baker2, Mary A Morgan3, Marina G Martinez4, Wayne J Morgan5, Eric C Wong6, Stephen R Karpen7, Eric M Snyder8. 1. Department of Pharmacy Practice & Science, University of Arizona, Tucson, AZ, USA; Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA. Electronic address: wheatley.courtney@mayo.edu. 2. Department of Pharmacy Practice & Science, University of Arizona, Tucson, AZ, USA; Department of Kinesiology, University of Minnesota, Minneapolis, MN, USA. Electronic address: land0376@umn.edu. 3. Department of Pharmacy Practice & Science, University of Arizona, Tucson, AZ, USA. Electronic address: uagrad06@gmail.com. 4. Department of Pharmacy Practice & Science, University of Arizona, Tucson, AZ, USA. Electronic address: mgm2@email.arizona.edu. 5. Department of Pediatrics- Pulmonology, Allergy and Immunology, University of Arizona, Tucson, AZ, USA. Electronic address: wjmorgan@arc.arizona.edu. 6. Department of Pharmacy Practice & Science, University of Arizona, Tucson, AZ, USA. Electronic address: ecwong47@gmail.com. 7. Department of Pharmacy Practice & Science, University of Arizona, Tucson, AZ, USA. Electronic address: karpen@pharmacy.arizona.edu. 8. Department of Pharmacy Practice & Science, University of Arizona, Tucson, AZ, USA; Department of Kinesiology, University of Minnesota, Minneapolis, MN, USA. Electronic address: snyd0180@umn.edu.
Abstract
BACKGROUND: Although exercise is a vital component of the therapy prescribed to individuals with cystic fibrosis (CF), it is not a priority due to a finite amount of treatment time and the view that exercise is not as beneficial as pharmacological treatments by many individuals with CF. We sought to compare the therapeutic benefits of exercise and their prescribed bronchodilator albuterol. METHODS: CF (n = 14) and healthy (n = 16) subjects completed three visits, a baseline screening with VO2 max test and two treatment visits. On the two treatment visits, subjects completed spirometry and diffusing capacity of the lungs for nitric oxide (DLNO) maneuvers either at baseline, 60, and 110 min post-albuterol administration, or at baseline and the midway point of three separate 15 min exercise bouts at low, moderate and vigorous intensity (25, 50 and 65% of the maximum workload, respectively). RESULTS: With moderate exercise the increase in DLNO was double (39 ± 8 vs 15 ± 6% change) and the level of bronchodilation similar (23% change) when compared to 110 min post-albuterol in individuals with CF. During exercise FVC became reduced (-309 ± 66 mL with moderate exercise) and the increase in FEV1 was attenuated (103 ± 39 vs 236 ± 58 mL, exercise vs. albuterol) when compared with the response to albuterol in individuals with CF. Epinephrine (EPI) release increased 39, 72 and 144% change with low, moderate and vigorous intensity exercise respectively for individuals with CF, but this increase was blunted when compared to healthy subjects. CONCLUSION: Our results suggest that moderate intensity exercise is the optimal intensity for individuals with CF, as low intensity exercise increases EPI less than 50% and vigorous intensity exercise is over taxing, such that airflow can be restricted. Although the duration of the beneficial effect is uncertain, exercise can promote greater improvements in gas diffusion and comparable bronchodilation when compared to albuterol.
RCT Entities:
BACKGROUND: Although exercise is a vital component of the therapy prescribed to individuals with cystic fibrosis (CF), it is not a priority due to a finite amount of treatment time and the view that exercise is not as beneficial as pharmacological treatments by many individuals with CF. We sought to compare the therapeutic benefits of exercise and their prescribed bronchodilator albuterol. METHODS: CF (n = 14) and healthy (n = 16) subjects completed three visits, a baseline screening with VO2 max test and two treatment visits. On the two treatment visits, subjects completed spirometry and diffusing capacity of the lungs for nitric oxide (DLNO) maneuvers either at baseline, 60, and 110 min post-albuterol administration, or at baseline and the midway point of three separate 15 min exercise bouts at low, moderate and vigorous intensity (25, 50 and 65% of the maximum workload, respectively). RESULTS: With moderate exercise the increase in DLNO was double (39 ± 8 vs 15 ± 6% change) and the level of bronchodilation similar (23% change) when compared to 110 min post-albuterol in individuals with CF. During exercise FVC became reduced (-309 ± 66 mL with moderate exercise) and the increase in FEV1 was attenuated (103 ± 39 vs 236 ± 58 mL, exercise vs. albuterol) when compared with the response to albuterol in individuals with CF. Epinephrine (EPI) release increased 39, 72 and 144% change with low, moderate and vigorous intensity exercise respectively for individuals with CF, but this increase was blunted when compared to healthy subjects. CONCLUSION: Our results suggest that moderate intensity exercise is the optimal intensity for individuals with CF, as low intensity exercise increases EPI less than 50% and vigorous intensity exercise is over taxing, such that airflow can be restricted. Although the duration of the beneficial effect is uncertain, exercise can promote greater improvements in gas diffusion and comparable bronchodilation when compared to albuterol.
Authors: Joachim Saur; Frederik Trinkmann; Christina Doesch; Armin Scherhag; Joachim Brade; Stefan O Schoenberg; Martin Borggrefe; Jens J Kaden; Theano Papavassiliu Journal: Lung Date: 2010-07-31 Impact factor: 2.584
Authors: David M Orenstein; Melbourne F Hovell; Mary Mulvihill; Kristen K Keating; C Richard Hofstetter; Sheryl Kelsey; Kimberly Morris; Patricia A Nixon Journal: Chest Date: 2004-10 Impact factor: 9.410
Authors: Eric M Snyder; Kenneth C Beck; Niki M Dietz; Michael J Joyner; Stephen T Turner; Bruce D Johnson Journal: Chest Date: 2006-03 Impact factor: 9.410
Authors: Courtney M Wheatley; Sarah E Baker; Bryan J Taylor; Manda L Keller-Ross; Steven C Chase; Alex R Carlson; Robert J Wentz; Eric M Snyder; Bruce D Johnson Journal: High Alt Med Biol Date: 2017-09-06 Impact factor: 1.981
Authors: Courtney M Wheatley; Sarah E Baker; Mary A Morgan; Marina G Martinez; Bo Liu; Steven M Rowe; Wayne J Morgan; Eric C Wong; Stephen R Karpen; Eric M Snyder Journal: Respir Med Date: 2015-05-23 Impact factor: 3.415
Authors: Alexander L Bisch; Courtney M Wheatley; Sarah E Baker; Elizabeth R Peitzman; Erik H Van Iterson; Theresa A Laguna; Wayne J Morgan; Eric M Snyder Journal: Clin Med Insights Circ Respir Pulm Med Date: 2019-03-29