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Effects of a Long-term Pulmonary Rehabilitation Program on Functional Capacity and Inflammatory Profile of Older Patients With COPD

Vieira, Fabíola C. O. S., MSc; Pereira, Daniele S., PhD; Costa, Thacianna B., PhD; Souza, Rilda C. A., MSc; Castro, Célia M. M. B., PhD; Dornelas de Andrade, Arméle, PhD; Marinho, Patrícia Érika de Melo, PhD

Journal of Cardiopulmonary Rehabilitation and Prevention: September 2018 - Volume 38 - Issue 5 - p E12–E15
doi: 10.1097/HCR.0000000000000303
Brief Reports

Purpose: To evaluate the effects of a long-term pulmonary rehabilitation program (PRP) on functional capacity, maximal inspiratory pressure (MIP), quality of life, and plasma levels of tumor necrosis factor alpha (TNF-α), soluble tumor necrosis factor receptors 1 and 2 (sTNFR1 and sTNFR2, respectively), and cytokine interleukin 1beta (IL-1β) in elderly patients with chronic obstructive pulmonary disease (COPD).

Methods: In a quasi-experimental study, PRP effectiveness was investigated in elderly patients with stage I-IV COPD undergoing a 6-mo training program. Participants took part in an 80-min PRP 3 times/wk. Before and after the intervention, the distance walked during a 6-min walk test (6MWD), MIP, St George's Respiratory Questionnaire (SGRQ), and plasma levels of TNF-α, sTNFR1, sTNFR2, and IL-1β were evaluated.

Results: In 7 patients who completed the PRP and had markers evaluated, we observed improvement in 6MWD (range, 26-331 m) and MIP for most patients. There was an improvement in impact and total domains for all patients and in symptoms and activity for most patients on the SGRQ at the completion of the PRP. TNF-α, sTNFR1, sTNFR2, and IL-1β increased in some patients at the end of the PRP. The 6-mo PRP improved functional capacity, MIP, and quality of life for most patients.

Conclusions: Inflammatory markers showed various changes at the end of the study; however, only sTNFR2 levels improved after the PRP.

This study aimed to evaluate the functional capacity and the behavior of inflammatory mediators in patients with stage I-IV chronic obstructive pulmonary disease in response to a pulmonary rehabilitation program (PRP). Both distance walked and maximal inspiratory pressure increased. The inflammatory markers showed varied behavior, with only soluble tumor necrosis factor receptor 1 levels reflecting improvement in inflammation after the PRP.

Post-Graduate Program of Health Science (Mss Vieira and Souza and Dr Marinho), Immunopathology Laboratory Keizo Asami (Drs Costa and Castro), and Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department (Drs Dornelas de Andrade and Marinho), Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil; and Nursing Course and Physical Therapy Course, Universidade Federal de Alfenas, Minas Gerais, Brazil (Dr Pereira).

Correspondence: Patrícia Érika de Melo Marinho, PhD, Cardiopulmonary Physical Therapy Laboratory, Department of Physical Therapy, Universidade Federal de Pernambuco, Av Jornalista Aníbal Fernandes, s/n Cidade Universitária, Recife, PE, Brazil, CEP: 50740-560 ( or

All the authors have read and approved submission of the manuscript.

The authors declare no conflicts of interest.

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