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Medicinal clays improve the endurance of loaded inspiratory muscles in COPD: a randomized clinical trial of nonpharmacological treatment

BACKGROUND: Inspiratory resistive breathing (IRB) challenges affect respiratory muscle endurance in healthy individuals, which is considered to be an interleukin 6 (IL-6)–dependent mechanism. Whether nonpharmacological thermal therapies promote the endurance of loaded inspiratory muscles in chronic...

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Autores principales: Baldi, Simonetta, Pinna, Gian Domenico, Bruschi, Claudio, Caldara, Fabrizio, Maestri, Roberto, Dacosto, Elena, Rezzani, Antonella, Popovich, Ermanno, Bellinzona, Ezio, Crotti, Paola, Montemartini, Silvia, Fracchia, Claudio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4629956/
https://www.ncbi.nlm.nih.gov/pubmed/26604728
http://dx.doi.org/10.2147/COPD.S87999
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author Baldi, Simonetta
Pinna, Gian Domenico
Bruschi, Claudio
Caldara, Fabrizio
Maestri, Roberto
Dacosto, Elena
Rezzani, Antonella
Popovich, Ermanno
Bellinzona, Ezio
Crotti, Paola
Montemartini, Silvia
Fracchia, Claudio
author_facet Baldi, Simonetta
Pinna, Gian Domenico
Bruschi, Claudio
Caldara, Fabrizio
Maestri, Roberto
Dacosto, Elena
Rezzani, Antonella
Popovich, Ermanno
Bellinzona, Ezio
Crotti, Paola
Montemartini, Silvia
Fracchia, Claudio
author_sort Baldi, Simonetta
collection PubMed
description BACKGROUND: Inspiratory resistive breathing (IRB) challenges affect respiratory muscle endurance in healthy individuals, which is considered to be an interleukin 6 (IL-6)–dependent mechanism. Whether nonpharmacological thermal therapies promote the endurance of loaded inspiratory muscles in chronic obstructive pulmonary disease (COPD) is unclear. The objectives of this study were to compare the effects of two thermal interventions on endurance time (ET) and plasma IL-6 concentration following an IRB challenge. METHODS: This study was a randomized, parallel-group, unblinded clinical trial in a single-center setting. Forty-two patients (aged 42–76 years) suffering from mild to severe COPD participated in this study. Both groups completed 12 sessions of the mud bath therapy (MBT) (n=22) or leisure thermal activity (LTA) (n=19) in a thermal spa center in Italy. Pre- and postintervention spirometry, maximum inspiratory pressure, and plasma mediators were obtained and ET and endurance oxygen expenditure (VO(2Endur)) were measured following IRB challenge at 40% of maximum inspiratory pressure. RESULTS: There was no difference in ΔIL-6 between the intervention groups. But, IRB challenge increased cytokine IL-6 plasma levels systematically. The effect size was small. A statistically significant treatment by IRB challenge effect existed in ET, which significantly increased in the MBT group (P=0.003). In analysis of covariance treatment by IRB challenge analysis with LnVO(2Endur) as the dependent variable, ΔIL-6 after intervention predicted LnVO2Endur in the MBT group, but not in the LTA group. Adverse events occurred in two individuals in the MBT group, but they were mainly transient. One patient in the LTA group dropped out. CONCLUSION: MBT model improves ET upon a moderate IRB challenge, indicating the occurrence of a training effect. The LnVO(2Endur)/ΔIL-6 suggests a physiologic adaptive mechanism in respiratory muscles of COPD patients allocated to treatment. Both thermal interventions are safe.
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spelling pubmed-46299562015-11-24 Medicinal clays improve the endurance of loaded inspiratory muscles in COPD: a randomized clinical trial of nonpharmacological treatment Baldi, Simonetta Pinna, Gian Domenico Bruschi, Claudio Caldara, Fabrizio Maestri, Roberto Dacosto, Elena Rezzani, Antonella Popovich, Ermanno Bellinzona, Ezio Crotti, Paola Montemartini, Silvia Fracchia, Claudio Int J Chron Obstruct Pulmon Dis Original Research BACKGROUND: Inspiratory resistive breathing (IRB) challenges affect respiratory muscle endurance in healthy individuals, which is considered to be an interleukin 6 (IL-6)–dependent mechanism. Whether nonpharmacological thermal therapies promote the endurance of loaded inspiratory muscles in chronic obstructive pulmonary disease (COPD) is unclear. The objectives of this study were to compare the effects of two thermal interventions on endurance time (ET) and plasma IL-6 concentration following an IRB challenge. METHODS: This study was a randomized, parallel-group, unblinded clinical trial in a single-center setting. Forty-two patients (aged 42–76 years) suffering from mild to severe COPD participated in this study. Both groups completed 12 sessions of the mud bath therapy (MBT) (n=22) or leisure thermal activity (LTA) (n=19) in a thermal spa center in Italy. Pre- and postintervention spirometry, maximum inspiratory pressure, and plasma mediators were obtained and ET and endurance oxygen expenditure (VO(2Endur)) were measured following IRB challenge at 40% of maximum inspiratory pressure. RESULTS: There was no difference in ΔIL-6 between the intervention groups. But, IRB challenge increased cytokine IL-6 plasma levels systematically. The effect size was small. A statistically significant treatment by IRB challenge effect existed in ET, which significantly increased in the MBT group (P=0.003). In analysis of covariance treatment by IRB challenge analysis with LnVO(2Endur) as the dependent variable, ΔIL-6 after intervention predicted LnVO2Endur in the MBT group, but not in the LTA group. Adverse events occurred in two individuals in the MBT group, but they were mainly transient. One patient in the LTA group dropped out. CONCLUSION: MBT model improves ET upon a moderate IRB challenge, indicating the occurrence of a training effect. The LnVO(2Endur)/ΔIL-6 suggests a physiologic adaptive mechanism in respiratory muscles of COPD patients allocated to treatment. Both thermal interventions are safe. Dove Medical Press 2015-10-23 /pmc/articles/PMC4629956/ /pubmed/26604728 http://dx.doi.org/10.2147/COPD.S87999 Text en © 2015 Baldi et al. This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
spellingShingle Original Research
Baldi, Simonetta
Pinna, Gian Domenico
Bruschi, Claudio
Caldara, Fabrizio
Maestri, Roberto
Dacosto, Elena
Rezzani, Antonella
Popovich, Ermanno
Bellinzona, Ezio
Crotti, Paola
Montemartini, Silvia
Fracchia, Claudio
Medicinal clays improve the endurance of loaded inspiratory muscles in COPD: a randomized clinical trial of nonpharmacological treatment
title Medicinal clays improve the endurance of loaded inspiratory muscles in COPD: a randomized clinical trial of nonpharmacological treatment
title_full Medicinal clays improve the endurance of loaded inspiratory muscles in COPD: a randomized clinical trial of nonpharmacological treatment
title_fullStr Medicinal clays improve the endurance of loaded inspiratory muscles in COPD: a randomized clinical trial of nonpharmacological treatment
title_full_unstemmed Medicinal clays improve the endurance of loaded inspiratory muscles in COPD: a randomized clinical trial of nonpharmacological treatment
title_short Medicinal clays improve the endurance of loaded inspiratory muscles in COPD: a randomized clinical trial of nonpharmacological treatment
title_sort medicinal clays improve the endurance of loaded inspiratory muscles in copd: a randomized clinical trial of nonpharmacological treatment
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4629956/
https://www.ncbi.nlm.nih.gov/pubmed/26604728
http://dx.doi.org/10.2147/COPD.S87999
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