Influência do treinamento aeróbio no processo inflamatório, capacidade de exercício e qualidade de vida em pacientes com fibrose cística.

Abstract

Cystic fibrosis (CF) is characterized by progressive, chronic, suppurative, obstructive pulmonary disease, pancreatic failure with poor digestion, poor absorption of food and secondary malnutrition, with increased chloride and sodium concentrations in perspiration, and male infertility in adult life. The severity of lung disease leads these children to experience recurring infection and a progressive loss of lung function, leading to intolerance to aerobic exercise, which is likely related to the mechanisms of lung injury.8 Systemic inflammatory response in CF alters exercise capacity. Thus, treatment strategies should not focus merely on direct approaches to obstructive pulmonary disease, but also on interventions that modulate the inflammatory response to infection and increase tolerance to exercise, thereby improving quality of life. The aim of the present study was to assess the systemic inflammatory process through C-reactive protein levels and the capacity for aerobic exercise in patients with cystic fibrosis submitted to physical training. Material and methods: A controlled, prospective clinical trial was carried out on a consecutive sample at a private clinic in the city of Cascavel (Brazil) and a physiotherapy clinic at the Universidade Nove de Julho (Brazil). CP was confirmed for all patients by the positive sweat test. The participants were twenty Caucasian children, with a mean age of 13.21 years. Two groups of patients with CF were formed: one group submitted to physical training (G1; n= 10) and one group without physical training G2; n=10). A third group was the control (CG), made up healthy children who were not submitted to physical training, but were free to perform their activities of daily living. The experimental protocol consisted of medical history, lung function test, 3-minute step test, maximum exertion test, collection of blood samples and a quality of life questionnaire, which were administered during both the evaluation and reevaluation. Results: There was a correlation between lung function and CRP (moderate correlation = -0.62), with a significant correlation between VEF1 and CRP (p<0.01). There was a significant increase in the number of steps in G1, with a reduction in dyspnea, HR and leg fatigue. CRP was also reduced, but this reduction did not achieve statistical significance. Inter-group delta analysis revealed a significant difference in the number of steps, but there was no significant difference for the other variables analyzed. There was a significant increase in the total score of the CF-specific quality of life questionnaire. Conclusions: From the results of the present study, we may infer that aerobic exercise training reduced the inflammatory process and increased the capacity for exercise among patients with cystic fibrosis. Thus, the measurement of systemic inflammatory response may be a variable for determining whether a proposed training program will trigger greater inflammation. Moreover, the CF-specific questionnaire revealed a better quality of life for these patients