Effects of exercise on respiratory flow and sputum properties in cystic fibrosis.

Chest. 2010 Sep 9.

Effects of exercise on respiratory flow and sputum properties in cystic fibrosis.

Dwyer TJ, Alison JA, McKeough ZJ, Daviskas E, Bye PT.
1Discipline of Physiotherapy, Faculty of Health Sciences, University of Sydney, Sydney, Australia.


BACKGROUND: The physiological mechanisms by which exercise may clear secretions in subjects with cystic fibrosis (CF) are unknown. The purpose of this study was to compare ventilation, respiratory flow and sputum properties following treadmill and cycle exercise to resting breathing (control).


METHODS: In 14 adult subjects with CF, ventilation and respiratory flow were measured during 20 minutes of resting breathing, treadmill and cycle exercise in a three-day, cross-over study. Treadmill and cycle exercise were performed at the workrate equivalent to 60% of the subject's peak VO(2). Ease of expectoration and sputum properties (solids content and mechanical impedance) were measured before and immediately after the interventions and after 20 minutes recovery.
RESULTS: Ease of expectoration improved following exercise. Ventilation and respiratory flow were significantly higher during treadmill and cycle exercise, compared to control. Sputum solids content did not change following treadmill or cycle exercise. There was a significantly greater decrease in sputum mechanical impedance following treadmill exercise compared to control, but no significant decrease in sputum mechanical impedance following cycle exercise compared to control.
CONCLUSIONS: The improvement in ease of expectoration following exercise may have been due to the higher ventilation and respiratory flow. The reductions in sputum mechanical impedance with treadmill exercise may have been due to the trunk oscillations associated with walking.

AMAZING workout videos + Book

For those of you who know me, I've had amazing results both with my lungs and with my body from Jillian Michaels workout videos.

My fav is the Banish Fat Boost Metabolism.

I just found out how to get her videos SUPER CHEAP (and 3 of them) here: http://www.qvc.com/qic/qvcapp.aspx/view.2/app.detail/params.CM_SCID.coll.item.F08319.desc.Jillian-Michaels-Ultimate-Body-Makeover-3-DVD-Workout-Set

Also, I know there are quite a number of CFer's who are flabby and looking to get into shape. This book has been INCREDIBLE for me as well. I don't have a recommended website to purchase this book, but you could even go to your local library if you want to check it out.

Exercise Update

So I have to admit, getting adjusted to my new job was tougher than I thought.

I started work in June and I was doing pretty well until about the beginning of October (eating well, exercise, getting enough sleep and of course doing meds).

Fall and winter are the times that are the roughest on me - granted it's MUCH better than it was 10-15 years ago before I treated my allergies with shots, environmental controls, EXERCISE (oh yes, exercise reduces inflammation big time for me), anti-histamines and leukotriene agonists. But I still get a bit tighter in the fall/winter and it makes clearing mucus that much tougher.

Plus, things at my job were making me more tired around this time so I have to admit that my exercising went from about 3-4/week with Jillian to about 1x a week. Not sure about the rest of you all, but I don't fully grasp how crappy I feel until I start to feel better. I'm not sure if my self-awareness is just horrendous or if we CFer's are able to adapt so well to the ups and downs of our illnesses we just cope easily.

So as a result of less exercise, more stress, fatigue, and fall allergies, I had some pretty decent hemoptysis on Halloween. As you would expect, I was on 2 weeks of IV's where I didn't exercise a whole lot due to simple fear of coughing more blood / being wiped out from the IV's. I also threw another DVT so I was on blood thinners 'til mid december and of course that freaked me out because if I coughed up blood with Lovenox in my system, that would be BAD BAD news.

I got a 2 week break after the IV's before I caught a wicked cold where naturally I was preparing for some more hemoptysis. Thank God that didn't happen (lungs were probably in better shape because I had just finished IV's?) although the cold lasted for a good 2 weeks and I had to fight it with nebbed Colistin and PO Lequin. I felt better after 2 weeks of treatment, but never fully back to normal.

After about a week of the cold/ CF PA exacerbation being gone and I caught a stomach virus that was going around. Luckily no puking or the runs, but unbelievable stomach cramps, nausea, fevers and no appetite for about 4 days.

I also got my Mirena put in the 1st week of December and had a lovely period that lasted nearly 4 weeks. Cramps were pretty horrendous as well and I just decided to give myself the holidays off from exercising (not treatments) after a really tough 2 months.

So what's my point?

My point is, I started 2010 anew.

• My period finally ended and I feel so good with this Mirena. I mean really, really, really good. I can't wait to see if this continues.
• I am back on the exercise band wagon with Jillian Michaels' video that I wrote about last May. Yes, I took a good 3 months off from consistent exercising so it was pretty tough getting back in to shape. But MAN, do I feel good. I cough up 2-3 plugs/day about the size of my pinky finger nail and my problem area (right middle lobe) hasn't felt this good in probably well over a year. I have much more energy, and moods are amazing. Not goign to lie - when it's time to exercise I get pretty angry... I am not the type of person that likes to work out. At all. Buuuuuuuuuuuut I refer to my list that I made for 2010 to remind myself of the benefits of exercise and the consequences of not exercising:

-Lower chance of diabetes by creating muscle mass that contains more insulin receptors

-Lower chance of osteoporosis related fracture by creating muscle mass which leads to inreased bone mass

-Better moods which leads to better performance on the job, happier relationships and overall increased enjoyment of life

-Lower chance of hemoptysis because I'm clearing areas of my lungs that I couldn't otherwise clear doing CPT, IV's or coughing

-Lower chance of exacerbation because exercising decreases inflammation in my lungs, and inflammation can inhibit mucus clearance

-Increase FEV1 which is the best predictor of life expectancy. VX-809 may or may not come to fruition, but in case it does, I'm determined to have the best lungs possible to maximize the benefits of the drug

-Increase immune system, and in turn chances of catching a virus that could cause permanent lung damage

And the list could go on and on.... but for me, this is enough to get me motivated.

So my point? I feel off the exercise bandwagon for a host of reasons - the first time I've fallen off since I started consistent, regular exercise in June 2007. Seriously.

But, by undersatnding the factors that contributed to me falling off the bandwagon and setting myself up for success by understanding the long list of benefits of exercising just 45 minutes 3x/week, I am more likely to stay on the bandwagon the next time things get tough.

Have no respect for the status quo. FIGHT ON

Long-term effects of a partially supervised conditioning program in cystic fibrosis

Eur Respir J. 2009 Jul 30. [Epub ahead of print]

Long-term effects of a partially supervised conditioning program in cystic fibrosis.

Hebestreit H, Kieser S, Junge S, Ballmann M, Hebestreit A, Schindler C, Schenk T, Posselt HG, Kriemler S.

Julius-Maximilians-Universität Würzburg, Germany.

Little is known about the long-term persistence of positive effects induced by a physical conditioning program. Therefore, this study determined the effects of a 6-months conditioning program on peak oxygen uptake (primary outcome), and other markers of fitness, physical activity, anthropometry, lung function, and quality of life (secondary outcomes) 18 and 24 months after the program was initiated.

Patients with CF aged 12-40 years were randomly assigned to an intervention (n=23) and a control (n=15) group. The intervention group consented to add three hours of sports per week for at least six months to their previous activities. Controls were asked to maintain their level of activity for 12 months. Patients were seen at baseline and after 3, 6, 12, 18, and 24 months.

There was no significant difference between groups at baseline.

The intervention induced positive effects on peak oxygen uptake (difference in changes from baseline to the 18- and 24-months assessments between groups: +3.72+/-1.23 ml.min(-1).kg(-1), p<0.01),>

A home-based partially supervised physical conditioning program can improve physical fitness, lung function and perceived health long after the intervention has ended.

PMID: 19643946 [PubMed - as supplied by publisher]

http://www.ncbi.nlm.nih.gov/pubmed/19643946?dopt=Abstract

Exercise programs for children with cystic fibrosis: A systematic review of randomized controlled trials.

Disabil Rehabil. 2009 Jun 26:1-9. [Epub ahead of print]

Exercise programs for children with cystic fibrosis: A systematic review of randomized controlled trials.

van Doorn N.

Department of Exercise and Sports Science, University of Sydney, Sydney, Australia.

Purpose. The aim of this article was to review the evidence for using exercise programs to improve pulmonary function and fitness in children with cystic fibrosis (CF). Method. Electronic databases - Medline, SPORTDiscus, CINAHL, AMED, EMBASE, and Cochrane Central Register of Controlled Trials were searched with terms 'CF' and keywords related to 'exercise'. These papers were analysed for study quality, participant details, exercise intervention details, and outcomes on pulmonary function and fitness components. Results. Only four randomized controlled trials (RCTs) met the eligibility criteria for review. These detailed exercise interventions cover short- and long-term duration. Modalities consisted of aerobic, strength, and anaerobic interventions. Severity of CF ranged from mild to severe. Significant improvement in pulmonary function was seen from short-term in-hospital aerobic or strength interventions. Significant strength gains were seen from strength training interventions. Aerobic fitness was shown to improve with short-term aerobic training. Conclusions. There is some evidence to support that both aerobic and strength training can impact positively on pulmonary function, aerobic fitness, and strength. More RCTs in this area would be welcomed. There is potential for future research into designing exercise programs for children with CF using a combination of modalities.

PMID: 19562582 [PubMed - as supplied by publisher]

http://www.ncbi.nlm.nih.gov/pubmed/19562582?dopt=Abstract

My exercise update

Well it's been a while since I've updated you all on my exercise progress. I do exercise because of it's innumerable benefits, not really because I like it (yet). So blogging about it many days of the week just wasn't working for me...

So I've reverted back to my 3-4x 45min a week routine instead of my 5x 30min a week routine. I was trying the 5x a week and frankly it was just too much and I wasn't seeing the fitness results I wanted.

FOR ME (not saying it's best for everyone), that extra 15 minutes for whatever reason really gets me more toned, makes me feel a greater endorphin rush, and it forces my lungs to work harder longer and I cough up more junk. So there you go.

Those who know me know that I do the eliptical I have in my house to work out and I use free weights to tone and keep my osteopenia at bay (BTW i'm now NORMAL in my spine and less osteopenic in my hip over last year....very exciting). But about 6 weeks ago I decided to mix it up and I bought an exercise video. VERY unlike me, but I wanted to see if I could be doing better by trying something new.

I listen to Jillian Michaels on the radio Sunday mornings to get inspiration to eat better (i'm on so many antibiotics, why buy chicken that's not organic, etc), use more natural products on my face, body, hair etc and of course exercise! So I figured maybe I'd try one of her videos. OMG I LOVE IT.

Let me be clear - I receive no benefit what so ever for mentioning her video, blah blah blah. I'm just posting this, like everything else in my blog, for the benefit of health of my fellow CFer's.

So why do I like her video? Well, it's 45 minutes (which is the time frame I like), and it combines cardio and weight training (but with my body weight, which is different) all in one. And HOLY COW my body has changed quite a bit over these past 6 weeks. I've only lost 2lbs (which I probably needed... I don't need to be 120 and 5'3), but I've gained a ton of muscle.

My upper legs, my arms, my abs - WOW! I've never been a team sports gal, or any type of sports gal except for tennis, so this type of muscle tone is something i've never had. So of course benefits of muscle tone are less risk for osteoperosis and less risk for insulin resistance, a component in CFRD.

So what I've been doing is my eliptical for 45 minutes 2x a week and this Jillian Michaels video 2x a week (oh here's the video http://www.amazon.com/Jillian-Michaels-Banish-Boost-Metabolism/dp/B001NFNFN0/ref=sr_1_3?ie=UTF8&s=dvd&qid=1241878375&sr=8-3). I do PFT's on Monday so I'll etyou konw how that goes.

But there's no doubt in my mind that mixing things up has really done my body good. I could barely do the whole video after pausing it like every 5 minutes, but now I only pause it every once in a while to catch my breath.... yey improvement!

How's everyone else doing with exercise?

BTW I want to give a shout out to Dr. Julie Desch and her blog and YouTube channel about exercise. She is a 47-year-old retired pathologist with cystic fibrosis. Julie’s professional career began at Stanford Medical School, where she spent 10 years in medical training. While at Stanford, Julie also worked in the Stanford Cystic Fibrosis Research Laboratory and she really focuses on wellness and exercise. I'd recommended RSS-ing her blog if you haven't already. Plus she has a schnauzer so you KNOW she has to be a cool woman!

FIGHT ON

New workout

So I was blogging frequently there for a while regarding my exercise routine. I've been super busy recently so I haven't had time to blog about exercise - but I've been exercising, don't you worry :)

I'm pretty pleased with a new part of my workout I have integrated into my routine. Instead of doing cardio 5 days a week on my eliptical, I am doing this new Jillian Michaels video 2-3x a week and doing my eliptical 2-3x a week (still totaling 5 days a week of working out in all). When I do the eliptical I do it for 40 minutes instead of the 30 like I have been doing for the past 6 months. Those extra 10 minutes really challenges my stamina, my heart and my lungs.

The Jillian Michaels video had make me sore in areas I didn't even know could get sore, so obviously I'm getting in some muscle work which as we all know is ESSENTIAL to staving off diabetes (more muscles = more insulin receptors = less insulin resistance). My legs, abs and arms are more toned after just 2 weeks.

But my heart rate gets up pretty high for the full 40 minutes with the Jillian video as well, so it's good cardio. I've lost about 2 lbs inthe past 2 weeks which is good for me - I'm a tad but un-toned so I'm about 119-120 instead of 122-123 lately.

So anyway, if you're looking to mix things up with your routine, build muscle and engage your mind differently (I swear my body got so used to the eliptical I don't think it was giving me the same work out as I was gettinga bout a year ago) then I recommend looking into this video. The workout is painful and it took a few times of doing it for me to be able to do it all the way through, but it's a great investment in my health.


http://www.amazon.com/Jillian-Michaels-Banish-Boost-Metabolism/dp/B001NFNFN0/ref=pd_bbs_1?ie=UTF8&s=dvd&qid=1238954048&sr=8-1

Full belly + exercise

Taiwanese sausage is an incredible dish. I've been eating it a little too much lately - I just can't get enough since I got back from my trip a few months back.

But man did this stuff just SIT in my stomach today. Yup, just sat there. So when it came to motivating for exercise this evening.... ya, wow. Didn't feel so good.

But I pushed myself anyway. So I'm 3/5 for cardio and 2/3 for weights for the week. And I might barf. No, I'm not joking. I do feel a little heavy in the yummy area and the water I'm drinking to re-hydrate isn't going down very easily.

Cheers! Here's to a great weekend guys :)

Busy Day + Exercise

I snuck in some exercise today (cardio.... 2/5). Tuesdays aren't usually my exercising days because I'm so darn busy, but I wanted to sneek it in in homes to increase my chances of reaching 5/5 for cardio. It's HARD. But I can do it.

Tomorrow I get re-scanned for my DVT (can you believe it's been 6 weeks already???). Hopefully we have shown some progress. As I've told many of you, swelling and tenderness went down 10 hours after my very 1st Lovenox dose 6 weeks ago and I haven't seen any symptoms since.

The Lovenox hasn't been too hard to remember - I just do what I do with all my other meds - set an iCal appointment on my computer and have it pop up 2x a day to remember to take the shot. I've had quite a bit of bruising from the shots on both sides but it doesn't really hurt and goes away quickly.

I'll let you know the verdict tomorrow.

Barbie

Running off to bed because I have class early tomorrow, but I get my cardio and weights in today. (1/5) and (1/3).

I'm watching dancing with the stars and I feel dumber for it. Denise Richards looks exactly like barbie. *dies*

Hope you guys are all doing well!

Roller skating as cardio

I went roller skating yesterday, which was so exhausting I'm counting it as cardio. I wish I wasn't so private because I'd show you how ridiculously i was dressed up..... ahhhh so funny. So that was 4/5 for cardio for the week.

Oh and I just did my eliptical and weights right now so that's 5/5 and 3/3. Yey!!!!

Hop everyone is doing great with their exercise goals. I'd love any updates if you have them. I follow some of you on your blogs so I get them that way.

Here's to a great week!

That tickle...

That post-cost tickle nearly sidelined me from working out today. But I snuck in a 1/2 hour of cardio when I felt the tickle monster wouldn't totally dominate me. That's 3/5 for cardio and 2/3 for weights.

In addition to my cardio, I did plee's (however you spell it) to mix things up. Oooooooh my inner thighs will feel it tomorrow!

Too many dates

So I did my cardio today (2/5) and weights (2/3). I'm still battling the remants of this cold (you know how that goes, right? The virus is gone but the inflammation in the lungs certainly is not... and neither are the accompanying bronchospams ugh!!!).

But I managed a decent work out despite eating an inappropriate amount of dates today. I have no idea why I ate so many... they taste SO GOOD. so sweet. man.

Ya and I did that two days ago too. I don't think it's necessarily too too bad for me other than the fact that it's taking the place of other healthy food I normally eat and I think diversity in food is probably a good thing. Anyway.

TOO MANY DATES :) But not too much exercise. Hope everyone is well!

Exercise + Cold virus

It took lots of talking myself into it, but I exercised with this cold. I'm always glad I do it after the fact - I get up lots of junk and I swear the hard breathing forces my constricted air open!

I didn't exercise like I was supposed to this weekend because I was sleeping the whole dang time.

I'm glad you guys liked my CF Story post.... I hope some of the rest of you will do it too!

Exercise on.......

Show me those muscles baby

No time for cardio yesterday but I did get in my weights.

Say it loud, say it proud!: 2/3 for weights and 3/5 for cardio.

How's everyone else doing out there?

Heheheh funny picture, eh?

Exercise Review

Ya I haven't posted in the past few days cuz I've been so dang busy.

I did cardio and weights yesterday (2/5), (1/3) and cardio again today (3/5).

I'm still super excited about the modifier gene article from yesterday http://noexcusesnoexcuses.blogspot.com/search/label/News . I've had so many discussions with people who are CONVINCED their CF mutations are responsible for their CF symptoms.... simply not the case!

Work it!

I've been so busy the past few days I have forgotten to post about exercise.

0/3 for weights as of yesterday and 1/5 for cardio.

All the single ladies!

I was listening to one of my fav song's today "Single Ladies" by Beyonce while doing my eliptical and found myself going much faster than I usually do.... whoa there! It's fun to listen to go music, though...

So I'm 4/5 for cardio and 3/3 for weights this week. Yipeeee.

Anyone else set exercise goals? I don't need a daily update of course but I'd love to hear of anyone's goals....

Exercise: I'm just not that into you

I wanted to tell exercise today "I'm just not that into you."

But then I say the 103% sign hanging above my TV and thought "there's no way I'm going to get to my FEV1 by not exercising today....."

Grrrr.

So I did it. 3/5 for cardio and 2/3 for weights. Yey!

Hope you all are having a great week.

goin' just fine

2/5 for cardio as of today. not bad for 1/2 way through the week :)