Increased physical activity post-exacerbation is associated with decreased systemic inflammation in cystic fibrosis – An observational study

ABSTRACT

Background and Objective: We assessed whether measured physical activity in adults with cystic fibrosis (CF) following in-hospital treatment for an acute exacerbation was impacted by levels of systemic and airway inflammation, and whether physical activity post-discharge predicted for time to next pulmonary exacerbation.

Methods: Adults with CF were included following hospitalization for a pulmonary exacerbation, and were followed for 12 months. Inflammatory markers and physical activity were measured immediately post-discharge via sputum and plasma concentrations of interleukin-6, interleukin-8, and tumor necrosis factor-α. Physical activity was monitored for 7 days via a Sensewear Armband. Statistical analyses included Shapiro-Wilk’s test and Q–Q plots to determine normal distribution, t-tests, Pearson’s correlational analyses, and one-way MANOVAs.

Results: Thirty-one adults with CF (13 females, 28.8 ± 8.8 years, forced expiratory volume in 1 s (FEV₁) 59.4 ± 23.0% predicted) were prospectively recruited. Physical activity negatively correlated with plasma inflammation (r = −0.48, p < 0.01), and positively with FEV₁ (r = 0.45, p < 0.05) and body mass index (r = 0.39, p < 0.05). There was no significant relationship between time to re-exacerbation and any inflammatory markers or measurement of physical activity (all p > 0.05).

Conclusion: Increased physical activity following exacerbation in CF is associated with lower levels of systemic inflammation. Time to re-exacerbation is not related to post-discharge inflammation or physical activity levels.

KEYWORDS:

• Adults
• cystic fibrosis
• cytokines
• inflammation
• physical activity

Acknowledgments

We would like to acknowledge the assistance of the Physiotherapy Department, Thoracic Medicine Unit and Adult Cystic Fibrosis Centre of The Prince Charles Hospital, in particular Professor Scott Bell, Helen Seale and Dr James Walsh. We would also like to acknowledge the Queensland Lung Transplant Service Laboratory staff for their assistance with sample processing and storage, and the participants in this study. This study was supported by The Prince Charles Hospital Foundation Novice Researcher Grant (NR2012-209; $10,000).

Disclosure Statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by the The Prince Charles Hospital Foundation [NR2012-209].