Impact of exercise training on inflammatory markers in adult and elderly patients with chronic obstructive pulmonary disease: A Systematic review and meta-analysis

Abstract

Introduction: Chronic obstructive pulmonary disease (COPD) is one of the respiratory diseases in which inflammation plays a key role in its development. Exercise training has acritical role in improving chronic inflammation. Nonetheless, the effects of various exercise training on inflammatory markers in these patients are not clear. Therefore, the present study aimed to assess the impact of exercise on the inflammatory markers, including IL-6, TNF-α, and c-reactive protein in patients with COPD. Material & Methods: A systematic search was conducted on PubMed, Web of Science, SID, Magiran, and Google scholar databases for articles published until July 2023. A meta-analysis was performed for the impact of exercise on inflammatory markers in COPD patients. Effect size (SMD) and 95% confidence interval were calculated using random effect model. Moreover, I2 test was employed to determine heterogeneity, while Funnel plot test and Egger test were used to check publication bias. Results: The results of the data analysis of 11 studies on 578 patients with COPD demonstrated that exercise led to a non-significant decrease in circulating CRP values [SMD=-0.413 (-0.100 to 0.175), P=0.16], IL-6 [SMD=-0.164 (-0.69 to 0.36], P=0.54], TNF-α [SMD=-0.358 (-1.44 to 0.72), P=0.51) in COPD patients. Furthermore, the results of the subgroup analysis pointed out that aerobic training [SMD=-0.55, P=0.1] compared to resistance training [SMD=-0.09, P=0.7] led to a decrease in CRP in patients with COPD. Nonetheless, this difference was not significant. Discussion & Conclusion: The findings of the present meta-analysis illustrated that aerobic exercise is probably an effective exercise intervention to reduce CRP in patients with COPD.

Keywords

• chronic obstructive pulmonary disease
• c-reactive protein exercise
• interleukin 6
• tumor necrosis factor-alpha