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Biomedical subjects

Rachel Garrod

Publications and source records attributed to Rachel Garrod.

4 recordsLinked to original sources
PubMed2006

Exercise and the inflammatory response in chronic obstructive pulmonary disease (COPD)--Does training confer anti-inflammatory properties in COPD?

There is increasing evidence that systemic inflammation plays an important role in the pathogenesis of COPD. Inflammatory markers show relationships with exercise performance, health related quality of life and breathlessness. These are important clinical outcomes in the management of COPD. Even more so is the consideration that systemic inflammation in COPD may be directly associated with mortality and deterioration of disease. Long-term exercise training clearly has beneficial properties in healthy subjects, whether the same is true in COPD remains to be seen. This review discusses aspects of the anti-inflammatory effects of exercise in relation to patients with COPD. There is intriguing evidence that the exercise-induced cytokine response differs in COPD patients compared with healthy subjects. We consider the role of IL-6 in the manifestation of fatigue in COPD and consider the implications of raised CRP- and TNF-alpha. Early data suggests beneficial effects of polyunsaturated fatty acid PUFA supplementation and exercise training in combination with appropriate nutritional support may yield rewarding therapeutic benefits. This review raises the hypothesis that physical training in COPD is associated with immunological changes that may confer anti-inflammatory benefits and in part, explain changes seen after pulmonary rehabilitation in COPD patients.

Exercise↗
PubMed2004

Pulmonary rehabilitation: analysis of a clinical service.

BACKGROUND AND PURPOSE: There is significant research supporting the role of pulmonary rehabilitation in chronic obstructive pulmonary disease (COPD). However, less is known about real-life clinical rehabilitation services. Data were analysed from a clinical pulmonary rehabilitation service provided in the UK, consisting of seven weeks' twice-weekly training and education. METHOD: A retrospective study. Baseline measures consisted of activity of daily living, mood state, spirometry, exercise tolerance using the Incremental Shuttle Walk Test (ISWT) and health status using the St George's Hospital Respiratory Questionnaire (SGRQ). Responders to pulmonary rehabilitation were defined as those with a mean reduction of four points on the SGRQ and a mean increase of 48 metres on the ISWT. RESULTS: One hundred and eight patients entered the programme and 91 completed it. All outcomes showed statistically and clinically significant change after the rehabilitation programme. Responder analysis showed that 37% of patients achieved benefits for both the SGRQ and the ISWT. Twenty-eight per cent of patients were non-responders for both; 17% benefited for the SGRO only and 14% improved their exercise tolerance. Patients with restrictive disease (n = 11) showed large mean ISWT score of 98.2 m (Standard deviation (SD) 69.4 m) (p < 0.01), as did patients with moderate COPD (n = 30), who scored a mean ISWT change of 77.3 m (SD 92.0 m) (p < 0.01) and a SGRQ score of -7.6 (SD 13.7) (p < 0.01), and those with mild COPD (n = 12), who scored a mean ISWT change of 62.5 m (SD 87.4 m) (p < 0.01) and a mean SGRQ change of -3. 7 (SD 8.1) (p < 0.01). Patients with severe COPD (n = 23) showed a smaller mean change in ISWT of 32.6 m (SD 79.4 m) and in SGRQ of -2.8 (SD 7.1). However, analysis of variance (ANOVA) showed no statistical differences between the groups (p = 0.13). CONCLUSIONS: Clinical pulmonary rehabilitation programmes are effective for most patients. However for patients with more severe impairment, maximal gains may be harder, or take longer, to achieve. Patients with restrictive disease appear to do well, although future trials will be needed to test this supposition.

Aged↗
PubMedDate not supplied

Exercise for breast cancer survival: the effect on cancer risk and cancer-related fatigue (CRF).

To date, all epidemiological research in this area has focused on the relationship between physical activity level and the risk of breast cancer in healthy women, or more recently, those who have recovered from the disease. Most of this research highlights the fact that those women who are physically active are at a reduced risk of the disease. Although physical activity is similar to exercise, it lacks the specificity of a prescribed exercise training program. Consequently, such research can only be viewed as a promising indicator of the beneficial effect that regular exercise may have for breast cancer survivors. Furthermore, due to the nature of such research, there has been a failure to provide specific evidence concerning the most suitable modality, duration, intensity, and frequency of training for risk reduction in breast cancer survivors. Thus, evidence aiding the correct prescription of exercise for this population has been lacking. More promising evidence is provided by randomized controlled trials, which examine the effect of exercise on specific risk factors and provide convincing scientific rationale for the use of exercise among breast cancer survivors. These studies not only provide understanding of the physiological mechanisms by which exercise can be effective at aiding a reduction in breast cancer risk, but also allow conclusions on the correct prescription to be drawn. Additionally, exercise has proven to be effective in combating cancer-related fatigue (CRF), significantly improving both quality of life outcomes (QOL) and physiological capacity in women who have survived breast cancer. In order to promote a wider understanding of the beneficial effect that exercise holds for this population regarding reduction of breast cancer risk and CRF, this review discusses this research, making conclusions regarding the necessary training prescription to elicit such benefits.

Breast Neoplasms↗