The Effect of Therapeutic Exercises Model on Oxidative Stress and Gait Speed in Chronic Obstructive Pulmonary Disease

Abstract

Tresia Fransiska Ulianna Tambunan, Angela B.M.Tulaar, Suzanna Immanuel, Murdani Abdullah, Tirza Z. Tamin, Budhi Antariksa, Dewi Irawati, Damayanti Tinduh, Rondang R Soegianto.

Background: Chronic obstructive pulmonary disease (COPD) has a high mortality and morbidity worldwide. Oxidative stress and inflammation are potentially important mechanisms in the pathogenesis of COPD where there is an imbalance between oxidants (free radicals) and antioxidants. High-intensity therapeutic exercise might reduce the plasma oxidative stress level while increasing exercise capacity and lowering lactic acid levels in moderate-to-severe COPD patients. This study aimed to obtain an effective therapeutic exercise model in the levels of oxidative stress and walking speed with an appropriate prescription for stable COPD patients. Methods: This study was a randomized clinical trial. The subjects were those aged over 50-85 years old. A total of 43 subjects were analyzed. The subjects underwent several tests (six-minute walk test, 4-meter gait speed, quadriceps muscle strength, and laboratory test), while given pulmonary rehabilitation and measured for the MDA and GSH levels. Statistical analysis was done by univariate analysis, Paired T-test and Friedmann test. Results The study result showed an insignificant increase of GSH values in the type II training group (p=0.688) and a reduction in the type III group (p=0.56). Our study also found a significant difference in gait speed between the three exercise groups (p<0.001). Conclusion: Type II training is the most effective regimen in reducing the MDA plasma levels and increasing plasma GSH levels. The changes in blood MDA and GSH levels would be more noticeable if additional samples and extended training periods were applied in lung rehabilitation programs.