Papers by Tamara Iturriaga Ramirez
El papel del ejercicio en la regulacion de la proteina alfa klotho
UEM, 2020
P406 Effects of the treatment with elexacaftor/tezacaftor/ivacaftor on aerobic fitness of adolescents with cystic fibrosis
Journal of Cystic Fibrosis, Jun 1, 2023
Authorea (Authorea), Dec 3, 2022
Introduction. Exercise intolerance is common in chronic respiratory diseases (CRD), but its mecha... more Introduction. Exercise intolerance is common in chronic respiratory diseases (CRD), but its mechanisms are still poorly understood. The aim of this study was to evaluate exercise capacity and its association with lung function, ventilatory limitation, and ventilatory efficiency in children and adolescents with cystic fibrosis (CF) and asthma when compared to healthy controls. Methods. Cross-sectional study including patients with mild-to-moderate asthma, CF and healthy children and adolescents. Anthropometric data, lung function (spirometry) and exercise capacity (cardiopulmonary exercise testing) were evaluated. Primary outcomes were peak oxygen consumption (VO 2 peak), forced expiratory volume in 1 second (FEV 1 ), breathing reserve (BR), ventilatory equivalent for oxygen consumption (V E /VO 2 ) and for carbon dioxide production (V E /VCO 2 ), both at the ventilatory threshold (VT 1 ) and peak exercise. Results. Mean age of 147 patients included was 11.8±3.0 years. There were differences between asthmatics and CF children when compared to their healthy peers for anthropometric and lung function measurements. Asthmatics showed lower VO 2 peak when compared to both healthy and CF subjects, although no differences were found between healthy and CF patients. A lower BR was found when CF patients were compared to both healthy and asthmatic. Both CF and asthmatic patients presented higher values for V E /VO 2 and V E /VCO 2 at VT 1 when compared to healthy individuals. For both V E /VO 2 and V E /VCO 2 at peak exercise CF patients presented higher values when compared to their healthy peers. Conclusion. Patients with CF achieved good exercise capacity despite low ventilatory efficiency, low BR, and reduced lung function. However, asthmatics reported reduced cardiorespiratory capacity and normal ventilatory efficiency at peak exercise. These results demonstrate differences in the mechanisms of ventilatory limitation to maximum exercise testing in children and adolescents with CRD.
Effect of a strength exercise program on muscle function in children with CF: Preliminary results
Introduction Cystic fibrosis is the most lethal autosomal recessive disease with higher prevalenc... more Introduction Cystic fibrosis is the most lethal autosomal recessive disease with higher prevalence in Caucasian population [1]. More than 1,800 mutations have been identified and can be clustered in six functional groups, therefore, altering the secretion and absorption in different tissues. Recurrent infections result in an increased damage to the lungs that leads to hypoxia in peripheric tissues such as skeletal muscle. Then, skeletal muscle weakness displays very early in patients with CF [2]. Recent studies have shown that CFTR protein is expressed in skeletal muscle, and therefore CF has a direct effect in this tissue [3]. Both respiratory damage and muscular weakness result in a reduced exercise capacity that will lead to exercise intolerance and reduction of expectoration and pulmonary function. Objective: Determine the effect of a strength exercise program on muscle function in children with CF. Methods: 17 pediatric patients with CF participated in a randomized, prospective...
Is exercise and electrostimulation effective in improving muscle strength and cardiorespiratory fitness in children with cystic fibrosis and mild-to-moderate pulmonary impairment?: Randomized controlled trial
Respiratory Medicine, 2022
BACKGROUND Evidence on resistance-training programs for cystic fibrosis (CF) is limited and the p... more BACKGROUND Evidence on resistance-training programs for cystic fibrosis (CF) is limited and the possible benefits of the addition of neuromuscular electrical stimulation (NMES) are unknown. This study aimed to evaluate the effects of a supervised resistance-training program, associated or not with NMES, on muscle strength, aerobic fitness, lung function and quality of life in children with CF presenting mild-to-moderate pulmonary impairment. METHODS This is a randomized controlled trial including CF patients aged between 6 and 17years. Subjects were randomly allocated to control (CON); exercise (EX); or exercise and NMES (EX + NMES) groups, and evaluated at baseline and at the end of an 8-week individualized exercise-program (3 days/week, 60min/session). NMES was applied in the quadriceps and the interscapular region, simultaneously to the exercises. CON group followed the CF team recommendations. The main outcome measures were lung function, cardiorespiratory fitness, functional capacity, quality of life and muscle strength. RESULTS Twenty-seven patients, aged 12.6 ± 3.0 years, were analyzed. No significant interactions were found for cardiorespiratory fitness. Functional capacity presented significant differences, indicating a better performance in both EX and EX + NMES. No significant changes between groups were seen for quality of life and lung function. As for muscle strength, EX and EX + NMES presented large effect sizes and significant differences, compared to CON, for quadriceps (p = 0.004, η2p = 0.401), pectoral (p = 0.001, η2p = 0.487), dorsal (p = 0.009, η2p = 0.333) and handgrip (p = 0.028, η2p = 0.278). CONCLUSION A resistance exercise-training program led to improvements in muscle strength and functional capacity in CF patients with mild-to-moderate pulmonary impairment. The addition of NMES to the training program resulted in no extra favorable effects.
Frontiers in Physiology, 2021
Introduction: Elevated plasma α-klotho (αKl) protects against several ageing phenotypes and has b... more Introduction: Elevated plasma α-klotho (αKl) protects against several ageing phenotypes and has been proposed as a biomarker of a good prognosis for different diseases. The beneficial health effects of elevated plasma levels of soluble αKl (SαKl) have been likened to the positive effects of exercise on ageing and chronic disease progression. It has also been established that molecular responses and adaptations differ according to exercise dose. The aim of this study is to compare the acute SαKl response to different exercise interventions, cardiorespiratory, and strength exercise in healthy, physically active men and to examine the behavior of SαKl 72h after acute strength exercise.Methods: In this quasi-experimental study, plasma SαKl was measured before and after a cardiorespiratory exercise session (CR) in 43 men, and strength exercise session (ST) in 39 men. The behavior of SαKl was also examined 24, 48, and 72h after ST.Results: Significant differences (time×group) were detecte...
Pediatric Pulmonology, 2020
Background: Asthmatic patients may benefit from exercise training, although the effects of a comb... more Background: Asthmatic patients may benefit from exercise training, although the effects of a combined aerobic and resistance training program are still poorly investigated in children and adolescents. Objective: To analyze the effects of a combined exercise training (resistance and aerobic) program on aerobic fitness, lung function, asthma control and quality of life in a group of mild-moderate asthmatic children with exercise symptoms. Methods: This was a 12-week randomized controlled trial including children and adolescents diagnosed with mild-moderate asthma and presenting exercise-induced symptoms. The intervention group (IG) performed the exercise training (resistance and aerobic) 3 days/week, for 60 minutes. The control group (CG) followed routine clinical orientations. The main outcomes were cardiorespiratory fitness, muscle strength, lung function, quality of life, asthma control, and functional tests after 3 months of the intervention. Results: Fifty-three patients (IG = 25 and CG = 28) with a mean age of 11.5 ± 2.6 years were included. No significant differences were found between groups regarding lung function, asthma control, quality of life, and functional tests. Ventilatory equivalent for oxygen consumption at ventilatory threshold (P = .025; p 2 η = 0.083), peak oxygen consumption (P = .008; p 2 η = 0.116) and test duration (P = .014; p 2 η = 0.1) presented greater improvements in the IG. In addition, improvements were observed in leg press (P < .001; p 2 η = 0.36), hamstring curl (P = .001; p 2 η = 0.217), high row (P = .003; p 2 η = .167), low row (P = .009; p 2 η = 0.128) and quadriceps leg extension (P = .015; p 2 η = 0.108) in the IG. Conclusion: Combined exercise training (resistance and aerobic) improved cardiorespiratory fitness and muscle strength in children and adolescents with controlled asthma and exercise symptoms.
Mechanisms of ventilatory limitation to maximum exercise in children and adolescents with chronic airway diseases
Pediatric Pulmonology
IntroductionExercise intolerance is common in chronic airway diseases (CAD), but its mechanisms a... more IntroductionExercise intolerance is common in chronic airway diseases (CAD), but its mechanisms are still poorly understood. The aim of this study was to evaluate exercise capacity and its association with lung function, ventilatory limitation, and ventilatory efficiency in children and adolescents with cystic fibrosis (CF) and asthma when compared to healthy controls.MethodsCross‐sectional study including patients with mild‐to‐moderate asthma, CF and healthy children and adolescents. Anthropometric data, lung function (spirometry) and exercise capacity (cardiopulmonary exercise testing) were evaluated. Primary outcomes were peak oxygen consumption (VO2peak), forced expiratory volume in 1 s (FEV1), breathing reserve (BR), ventilatory equivalent for oxygen consumption (VE/VO2) and for carbon dioxide production (VE/VCO2), both at the ventilatory threshold (VT1) and peak exercise.ResultsMean age of 147 patients included was 11.8 ± 3.0 years. There were differences between asthmatics an...
Effects of a Short-Term Resistance-Training Program on Heart Rate Variability in Children With Cystic Fibrosis—A Randomized Controlled Trial
Background: Cystic fibrosis (CF) affects the autonomic nervous system (ANS) and exercise in healt... more Background: Cystic fibrosis (CF) affects the autonomic nervous system (ANS) and exercise in healthy children modulates the interaction between sympathetic and parasympathetic activity. This study aimed to evaluate the effects of a short-term resistance exercise program on heart rate variability (HRV) in children and adolescents with CF. Methods: A randomized controlled trial was carried out in children diagnosed with CF aged 6–18 years. Individuals were divided into two groups: control (CON) and resistance-training (EX). Individuals in the EX group completed an individualized guided resistance program (5-RM—60–80%) for 8 weeks (3 sessions of 60 min/week). Upper and lower limbs exercises (seated bench press, seated lateral row, and leg press) were used. HRV was measured using a Suunto watch with subjects in lying position. Results: Nineteen subjects (13 boys) were included (CON = 11; and EX = 8). Mean age was 12.2 ± 3.3, FEV1 (forced expiratory volume in the first second) z-score was...
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Papers by Tamara Iturriaga Ramirez