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ORIJINAL ARAŞTIRMA
Ev-Bazlı Aerobik Egzersiz Programının Behçet Hastalarında Kanama Profili ve İnflamasyon Üzerine Etkisi
Effect of Home-Based Aerobic Exercise Program on Bleeding Profile and Inflammation in Patients with Behçet's Disease
Received Date : 03 Feb 2020
Accepted Date : 03 May 2020
Available Online : 23 Jul 2020
Özet PDF Benzer Makaleler
Tuba Tülay KOCAa, Muhammet SEYİTHANOĞLUb, Hülya NAZİKc, Vedat NACİTARHANa, Gizem GÜMÜRDÜa
aDepartment of Physical Medicine and Rehabilitation, Kahramanmaraş Sütçü İmam University Faculty of Medicine, Kahramanmaraş, TURKEY bDepartment of Clinic Biochemistry, Kahramanmaraş Sütçü İmam University Faculty of Medicine, Kahramanmaraş, TURKEY cDepartment of Dermatology, Kahramanmaraş Sütçü İmam University Faculty of Medicine, Kahramanmaraş, TURKEY
Doi: 10.31609/jpmrs.2020-74069 - Makale Dili: EN
J PMR Sci. 2020;23(3):183-90
ÖZET
Amaç: Sedanter yaşam tarzı kardiyovasküler hastalık (CVS) ve trombotik komplikasyonlar için önemli bir risk faktörüdür. Farklı egzersiz türlerinin trombosit fonksiyonu üzerindeki etkisi sınırlı sayıda çalışmanın konusu olmuştur. Behçet hastalığı, tekrarlayan oral ve genital aftöz lezyonlar ve etiyolojisi bilinmeyen üveit ile karakterize çok sistemli bir hastalıktır. Hastalığın bilinmeyen bir nedeni ve prokoagülan kaskadın hiperaktivasyonu ile arteriyel ve venöz tromboz ilişkili mortalite vardır. Burada Behçet hastalarında aerobik egzersizin kanama profili ve akut faz reaktanları üzerindeki etkisi deneysel olarak analiz edildi. Gereç ve Yöntemler: Behçet hastalığı olan 24 (n=24) hasta çalışmaya dahil edildi. Yaş, boy, kilo, cinsiyet, sigara içme, bilinen sistemik hastalık (diyabet, hipertansiyon, tiroid gibi) ve vasküler kladikasyo araştırıldı. Protokolü tamamlamayanlar (n=5) çalışma dışı bırakıldı. Orta yoğunluklu aerobik egzersiz programından önce ve sonra (4 hafta, haftada 3 kez, günde 45 dakika) sedimantasyon (ESR), C-reaktif protein (CRP), protrombin zamanı (PT) dahil kanama profili, protrombin zaman yüzdesi (PT%), aktive edilmiş protrombin zamanı (aPTT), trombosit, kollajen epinefrin, kollajen adenosin difosfat (ADP) ve uluslararası normalleştirilmiş oran (INR) kaydedildi. Bulgular: Behçet hastalığı olan 19 hasta çalışmaya dahil edildi. Yaş ortalaması 37.8±9.8 yıl idi. Ortalama vücut kitle indeksi (VKİ) 28.6±5.5 kg/m2 idi. Dokuz hastada (%47.4) vasküler kladikasyo, 1 hastada (%5.3) sigara içimi ve 2 hastada hipertansiyon (%10.5) mevcuttu. Egzersiz sonrası ESR (p=0.028) ve kollajen ADP (p=0.02) azalırken; trombosit sayısı (p=0.005), Aptt (p=0.08), PT (p=0.022) ve % PT (p=0.014) arttı. Sonuç: Egzersiz programından sonra agregasyon süresinin uzaması ve inflamasyondaki azalma trombozun egzersiz ile engellenebileceğini desteklemektedir. Behçet hastalarında kısa dönem ev temelli aerobik egzersiz programının homeostaz üzerinde olumlu etkisi vardır.
Anahtar Kelimeler: Aerobik egzersiz; trombosit fonksiyonu; kanama profili; Behçet hastalığı; homeostaz
ABSTRACT
Objective: Sedentary lifestyle is a major risk factor for cardiovascular disease (CVS) and thrombotic complications. The effect of different types of exercise on platelet function has been the subject of a limited number of studies. Behçet's disease is a multisystemic disease characterized by recurrent oral and genital aphthous lesions and uveitis with unknown etiology. There is an unknown cause of the disease and hyperactivation of the procoagulant cascade and associated mortality due to arterial and venous thrombosis. Here, the effect of aerobic exercise on the bleeding profile and acute phase reactants in Behçet's patients was analyzed experimentally. Material and Methods: Twenty-four (n=24) patients with Behcet's disease were included in the study. Age, height, weight, sex, smoking, known systemic disease (such as diabetes, hypertension, thyroid) and vascular claudication were investigated. Those who didn’t complete the protocole (n=5) were excluded from the study. Before and after moderate intensity aerobic exercise program (4 weeks, 3 times a week, 45 minutes per day) sedimentation (ESR), C-reactive protein (CRP), bleeding profile including prothrombin time (PT), prothrombin time percentage (PT%), activated prothrombin time (aPTT), platelet, collagen epinephrine, collagen adenosine diphosphate (ADP) and international normalized ratio (INR) were recorded. Results: Nineteen patients with Behçet's disease were enrolled. The mean age was 37.8±9.8 years. The mean body mass index (BMI) was 28.6±5.5 kg/m2. Vascular claudication was present in 9 patients (47.4%), smoking in 1 patient (5.3%), and hypertension (10.5%) in 2 patients. While ESR (p=0.028) and collagen ADP (p=0.02) decreased after exercise; platelet count (p=0.005), aPTT (p=0.08), PT (p=0.022) and PT% (p=0.014) were increased. Conclusion: Increase in the duration of aggregation and decrease in inflammation after the exercise program supports that thrombosis can be prevented by exercise. We conclude that short term home-based aerobic exercise program has positive effect on homeostasis in patients with Behçet's disease.
Keywords: Aerobic exercise; platelet function; bleeding profile; Behçet’s disease; homeostasis
REFERENCES
  1. Barrow HM, Brown JD. Man and Movement: Principles of Physical Education. In: Barrow HM, ed. 4th ed. Philadelphia, Pa: Lea & Febiger; 1988. p.198.
  2. Guyton AC, Hall JE. Textbook of Medical Physiology. In: Guyton, Arthur C., Hall, John E, eds. 9th ed. Philadelphia, Pa: WB Saunders Company; 1996. p.1148.
  3. Karvonen J, Lemon PWR, Iliev I. Medicine in Sports Training and Coaching. In: Karvonen J, Lemon PW, Iliev I, eds. Medicine and Sport Science, 35. Basel, Switzerland: S Karger Publishers; 1992. p.235.
  4. Rumbaut RE, Thiagarajan P. Platelet-Vessel Wall Interactions in Hemostasis and Thrombosis. San Rafael (CA): Morgan & Claypool Life Sciences; 2010. [PubMed] 
  5. Sangkuhl K, Shuldiner AR, Klein TE, Altman RB. Platelet aggregation pathway. Pharmacogenet Genomics. 2011;21(8):516-21. [Crossref]  [PubMed]  [PMC] 
  6. Ahmed HM, Blaha MJ, Nasir K, Rivera JJ, Blumenthal RS. Effects of physical activity on cardiovascular disease. Am J Cardiol. 2012;109(2):288-95. [Crossref]  [PubMed] 
  7. Saleh Z, Arayssi T. Update on the therapy of Behçet disease. Ther Adv Chronic Dis. 2014;5(3):112-34. [Crossref]  [PubMed]  [PMC] 
  8. Kiraz S, Ertenli I, Oztürk MA, Haznedaroğlu IC, Celik I, Calgüneri M. Pathological haemostasis and "prothrombotic state" in Behçet's disease. Thromb Res. 2002;105(2):125-33. [Crossref]  [PubMed] 
  9. Ugurlu S, Seyahi E, Oktay V, Kantarci F, Tuzun H, Yigit Z, et al. Venous claudication in Behçet's disease. J Vasc Surg. 2015;62(3): 698-703.e1. [Crossref]  [PubMed] 
  10. Güngen AC, Çoban H, Aydemir Y, Düzenli H. Consider Behcet's disease in young patients with deep vein thrombosis. Respir Med Case Rep. 2016;18:41-4. [Crossref]  [PubMed]  [PMC] 
  11. Burris CA, Ashwood ER, Burns DE. Tietz Textbook of Clinical Chemistry and Molecular 403 Diagnostics. 4th ed. 2006. St Louis: Elsevier Saunders; 1633. p.962-967.
  12. Bernard HJ, McPherson RA, Pincus MR. Henry's Clinical Diagnosis and Management By Laboratory Methods. Philadelphia: Elsevier Saunders; 2011. p.254-5.
  13. Wallach JB. Interpretation of Diagnostic Tests. In: Williamson MA, Michael SL, eds. 6th ed. New York: Little, Brown; 1996. p.717.
  14. Lee J, Kim JK, Kim JH, Dunuu T, Park SH, Park SJ, et al. Recovery time of platelet function after aspirin withdrawal. Curr Ther Res Clin Exp. 2014;76:26-31. [Crossref]  [PubMed]  [PMC] 
  15. Favaloro EJ, Bonar R. External quality assessment/proficiency testing and internal quality control for the PFA-100 and PFA-200: an update. Semin Thromb Hemost. 2014;40(2):239-53. [Crossref]  [PubMed] 
  16. Anderssen SA, Hjermann I. [Physical activity--a crucial factor in the prevention of cardiovascular diseases]. Tidsskr Nor Laegeforen. 2000;120(26):3168-72. [PubMed] 
  17. Wang JS. Exercise prescription and thrombogenesis. J Biomed Sci. 2006;13(6):753-61. [Crossref]  [PubMed] 
  18. Franco AT, Corken A, Ware J. Platelets at the interface of thrombosis, inflammation, and cancer. Blood. 2015;126(5):582-8. [Crossref]  [PubMed]  [PMC] 
  19. Lippi G, Maffulli N. Biological influence of physical exercise on hemostasis. Semin Thromb Hemost. 2009;35(3):269-76. [Crossref]  [PubMed] 
  20. Haynes A, Linden MD, Robey E, Naylor LH, Ainslie PN, Cox KL, et al. Beneficial impacts of regular exercise on platelet function in sedentary older adults: evidence from a randomized 6-mo walking trial. J Appl Physiol (1985). 2018;125(2):401-8. [Crossref]  [PubMed] 
  21. Posthuma JJ, van der Meijden PE, Cate HT, Spronk HMH. Short- and long-term exercise induced alterations in haemostasis: a review of the literature. Blood Rev. 2015;29(3):171-8. [Crossref]  [PubMed] 
  22. Haynes A, Linden MD, Robey E, Watts GF, Barrett H, Naylor LH, et al. Impact of commonly prescribed exercise interventions on platelet activation in physically inactive and overweight men. Physiol Rep. 2016;4(20): e1295. [Crossref]  [PubMed]  [PMC] 
  23. Haynes A, Linden MD, Robey E, Watts GF, Barrett PHR, Naylor LH, et al. Acute impact of different exercise modalities on arterial and platelet function. Med Sci Sports Exerc. 2018;50(4):785-91. [Crossref]  [PubMed] 
  24. Kestin AS, Ellis PA, Barnard MR, Errichetti A, Rosner BA, Michelson AD. Effect of strenuous exercise on platelet activation state and reactivity. Circulation. 1993;88(4 Pt 1):1502-11. [Crossref]  [PubMed] 
  25. Chen YW, Chen JK, Wang JS. Strenuous exercise promotes shear-induced thrombin generation by increasing the shedding of procoagulant microparticles from platelets. Thromb Haemost. 2010;104(2):293-301. [Crossref]  [PubMed] 
  26. De Meirelles LR, Matsuura C, Resende AC, Salgado AA, Pereira NR, Coscarelli PG, et al. Chronic exercise leads to antiaggregant, antioxidant and anti-inflammatory effects in heart failure patients. Eur J Prev Cardiol. 2014;21(10):1225-32. [Crossref]  [PubMed] 
  27. Chen YW, Apostolakis S, Lip GYH. Exercise-induced changes in inflammatory processes: implications for thrombogenesis in cardiovascular disease. Ann Med. 2014;46(7):439-55. [Crossref]  [PubMed] 
  28. Ahmadizad S, Nouri-Habashi A, Rahmani H, Maleki M, Naderi N, Lotfian S, et al. Platelet activation and function in response to high intensity interval exercise and moderate continuous exercise in CABG and PCI patients. Clin Hemorheol Microcirc. 2016;64(4):911-9. [Crossref]  [PubMed] 
  29. Mauer K, Exaire JE, Stoner JA, Saucedo JF, Montgomery PS, Gardner AW. Effect of exercise training on clot strength in patients with peripheral artery disease and intermittent claudication: an ancillary study. SAGE Open Med. 2015;19;3:2050312115575938. [Crossref]  [PubMed]  [PMC] 
  30. Waha JE, Goswami N, Schlagenhauf A, Leschnik B, Koestenberger M, Reibnegger G, et al. Effects of exercise and nutrition on the coagulation system during bedrest immobilization. Medicine (Baltimore). 2015;94(38): e1555. [Crossref]  [PubMed]  [PMC] 
  31. Lamprecht M, Moussalli H, Ledinski G, Leschnik B, Schlagenhauf A, Koestenberger M, et al. Effects of a single bout of walking exercise on blood coagulation parameters in obese women. J Appl Physiol (1985). 2013;115(1):57-63. [Crossref]  [PubMed] 
  32. Kupchak BR, Creighton BC, Aristizabal JC, Dunn-Lewis C, Volk BM, Ballard KD, et al. Beneficial effects of habitual resistance exercise training on coagulation and fibrinolytic responses. Thromb Res. 2013;131(6):e227-34. [Crossref]  [PubMed] 
  33. Whittaker JP, Linden MD, Coffey VG. Effect of aerobic interval training and caffeine on blood platelet function. Med Sci Sports Exerc. 2013;45(2):342-50. [Crossref]  [PubMed] 
  34. Hatemi G, Merkel PA, Hamuryudan V, Boers M, Direskeneli H, Aydin SZ, et al. Outcome measures used in clinical trials for Behçet syndrome: asystematic review. J Rheumatol. 2014;41(3):599-612. [Crossref]  [PubMed]  [PMC] 
  35. Seyahi E. Behçet's disease: how to diagnose and treat vascular involvement. Best Pract Res Clin Rheumatol. 2016;30(2):279-95. [Crossref]  [PubMed] 
  36. Gökoğlu F, Yorgancioğlu ZR, Ustün N, Ayhan Ardiç F. Evaluation of pulmonary function and bicycle ergometry tests in patients with Behçet's disease. Clin Rheumatol. 2007;26(9): 1421-5. [Crossref]  [PubMed] 
  37. Türkölmez S, Gökçora N, Alkan M, Gorer MA. Evaluation of myocardial perfusion in patients with Behçet's disease. Ann Nucl Med. 2005;19(3):201-6. [Crossref]  [PubMed] 
  38. Liu D, Ning W, Zuo X. Serious coronary thrombosis and pulmonary artery thrombosis revealing Behçet's disease. Arch Rheumatol. 2018;33(1):85-8. [Crossref]  [PubMed]  [PMC] 
  39. Aşker S, Aşker M, Gürsu O, Mercan R, Timuçin OB. A Behcet's disease patient with right ventricular thrombus, pulmonary artery aneurysms, and deep vein thrombosis complicating recurrent pulmonary thromboembolism. Case Rep Pulmonol. 2013;2013: 492321. [Crossref]  [PubMed]  [PMC] 
  40. Hassikou H, Bono W, Bahiri R, Abir S, Benomar M, Hassouni NH. Vascular involvement in Behçet's disease. Two case reports. Joint Bone Spine. 2002;69(4):416-8. [Crossref]  [PubMed] 
  41. Emmi G, Becatti M, Bettiol A, Hatemi G, Prisco D, Fiorillo C. Behçet's syndrome as a model of thrombo-inflammation: the role of neutrophils. Front Immunol. 2019;10:1085. [Crossref]  [PubMed]  [PMC] 
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