THE EFFECT OF LOW ALTITUDE AT THE DEAD SEA ON EXERCISE CAPACITY AND CARDIO-PULMONARY RESPONSE TO EXERCISE IN CF PATIENTS OF MODERATE SEVERITY
Bareket Falk Ph.D.1, Asaph Nini M.D., M.Sc.2, Levana Zigel B.Sc.1, Yaacov Yahav M.D.3, Huda Mussaffi M.D.4, Micha Aviram, M.D.5, Joseph Rivlin, M.D.6, Lea Bentur M.D.7 Avraham Avital M.D.8, Raffy Dotan M.Sc.1, Hannah Blau M.B.B.S.4

1 Ribstein Center for Sport Medicine Sciences and Research, Wingate Institute, Israel
2 Tel Aviv Sourasky Medical Center, Department of Medicine, Sackler Faculty of Medicine, Tel-Aviv University, Israel
3 National Center for Cystic Fibrosis, Chaim Sheba Medical Center, Tel-Hashomer, and Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
4 Pulmonary and Cystic Fibrosis Unit, Schneider Children's Medical Center of Israel, Petah-Tikva, and Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
5 Department of Pediatrics and Cystic Fibrosis Clinic, Soroka Medical Center, Ben Gurion University, Beer Sheva, Israel
6 Department of Pediatrics and Cystic Fibrosis Center, Carmel Medical Center, Haifa, Israel
7 Division of Pediatric Pulmonology, Rambam Medical Center, Haifa, Israel
8 Institute of Pulmonology, Hadassah University Hospital, Jerusalem, Israel

Abstract:

Oxygen supplementation may improve exercise tolerance and the physiological response to exercise in cystic fibrosis (CF) patients. Elevating barometric pressure at low altitude is a simple means of increasing the quantity of inspired oxygen.

Study Objectives:
To examine the effect of natural oxygen enrichment (at the Dead Sea, 396 m below sea level) on exercise capacity and the physiological responses to maximal and submaximal exercise in CF patients.

Setting:
Patients were tested twice: at sea level (barometric pressure 754 + 6 mmHg and at the Dead Sea, (barometric pressure 791 + 3 mmHg) in a randomized (?) crossover design.

Patients:
Fourteen CF patients (6 females, 8 males), aged 15-45 years, with moderate to severe lung disease (mean FEV1 = 50.0 ± 11.2% predicted).

Measurements and Results:
Tests at each site included resting spirometry, anthropometry, a graded submaximal exercise test and a maximal exercise test on a treadmill, as well as a 6-min walking test. Tests were performed in identical order at both sites. Tests at the Dead Sea were performed 72 hours after arrival. No differences between sites were observed in lung function at rest. Peak oxygen consumption was significantly improved at the Dead Sea compared with sea level (1.68 ± 0.73 vs. 1.57 ± 0.74 l/min, respectively, p < (?)0.05), along with an improvement in the ventilatory equivalent for oxygen (41.2 ± 6.3 vs. 46.1 ± 7.1, respectively, p< 0.05). During submaximal exercise, blood oxygen saturation improved at the Dead Sea compared with sea level at all exercise intensities, p< 0.05).

Conclusion:
These results suggest that even a brief stay at the Dead Sea area may have physiological benefits for CF patients with moderate to severe lung disease.
This study was presented at the meeting of the Israel Clinical Pediatric Society in Tel Aviv, February 2005

 



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