Effect of exercise therapy on cytokine secretion in the saliva of bedridden patients.
Hidemasa Iki, Shunji Sawa, Toshio Teranishi and 3 others
PMID 27821953WHAT IT FOUND
In bedridden patients, saliva cytokine peaks rose after assisted arm and leg movement.
IL-6, IL-8, IL-15 and IL-17 increased above pre-exercise values, but pneumonia or recovery outcomes were not measured.
Key findings
01For IL-6, IL-8 and IL-15, mean values at 0.5 hours, 1 hour and 3 hours did not differ significantly from before exercise, but maximum post-exercise values were significantly higher.
02IL-17 maximum relative value was 5.2 ± 2.9 compared with 1 before exercise.
03IL-10 and IL-22 were not detected in saliva.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study had no control group, random allocation or blinding, so changes cannot be separated from time, care activities or measurement effects. The sample was small: 21 participants for IL-6, IL-8, IL-10 and IL-15, and 14 participants for IL-17 and IL-22. The outcomes were salivary cytokine levels and vital signs, not pneumonia, aspiration, swallowing, function, recovery or mortality. Only values up to 3 hours after exercise were measured, and IL-10 and IL-22 were not detected, so the timing and completeness of immune responses are unclear. Participants were severely bed-confined, tube-fed and mostly after cerebrovascular disease, so results may not apply to more mobile patients. Informed consent was obtained from representatives because participants' physical and cognitive states made consent difficult. The paper excluded values more than two standard deviations from the mean, and it did not confirm muscle cytokine production by biopsy.
The easy way to misread this
Do not conclude that exercise therapy prevents aspiration pneumonia or speeds recovery. The study measured saliva cytokine peaks and vital signs after an assisted exercise session, not pneumonia, swallowing or long-term patient outcomes.