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Janssens L, Jacobs N, Goossens N, Brumagne S, Langer D, Hodges PW. The effect of acute respiratory demand on postural control: A systematic review. Gait Posture 2024; 113:310-318. [PMID: 38996504 DOI: 10.1016/j.gaitpost.2024.06.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 05/16/2024] [Accepted: 06/25/2024] [Indexed: 07/14/2024]
Abstract
BACKGROUND Postural control can be challenged by breathing. RESEARCH QUESTION What is the effect of an acute increase in respiratory demand on postural control compared to quiet breathing? METHODS A systematic review was conducted. Electronic databases were systematically searched until October 18, 2022 on studies reporting changes in center of pressure (CoP) motion related to an acute manipulation of respiratory demand compared to quiet breathing during upright standing in healthy participants and/or participants with a clinical condition. RESULTS Twenty-one studies in healthy participants showed that voluntary (not metabolic-induced) hyperventilation or inspiratory resistive loading significantly increased CoP motion, while breath-holding decreased CoP motion, compared to quiet breathing (p< 0.05). Manipulating respiratory rate or breathing patterns did not reveal consistent results. Four studies showed that people with low back pain showed similar CoP responses to increasing respiratory demand (p> 0.05), except for breathing at different rates, whereas they showed greater CoP motion during quiet breathing. SIGNIFICANCE The extent of postural disturbance depended on the breathing mode and how it was quantified (i.e., CoP coupled with breathing movement or overall CoP measures). Voluntary hyperventilation and inspiratory resistive loading increased postural sway. For voluntary hyperventilation, this could be explained by CoP motion being directly coupled to chest wall movements whereas metabolic-induced hyperventilation did not increase CoP motion or CoP coupling with breathing. Breath-holding decreased postural sway. Patients with low back pain show greater postural sways than pain-free individuals during quiet breathing, although they exhibit similar postural adaptations to respiratory-related challenges as controls.
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Affiliation(s)
- Lotte Janssens
- REVAL Rehabilitation Research, Faculty of Rehabilitation Sciences, Wetenschapspark 7, 3590 Diepenbeek, Belgium.
| | - Nina Jacobs
- REVAL Rehabilitation Research, Faculty of Rehabilitation Sciences, Wetenschapspark 7, 3590 Diepenbeek, Belgium.
| | - Nina Goossens
- REVAL Rehabilitation Research, Faculty of Rehabilitation Sciences, Wetenschapspark 7, 3590 Diepenbeek, Belgium.
| | - Simon Brumagne
- Research Group for Musculoskeletal Rehabilitation, Department of Rehabilitation Sciences, KU Leuven, Tervuursevest 101, 3000 Leuven, Belgium.
| | - Daniel Langer
- Research Group for Rehabilitation in Internal Disorders, Department of Rehabilitation Sciences, KU Leuven, Tervuursevest 101, 3000 Leuven, Belgium.
| | - Paul W Hodges
- The University of Queensland, School of Health & Rehabilitation Sciences/Biomedical Sciences, Brisbane, Qld 4072, Australia.
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Bischoff H, Kovach C, Kumar S, Bruss J, Tranel D, Khalsa SS. Sensing, feeling and regulating: investigating the association of focal brain damage with voluntary respiratory and motor control. Philos Trans R Soc Lond B Biol Sci 2024; 379:20230251. [PMID: 39005040 DOI: 10.1098/rstb.2023.0251] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 03/26/2024] [Indexed: 07/16/2024] Open
Abstract
Breathing is a complex, vital function that can be modulated to influence physical and mental well-being. However, the role of cortical and subcortical brain regions in voluntary control of human respiration is underexplored. Here we investigated the influence of damage to human frontal, temporal or limbic regions on the sensation and regulation of breathing patterns. Participants performed a respiratory regulation task across regular and irregular frequencies ranging from 6 to 60 breaths per minute (bpm), with a counterbalanced hand motor control task. Interoceptive and affective states induced by each condition were assessed via questionnaire, and autonomic signals were indexed via skin conductance. Participants with focal lesions to the bilateral frontal lobe, right insula/basal ganglia and left medial temporal lobe showed reduced performance relative to individually matched healthy comparisons during the breathing and motor tasks. They also reported significantly higher anxiety during the 60 bpm regular and irregular breathing trials, with anxiety correlating with difficulty in rapid breathing specifically within this group. This study demonstrates that damage to frontal, temporal or limbic regions is associated with abnormal voluntary respiratory and motor regulation and tachypnoea-related anxiety, highlighting the role of the forebrain in affective and motor responses during breathing. This article is part of the theme issue 'Sensing and feeling: an integrative approach to sensory processing and emotional experience'.
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Affiliation(s)
- Henrik Bischoff
- Department of Psychology, University of Stockholm, 10691 Stockholm, Sweden
- Department of Psychology, Carl-von-Ossietzky University Oldenburg, 26129 Oldenburg, Germany
| | - Christopher Kovach
- Department of Neurosurgery, University of Iowa, Iowa City, IA 52242, USA
- Department of Neurosurgery, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Sukbhinder Kumar
- Department of Neurosurgery, University of Iowa, Iowa City, IA 52242, USA
| | - Joel Bruss
- Departments of Pediatrics, Neurology, and Psychiatry, University of Iowa, Iowa City, IA 52242, USA
| | - Daniel Tranel
- Departments of Neurology and Psychological and Brain Sciences, University of Iowa, Iowa City, IA 52242, USA
| | - Sahib S Khalsa
- Laureate Institute for Brain Research, Tulsa, OK 74136, USA
- Oxley College of Health Sciences, University of Tulsa, Tulsa, OK 74119, USA
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA 90095, USA
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Bischoff H, Kovach C, Kumar S, Bruss J, Tranel D, Khalsa SS. Sensing, Feeling, and Regulating: Investigating the Association of Focal Brain Damage with Voluntary Respiratory and Motor Control. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2023.10.16.562254. [PMID: 37905134 PMCID: PMC10614780 DOI: 10.1101/2023.10.16.562254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Abstract
Breathing is a complex, vital function that can be modulated to influence physical and mental well-being. However, the role of cortical and subcortical brain regions in voluntary control of human respiration is underexplored. Here we investigated the influence of damage to human frontal, temporal, or limbic regions on the sensation and regulation of breathing patterns. Participants performed a respiratory regulation task across regular and irregular frequencies ranging from 6 to 60 breaths per minute (bpm), with a counterbalanced hand motor control task. Interoceptive and affective states induced by each condition were assessed via questionnaire and autonomic signals were indexed via skin conductance. Participants with focal lesions to the bilateral frontal lobe, right insula/basal ganglia, and left medial temporal lobe showed reduced performance than individually matched healthy comparisons during the breathing and motor tasks. They also reported significantly higher anxiety during the 60-bpm regular and irregular breathing trials, with anxiety correlating with difficulty in rapid breathing specifically within this group. This study demonstrates that damage to frontal, temporal, or limbic regions is associated with abnormal voluntary respiratory and motor regulation and tachypnea-related anxiety, highlighting the role of the forebrain in affective and motor responses during breathing. Highlights Impaired human respiratory regulation is associated with cortical/subcortical brain lesionsFrontolimbic/temporal regions contribute to rhythmic breathing and hand motor controlFrontolimbic/temporal damage is associated with anxiety during tachypnea/irregular breathingThe human forebrain is vital for affective and interoceptive experiences during breathing.
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Shamantseva ND, Klishkovskaia TA, Ananyev SS, Aksenov AY, Moshonkina TR. Efficacy of Marker-Based Motion Capture for Respiratory Cycle Measurement: A Comparison with Spirometry. SENSORS (BASEL, SWITZERLAND) 2023; 23:9736. [PMID: 38139582 PMCID: PMC10748239 DOI: 10.3390/s23249736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 12/06/2023] [Accepted: 12/07/2023] [Indexed: 12/24/2023]
Abstract
Respiratory rate monitoring is fundamental in clinical settings, and the accuracy of measurement methods is critical. This study aimed to develop and validate methods for assessing respiratory rate and the duration leof respiratory cycle phases in different body positions using optoelectronic plethysmography (OEP) based on a motion capture video system. Two analysis methods, the summation method and the triangle method were developed. The study focused on determining the optimal number of markers while achieving accuracy in respiratory parameter measurements. The results showed that most analysis methods showed a difference of ≤0.5 breaths per minute, with R2 ≥ 0.94 (p < 0.001) compared to spirometry. The best OEP methods for respiratory rate were the abdominal triangles and the sum of abdominal markers in all body positions. The study explored inspiratory and expiratory durations. The research found that 5-9 markers were sufficient to accurately determine respiratory time components in all body positions, reducing the marker requirements compared to previous studies. This interchangeability of OEP methods with standard spirometry demonstrates the potential of non-invasive methods for the simultaneous assessment of body segment movements, center of pressure dynamics, and respiratory movements. Future research is required to improve the clinical applicability of these methods.
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Affiliation(s)
- Natalia D. Shamantseva
- Pavlov Institute of Physiology, Russian Academy of Sciences, 6 Makarova Emb., Saint Petersburg 199034, Russia; (S.S.A.); (T.R.M.)
| | - Tatiana A. Klishkovskaia
- Faculty of Information Measurement and Biotechnical Systems, Saint Petersburg Electrotechnical University “LETI”, 5 Professora Popova Str., Saint Petersburg 197022, Russia; (T.A.K.); (A.Y.A.)
| | - Sergey S. Ananyev
- Pavlov Institute of Physiology, Russian Academy of Sciences, 6 Makarova Emb., Saint Petersburg 199034, Russia; (S.S.A.); (T.R.M.)
| | - Andrey Y. Aksenov
- Faculty of Information Measurement and Biotechnical Systems, Saint Petersburg Electrotechnical University “LETI”, 5 Professora Popova Str., Saint Petersburg 197022, Russia; (T.A.K.); (A.Y.A.)
| | - Tatiana R. Moshonkina
- Pavlov Institute of Physiology, Russian Academy of Sciences, 6 Makarova Emb., Saint Petersburg 199034, Russia; (S.S.A.); (T.R.M.)
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Keogan S, Alonso T, Sunday S, Hanafin J, Tigova O, Fernandez E, Lopez MJ, Gallus S, Semple S, Tzortzi A, Boffi R, Gorini G, Lopez-Nicolas A, Arvind DK, Radu-Loghin C, Soriano JB, Clancy L. Particle Exposure Hazards of Visiting Outdoor Smoking Areas for Patients with Asthma or COPD Even in EU Countries with Comprehensive Smokefree Laws. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5978. [PMID: 37297582 PMCID: PMC10252725 DOI: 10.3390/ijerph20115978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 04/19/2023] [Accepted: 05/25/2023] [Indexed: 06/12/2023]
Abstract
Smokefree laws are intended to protect against second-hand smoke (SHS) in outdoor areas. We examined if exposure to PM2.5 particles in outdoor smoking areas changed breathing rates in 60 patients with asthma (n = 30) or with COPD (n = 30), in an open, non-randomised, interventional study model in Czechia, Ireland and Spain. The patients wore a PM2.5 particle monitor (AirSpeck) and a breath monitor (RESpeck) for 24 h to determine changes in breathing rates (Br) at rest and during a visit to an outside smoking area. Spirometry and breath CO were measured before and the day after visiting an outdoor smoking area. The PM2.5 levels at the 60 venues were highly variable, ranging from ≥2000 µg/m3 (in 4 premises) to ≤10 µg/m3 (in 3 premises, which had only a single wall in the structure). At 39 venues, the mean PM 2.5 levels were ≥25 µg/m3. The breathing rate changed significantly in 57 of the 60 patients, resulting in an increase in some patients and a decrease in others. Comprehensive smokefree laws were ineffective in protecting asthma and COPD patients from exposure to high levels of SHS in outside areas of pubs and terraces, which should be avoided by these patients. These findings also support the extension of smokefree laws to outside areas.
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Affiliation(s)
- Sheila Keogan
- TobaccoFree Research Institute Ireland (TFRI), D02 HW71 Dublin, Ireland
| | - Tamara Alonso
- Hospital Universitario de la Princesa, Universidad Autónoma de Madrid, 28049 Madrid, Spain
- CIBER Respiratory Diseases (CIBERES), 28029 Madrid, Spain
| | - Salome Sunday
- TobaccoFree Research Institute Ireland (TFRI), D02 HW71 Dublin, Ireland
| | - Joan Hanafin
- TobaccoFree Research Institute Ireland (TFRI), D02 HW71 Dublin, Ireland
| | - Olena Tigova
- CIBER Respiratory Diseases (CIBERES), 28029 Madrid, Spain
- Tobacco Control Unit, Catalan Institute of Oncology (ICO), 08908 Barcelona, Spain
- Tobacco Control Research Group, Bellvitge Biomedical Research Institute (IDIBELL), 08908 Barcelona, Spain
- School of Medicine and Health Sciences, Bellvitge Campus, Universitat de Barcelona, 08007 Barcelona, Spain
| | - Esteve Fernandez
- CIBER Respiratory Diseases (CIBERES), 28029 Madrid, Spain
- Tobacco Control Unit, Catalan Institute of Oncology (ICO), 08908 Barcelona, Spain
- Tobacco Control Research Group, Bellvitge Biomedical Research Institute (IDIBELL), 08908 Barcelona, Spain
- School of Medicine and Health Sciences, Bellvitge Campus, Universitat de Barcelona, 08007 Barcelona, Spain
| | - Maria Jose Lopez
- Public Health Agency of Barcelona (ASPB), 08023 Barcelona, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
- Institut d’Investigació Biomèdica Sant Pau (IIB St. Pau), 08025 Barcelona, Spain
| | - Silvano Gallus
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS (IRFMN), 20156 Milano, Italy
| | - Sean Semple
- Institute for Social Marketing and Health, Faculty of Health Sciences and Sport, University of Stirling (UNISTIR), Stirling FK9 4LA, UK
| | - Anna Tzortzi
- Institute of Public Health, The American College of Greece, GR-153 42 Athens, Greece
| | - Roberto Boffi
- Fondazione IRCCS Istituto Nazionale dei Tumori (INT), 20133 Milan, Italy
| | - Giuseppe Gorini
- Istituto per lo Studio, la Prevenzione, e la Rete Oncologica (ISPRO), 50139 Firenze, Italy
| | - Angel Lopez-Nicolas
- Department of Economics, Polytechnic University of Cartagena (UPCT), 30202 Cartagena, Spain
| | - D. K. Arvind
- School of Informatics, University of Edinburgh, Edinburgh EH8 9YL, UK
| | - Cornel Radu-Loghin
- European Network on Smoking and Tobacco Prevention (ENSP), 1050 Brussels, Belgium
| | - Joan B. Soriano
- Hospital Universitario de la Princesa, Universidad Autónoma de Madrid, 28049 Madrid, Spain
- CIBER Respiratory Diseases (CIBERES), 28029 Madrid, Spain
| | - Luke Clancy
- TobaccoFree Research Institute Ireland (TFRI), D02 HW71 Dublin, Ireland
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Kim SH, Shin HJ, Cho HY. Impact of Types of Breathing on Static Balance Ability in Healthy Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031205. [PMID: 35162227 PMCID: PMC8835336 DOI: 10.3390/ijerph19031205] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 01/18/2022] [Accepted: 01/20/2022] [Indexed: 12/04/2022]
Abstract
Recent studies have suggested that breathing type may affect balance ability. However, most of these studies were conducted on the elderly and patients with musculoskeletal or neurological disorders. Therefore, the effect of voluntary breathing, such as thoracic and abdominal breathing, on the balance ability of people in various age groups is not clearly understood. The purpose of this study was to investigate the differences in balance ability according to the type of breathing in healthy young adults. This study included 78 healthy, young adults. All subjects were assessed for balance ability in neutral breathing, thoracic breathing, and abdominal breathing through a crossover design. Balance ability was assessed during static standing using a force plate. Participants were trained in voluntary breathing, evaluated using electromyography. During voluntary breathing, sway velocity, anterior-posterior difference, and anterior-posterior standard deviation increased while anterior-posterior sample entropy decreased compared to neutral breathing (p < 0.05). Compared with thoracic breathing, abdominal breathing increased sway velocity and variability, and reduced complexity (p < 0.05). These findings show that balance ability is affected by breathing, even in healthy young adults.
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Affiliation(s)
- Sung-Hyeon Kim
- Department of Health Science, Gachon University Graduate School, Incheon 21936, Korea; (S.-H.K.); (H.-J.S.)
| | - Ho-Jin Shin
- Department of Health Science, Gachon University Graduate School, Incheon 21936, Korea; (S.-H.K.); (H.-J.S.)
| | - Hwi-Young Cho
- Department of Physical Therapy, College of Health Science, Gachon University, Incheon 21936, Korea
- Correspondence: ; Tel.: +82-32-820-4560; Fax: +82-32-820-4449
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Li Y, Zhang S, Odeh C. Automated Classification of Postural Control for Individuals With Parkinson's Disease Using a Machine Learning Approach: A Preliminary Study. J Appl Biomech 2020; 36:334-339. [PMID: 32736341 DOI: 10.1123/jab.2019-0400] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Revised: 04/30/2020] [Accepted: 05/07/2020] [Indexed: 11/18/2022]
Abstract
The purposes of the study were (1) to compare postural sway between participants with Parkinson's disease (PD) and healthy controls and (2) to develop and validate an automated classification of PD postural control patterns using a machine learning approach. A total of 9 participants in the early stage of PD and 12 healthy controls were recruited. Participants were instructed to stand on a force plate and maintain stillness for 2 minutes with eyes open and eyes closed. The center of pressure data were collected at 50 Hz. Linear displacements, standard deviations, total distances, sway areas, and multiscale entropy of center of pressure were calculated and compared using mixed-model analysis of variance. Five supervised machine learning algorithms (ie, logistic regression, K-nearest neighbors, Naïve Bayes, decision trees, and random forest) were used to classify PD postural control patterns. Participants with PD exhibited greater center of pressure sway and variability compared with controls. The K-nearest neighbor method exhibited the best prediction performance with an accuracy rate of up to 0.86. In conclusion, participants with PD exhibited impaired postural stability and their postural sway features could be identified by machine learning algorithms.
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Matić Z, Platiša MM, Kalauzi A, Bojić T. Slow 0.1 Hz Breathing and Body Posture Induced Perturbations of RRI and Respiratory Signal Complexity and Cardiorespiratory Coupling. Front Physiol 2020; 11:24. [PMID: 32132926 PMCID: PMC7040454 DOI: 10.3389/fphys.2020.00024] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Accepted: 01/14/2020] [Indexed: 12/21/2022] Open
Abstract
Objective: We explored the physiological background of the non-linear operating mode of cardiorespiratory oscillators as the fundamental question of cardiorespiratory homeodynamics and as a prerequisite for the understanding of neurocardiovascular diseases. We investigated 20 healthy human subjects for changes using electrocardiac RR interval (RRI) and respiratory signal (Resp) Detrended Fluctuation Analysis (DFA, α1RRI, α2RRI, α1Resp, α2Resp), Multiple Scaling Entropy (MSERRI1-4, MSERRI5-10, MSEResp1-4, MSEResp5-10), spectral coherence (CohRRI-Resp), cross DFA (ρ1 and ρ2) and cross MSE (XMSE1-4 and XMSE5-10) indices in four physiological conditions: supine with spontaneous breathing, standing with spontaneous breathing, supine with 0.1 Hz breathing and standing with 0.1 Hz breathing. Main results: Standing is primarily characterized by the change of RRI parameters, insensitivity to change with respiratory parameters, decrease of CohRRI-Resp and insensitivity to change of in ρ1, ρ2, XMSE1-4, and XMSE5-10. Slow breathing in supine position was characterized by the change of the linear and non-linear parameters of both signals, reflecting the dominant vagal RRI modulation and the impact of slow 0.1 Hz breathing on Resp parameters. CohRRI-Resp did not change with respect to supine position, while ρ1 increased. Slow breathing in standing reflected the qualitatively specific state of autonomic regulation with striking impact on both cardiac and respiratory parameters, with specific patterns of cardiorespiratory coupling. Significance: Our results show that cardiac and respiratory short term and long term complexity parameters have different, state dependent patterns. Sympathovagal non-linear interactions are dependent on the pattern of their activation, having different scaling properties when individually activated with respect to the state of their joint activation. All investigated states induced a change of α1 vs. α2 relationship, which can be accurately expressed by the proposed measure-inter-fractal angle θ. Short scale (α1 vs. MSE1-4) and long scale (α2 vs. MSE5-10) complexity measures had reciprocal interrelation in standing with 0.1 Hz breathing, with specific cardiorespiratory coupling pattern (ρ1 vs. XMSE1-4). These results support the hypothesis of hierarchical organization of cardiorespiratory complexity mechanisms and their recruitment in ascendant manner with respect to the increase of behavioral challenge complexity. Specific and comprehensive cardiorespiratory regulation in standing with 0.1 Hz breathing suggests this state as the potentially most beneficial maneuver for cardiorespiratory conditioning.
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Affiliation(s)
- Zoran Matić
- Biomedical Engineering and Technology, University of Belgrade, Belgrade, Serbia
| | - Mirjana M. Platiša
- Faculty of Medicine, Institute of Biophysics, University of Belgrade, Belgrade, Serbia
| | - Aleksandar Kalauzi
- Department for Life Sciences, Institute for Multidisciplinary Research, University of Belgrade, Belgrade, Serbia
| | - Tijana Bojić
- Laboratory for Radiobiology and Molecular Genetics-080, Institute for Nuclear Sciences Vinča, University of Belgrade, Belgrade, Serbia
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