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Adams ZH, Blythe HC, Charkoudian N, Curry TB, Joyner MJ, Kendrick AH, Nightingale AK, Abdala Sheikh AP, Hart EC. Aging in females is associated with changes in respiratory modulation of sympathetic nerve activity and blood pressure. Am J Physiol Heart Circ Physiol 2023; 325:H1108-H1117. [PMID: 37656132 PMCID: PMC10907029 DOI: 10.1152/ajpheart.00226.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 08/31/2023] [Accepted: 08/31/2023] [Indexed: 09/02/2023]
Abstract
Sympathetic nerve activity (SNA) is tightly coupled with the respiratory cycle. In healthy human males, respiratory modulation of SNA does not change with age. However, it is unclear how this modulation is affected by age in females. We investigated whether respiratory sympathetic modulation is altered in healthy postmenopausal (PMF) versus premenopausal female (YF), and younger male (YM) adults, and determined its relationship to resting blood pressure. Muscle SNA (MSNA; microneurography), respiration (transducer belt), ECG, and continuous blood pressure were measured in 12 YF, 13 PMF, and 12 YM healthy volunteers. Respiratory modulation of MSNA was quantified during two phases of the respiratory cycle: mid-late expiration and inspiration/postinspiration. All groups showed respiratory modulation of MSNA (P < 0.0005). There was an interaction between the respiratory phase and group for MSNA [bursts/100 heartbeats (HB) (P = 0.004) and bursts/min (P = 0.029)], with smaller reductions in MSNA during inspiration observed in PMF versus the other groups. Respiratory modulation of blood pressure was also reduced in PMF versus YF (6 [2] vs. 12 [9] mmHg, P = 0.008) and YM (13 [13] mmHg, P = 0.001, median [interquartile range]). The magnitude of respiratory sympathetic modulation was related to resting blood pressure in PMF only, such that individuals with less modulation had greater resting blood pressure. The data indicate that aging in postmenopausal females is associated with less inspiratory inhibition of MSNA. This correlated with a higher resting blood pressure in PMF only. Thus, the reduced modulation of MSNA could contribute to the age-related rise in blood pressure that occurs in females.NEW & NOTEWORTHY The current study demonstrates that respiratory modulation of sympathetic nerve activity (SNA) is reduced in healthy postmenopausal (PMF) versus premenopausal females (YF). Furthermore, respiratory sympathetic modulation was negatively related to resting blood pressure in postmenopausal females, such that blood pressure was greater in individual with less modulation. Reduced respiratory sympathetic modulation may have implications for the autonomic control of blood pressure in aging postmenopausal females, by contributing to age-related sympathetic activation and reducing acute, respiratory-linked blood pressure variation.
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Affiliation(s)
- Zoe H Adams
- School of Physiology, Pharmacology and Neuroscience, University of Bristol, Bristol, United Kingdom
| | - Hazel C Blythe
- Translational Health Sciences, University of Bristol, Bristol, United Kingdom
| | - Nisha Charkoudian
- United States Army Research Institute of Environmental Medicine, Natick, Massachusetts, United States
| | - Timothy B Curry
- Department of Anaesthesiology, Mayo Clinic, Rochester, Minnesota, United States
| | - Michael J Joyner
- Department of Anaesthesiology, Mayo Clinic, Rochester, Minnesota, United States
| | - Adrian H Kendrick
- School of Physiology, Pharmacology and Neuroscience, University of Bristol, Bristol, United Kingdom
- Department of Respiratory Medicine, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom
| | - Angus K Nightingale
- School of Physiology, Pharmacology and Neuroscience, University of Bristol, Bristol, United Kingdom
- Bristol Heart Institute, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom
| | - Ana P Abdala Sheikh
- School of Physiology, Pharmacology and Neuroscience, University of Bristol, Bristol, United Kingdom
| | - Emma C Hart
- School of Physiology, Pharmacology and Neuroscience, University of Bristol, Bristol, United Kingdom
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Dos Santos NLO, Pegorari MS, Silva CDFR, Jamami M, Matos AP, Pinto ACPN, Ohara DG. Pulmonary Function as a Predictor of Frailty Syndrome in Community-Dwelling Older Adults. J Geriatr Phys Ther 2023; 46:64-70. [PMID: 34091489 DOI: 10.1519/jpt.0000000000000315] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND AND PURPOSE Diminished pulmonary function is associated with negative health outcomes and pulmonary impairment, and can be associated with frailty. The objectives of this study were to compare pulmonary function between frail, prefrail, and nonfrail older adults; to verify the association between pulmonary function and frailty syndrome; and to establish cut-off points for pulmonary function variables for predicting frailty. METHODS A cross-sectional study was conducted with 379 community-dwelling older adults of both sexes. Spirometry was used to measure pulmonary function criteria (forced vital capacity, FVC; forced expiratory volume in 1 second, FEV 1 ; and FEV 1 /FVC ratio). The presence of frailty was evaluated with Fried's frailty phenotype. Statistical analysis included a multinomial logistic regression model. Pulmonary function cut-off points for discriminating frailty syndrome were established through analysis of the receiver operating characteristic curves. RESULTS AND DISCUSSION The study participants were a median of 69.0 (64.0-74.0) years old, and 12.4% presented frailty while 58% presented prefrailty. Frail and prefrail older adults presented significantly lower median FVC and FEV 1 values-FVC = 1.89 L (1.45-2.31) and FEV 1 = 1.60 L (1.24-1.91); FVC = 2.07 L (1.62-2.67) and FEV 1 = 1.66 L (1.32-2.09), respectively-than nonfrail participants-FVC = 2.53 L (1.96-3.16) and FEV 1 = 2.01 L (1.54-2.43). The adjusted analysis indicated that FEV 1 (odds ratio [OR] = 0.63; 95% confidence interval [CI], 0.39-0.99) and the FVC (OR = 0.68; 95% CI, 0.48-0.96) were inversely associated with prefrailty and that FVC (OR = 0.52; 95% CI, 0.29-0.94) was associated with frailty. Cut-off points for prefrailty (FVC ≤2.3 L and FEV 1 ≤1.86 L) and frailty (FVC ≤2.07 L and FEV 1 ≤1.76 L) were established. CONCLUSIONS Pulmonary function was lower in frail and prefrail older adults than in their nonfrail peers. Frailty and prefrailty were inversely associated with pulmonary function. Cut-off points for FEV 1 and FVC for discriminating frailty were established and may allow pulmonary function to serve as an indicator of frailty in older adults.
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Affiliation(s)
- Nara L O Dos Santos
- Department of Biological and Health Sciences, Federal University of Amapá, Macapá, Amapá, Brazil
| | - Maycon S Pegorari
- Department of Biological and Health Sciences, Federal University of Amapá, Macapá, Amapá, Brazil
| | - Caroline de F R Silva
- Department of Biological and Health Sciences, Federal University of Amapá, Macapá, Amapá, Brazil
| | - Maurício Jamami
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | - Areolino P Matos
- Department of Biological and Health Sciences, Federal University of Amapá, Macapá, Amapá, Brazil
| | - Ana Carolina P N Pinto
- Department of Biological and Health Sciences, Federal University of Amapá, Macapá, Amapá, Brazil
| | - Daniela G Ohara
- Department of Biological and Health Sciences, Federal University of Amapá, Macapá, Amapá, Brazil
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Resistance training of peripheral muscles benefits respiratory parameters in older women with sarcopenia: Randomized controlled trial. Arch Gerontol Geriatr 2023; 104:104799. [PMID: 36070636 DOI: 10.1016/j.archger.2022.104799] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 08/26/2022] [Accepted: 08/28/2022] [Indexed: 02/07/2023]
Abstract
PURPOSE OF THE RESEARCH Ageing entails a decrease in muscle mass and strength, known as sarcopenia, which also affects respiratory function. Physical exercise is an appropriate intervention to treat both conditions. This study aims to assess the efficacy of high-intensity resistance training (HIRT) on clinical parameters of respiratory function and health-related quality of life (QoL) in community-dwelling older women with sarcopenia. METHODS Fifty-one sarcopenic community-dwelling women aged 70 years and older were randomized to either six months of HIRT (n = 24) or control (n = 27). At baseline and post-intervention, participants were assessed for skeletal-muscle sarcopenia; respiratory sarcopenia status; respiratory function: spirometry (FEV1, FVC, FEV1/FVC, and FEF25-75) and expiratory (MEP) and inspiratory (MIP) respiratory muscle strength parameters; and health-related QoL (EURO-QOL 5D-3 L). RESULTS A group-by-time interaction effect for MEP (p = 0.044, Ƞ2=0.108) was observed. CG showed a significant decrease in FEV1 (mean difference [MD] -0.12 L; 95% confidence interval [CI] -0.20, -0.05; p = 0.002); and FVC (MD -0.18 L; 95% CI -0.33, -0.03; p = 0.024) after six months, whereas the HIRT maintained respiratory function without change. Post-intervention, mean EQ-VAS increased in the HIRT and decreased in CG, resulting in a significant between-group difference (mean 73.0 standard deviation [SD] 16.99 vs 61.1 SD 18.2 points, respectively; p = 0.044). Respiratory sarcopenia status was reverted in the HIRT. CONCLUSIONS HIRT increased muscle strength and halted age-related respiratory function decline in sarcopenic old women. A strength intervention could benefit health-related QoL and physical well-being. REGISTERED IN CLINICALTRIALS.GOV: NCT03834558.
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Kalu ME, Dal Bello-Haas V, Griffin M, Boamah SA, Harris J, Zaide M, Rayner D, Khattab N, Bhatt V, Goodin C, Song JW(B, Smal J, Budd N. Physical mobility determinants among older adults: a scoping review of self-reported and performance-based measures. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2022. [DOI: 10.1080/21679169.2022.2153303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Michael E. Kalu
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Vanina Dal Bello-Haas
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Meridith Griffin
- Department of Health, Aging & Society, Faculty of Social Science, McMaster University, Hamilton, Canada
| | - Sheila A. Boamah
- School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Jocelyn Harris
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Mashal Zaide
- Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Daniel Rayner
- Department of Health Science, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Nura Khattab
- Department of Kinesiology, Faculty of Sciences, McMaster University, Hamilton, Canada
| | - Vidhi Bhatt
- Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | | | | | - Justin Smal
- Manitoulin Physio Centre, M'Chigeeng, Canada
| | - Natalie Budd
- The Arthtitis and Sports Medicine Centre, Ancaster, Canada
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Sawaya Y, Hirose T, Ishizaka M, Shiba T, Sato R, Kubo A, Urano T. Patterns of Changes in Respiratory Muscle Strength over 1 Year in Non-Sarcopenia, Sarcopenia, and Severe Sarcopenia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16571. [PMID: 36554450 PMCID: PMC9779222 DOI: 10.3390/ijerph192416571] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 11/27/2022] [Accepted: 12/07/2022] [Indexed: 06/17/2023]
Abstract
In this prospective longitudinal cohort study, we explored the characteristics of older people with lower respiratory muscle strength, according to sarcopenia severity, over the course of 1 year. The maximum expiratory pressure (MEP), grip strength, walking speed, and skeletal muscle mass index of 58 participants (28 men, 30 women; mean age, 76.9 ± 7.7 years) were measured at baseline and at the 1-year follow-up. Participants were classified into a decreased MEP group (n = 29; MEP decreased by ≥10% after 1 year) and a non-decreased MEP group (n = 29; MEP decreased by <10%). Sarcopenia status in the mild direction at baseline was significantly associated with MEP decline after one year. Repeated two-way analysis of variance showed significant main effects of measurement time (p < 0.001) and severity of sarcopenia (p = 0.026), as well as a significant interaction effect (p = 0.006). Surprisingly, MEP decreased significantly in the non-sarcopenia and sarcopenia groups, but not in the severe sarcopenia group. Thus, individuals without sarcopenia and those with moderate sarcopenia at baseline are predisposed to MEP decline and should be closely monitored for signs of such decline and associated adverse events.
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Affiliation(s)
- Yohei Sawaya
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, 2600-1 Kitakanemaru, Otawara 324-8501, Tochigi, Japan
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly “Maronie-en,” 533-11 Iguchi, Nasushiobara 329-2763, Tochigi, Japan
| | - Tamaki Hirose
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, 2600-1 Kitakanemaru, Otawara 324-8501, Tochigi, Japan
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly “Maronie-en,” 533-11 Iguchi, Nasushiobara 329-2763, Tochigi, Japan
| | - Masahiro Ishizaka
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, 2600-1 Kitakanemaru, Otawara 324-8501, Tochigi, Japan
| | - Takahiro Shiba
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly “Maronie-en,” 533-11 Iguchi, Nasushiobara 329-2763, Tochigi, Japan
| | - Ryo Sato
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly “Maronie-en,” 533-11 Iguchi, Nasushiobara 329-2763, Tochigi, Japan
| | - Akira Kubo
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, 2600-1 Kitakanemaru, Otawara 324-8501, Tochigi, Japan
| | - Tomohiko Urano
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly “Maronie-en,” 533-11 Iguchi, Nasushiobara 329-2763, Tochigi, Japan
- Department of Geriatric Medicine, School of Medicine, International University of Health and Welfare, 4-3 Kozunomori, Narita 286-8686, Chiba, Japan
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Association Between Inspiratory Muscle Function and Balance Ability in Older People: A Pooled Data Analysis Before and After Inspiratory Muscle Training. J Aging Phys Act 2021; 30:421-433. [PMID: 34530401 DOI: 10.1123/japa.2020-0507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 05/10/2021] [Accepted: 07/06/2021] [Indexed: 11/18/2022]
Abstract
Inspiratory muscle training (IMT) improved balance ability and respiratory muscle function in healthy older adults. The current study is a retrospective analysis to explore the relationship between inspiratory muscle function, balance ability, and adaptation to IMT. All participants (total = 129; IMT = 60; age range = 65-85 years) performed inspiratory and balance assessments, including the mini-balance evaluation system test, maximal inspiratory pressure, and peak inspiratory flow tests. Baseline inspiratory muscle function was positively related to balance ability (p < .05), and IMT-induced improvements in inspiratory function (23.3% in maximal inspiratory pressure, 8.0% in peak inspiratory flow rate, 14.9% in maximal peak inspiratory power) were related to improvements in balance (10.6% in mini-balance evaluation system test), with the greatest improvements (17.0%) observed in the oldest participants (76-85 years old, p < .05). In conclusion, with or without IMT, positive associations between inspiratory function and balance ability exist, with greater improvements in inspiratory muscle function related to greater improvements in balance ability.
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7
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Sicard RM, Frank-Ito DO. Role of nasal vestibule morphological variations on olfactory airflow dynamics. Clin Biomech (Bristol, Avon) 2021; 82:105282. [PMID: 33548767 PMCID: PMC8294407 DOI: 10.1016/j.clinbiomech.2021.105282] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 12/06/2020] [Accepted: 01/21/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND The conductive mechanisms of olfaction are typically given little priority in the evaluation of olfactory function. The objective of this study is to investigate the role of nasal vestibule morphological variations on airflow volume at the olfactory recess in healthy subjects. METHODS Anatomically realistic three-dimensional nasal airway models were constructed from computed tomography scans in five subjects. Each individual's unilateral nasal cavity (10 total) was classified according to the shape of their nasal vestibule: Standard, Notched, or Elongated. Nasal airflow simulations were performed using computational fluid dynamics modeling at two inspiratory flow rates (15 L/min and 30 L/min) to reflect resting and moderate breathing rates. Olfactory airflow volume and cross-sectional flow resistance were computed. FINDINGS Average olfactory airflow volumes (and percent airflow in olfactory) were: 0.25 L/min to 0.64 L/min (3.0%-7.7%; 15 L/min simulations) and 0.53 L/min to 1.30 L/min (3.2%-7.8%; 30 L/min simulations) for Standard; 0.13 L/min - 0.47 L/min (2.0%-6.8%; 15 L/min simulations) and 0.06 L/min - 0.82 L/min (1.7%-6.1%; 30 L/min simulations) for Notched; and 0.07 L/min - 0.39 L/min (1.2%-5.4%; 15 L/min simulations) and 0.30 L/min - 0.99 L/min (2.1%-6.7%; 30 L/min simulations) for Elongated. On average, relative difference in olfactory resistance between left and right sides was 141.5% for patients with different unilateral phenotypes and 82.2% for patients with identical unilateral phenotype. INTERPRETATION Olfactory cleft airflow volume was highest in the Standard nasal vestibule phenotype, followed by Notched phenotype for 15 L/min simulations and Elongated phenotype for 30 L/min simulations. Further, intra-patient variation in olfactory cleft airflow resistance differs greatly for patients with different unilateral phenotypes compared to patients with identical unilateral phenotype.
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Affiliation(s)
- Ryan M Sicard
- Department of Head and Neck Surgery & Communication Sciences, Duke University Medical Center, Durham, NC, USA
| | - Dennis O Frank-Ito
- Department of Head and Neck Surgery & Communication Sciences, Duke University Medical Center, Durham, NC, USA; Computational Biology & Bioinformatics PhD Program, Duke University, Durham, NC, USA; Department of Mechanical Engineering and Materials Science, Duke University, Durham, NC, USA.
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Shimizu K, Shiozawa K, Ishida K, Saito M, Mizuno S, Akima H, Katayama K. Age and sex differences in blood pressure responses during hyperpnoea. Exp Physiol 2021; 106:736-747. [PMID: 33428277 DOI: 10.1113/ep089171] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Accepted: 01/06/2021] [Indexed: 01/13/2023]
Abstract
NEW FINDINGS What is the central question of this study? Increased respiratory muscle activation is associated with neural and cardiovascular consequences via the respiratory muscle-induced metaboreflex. Does ageing and/or sex influence the arterial blood pressure response during voluntary normocapnic incremental hyperpnoea? What is the main finding and its importance? The increase in blood pressure during hyperpnoea was smaller in younger females than in older females, whereas no difference was found between older males and older females. The blunted respiratory muscle-induced metaboreflex in younger females is normalized with advancing age, whereas ageing has no such effect in males. ABSTRACT We hypothesized that older females (OF) have a greater arterial blood pressure response to increased respiratory muscle work compared with younger females (YF) and that no such difference exists between older males (OM) and younger males (YM). To test these hypotheses, cardiovascular responses during voluntary normocapnic incremental hyperpnoea were evaluated and compared between older and younger subjects. An incremental respiratory endurance test (IRET) was performed as follows: target minute ventilation was initially set at 30% of the maximal voluntary ventilation (MVV12) and was increased by 10% of MVV12 every 3 min. The test was terminated when the subject could not maintain the target percentage of MVV12. Heart rate and mean arterial blood pressure (MAP) were recorded continuously. The increase in MAP from baseline (ΔMAP) during the IRET in OM (+24.0 ± 14.7 mmHg, mean ± SD) did not differ (P = 0.144) from that in YM (+24.3 ± 13.4 mmHg), but it was greater (P = 0.004) in OF (+31.2 ± 11.6 mmHg) than in YF (+10.3 ± 5.5 mmHg). No significant difference in ΔMAP during the IRET was observed between OM and OF (P = 0.975). These results suggest that the respiratory muscle-induced metaboreflex is blunted in YF, but it could be normalized with advancing age. In males, ageing has little effect on the respiratory muscle-induced metaboreflex. These results show no sex difference in the respiratory muscle-induced metaboreflex in older adults.
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Affiliation(s)
- Kaori Shimizu
- Graduate School of Education and Human Development, Nagoya University, Nagoya, Japan
| | - Kana Shiozawa
- Department of Sports and Fitness, Faculty of Wellness, Shigakkan University, Obu, Japan.,Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Koji Ishida
- Graduate School of Medicine, Nagoya University, Nagoya, Japan.,Research Center of Health, Physical Fitness and Sports, Nagoya University, Nagoya, Japan
| | - Mitsuru Saito
- Applied Physiology Laboratory, Toyota Technological Institute, Nagoya, Japan
| | - Sahiro Mizuno
- Research Center of Health, Physical Fitness and Sports, Nagoya University, Nagoya, Japan.,Research Fellowship for Young Scientists of Japan Society for the Promotion of Science
| | - Hiroshi Akima
- Graduate School of Education and Human Development, Nagoya University, Nagoya, Japan.,Research Center of Health, Physical Fitness and Sports, Nagoya University, Nagoya, Japan
| | - Keisho Katayama
- Graduate School of Medicine, Nagoya University, Nagoya, Japan.,Research Center of Health, Physical Fitness and Sports, Nagoya University, Nagoya, Japan
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9
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Darden DB, Moore FA, Brakenridge SC, Navarro EB, Anton SD, Leeuwenburgh C, Moldawer LL, Mohr AM, Efron PA, Mankowski RT. The Effect of Aging Physiology on Critical Care. Crit Care Clin 2021; 37:135-150. [PMID: 33190766 PMCID: PMC8194285 DOI: 10.1016/j.ccc.2020.08.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Older patients experience a decline in their physiologic reserves as well as chronic low-grade inflammation named "inflammaging." Both of these contribute significantly to aging-related factors that alter the acute, subacute, and chronic response of these patients to critical illness, such as sepsis. Unfortunately, this altered response to stressors can lead to chronic critical illness followed by dismal outcomes and death. The primary goal of this review is to briefly highlight age-specific changes in physiologic systems majorly affected in critical illness, especially because it pertains to sepsis and trauma, which can lead to chronic critical illness and describe implications in clinical management.
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Affiliation(s)
- Dijoia B Darden
- Department of Surgery, University of Florida College of Medicine, 1600 SW Archer Road, Gainesville, FL 32610, USA
| | - Frederick A Moore
- Department of Surgery, University of Florida College of Medicine, 1600 SW Archer Road, Gainesville, FL 32610, USA
| | - Scott C Brakenridge
- Department of Surgery, University of Florida College of Medicine, 1600 SW Archer Road, Gainesville, FL 32610, USA
| | - Eduardo B Navarro
- Department of Surgery, University of Florida College of Medicine, 1600 SW Archer Road, Gainesville, FL 32610, USA
| | - Stephen D Anton
- Department of Aging and Geriatric Research, University of Florida, 2004 Mowry Road, Gainesville, FL 32611, USA
| | - Christiaan Leeuwenburgh
- Department of Aging and Geriatric Research, University of Florida, 2004 Mowry Road, Gainesville, FL 32611, USA
| | - Lyle L Moldawer
- Department of Surgery, University of Florida College of Medicine, 1600 SW Archer Road, Gainesville, FL 32610, USA
| | - Alicia M Mohr
- Department of Surgery, University of Florida College of Medicine, 1600 SW Archer Road, Gainesville, FL 32610, USA
| | - Philip A Efron
- Department of Surgery, University of Florida College of Medicine, 1600 SW Archer Road, Gainesville, FL 32610, USA
| | - Robert T Mankowski
- Department of Aging and Geriatric Research, University of Florida, 2004 Mowry Road, Gainesville, FL 32611, USA.
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Nagano A, Wakabayashi H, Maeda K, Kokura Y, Miyazaki S, Mori T, Fujiwara D. Respiratory Sarcopenia and Sarcopenic Respiratory Disability: Concepts, Diagnosis, and Treatment. J Nutr Health Aging 2021; 25:507-515. [PMID: 33786569 PMCID: PMC7799157 DOI: 10.1007/s12603-021-1587-5] [Citation(s) in RCA: 69] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 12/15/2020] [Indexed: 01/31/2023]
Abstract
The condition of muscle fiber atrophy and weakness that occurs in respiratory muscles along with systemic skeletal muscle with age is known as respiratory sarcopenia. The Japanese Working Group of Respiratory Sarcopenia of the Japanese Association of Rehabilitation Nutrition narratively reviews these areas, and proposes the concept and diagnostic criteria. We have defined respiratory sarcopenia as "whole-body sarcopenia and low respiratory muscle mass followed by low respiratory muscle strength and/or low respiratory function." Respiratory sarcopenia can be caused by various factors such as aging, decreased activity, undernutrition, disease, cachexia, and iatrogenic causes. We have also created an algorithm for diagnosing respiratory sarcopenia. Respiratory function decreases with age in healthy older people, along with low respiratory muscle mass and strength. We have created a new term, "Presbypnea," meaning a decline in respiratory function with aging. Minor functional respiratory disability due to aging, such as that indicated by a modified Medical Research Council level 1 (troubled by shortness of breath when hurrying or walking straight up hill), is an indicator of presbypnea. We also define sarcopenic respiratory disability as "a disability with deteriorated respiratory function that results from respiratory sarcopenia." Sarcopenic respiratory disability is diagnosed if respiratory sarcopenia is present with functional disability. Cases of respiratory sarcopenia without functional disability are diagnosed as "at risk of sarcopenic respiratory disability." Functional disability is defined as a modified Medical Research Council grade of 2 or more. Rehabilitation nutrition, treatment that combines rehabilitation and nutritional management, may be adequate to prevent and treat respiratory sarcopenia and sarcopenic respiratory disability.
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Affiliation(s)
- A Nagano
- Hidetaka Wakabayashi, MD, PhD, Department of Rehabilitation Medicine, Tokyo Women's Medical University Hospital, 8-1, Kawada-cho, Shinjuku-ku, Tokyo, Japan. Code; 162-0054, Tel: +81-3-3353-8111, Fax: +81-3-5269-7639, E-mail:
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11
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Finkel D, Ernsth Bravell M, Pedersen NL. Role of motor function and lung function in pathways to ageing and decline. Aging Clin Exp Res 2020; 32:2479-2487. [PMID: 32056153 PMCID: PMC7680325 DOI: 10.1007/s40520-020-01494-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 01/22/2020] [Indexed: 11/26/2022]
Abstract
Background Extensive research has investigated the association between age changes in various domains, including lung function and motor function. However, a few analyses have tested models that incorporate bidirectional longitudinal influences between lung and motor function to test the temporal chain of events in the disability process. Dual change score models (DCSM) assist with identification of leading indicators of change by leveraging longitudinal data to examine the extent to which changes in one variable influence subsequent changes in a second variable, and vice versa. Aims The purpose of the current-analysis study was to apply DCSM to data from the Swedish Adoption/Twin Study of ageing to examine the nature of the longitudinal relationship between motor functioning and lung function. Methods Three motor functioning factors were created from 20 performance measures, including measures of balance, flexibility, and fine motor skills. Peak expiratory flow measured lung function. Participants were 829 adults aged 50–88 at the first of 9 waves of testing covering a 27-year follow-up period; 80% participated in at least three waves. Results Model comparisons indicated that decline in lung function preceded and contributed to subsequent decline in motor function. Discussion Combined with previous results, these results suggest that declining lung function results in increasing difficulties in motor function, which contribute to subsequent declines in multiple domains. Conclusion Understanding the cascade of events that can lead to dependence can help in the development of interventions targeted early in the disablement process. Electronic supplementary material The online version of this article (10.1007/s40520-020-01494-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Deborah Finkel
- Department of Psychology, Indiana University Southeast, New Albany, IN, USA.
- School of Health and Welfare, Jönköping University, Jönköping, Sweden.
| | | | - Nancy L Pedersen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
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12
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Barnes N, Walsh B, Samuel D. Feasibility of Using Strength Measures, Including Peak Inspiratory Flow, for Routine Monitoring in Case Management Patients Aged 65 and Over. Geriatrics (Basel) 2020; 5:E59. [PMID: 32967375 PMCID: PMC7555426 DOI: 10.3390/geriatrics5030059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 09/15/2020] [Accepted: 09/16/2020] [Indexed: 11/17/2022] Open
Abstract
Peak inspiratory flow (PIF) is a portable, relatively new method for measuring respiratory function and indirect muscle strength; the feasibility of its routine clinical measurement is unknown. To investigate the acceptability, reliability and short-term stability of PIF, alongside the established measures of peak expiratory flow (PEF) and grip strength in community dwelling case management patients. Patients were tested in a sitting position, initially on two occasions, one week apart; seven patients having repeated measures taken on a further four occasions over a seven-week period. The best of three attempts for all measures were recorded. Reliability was tested using intra-class correlation coefficient (ICC), standard error of measurement (SEM), minimal detectable change (MDC) and Bland-Altman analysis. Eight patients aged 69-91 years (mean age 81.5 ± 7.7 years; 5 males) participated. For between-day reliability using the first two time points, one week apart the ICCs (3,1) were 0.97, 0.98 and 0.99 for PIF, PEF and grip strength respectively; using all five time points resulted in ICCs of 0.92, 0.99 and 0.99 respectively. Bland-Altman plots also illustrated a good level of agreement across days. Feedback on the acceptability of the measures was gathered from patients. PIF, PEF and grip strength showed excellent reliability and acceptability. Whilst excellent reliability was observed over the seven-week period, the occurrence of clinically significant symptoms and adverse events in the presence of unchanging PIF, PEF and grip strength, suggests that the measures may not be suitable to identify patients with multiple health conditions entering a period of acute decline.
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Affiliation(s)
| | | | - Dinesh Samuel
- Faculty of Environmental and Life Sciences, University of Southampton, Highfield Campus, Southampton SO17 1BJ, UK; (N.B.); (B.W.)
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13
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Kubo H, Asai T, Fukumoto Y, Oshima K, Koyama S, Monjo H, Tajitsu H, Oka T. Comparison of voluntary cough function in community - dwelling elderly and its association with physical fitness. Phys Ther Res 2020; 23:47-52. [PMID: 32850278 DOI: 10.1298/ptr.e10007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 11/12/2019] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To compare the association of cough peak flow (CPF) with aging in community-dwelling older adults and to investigate the relationship between physical fitness and CPF in these individuals. METHOD Two hundred twenty two community-dwelling older adults were enrolled. CPF was assessed as a cough function parameter. Forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1.0) were assessed as respiratory function. Maximal expiratory pressure (MEP) and inspiratory pressure (MIP) were assessed as respiratory muscle strength. The 3-minute walk test (3MWT) performance was assessed as a physical fitness. Participants were divided into the following age groups: 60-64, 65-69, 70-74, 75-79 and 80-89 years. One way analysis of variance were computed for comparison between age group, sex and CPF. Multivariate regression analyses were used to investigate the association of CPF with 3MWT. RESULTS The value of CPF significantly decreased in the 75-79 and 80-89 years group than 60-64 years group in men and in the 80-89 years group than 65-69 years group in women. The value of CPF were 545.5, 497.2, 403.3, 354.8 and 325.4 L/min in the 60-64, 65-69, 70-74, 75-79 and 80-89-year group in men and 263.4, 278.8, 264.5, 214.0, and 193.6 L/min in the corresponding age groups in women, respectively. 3MWT (p = 0.041) was significantly associated with CPF. CONCLUSIONS Cough function tends to decrease with aging in community-dwelling elderly. Physical fitness is associated with cough function.
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Affiliation(s)
- Hiroki Kubo
- Graduate School of Rehabilitation, Kobe Gakuin University.,Department of Rehabilitation, Itami Kousei Neurosurgical Hospital
| | - Tsuyoshi Asai
- Department of Physical Therapy, Faculty of Rehabilitation, Kobe Gakuin University
| | - Yoshihiro Fukumoto
- Department of Physical Medicine and Rehabilitation, Kansai Medical University
| | - Kensuke Oshima
- Graduate School of Rehabilitation, Kobe Gakuin University
| | - Shota Koyama
- Department of Rehabilitation, Saiseikai Hyogoken Hospital
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14
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Vidal MB, Pegorari MS, Santos EC, Matos AP, Pinto ACPN, Ohara DG. Respiratory muscle strength for discriminating frailty in community-dwelling elderly: a cross-sectional study. Arch Gerontol Geriatr 2020; 89:104082. [PMID: 32442847 DOI: 10.1016/j.archger.2020.104082] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 03/24/2020] [Accepted: 04/14/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES To compare obtained and predicted inspiratory and expiratory muscle strength between frail, pre-frail, and non-frail older people; to examine the association between inspiratory and expiratory muscle strength and frailty in older people; and to determine cut-off points for inspiratory and expiratory muscle strength for discriminating frailty in older people. METHODS A cross-sectional study was conducted with 379 community-dwelling older adults. Frailty was assessed using Fried's phenotype, while inspiratory and expiratory muscle strength were measured with maximum inspiratory and maximum expiratory pressures. Inferential analyses were performed using paired Student t-tests, one-way analysis of variance (ANOVA) tests, and a multinomial logistic regression model. ROC curves were constructed to establish cut-off points of maximum inspiratory and expiratory pressures for discriminating frailty and pre-frailty. RESULTS Frail and pre-frail participants presented significantly lower mean inspiratory and expiratory pressures compared to non-frail participants; values were significantly lower than predicted. Inspiratory and expiratory muscle strength were inversely associated with frailty and pre-frailty. Cut-off points ≥-50cmH2O and ≤60cmH2O for maximum inspiratory and expiratory pressures, respectively, were established as optimal discriminators of frailty. The cut-off point ≤65cmH2O for maximum expiratory pressure was established as a discriminant for the presence of pre-frailty. CONCLUSIONS Inspiratory and expiratory muscle strength were lower in frail than in pre-frail older adults, and lower in pre-frail than in non-frail peers. Frailty and pre-frailty were inversely associated with inspiratory and expiratory muscle strength. Cut-off points for inspiratory and expiratory muscle strength may be useful in clinical practice for discriminating frailty and pre-frailty in older adults.
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Affiliation(s)
- Marcela B Vidal
- Department of Biological and Health Sciences, Federal University of Amapá, Macapá, Amapá, Brazil
| | - Maycon S Pegorari
- Department of Biological and Health Sciences, Federal University of Amapá, Macapá, Amapá, Brazil.
| | - Elinaldo C Santos
- Department of Biological and Health Sciences, Federal University of Amapá, Macapá, Amapá, Brazil
| | - Areolino P Matos
- Department of Biological and Health Sciences, Federal University of Amapá, Macapá, Amapá, Brazil
| | - Ana Carolina P N Pinto
- Department of Biological and Health Sciences, Federal University of Amapá, Macapá, Amapá, Brazil
| | - Daniela G Ohara
- Department of Biological and Health Sciences, Federal University of Amapá, Macapá, Amapá, Brazil
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15
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Safety and feasibility of inspiratory muscle training for hospitalized patients undergoing hematopoietic stem cell transplantation: a randomized controlled study. Support Care Cancer 2019; 28:3627-3635. [DOI: 10.1007/s00520-019-05209-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 11/24/2019] [Indexed: 12/16/2022]
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16
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McKenna VS, Huber JE. The Accuracy of Respiratory Calibration Methods for Estimating Lung Volume During Speech Breathing: A Comparison of Four Methods Across Three Adult Cohorts. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2019; 62:2632-2644. [PMID: 31330112 PMCID: PMC6802911 DOI: 10.1044/2019_jslhr-s-18-0478] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 03/09/2019] [Accepted: 04/05/2019] [Indexed: 05/30/2023]
Abstract
Purpose This study evaluated the accuracy of respiratory calibration methods for estimating lung volume during speech breathing. Method Respiratory kinematic data were acquired via inductance plethysmography in 32 young adults, 22 older adults, and 13 older adults with Parkinson's disease (PD). Raw rib cage (RC) and abdomen (AB) signals (V) were calibrated to liters using 4 correction methods: (a) isovolume maneuvers, (b) a constant 2:1 RC-to-AB ratio, (c) least squares method with RC correction only (LsqRC), and (d) least squares method with both RC and AB corrections (LsqRC/AB). Mean percent error, the absolute difference between estimated and actual lung volumes then normalized to each speaker's vital capacity, was calculated for each method. Results For young adults, the LsqRC/AB method significantly reduced mean percent error compared to all other methods. Although LsqRC/AB also resulted in smaller errors for older adults and adults with PD, LsqRC/AB and LsqRC were not significantly different from one another in these groups. Conclusion The LsqRC/AB method reduces errors across all cohorts, but older adults and adults with PD also have reduced errors when using LsqRC. Further research should investigate both least squares methods across larger age and disease severity ranges.
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Affiliation(s)
- Victoria S. McKenna
- Department of Speech, Language, & Hearing Sciences, Purdue University, West Lafayette, IN
| | - Jessica E. Huber
- Department of Speech, Language, & Hearing Sciences, Purdue University, West Lafayette, IN
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17
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Biernat E, Skrok Ł, Krzepota J. Short-Term and Medium-Term Impact of Retirement on Sport Activity, Self-Reported Health, and Social Activity of Women and Men in Poland. BIOMED RESEARCH INTERNATIONAL 2019; 2019:8383540. [PMID: 31111069 PMCID: PMC6487168 DOI: 10.1155/2019/8383540] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 03/15/2019] [Accepted: 03/21/2019] [Indexed: 11/18/2022]
Abstract
Background. The aim of this study was to assess how retirement affects the short-term (up to 2 years after retirement) and medium-term (2-4 years) sport/exercise activity (S/EA) of Poles. To gain a broader context for interpretation, the effect of retirement on self-rated health status, attitudes, social activity, and sexual life was analysed. Methods. A quasiexperiment utilizing data from the longitudinal study Social Diagnosis and radius-matching method was conducted. Retiring men and women were matched with similar, nonretiring ones to make comparisons of differences in S/EA and other outcomes interpretable in terms of causality. Results. Retirement does not have a significant effect in the short term on S/EA of men (p=.440) and women (p=.340). The satisfaction of men with their health status in this period was improved (p=.007), although they more often declared health problems that impaired their everyday functioning (p=.045). Women rarely reported serious health problems (p=.024). In the medium perspective, retirement had the effect on reducing S/EA in men (p=.012) and various dimensions of their social life. Although men tend to worry more often about their health (p<0.001), they are less likely to suffer from problems with moving (p=.001) and fatigue (p=.013). Despite the fact that women are more often satisfied with their health (p=.027), they also more often complain about heart or chest pain (p=.010), body pain (p=.009), and fatigue (p=.007). Conclusion. It is necessary to prepare employees for retirement much earlier than in the preretirement age. In addition to raising awareness of the effect of S/EA functions, it is necessary to monitor the physical activity of employees and to use appropriate programmes for (1) maintaining motivation among employees who are physically active before they retire and (2) raising awareness and encouraging physical activity in employees who are physically passive.
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Affiliation(s)
- Elżbieta Biernat
- Department of Tourism, Collegium of World Economy, SGH Warsaw School of Economics, al. Niepodległości 162, 02-554 Warsaw, Poland
| | - Łukasz Skrok
- Department of Business Economics, Collegium of World Economy, SGH Warsaw School of Economics, al. Niepodległości 162, 02-554 Warsaw, Poland
| | - Justyna Krzepota
- Department of Physical Culture and Health Promotion, University of Szczecin, al. Piastów 40B blok 6, 71-065 Szczecin, Poland
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18
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Segall LE. The effect of group singing on the voice and swallow function of healthy, sedentary, older adults: A pilot study. ARTS IN PSYCHOTHERAPY 2017. [DOI: 10.1016/j.aip.2017.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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19
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Luvizutto GJ, Dos Santos MRL, Sartor LCA, da Silva Rodrigues JC, da Costa RDM, Braga GP, de Oliveira Antunes LC, Souza JT, de Carvalho Nunes HR, Bazan SGZ, Bazan R. Evaluation of Respiratory Muscle Strength in the Acute Phase of Stroke: The Role of Aging and Anthropometric Variables. J Stroke Cerebrovasc Dis 2017. [PMID: 28647421 DOI: 10.1016/j.jstrokecerebrovasdis.2017.05.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND During hospitalization, stroke patients are bedridden due to neurologic impairment, leading to loss of muscle mass, weakness, and functional limitation. There have been few studies examining respiratory muscle strength (RMS) in the acute phase of stroke. OBJECTIVE This study aimed to evaluate the RMS of patients with acute stroke compared with predicted values and to relate this to anthropometric variables, risk factors, and neurologic severity. METHODS This is a cross-sectional study in the acute phase of stroke. After admission, RMS was evaluated by maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP); anthropometric data were collected; and neurologic severity was evaluated by the National Institutes of Health Stroke Scale. The analysis of MIP and MEP with predicted values was performed by chi-square test, and the relationship between anthropometric variables, risk factors, and neurologic severity was determined through multiple linear regression followed by residue analysis by the Shapiro-Wilk test; P < .05 was considered statistically significant. RESULTS In the 32 patients studied, MIP and MEP were reduced when compared with the predicted values. MIP declined significantly by 4.39 points for each 1 kg/m2 increase in body mass index (BMI), and MEP declined significantly by an average of 3.89 points for each 1 kg/m2 increase in BMI. There was no statistically significant relationship between MIP or MEP and risk factors, and between MIP or MIP and neurologic severity in acute phase of stroke. CONCLUSION There is a reduction of RMS in the acute phase of stroke, and RMS was lower in individuals with increased age and BMI.
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Affiliation(s)
- Gustavo José Luvizutto
- Department of Applied Physical Therapy - Institute of Health Sciences, Federal University of Triângulo Mineiro (UFTM), Uberaba, MG, Brazil.
| | - Maria Regina Lopes Dos Santos
- Department of Applied Physical Therapy - Institute of Health Sciences, Federal University of Triângulo Mineiro (UFTM), Uberaba, MG, Brazil
| | - Lorena Cristina Alvarez Sartor
- Department of Applied Physical Therapy - Institute of Health Sciences, Federal University of Triângulo Mineiro (UFTM), Uberaba, MG, Brazil
| | | | - Rafael Dalle Molle da Costa
- Department of Applied Physical Therapy - Institute of Health Sciences, Federal University of Triângulo Mineiro (UFTM), Uberaba, MG, Brazil
| | - Gabriel Pereira Braga
- Department of Neurology, Psychology and Psychiatry, Botucatu Medical School (UNESP), Botucatu, SP, Brazil
| | | | - Juli Thomaz Souza
- Department of Internal Medicine, Botucatu Medical School (UNESP), Botucatu, SP, Brazil
| | | | | | - Rodrigo Bazan
- Department of Neurology, Psychology and Psychiatry, Botucatu Medical School (UNESP), Botucatu, SP, Brazil
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20
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Rahman NNAA, Singh DKA, Lee R. Correlation between thoracolumbar curvatures and respiratory function in older adults. Clin Interv Aging 2017; 12:523-529. [PMID: 28352165 PMCID: PMC5358964 DOI: 10.2147/cia.s110329] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Aging is associated with alterations in thoracolumbar curvatures and respiratory function. Research information regarding the correlation between thoracolumbar curvatures and a comprehensive examination of respiratory function parameters in older adults is limited. The aim of the present study was to examine the correlation between thoracolumbar curvatures and respiratory function in community-dwelling older adults. Thoracolumbar curvatures (thoracic and lumbar) were measured using a motion tracker. Respiratory function parameters such as lung function, respiratory rate, respiratory muscle strength and respiratory muscle thickness (diaphragm and intercostal) were measured using a spirometer, triaxial accelerometer, respiratory pressure meter and ultrasound imaging, respectively. Sixty-eight community-dwelling older males and females from Kuala Lumpur, Malaysia, with mean (standard deviation) age of 66.63 (5.16) years participated in this cross-sectional study. The results showed that mean (standard deviation) thoracic curvature angle and lumbar curvature angles were -46.30° (14.66°) and 14.10° (10.58°), respectively. There was a significant negative correlation between thoracic curvature angle and lung function (forced expiratory volume in 1 second: r=-0.23, P<0.05; forced vital capacity: r=-0.32, P<0.05), quiet expiration intercostal thickness (r=-0.22, P<0.05) and deep expiration diaphragm muscle thickness (r=-0.21, P<0.05). The lumbar curvature angle had a significant negative correlation with respiratory muscle strength (r=-0.29, P<0.05) and diaphragm muscle thickness at deep inspiration (r=-0.22, P<0.05). However, respiratory rate was correlated neither with thoracic nor with lumbar curvatures. The findings of this study suggest that increase in both thoracic and lumbar curvatures is correlated with decrease in respiratory muscle strength, respiratory muscle thickness and some parameters of lung function. Clinically, both thoracic and lumbar curvatures, respiratory muscles and lung function should be taken into consideration in the holistic management of respiratory function among older adults.
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Affiliation(s)
- Nor Najwatul Akmal Ab Rahman
- Physiotherapy Programme, School of Rehabilitation Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, Malaysia
| | - Devinder Kaur Ajit Singh
- Physiotherapy Programme, School of Rehabilitation Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, Malaysia
| | - Raymond Lee
- School of Applied Sciences, London South Bank University, London, UK
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21
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Roman MA, Rossiter HB, Casaburi R. Exercise, ageing and the lung. Eur Respir J 2016; 48:1471-1486. [PMID: 27799391 DOI: 10.1183/13993003.00347-2016] [Citation(s) in RCA: 85] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Accepted: 06/27/2016] [Indexed: 02/07/2023]
Abstract
This review provides a pulmonary-focused description of the age-associated changes in the integrative physiology of exercise, including how declining lung function plays a role in promoting multimorbidity in the elderly through limitation of physical function. We outline the ageing of physiological systems supporting endurance activity: 1) coupling of muscle metabolism to mechanical power output; 2) gas transport between muscle capillary and mitochondria; 3) matching of muscle blood flow to its requirement; 4) oxygen and carbon dioxide carrying capacity of the blood; 5) cardiac output; 6) pulmonary vascular function; 7) pulmonary oxygen transport; 8) control of ventilation; and 9) pulmonary mechanics and respiratory muscle function. Deterioration in function occurs in many of these systems in healthy ageing. Between the ages of 25 and 80 years pulmonary function and aerobic capacity each decline by ∼40%. While the predominant factor limiting exercise in the elderly likely resides within the function of the muscles of ambulation, muscle function is (at least partially) rescued by exercise training. The age-associated decline in pulmonary function, however, is not recovered by training. Thus, loss in pulmonary function may lead to ventilatory limitation in exercise in the active elderly, limiting the ability to accrue the health benefits of physical activity into senescence.
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Affiliation(s)
- Michael A Roman
- Division of Respiratory Medicine, Rockyview Hospital, University of Calgary, Calgary, AB, Canada
| | - Harry B Rossiter
- Rehabilitation Clinical Trials Center, Division of Respiratory and Critical Care Physiology and Medicine, Los Angeles Biomedical Research Institute, Torrance, CA, USA.,Faculty of Biological Sciences, University of Leeds, Leeds, UK
| | - Richard Casaburi
- Rehabilitation Clinical Trials Center, Division of Respiratory and Critical Care Physiology and Medicine, Los Angeles Biomedical Research Institute, Torrance, CA, USA
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Abstract
This article elicits why critical care nurses need to become aware of the pulmonary issues of older adults. The population of older adults is increasing. Older adults undergo anatomic and physiologic changes of the protective mechanisms of the pulmonary system. These changes alter the rate and effort of breathing. Speech is slowed because of expiratory strength effort. Cognition changes may be the only indication of impaired oxygenation. Bedside nursing care provides protection from pulmonary complications. Health behaviors of smoking cessation, oral hygiene, and exercise promote pulmonary health even in older adults.
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Affiliation(s)
- Delia E Frederick
- School of Nursing, The University of North Carolina at Greensboro, Unit #9, 44 White Oak Street, Franklin, NC 28734, USA.
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23
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Kweon M, Son SM, Kwon YH. The effect of aging on respiratory synergy. J Phys Ther Sci 2015; 27:997-9. [PMID: 25995541 PMCID: PMC4434032 DOI: 10.1589/jpts.27.997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Accepted: 11/28/2014] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The purpose of this study was to investigate the effect of aging on respiratory
synergy, through the comparison of an elderly group and a young group, to help further
understanding of postural control in the elderly. [Subjects and Methods] Ten
community-dwelling elderly subjects and ten young subjects performed standing under two
different respiratory conditions: quiet breathing and apnea. Center of foot pressure
displacement and joint angular movements of the head, trunk, pelvis, hips, knees and
ankles were measured. [Results] The results of this study showed that the elderly group
had a respiratory synergy different from that of the young group. The elderly group in
quiet stance used significantly more hip and pelvis movements when compensating for
respiratory disturbance than standing with apnea, while the young group used significantly
more whole body segments. There were no differences in angular displacements in the quiet
stance between the elderly and the young groups. [Conclusion] The elderly group
demonstrated a respiratory synergy pattern different from that of the young group. The
findings indicate that aging changes the respiratory synergy pattern and this change is
not due to decreased functioning of the ankle joint alone.
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Affiliation(s)
- Migyoung Kweon
- Department of Physical Therapy, Yeungnam University College, Republic of Korea
| | - Sung Min Son
- Department of Physical Therapy, College of Health Science, Cheongju University, Republic of Korea
| | - Yong Hyun Kwon
- Department of Physical Therapy, Yeungnam University College: 170 Hyungchung-ro, Namgu, Daegu 705-703, Republic of Korea
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Hsu WH, Chen CL, Kuo LT, Fan CH, Lee MS, Hsu RWW. The relationship between health-related fitness and quality of life in postmenopausal women from Southern Taiwan. Clin Interv Aging 2014; 9:1573-9. [PMID: 25258526 PMCID: PMC4172032 DOI: 10.2147/cia.s66310] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Health-related fitness has been reported to be associated with improved quality of life (QoL) in the elderly. Health-related fitness is comprised of several dimensions that could be enhanced by specific training regimens. It has remained unclear how various dimensions of health-related fitness interact with QoL in postmenopausal women. Objective The purpose of the current study was to investigate the relationship between the dimensions of health-related fitness and QoL in elderly women. Methods A cohort of 408 postmenopausal women in a rural area of Taiwan was prospectively collected. Dimensions of health-related fitness, consisting of muscular strength, balance, cardiorespiratory endurance, flexibility, muscle endurance, and agility, were assessed. QoL was determined using the Short Form Health Survey (SF-36). Differences between age groups (stratified by decades) were calculated using a one-way analysis of variance (ANOVA) and multiple comparisons using a Scheffé test. A Spearman’s correlation analysis was performed to examine differences between QoL and each dimension of fitness. Multiple linear regression with forced-entry procedure was performed to evaluate the effects of health-related fitness. A P-value of <0.05 was considered statistically significant. Results Age-related decreases in health-related fitness were shown for sit-ups, back strength, grip strength, side steps, trunk extension, and agility (P<0.05). An age-related decrease in QoL, specifically in physical functioning, role limitation due to physical problems, and physical component score, was also demonstrated (P<0.05). Multiple linear regression analyses demonstrated that back strength significantly contributed to the physical component of QoL (adjusted beta of 0.268 [P<0.05]). Conclusion Back strength was positively correlated with the physical component of QoL among the examined dimensions of health-related fitness. Health-related fitness, as well as the physical component of QoL, declined with increasing age.
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Affiliation(s)
- Wei-Hsiu Hsu
- Sports Medicine Center, Chang Gung Memorial Hospital at Chia Yi, Chia Yi, Taiwan ; Division of Sports Medicine, Department of Orthopedic Surgery, Chang Gung Memorial Hospital at Chia Yi, Chia Yi, Taiwan ; Department of Medicine, Chang Gung University, Tao Yuan, Taiwan
| | - Chi-lung Chen
- Division of Sports Medicine, Department of Orthopedic Surgery, Chang Gung Memorial Hospital at Chia Yi, Chia Yi, Taiwan
| | - Liang Tseng Kuo
- Division of Sports Medicine, Department of Orthopedic Surgery, Chang Gung Memorial Hospital at Chia Yi, Chia Yi, Taiwan
| | - Chun-Hao Fan
- Sports Medicine Center, Chang Gung Memorial Hospital at Chia Yi, Chia Yi, Taiwan
| | - Mel S Lee
- Division of Sports Medicine, Department of Orthopedic Surgery, Chang Gung Memorial Hospital at Chia Yi, Chia Yi, Taiwan
| | - Robert Wen-Wei Hsu
- Division of Sports Medicine, Department of Orthopedic Surgery, Chang Gung Memorial Hospital at Chia Yi, Chia Yi, Taiwan
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Cebrià I Iranzo MDÀ, Tortosa-Chuliá MÁ, Igual-Camacho C, Sancho P, Galiana L, Tomás JM. [Cost-consequence analysis of respiratory preventive intervention among institutionalized older people: randomized controlled trial]. Rev Esp Geriatr Gerontol 2014; 49:203-209. [PMID: 24417971 DOI: 10.1016/j.regg.2013.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Revised: 11/13/2013] [Accepted: 11/19/2013] [Indexed: 06/03/2023]
Abstract
INTRODUCTION The institutionalized elderly with functional impairment show a greater decline in respiratory muscle (RM) function. The aims of the study are to evaluate outcomes and costs of RM training using Pranayama in institutionalized elderly people with functional impairment. MATERIAL AND METHODS A randomized controlled trial was conducted on institutionalized elderly people with walking limitation (n=54). The intervention consisted of 6 weeks of Pranayama RM training (5 times/week). The outcomes were measured at 4 time points, and were related to RM function: the maximum respiratory pressures and the maximum voluntary ventilation. Perceived satisfaction in the experimental group (EG) was assessed by means of an ad hoc questionnaire. Direct and indirect costs were estimated from the social perspective. RESULTS The GE showed a significant improvement related with strength (maximum respiratory pressures) and endurance (maximum voluntary ventilation) of RM. Moreover, 92% of the EG reported a high satisfaction. The total social costs, direct and indirect, amounted to Euro 21,678. CONCLUSIONS This evaluation reveals that RM function improvement is significant, that intervention is well tolerated and appreciated by patients, and the intervention costs are moderate.
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Affiliation(s)
- Maria Dels Àngels Cebrià I Iranzo
- Departament de Fisioteràpia, Universitat de València, Valencia, España; Servicio de Rehabilitación, Hospital Universitari i Politècnic La Fe, Valencia, España.
| | | | - Celedonia Igual-Camacho
- Departament de Fisioteràpia, Universitat de València, Valencia, España; Servicio de Rehabilitación, Hospital Clínic Universitari, Valencia, España
| | - Patricia Sancho
- Departament de Metodologia de les Ciències del Comportament, Universitat de València, Valencia, España
| | - Laura Galiana
- Departament de Metodologia de les Ciències del Comportament, Universitat de València, Valencia, España
| | - José Manuel Tomás
- Departament de Metodologia de les Ciències del Comportament, Universitat de València, Valencia, España
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Lopes EDDS, Ruas G, Patrizzi LJ. Efeitos de exercícios do método Pilates na força muscular respiratória de idosas: um ensaio clínico. REVISTA BRASILEIRA DE GERIATRIA E GERONTOLOGIA 2014. [DOI: 10.1590/1809-9823.2014.13093] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
INTRODUÇÃO: Dentre os sistemas do organismo, acredita-se que o respiratório seja o que envelhece mais rapidamente, devido à maior exposição a poluentes ambientais ao longo dos anos. O método Pilates surge como forma de condicionamento físico particularmente interessado em proporcionar bem-estar geral ao indivíduo. OBJETIVO: Avaliar os efeitos de exercícios do método Pilates na força muscular respiratória de idosas antes e após 11 semanas de treinamento. Métodos: Trata-se de ensaio clínico, longitudinal e prospectivo. Foram selecionadas sete mulheres com idade igual e superior a 60 anos e com autonomia cognitiva preservada. A Prova de Função Pulmonar (Espirometria) foi realizada por meio do espirômetro marca Vitalograph(r) modelo 8600. A força muscular respiratória foi obtida pelas técnicas de medidas da pressão inspiratória máxima e pressão expiratória máxima, por meio de um manovacuômetro analógico da marca Gerar. O período experimental foi de 11 semanas. Para a análise comparativa dos dados obtidos nas avaliações, foi aplicado o teste t pareado e nível de significância de 5%. RESULTADOS: Os resultados do estudo mostraram aumento significativo (p≤0,01) em relação à pressão expiratória máxima de 46±18 para 75±29 cmH2O. CONCLUSÃO: Os resultados apresentaram aumento significativo na pressão expiratória máxima, sendo o método Pilates uma das práticas recomendadas à população idosa.
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Giua R, Pedone C, Scarlata S, Carrozzo I, Rossi FF, Valiani V, Incalzi RA. Relationship Between Respiratory Muscle Strength and Physical Performance in Elderly Hospitalized Patients. Rejuvenation Res 2014; 17:366-71. [DOI: 10.1089/rej.2014.1549] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Affiliation(s)
- Renato Giua
- Area di Geriatria, Policlinico Universitario “Campus Bio-Medico”, Rome, Italy
| | - Claudio Pedone
- Area di Geriatria, Policlinico Universitario “Campus Bio-Medico”, Rome, Italy
- Fondazione “Alberto Sordi”, Rome, Italy
| | - Simone Scarlata
- Area di Geriatria, Policlinico Universitario “Campus Bio-Medico”, Rome, Italy
| | - Irma Carrozzo
- Area di Geriatria, Policlinico Universitario “Campus Bio-Medico”, Rome, Italy
| | | | - Vincenzo Valiani
- Area di Geriatria, Policlinico Universitario “Campus Bio-Medico”, Rome, Italy
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Cebrià i Iranzo MDÀ, Arnall DA, Camacho CI, Tomás JM. Effects of Inspiratory Muscle Training and Yoga Breathing Exercises on Respiratory Muscle Function in Institutionalized Frail Older Adults. J Geriatr Phys Ther 2014; 37:65-75. [DOI: 10.1519/jpt.0b013e31829938bb] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Barnes N, Agyapong-Badu S, Walsh B, Stokes M, Samuel D. Reliability and acceptability of measuring sniff nasal inspiratory pressure (SNIP) and peak inspiratory flow (PIF) to assess respiratory muscle strength in older adults: a preliminary study. Aging Clin Exp Res 2014; 26:171-6. [PMID: 24085656 DOI: 10.1007/s40520-013-0146-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2013] [Accepted: 09/16/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND Sniff nasal inspiratory pressure (SNIP) and peak oral inspiratory flow (PIF) are portable, relatively new methods for indirect measurement of respiratory muscle strength. The reliability and acceptability of these measures were investigated in older adults. METHODS The study included 21 self-reported healthy adults, aged 65-84 years (mean 73.5; SD 6.4 years). Participants were tested in a sitting position on two occasions, 1 week apart. The best of three attempts for PIF measured through the mouth, and five for each nostril for SNIP were recorded. Reliability was tested using intra-class correlation coefficient (ICC), standard error of measurement, minimal detectable change (MDC) and Bland and Altman analysis. Feedback on the measures in relation to ease of completion and preference was obtained using a semi-structured interview. RESULTS Between-day reliability of SNIP and PIF were ICC3,1 0.76 (95 % CI 0.49-0.9) and 0.92 (0.81-0.97), respectively. Standard error of measurement for SNIP (11.94 cmH2O) and MDC (33.10 cmH2O) were at the least 61 % higher than for PIF. The participants reported difficulties in performing SNIP, rating it as being less easy and uncomfortable to perform than PIF, with a higher rate of missing data for SNIP due to participants' dislike of the test. CONCLUSIONS The wide range of SNIP readings, lower ICC value and negative user feedback are suggestive of a less robust and unacceptable clinical measure. PIF showed excellent reliability and acceptability and is therefore recommended for assessing inspiratory muscle strength in older people without known obstructive lung disease.
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Affiliation(s)
- Nicola Barnes
- Faculty of Health Sciences, University of Southampton, Building 45, Highfield Campus, Southampton, SO17 1BJ, UK
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Neves LMT, Karsten M, Neves VR, Beltrame T, Borghi-Silva A, Catai AM. Respiratory muscle endurance is limited by lower ventilatory efficiency in post-myocardial infarction patients. Braz J Phys Ther 2014; 18:1-8. [PMID: 24675907 PMCID: PMC4183236 DOI: 10.1590/s1413-35552012005000134] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2012] [Accepted: 06/18/2013] [Indexed: 11/22/2022] Open
Abstract
Background Reduced respiratory muscle endurance (RME) contributes to increased dyspnea
upon exertion in patients with cardiovascular disease. Objective The objective was to characterize ventilatory and metabolic responses during
RME tests in post-myocardial infarction patients without respiratory muscle
weakness. Method Twenty-nine subjects were allocated into three groups: recent myocardial
infarction group (RG, n=9), less-recent myocardial infarction group (LRG,
n=10), and control group (CG, n=10). They underwent two RME tests
(incremental and constant pressure) with ventilatory and metabolic analyses.
One-way ANOVA and repeated measures one-way ANOVA, both with Tukey post-hoc,
were used between groups and within subjects, respectively. Results Patients from the RG and LRG presented lower metabolic equivalent and
ventilatory efficiency than the CG on the second (50± 06, 50±
5 vs. 42± 4) and third part (50± 11, 51± 10 vs.
43± 3) of the constant pressure RME test and lower metabolic
equivalent during the incremental pressure RME test. Additionally, at the
peak of the incremental RME test, RG patients had lower oxygen uptake than
the CG. Conclusions Post-myocardial infarction patients present lower ventilatory efficiency
during respiratory muscle endurance tests, which appears to explain their
inferior performance in these tests even in the presence of lower pressure
overload and lower metabolic equivalent.
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Affiliation(s)
- Laura M T Neves
- Cardiovascular Physical Therapy Laboratory, Nucleus of Research in Physical Exercise, Universidade Federal de Sao Carlos, Sao Carlos, SP, Brazil
| | - Marlus Karsten
- Cardiovascular Physical Therapy Laboratory, Nucleus of Research in Physical Exercise, Universidade Federal de Sao Carlos, Sao Carlos, SP, Brazil
| | - Victor R Neves
- Cardiovascular Physical Therapy Laboratory, Nucleus of Research in Physical Exercise, Universidade Federal de Sao Carlos, Sao Carlos, SP, Brazil
| | - Thomas Beltrame
- Cardiovascular Physical Therapy Laboratory, Nucleus of Research in Physical Exercise, Universidade Federal de Sao Carlos, Sao Carlos, SP, Brazil
| | - Audrey Borghi-Silva
- Cardiovascular Physical Therapy Laboratory, Nucleus of Research in Physical Exercise, Universidade Federal de Sao Carlos, Sao Carlos, SP, Brazil
| | - Aparecida M Catai
- Cardiovascular Physical Therapy Laboratory, Nucleus of Research in Physical Exercise, Universidade Federal de Sao Carlos, Sao Carlos, SP, Brazil
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Albuquerque IMD, Rossoni CS, Cardoso DM, Paiva DN, Fregonezi G. Effects of short inspiratory muscle training on inspiratory muscle strength and functional capacity in physically active elderly: A quasi-experimental study. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2013. [DOI: 10.3109/21679169.2013.764925] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Abd El-Kader SM, El-Den Ashmawy EMS. Aerobic Exercise Training and Incentive Spirometry Can Control Age-Related Respiratory Muscles Performance Changes in Elderly. ELECTRONIC JOURNAL OF GENERAL MEDICINE 2013. [DOI: 10.29333/ejgm/82360] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Intervención fisioterápica preventiva del deterioro de la musculatura respiratoria en ancianas institucionalizadas con limitación funcional. Arch Bronconeumol 2013; 49:1-9. [DOI: 10.1016/j.arbres.2012.07.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2012] [Revised: 07/18/2012] [Accepted: 07/31/2012] [Indexed: 11/23/2022]
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Relationship between inspiratory muscle capacity and peak exercise tolerance in patients post-myocardial infarction. Heart Lung 2012; 41:137-45. [DOI: 10.1016/j.hrtlng.2011.07.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2010] [Revised: 07/20/2011] [Accepted: 07/27/2011] [Indexed: 11/21/2022]
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Pernambuco CS, Rodrigues BM, Bezerra JCP, Carrielo A, Fernandes ADDO, Vale RGDS, Dantas EHM. Quality of life, elderly and physical activity. Health (London) 2012. [DOI: 10.4236/health.2012.42014] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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An implication of the short physical performance battery (SPPB) as a predictor of abnormal pulmonary function in aging people. Arch Gerontol Geriatr 2011; 54:448-52. [PMID: 21511347 DOI: 10.1016/j.archger.2011.03.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2010] [Revised: 03/06/2011] [Accepted: 03/15/2011] [Indexed: 11/21/2022]
Abstract
If association between the decline in physical performance and the decline in pulmonary function is confirmed, the SPPB could be used as a predictor for pulmonary functional declines in aging people because of its convenient use. This study aimed to elucidate the association of the SPPB with the pulmonary function test (PFT) to determine the usefulness of the SPPB as a predictor of PFT decline. The SPPB and PFT were performed on random sample nested in the Korean Longitudinal Study of Aging (KLoSA) panel, a national representative sample of aging people in Korea. Comparisons of adjusted means of forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), forced expiratory ratio (FER) defined as FEV1/FVC between normal and abnormal SPPB groups were performed using the t-test. The association between PFT and SPPB abnormality was examined using multiple logistic regression analysis. Additionally, the associations of gait speed and chair stand time with FEV1 and FVC were examined using multiple linear regression analysis. Five hundred and eighteen subjects were included in analysis. Approximately 43% (222/518) of the subjects were male and 65% (338/518) were 60 years or older. Adjusted means of FEV1 and FER were significantly or marginally lower when SPPB score was abnormal in both overall and non-smoking men (p=0.009 and 0.053 for overall, p<0.001 and p<0.080 for non-smokers), but FVC was lower only in non-smoking men (p=0.024). Abnormal SPPB score was significantly associated with abnormal PFT regardless of sex. (adjusted odds ratio=OR=3.76, 95%CI=1.96-7.22 for men, adjusted OR=2.11, 95%CI 1.28-3.47 for women). Gait speed was significantly or marginally associated with FEV1 and FVC in participants 60 years or older, regardless of sex. We conclude that abnormal SPPB score was associated with abnormal pulmonary function. Thus, the SPPB has the potential to be used as an early predictor of abnormal pulmonary function in clinical settings and epidemiological study.
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Costa D, Gonçalves HA, Lima LPD, Ike D, Cancelliero KM, Montebelo MIDL. New reference values for maximal respiratory pressures in the Brazilian population. J Bras Pneumol 2010; 36:306-12. [PMID: 20625667 DOI: 10.1590/s1806-37132010000300007] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2009] [Accepted: 01/07/2010] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To compare MIP and MEP determined in healthy subjects with those predicted using the equations proposed in another study, and, if necessary, to suggest new equations for MIP and MEP to be used in the Brazilian population. METHODS The study sample comprised 60 healthy males and 60 healthy females, 20-80 years of age (20 subjects per ten-year age bracket). Maximal respiratory pressures were determined following a standardized protocol. RESULTS Regarding MIP, the measured values were significantly lower than those predicted for both males (31%) and females (24%). There were no significant differences between measured and predicted MEP in either gender. We found that age presented the greatest power to predict MIP and MEP in both genders. New equations were proposed. CONCLUSIONS The previously proposed equations were unable to predict MIP and MEP for all of the subjects in our sample. Therefore, the results of this study can facilitate the prediction of respiratory muscle strength in healthy adult subjects in Brazil. Further studies, involving subjects from different regions of the country, could lead to the development of better tables or equations for maximal respiratory pressures in the Brazilian population.
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Affiliation(s)
- Dirceu Costa
- Universidade Federal de São Carlos, Federal University of São Carlos, São Carlos, SP, Brazil .
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Matteini AM, Fallin MD, Kammerer CM, Schupf N, Yashin AI, Christensen K, Arbeev KG, Barr G, Mayeux R, Newman AB, Walston JD. Heritability estimates of endophenotypes of long and health life: the Long Life Family Study. J Gerontol A Biol Sci Med Sci 2010; 65:1375-9. [PMID: 20813793 PMCID: PMC2990267 DOI: 10.1093/gerona/glq154] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2010] [Accepted: 07/13/2010] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Identification of gene variants that contribute to exceptional survival may provide critical biologic information that informs optimal health across the life span. METHODS As part of phenotype development efforts for the Long Life Family Study, endophenotypes that represent exceptional survival were identified and heritability estimates were calculated. Principal components (PCs) analysis was carried out using 28 physiologic measurements from five trait domains (cardiovascular, cognition, physical function, pulmonary, and metabolic). RESULTS The five most dominant PCs accounted for 50% of underlying trait variance. The first PC (PC1), which consisted primarily of poor pulmonary and physical function, represented 14.3% of the total variance and had an estimated heritability of 39%. PC2 consisted of measures of good metabolic and cardiovascular function with an estimated heritability of 27%. PC3 was made up of cognitive measures (h(2) = 36%). PC4 and PC5 contained measures of blood pressure and cholesterol, respectively (h(2) = 25% and 16%). CONCLUSIONS These PCs analysis-derived endophenotypes may be used in genetic association studies to help identify underlying genetic mechanisms that drive exceptional survival in this and other populations.
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Affiliation(s)
- Amy M Matteini
- Johns Hopkins Asthma and Allergy Center, 5501 Hopkins Bayview Circle, Baltimore, MD 21224, USA.
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Feeney C, Hussey J, Carey M, Reynolds JV. Assessment of physical fitness for esophageal surgery, and targeting interventions to optimize outcomes. Dis Esophagus 2010; 23:529-39. [PMID: 20459443 DOI: 10.1111/j.1442-2050.2010.01058.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
This review examines how higher levels of physiological reserve and fitness can help the patient endure the demands of esophageal surgery. Lung function, body composition, cardiac function, inflammatory mediators and exercise performance are all determinants of fitness. Physical fitness, both as an independent risk factor and through its effect on other risk factors, has been found to be significantly associated with the risk of developing postoperative pulmonary complications (PPCs) in patients following esophagectomy. Respiratory dysfunction preoperatively poses the dominant risk of developing complications, and PPCs are the most common causes of morbidity and mortality. The incidence of PPCs is between 15 and 40% with an associated 4.5-fold increase in operative mortality leading to approximately 45% of all deaths post-esophagectomy. Cardiac complications are the other principal postoperative complications, and pulmonary and cardiac complications are reported to account for up to 70% of postoperative deaths after esophagectomy. Risk reduction in patients planned for surgery is key in attaining optimal outcomes. The goal of this review was to discuss the risk factors associated with the development of postoperative pulmonary complications and how these may be modified prior to surgery with a specific focus on the pulmonary complications associated with esophageal resection. There are few studies that have examined the effect of modifying physical fitness pre-esophageal surgery. The data to date would indicate a need to develop targeted interventions preoperatively to increase physical function with the aim of decreasing postoperative complications.
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Affiliation(s)
- C Feeney
- Department of Physiotherapy, St. James's Hospital and Trinity College Dublin, Dublin, Ireland
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Simões RP, Castello V, Auad MA, Dionísio J, Mazzonetto M. Prevalence of reduced respiratory muscle strength in institutionalized elderly people. SAO PAULO MED J 2009; 127:78-83. [PMID: 19597682 PMCID: PMC10964805 DOI: 10.1590/s1516-31802009000200005] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2008] [Revised: 03/23/2009] [Accepted: 03/31/2009] [Indexed: 11/22/2022] Open
Abstract
CONTEXT AND OBJECTIVES Respiratory muscle strength is relevant to the clinical situation of elderly patients, particularly those presenting with respiratory or cardiac diseases. The objectives of this study were to evaluate the respiratory muscle strength of institutionalized elderly women, compare this with predicted values for the Brazilian population and calculate the correlation with age and anthropometric characteristics. DESIGN AND SETTING Cross-sectional study at the Department of Physiotherapy of Universidade Camilo Castelo Branco. METHODS The participants were 56 institutionalized elderly women (74.87 +/- 10.55 years of age), evaluated in eight institutions in three cities in the central region of the State of São Paulo, between January 2005 and March 2006. They were separated into three subgroups according to age: 60-69 years (n = 20), 70-79 (n = 18) and 80-89 years (n = 18). Maximal respiratory pressures were obtained using a manovacuometer. The values obtained were compared between subgroups and with predicted values. Correlation analysis was used to evaluate age, weight, height and body mass index in relation to maximal respiratory pressures. The significance level was P < 0.05. RESULTS No significant differences in maximal respiratory pressures were seen between the three subgroups. The maximal respiratory pressures were significantly lower in the three subgroups, compared with predicted values. Negative correlations between maximal respiratory pressures and age and positive correlations in relation to weight, height and body mass index were found. CONCLUSIONS Respiratory muscle strength was markedly reduced in institutionalized 60 to 89-year-old women and the values demonstrated correlations with age and anthropometric characteristics.
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Affiliation(s)
- Rodrigo Polaquini Simões
- Postgraduate Program on Physiotherapy, Cardiopulmonary Physiotherapy Laboratory, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil.
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Liang WM, Chang CH, Yeh YC, Shy HY, Chen HW, Lin MR. Psychometric evaluation of the WHOQOL-BREF in community-dwelling older people in Taiwan using Rasch analysis. Qual Life Res 2009; 18:605-18. [DOI: 10.1007/s11136-009-9471-5] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2007] [Accepted: 03/10/2009] [Indexed: 11/30/2022]
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Abstract
This research examined the effects of respiratory-muscle (RM) training on RM function and exercise performance in older women. Twenty-six women (60-69 yr of age) were assessed for spirometry, RM strength (maximal inspiratory and expiratory pressure), inspiratory-muscle endurance, and walking performance to a perceived exertion rating of "hard." They were randomly allocated to a threshold RM training group (RMT) or a nonexercising control group (CON) for 8 wk.After training, the 22% (inspiratory) and 30% (expiratory) improvements in RM strength in the RMT group were significantly higher than in the CON group (p < .05). The RMT group also displayed several significant performance improvements, including improved within-group treadmill performance time (12%) and reductions in submaximal heart rate (5%), percentage of maximum voluntary ventilation (16%), and perceived exertion for breathing (8%). RM training appears to improve RM function in older women. Furthermore, these improvements appear to be related to improved submaximal exercise performance.
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Kenny GP, Yardley JE, Martineau L, Jay O. Physical work capacity in older adults: implications for the aging worker. Am J Ind Med 2008; 51:610-25. [PMID: 18543279 DOI: 10.1002/ajim.20600] [Citation(s) in RCA: 152] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND In many developed countries, the workforce is rapidly aging. Occupational demands however, have not decreased despite the fact that workers see a decline in physical work capacity with age. The purpose of this review is to examine the physiological adaptations to aging, the impact of aging on performance and the benefits of physical fitness in improving functional work capacity in aging individuals. METHODS An extensive search of the scientific literature was performed, acquiring published articles which examined the physiological changes associated with age-related decrements in the physical work capacity of healthy aging adults. The databases accessed included AARP Ageline, AccessScience, Annual Reviews, CISTI, Cochrane Library, Clinical Evidence, Digital Dissertations (Proquest), Embase, HealthSTAR, Medline, PubMed, Scopus, and PASCAL and included relevant information sites obtained on the world wide web. RESULTS While a great deal of variation exists, an average decline of 20% in physical work capacity has been reported between the ages of 40 and 60 years, due to decreases in aerobic and musculoskeletal capacity. These declines can contribute to decreased work capacity, and consequential increases in work-related injuries and illness. However, differences in habitual physical activity will greatly influence the variability seen in individual physical work capacity and its components. Well-organized, management-supported, work-site health interventions encouraging physical activity during work hours could potentially decrease the incidence of age-related injury and illness. CONCLUSIONS Age-associated functional declines and the accompanying risk of work-related injury can be prevented or at least delayed by the practice of regular physical activity. Older workers could optimally pursue their careers until retirement if they continuously maintain their physical training.
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Affiliation(s)
- Glen P Kenny
- Center for Human and Environmental Physiology Research, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada.
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Sultana F, Brisswalter J, Lepers R, Hausswirth C, Bernard T. Effet de l’âge et du sexe sur l’évolution des performances en triathlon olympique. Sci Sports 2008. [DOI: 10.1016/j.scispo.2008.01.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Abstract
INTRODUCTION The purpose of this study was to evaluate the relationship between body composition parameters and lung functions including vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in 1 second (FEV(1)), FEV(1):VC ratio, and FEV(1):FVC ratio in elderly men and women. METHODS The study was a cross-sectional evaluation of 99 healthy men and women (aged 60-88 years). Anthropometric and body composition parameters (including fat mass [FM], fat-free mass [FFM] and percentage body fat [%BF]) were evaluated using the skinfold method, and lung function was examined using spirometry. RESULTS Data analysis showed %BF, body FM and body mass index (BMI) of women to be significantly higher than men. Also, their body FFM was significantly less than men (P<0.05). Lung volume (P<0.01) and lung capacity values (P<0.05) (VC, FVC, FEV(1), FEV(1):VC, FEV(1):FVC) of women were significantly less than men. There was a positive significant relationship between the FFM versus FVC and FEV(1) values of women and men. A negative significant relationship was demonstrated between body FM, BMI and FVC of all subjects. CONCLUSION This investigation showed that women aged between 60 and 88 years had a lower lung capacity compared to men of the same age. Older women were found to have a higher body fat ratio than men, and it was found that increasing %BF and BMI had a negative effect on lung functions in both sexes.
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