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Manifield J, Alexiou C, Megaritis D, Baker K, Adams N, Barry G, Vogiatzis I. Effects of inspiratory muscle training on thoracoabdominal volume regulation in older adults: A randomised controlled trial. Respir Physiol Neurobiol 2024; 326:104278. [PMID: 38735425 DOI: 10.1016/j.resp.2024.104278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 04/22/2024] [Accepted: 05/04/2024] [Indexed: 05/14/2024]
Abstract
OBJECTIVES We investigated the effect of inspiratory muscle training (IMT) on inspiratory muscle strength, functional capacity and respiratory muscle kinematics during exercise in healthy older adults. METHODS 24 adults were randomised into an IMT or SHAM-IMT group. Both groups performed 30 breaths, twice daily, for 8 weeks, at intensities of ∼50 % maximal inspiratory pressure (PImax; IMT) or <15 % PImax (SHAM-IMT). Measurements of PImax, breathing discomfort during a bout of IMT, six-minute walk distance, physical activity levels, and balance were assessed pre- and post-intervention. Respiratory muscle kinematics were assessed via optoelectronic plethysmography (OEP) during constant work rate cycling. RESULTS PImax was significantly improved (by 20.0±11.9 cmH2O; p=0.001) in the IMT group only. Breathing discomfort ratings during IMT significantly decreased (from 3.5±0.9-1.7±0.8). Daily sedentary time was decreased (by 28.0±39.8 min; p=0.042), and reactive balance significantly improved (by 1.2±0.8; p<0.001) in the IMT group only. OEP measures showed a significantly greater contribution of the pulmonary and abdominal rib cage compartments to total tidal volume expansion post-IMT. CONCLUSIONS IMT significantly improves inspiratory muscle strength and breathing discomfort in this population. IMT induces greater rib cage expansion and diaphragm descent during exercise, thereby suggesting a less restrictive effect on thoracic expansion and increased diaphragmatic power generation.
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Affiliation(s)
- James Manifield
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle Upon Tyne NE1 8ST, UK.
| | - Charikleia Alexiou
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle Upon Tyne NE1 8ST, UK
| | - Dimitrios Megaritis
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle Upon Tyne NE1 8ST, UK
| | - Katherine Baker
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle Upon Tyne NE1 8ST, UK
| | - Nicola Adams
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle Upon Tyne NE1 8ST, UK
| | - Gill Barry
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle Upon Tyne NE1 8ST, UK
| | - Ioannis Vogiatzis
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle Upon Tyne NE1 8ST, UK
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Park TS, Kim SH, Shin MJ. Cumulative Effects of Concurrent Inspiratory Muscle Training and Postural Correction Bands on Older Individuals Community Dwellers: A Randomized Study. Yonsei Med J 2024; 65:472-479. [PMID: 39048323 PMCID: PMC11284306 DOI: 10.3349/ymj.2023.0551] [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: 01/03/2024] [Revised: 03/29/2024] [Accepted: 04/01/2024] [Indexed: 07/27/2024] Open
Abstract
PURPOSE Posture correction bands (PCBs) have been proposed as aids to help chest expansion and to enhance respiratory function. However, the impact of PCBs on community-based older individuals engaged in inspiratory muscle training (IMT) at home remains unclear. MATERIALS AND METHODS Community-based individuals aged 65 years and older were divided into the PCB group, wearing PCBs, and the NPCB group, not wearing PCBs. The IMT regimen lasted 8 weeks, with sessions 5 times a week, including 4 sets per day and 15 repetitions per set. Training intensity was set at 50% of the maximum inspiratory pressure of each subject. To assess the effects of IMT, respiratory function, 6-minute walk test, and grip strength were measured before, during, and after the training period. Data were analyzed using repeated-measures analysis of variance, with post-hoc evaluation employing Bonferroni correction. RESULTS A total of 40 subjects were evenly divided into the PCB group and the NPCB group, with 20 subjects in each group. No significant difference was observed in respiratory muscle strength based on PCB use. However, during the initial 4 weeks, the PCB group exhibited a trend towards an increase in respiratory muscle strength compared to the NPCB group; this trend, however, did not prove to be statistically significant by the end of the 8-week period. Performance on the 6-minute walk test significantly improved in both groups. CONCLUSION The PCB group exhibited a tendency for increase in respiratory muscle strength in the first 4 weeks; however, ultimately there was no significant difference compared to the NPCB group. CLINICAL TRIAL REGISTRATION This study was registered with the Clinical Research Information Service, part of the World Health Organization's International Clinical Trials Registry Platform (Clinical Research Information Service No. KCT0008075).
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Affiliation(s)
- Tae Sung Park
- Department of Convergence Medical Institute of Technology, Pusan National University Hospital, Busan, Korea
- Department of Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Sang Hun Kim
- Department of Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
- Department of Rehabilitation Medicine, Pusan National University Hospital, Busan, Korea
- Department of Rehabilitation Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Myung-Jun Shin
- Department of Convergence Medical Institute of Technology, Pusan National University Hospital, Busan, Korea
- Department of Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
- Department of Rehabilitation Medicine, Pusan National University Hospital, Busan, Korea
- Department of Rehabilitation Medicine, Pusan National University School of Medicine, Busan, Korea.
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Mello ESDF, Oliveira ALMB, Santanna TDC, Soares PPDS, Rodrigues GD. Updates in inspiratory muscle training for older adults: A systematic review. Arch Gerontol Geriatr 2024; 127:105579. [PMID: 39032314 DOI: 10.1016/j.archger.2024.105579] [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: 05/07/2024] [Revised: 07/01/2024] [Accepted: 07/13/2024] [Indexed: 07/23/2024]
Abstract
Systematic reviews support the benefits of inspiratory muscle training (IMT) for exercise performance. Recently, many health benefits from IMT have been reported in older adults. Therefore, this work reviewed the literature focusing on IMT effects beyond physical performance in older adults, such as cardiorespiratory, metabolic, and postural balance outcomes. Searches were conducted with the following terms: ("respiratory muscle training" OR "inspiratory muscle training") OR ("inspiratory muscle strength training") AND ("elderly" OR "older" OR "aging" OR "aging"), and using the databases: MEDLINE (PubMed), SCOPUS and EUROPE PMC. Of the 356 articles found, 13 matched the inclusion criteria after screening. Based on reviewed studies, four to eight weeks of IMT (Mostly from 50 % up to 75 % of MIP, 7 days/week) improve cardiac autonomic control at rest and post-exercise, cerebrovascular response to orthostatic stress, static and dynamic balance, blood pressure control, endothelial function, and oxidative stress in older adults. The benefits of IMT in cardiac autonomic and vascular functions are reversed after training cessation. It thus appears that IMT promotes broad physiological gains for the older population. It is necessary to carry out more randomized clinical trials on the subject to confirm the findings of this research.
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Affiliation(s)
- Elissa Silva de Farias Mello
- Department of Physiology and Pharmacology, Fluminense Federal University, Rua Prof. Hernani Pires de Melo 101, Niterói, Brazil
| | | | - Thais Dillinger Conway Santanna
- Department of Physiology and Pharmacology, Fluminense Federal University, Rua Prof. Hernani Pires de Melo 101, Niterói, Brazil
| | - Pedro Paulo da Silva Soares
- Department of Physiology and Pharmacology, Fluminense Federal University, Rua Prof. Hernani Pires de Melo 101, Niterói, Brazil
| | - Gabriel Dias Rodrigues
- Department of Physiology and Pharmacology, Fluminense Federal University, Rua Prof. Hernani Pires de Melo 101, Niterói, Brazil; Department of Clinical Sciences and Community Health, University of Milan, 20122, Milan, Italy.
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Morishita T, Toyama S, Suyama K, Nagata F, Itaki M, Tanaka T, Sato S, Ishimatsu Y, Sawai T, Kozu R. Effect of Inspiratory Muscle Training on Cough Strength in Older People With Frailty: A Single-Blind Randomized Controlled Trial. Arch Phys Med Rehabil 2024:S0003-9993(24)01048-7. [PMID: 38866223 DOI: 10.1016/j.apmr.2024.05.026] [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: 11/07/2023] [Revised: 05/15/2024] [Accepted: 05/22/2024] [Indexed: 06/14/2024]
Abstract
OBJECTIVE To investigate the effect of inspiratory muscle training (IMT) on cough strength in older people with frailty. DESIGN Single-blind randomized controlled trial. SETTING Day health care centers at 2 sites. PARTICIPANTS Older people with frailty (N=60). INTERVENTIONS Eligible people were randomly assigned to receive IMT program in addition to general exercise training (IMT group), or general exercise training alone (control group). The IMT group performed training using a threshold IMT device with the load set at 30% of maximum inspiratory mouth pressure in addition to the general exercise training program throughout the 8 weeks. The IMT took place twice a day and each session consisted of 30 breaths. MAIN OUTCOME MEASURES Primary outcome was cough strength, measured as the cough peak flow (CPF), at the beginning and the end of the program. RESULTS Data from 52 participants (26 in each group) were available for the analysis. The mean age was 82.6 years; 33% were men. The change in CPF at the end of the program was 28.7±44.4 L/min in the IMT group and -7.4±26.6 L/min in the control group. A linear regression model showed that the presence or absence of IMT was associated with changes in CPF (mean difference between groups, 36.3; 95% confidence interval, 16.7-55.9; effect size, 0.99). CONCLUSIONS IMT may be a useful intervention to improve cough strength in frail older people.
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Affiliation(s)
- Tatsuya Morishita
- Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki; Department of Rehabilitation, Tagami Hospital, Nagasaki
| | - Shusuke Toyama
- Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki; Department of Rehabilitation, Tagami Hospital, Nagasaki
| | - Kazuaki Suyama
- Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki; Department of Rehabilitation, Tagami Hospital, Nagasaki
| | - Fumiya Nagata
- Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki; Department of Rehabilitation, Tagami Hospital, Nagasaki
| | | | - Takako Tanaka
- Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki; Department of Rehabilitation, Tagami Hospital, Nagasaki
| | - Shuntaro Sato
- Clinical Research Center, Nagasaki University Hospital, Nagasaki
| | - Yuji Ishimatsu
- Department of Nursing, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Terumitsu Sawai
- Department of Nursing, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Ryo Kozu
- Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki.
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Flor-Rufino C, Pérez-Ros P, Martínez-Arnau FM. Influence of physical exercise on respiratory muscle function in older adults: A systematic review and meta-analysis. Geriatr Nurs 2024; 57:189-198. [PMID: 38685166 DOI: 10.1016/j.gerinurse.2024.04.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 04/12/2024] [Indexed: 05/02/2024]
Abstract
Respiratory function decreases with aging. The literature showed that non-ventilatory specific exercise could have a positive impact on respiratory muscles. A systematic literature review was conducted to assess the effects of non-ventilatory specific exercise on maximal inspiratory (MIP) and expiratory pressure (MEP) and peak expiratory flow (PEF) in older adults. The included 9 trials investigated the effects of resistance training, yoga, Pilates, physical activity based on walking, and whole-body vibration training. The meta-analysis showed no statistically significant differences in MIP, MEP, and PEF after implementation of a non-ventilatory specific exercise program in older individuals. Between-study heterogeneity was substantial for MIP and MEP outcomes but it was not statistically significant for PEF. Further RCTs will be necessary to determine the effects of physical exercise interventions. PROSPERO registry CRD42023478262.
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Affiliation(s)
- Cristina Flor-Rufino
- Department of Physiotherapy, Universitat de Valencia, Gascó Oliag 5, 46010, Valencia, Spain; Department of Physiotherapy, Universidad Europea de Valencia, Paseo de la Alameda, 7, 46010, Valencia
| | - Pilar Pérez-Ros
- Department of Nursing, Universitat de Valencia, Menéndez Pelayo, 19, 46010, Valencia, Spain; Frailty and cognitive impairment Research Group (FROG), University of Valencia, Menéndez y Pelayo, 19, 46010, Valencia, Spain..
| | - Francisco M Martínez-Arnau
- Department of Physiotherapy, Universitat de Valencia, Gascó Oliag 5, 46010, Valencia, Spain; Frailty and cognitive impairment Research Group (FROG), University of Valencia, Menéndez y Pelayo, 19, 46010, Valencia, Spain
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Zarralanga-Lasobras T, Romero-Estarlich V, Carrasco-Paniagua C, Serra-Rexach JA, Mayordomo-Cava J. "Inspiratory muscle weakness in acutely hospitalized patients 75 years and over": a secondary analysis of a randomized controlled trial on the effectiveness of multicomponent exercise and inspiratory muscle training. Eur Geriatr Med 2024; 15:83-94. [PMID: 37755683 DOI: 10.1007/s41999-023-00865-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 09/05/2023] [Indexed: 09/28/2023]
Abstract
PURPOSE The impact of hospitalization for acute illness on inspiratory muscle strength in oldest-old patients is largely unknown, as are the potential benefits of exercise and inspiratory muscle training (IMT) during in-hospital stay. DESIGN AND METHODS This was a sub-study of a randomized clinical trial that evaluated the efficiency of a multicomponent exercise program in preventing hospitalization-associated disability. Patients were randomized into control (CG) and intervention (IG) groups. The intervention included two daily sessions of supervised walking, squat, balance, and IMT. Baseline and discharge maximal inspiratory pressure (MIP) and inspiratory muscle weakness (IMW) were determined. The effect of the intervention on inspiratory muscle strength was assessed by analyzing (1) the differences between groups in baseline and discharge MIP and IMW, (2) the association, patient by patient, between baseline and discharge MIP, and the improvement index (MIP discharge/baseline) in patients with or without IMW. RESULTS In total, 174 patients were assessed (mean age of 87), 57 in CG and 117 in IG. Baseline MIP was lower than predicted in both sexes (women 29.7 vs 44.3; men 36.7 vs 62.5 cmH2O, P < 0.001, baseline vs predicted, respectively). More than 65% of patients showed IMW at admission. In women in IG, the mean MIP was higher at discharge than at admission (P = 0.003) and was the only variable that reached expected reference levels at discharge (Measured MIP 39.2 vs predicted MIP 45 cmH2O, P = 0.883). Patients with IMW on admission showed a statistically significant improvement in MIP after the intervention. CONCLUSION IMW is very prevalent in oldest-old hospitalized with acute illness. Patients might benefit from a multicomponent exercise program including IMT, even during short-stay hospitalization. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov; No.: NTC03604640. May 3, 2018.
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Affiliation(s)
- Teresa Zarralanga-Lasobras
- Department of Geriatrics, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Gregorio Marañón Health Research Institute, C. Castillo de Alarcón, 49, 28692, Villafranca del Castillo, Madrid, Spain
| | | | | | - José Antonio Serra-Rexach
- Department of Geriatrics, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Gregorio Marañón Health Research Institute, C. Castillo de Alarcón, 49, 28692, Villafranca del Castillo, Madrid, Spain
- Biomedical Research Networking Center on Frailty and Healthy Aging, CIBERFES, Madrid, Spain
- Department of Medicine, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Jennifer Mayordomo-Cava
- Gregorio Marañón Health Research Institute, C. Castillo de Alarcón, 49, 28692, Villafranca del Castillo, Madrid, Spain.
- Facultad HM Hospitales de Ciencias de la Salud de la Universidad Camilo José Cela, Madrid, Spain.
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Tashiro D, Oki Y, Nonomura N, Takeyama Y, Osaki T, Morimoto Y. Maximum abdominal excursion assessment using an abdominal excursion measuring device: Reliability and validity of a new device for simple and quantitative assessment of respiratory function. Med Eng Phys 2024; 124:104093. [PMID: 38418023 DOI: 10.1016/j.medengphy.2023.104093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 12/14/2023] [Accepted: 12/21/2023] [Indexed: 03/01/2024]
Abstract
This study aimed to verify the reliability and validity of abdominal expansion and respiratory function measurements. Forty healthy adult males underwent lung capacity, effort lung capacity, respiratory muscle strength, cough strength, diaphragm ultrasound, and abdominal expansion measurements. Abdominal expansion was measured using a device developed to accurately evaluate abdominal movements and calculate maximum abdominal expansion on the ventral side (AE-max: the difference between maximal abdominal contraction at the same time as maximal-effort expiration and maximal abdominal expansion at the same time as maximal-effort inspiration). Intra- and inter-rater reliabilities of the AE-max measurements were examined, the paired t-test was used for assessing the ratios of the expansion and contraction displacement components in AE-max, and regression analysis was used to obtain equations for predicting maximum inspiratory pressure (MIP) based on AE-max. Both intra- and inter-rater reliabilities were high. Criterion-related validity showed that AE-max was associated with all respiratory function parameters, especially MIP, and a high percentage of expansion displacement. Regression analysis showed that AE-max was significantly associated with MIP. Based on its association with MIP, the large proportion of expansion displacement in AE-max, and the results of the multiple regression analysis, we conclude that AE-max is a helpful measure for estimating MIP.
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Affiliation(s)
- Daisuke Tashiro
- Department of Occupational Therapy, Faculty of Rehabilitation, Kobe Gakuin University, Kobe City, Hyogo, Japan.
| | - Yutaro Oki
- Department of Public Health Kobe University Graduate School of Health Sciences, Kobe City, Hyogo, Japan
| | - Natsuha Nonomura
- Department of Occupational Therapy, Faculty of Rehabilitation, Kobe Gakuin University, Kobe City, Hyogo, Japan
| | - Yuki Takeyama
- Department of Occupational Therapy, Faculty of Rehabilitation, Kobe Gakuin University, Kobe City, Hyogo, Japan
| | - Tohmi Osaki
- Department of Occupational Therapy, Faculty of Rehabilitation, Kobe Gakuin University, Kobe City, Hyogo, Japan
| | - Yosuke Morimoto
- Department of Physical Therapy, Faculty of Rehabilitation, Kobe Gakuin University, Kobe City, Hyogo, Japan; Department of Rehabilitation, Nishi-Kinen Port-island Rehabilitation Hospital, Kobe City, Hyogo, Japan
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Shi J, Liu Z, Zhou X, Jin F, Chen X, Wang X, Lv L. Effects of breathing exercises on low back pain in clinical: A systematic review and meta-analysis. Complement Ther Med 2023; 79:102993. [PMID: 37827444 DOI: 10.1016/j.ctim.2023.102993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 10/05/2023] [Accepted: 10/09/2023] [Indexed: 10/14/2023] Open
Abstract
OBJECTIVE This study aims to systematically evaluate the effect of breathing exercises on the low back pain (LBP). METHODS The studies of relevant randomized controlled trials (RCTs) testing the effect of breathing exercises on LBP were selected after strict screening from the establishment of PubMed, EMBASE, Cochrane Library, Web of Science, CBM, and CNKI databases until September 2022. The studies included were then independently assessed for risk bias by two investigators. The PRISMA 2020 statement was followed in this study. RESULTS 11 RCTs involving 383 patients were included in this analysis. Results showed that the effective rate of LBP patients after breathing exercises was significantly higher than those in the control group, and the VAS (Visual Analogue Score) and ODI (Oswestry Disability Index) scores of LBP patients were significantly lower than those in the control group [VAS: MD = -0.50, 95% CI (-0.88, -0.11), I2 = 76%, p = 0.0009; ODI: MD = -2.46, 95% CI (-3.41, -1.52), I2 = 20%, p = 0.28]. The results of subgroup showed that the duration of treatment had little effect on the effect of breathing exercises, and breathing exercises alone could also have a positive effect on LBP. However, there were methodological limitations in the included studies, future studies should ensure blinded outcome assessors and full reporting to reduce bias risks. Because this review is a study of breathing exercises as an intervention without any adverse events, all studies did not involve safety assessments. CONCLUSIONS The results indicated that breathing exercises have a positive effect on alleviating LBP, but due to the lack of methodological rigor and some limitations of the included studies, more critical RCTs are still needed in the future to verify the precision of this conclusion. The protocol was registered in PROSPERO (No. CRD42022345561).
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Affiliation(s)
- Jiao Shi
- The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China
| | - Zhen Liu
- The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China
| | - Xingchen Zhou
- The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China
| | - Fanyuan Jin
- The First Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China
| | - Xiaojie Chen
- 72nd Group Army Hospital of Chinese People's Liberation Army
| | - Xiaodong Wang
- The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China.
| | - Lijiang Lv
- The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China.
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Castro A, Catai AM, Rehder-Santos P, Signini ÉF, de Abreu RM, Da Silva CD, Dato CC, Oliveira RV, Ferreira AG. Insights into the Serum Metabolic Adaptations in Response to Inspiratory Muscle Training: A Metabolomic Approach Based on 1H NMR and UHPLC-HRMS/MS. Int J Mol Sci 2023; 24:16764. [PMID: 38069087 PMCID: PMC10706640 DOI: 10.3390/ijms242316764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 11/17/2023] [Accepted: 11/21/2023] [Indexed: 12/18/2023] Open
Abstract
Inspiratory muscle training (IMT) is known to promote physiological benefits and improve physical performance in endurance sports activities. However, the metabolic adaptations promoted by different IMT prescribing strategies remain unclear. In this work, a longitudinal, randomized, double-blind, sham-controlled, parallel trial was performed to investigate the effects of 11 weeks (3 days·week-1) of IMT at different exercise intensities on the serum metabolomics profile and its main regulated metabolic pathways. Twenty-eight healthy male recreational cyclists (30.4 ± 6.5 years) were randomized into three groups: sham (6 cm·H2O of inspiratory pressure, n = 7), moderate-intensity (MI group, 60% maximal inspiratory pressure (MIP), n = 11) and high-intensity (HI group, 85-90% MIP, n = 10). Blood serum samples were collected before and after 11 weeks of IMT and analyzed by 1H NMR and UHPLC-HRMS/MS. Data were analyzed using linear mixed models and metabolite set enrichment analysis. The 1H NMR and UHPLC-HRMS/MS techniques resulted in 46 and 200 compounds, respectively. These results showed that ketone body metabolism, fatty acid biosynthesis, and aminoacyl-tRNA biosynthesis were upregulated after IMT, while alpha linolenic acid and linoleic acid metabolism as well as biosynthesis of unsaturated fatty acids were downregulated. The MI group presented higher MIP, Tryptophan, and Valine levels but decreased 2-Hydroxybutyrate levels when compared to the other two studied groups. These results suggest an increase in the oxidative metabolic processes after IMT at different intensities with additional evidence for the upregulation of essential amino acid metabolism in the MI group accompanied by greater improvement in respiratory muscle strength.
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Affiliation(s)
- Alex Castro
- Department of Chemistry, Universidade Federal de São Carlos (UFSCar), São Carlos 13565-905, Brazil;
- Biosciences National Laboratory (LNBio), Brazilian Center for Research in Energy and Materials (CNPEM), Campinas 13083-100, Brazil
| | - Aparecida M. Catai
- Department of Physiotherapy, Universidade Federal de São Carlos (UFSCar), Sao Carlos 13565-905, Brazil; (A.M.C.); (P.R.-S.); (É.F.S.); (R.M.d.A.); (C.D.D.S.)
| | - Patrícia Rehder-Santos
- Department of Physiotherapy, Universidade Federal de São Carlos (UFSCar), Sao Carlos 13565-905, Brazil; (A.M.C.); (P.R.-S.); (É.F.S.); (R.M.d.A.); (C.D.D.S.)
| | - Étore F. Signini
- Department of Physiotherapy, Universidade Federal de São Carlos (UFSCar), Sao Carlos 13565-905, Brazil; (A.M.C.); (P.R.-S.); (É.F.S.); (R.M.d.A.); (C.D.D.S.)
| | - Raphael Martins de Abreu
- Department of Physiotherapy, Universidade Federal de São Carlos (UFSCar), Sao Carlos 13565-905, Brazil; (A.M.C.); (P.R.-S.); (É.F.S.); (R.M.d.A.); (C.D.D.S.)
| | - Claudio Donisete Da Silva
- Department of Physiotherapy, Universidade Federal de São Carlos (UFSCar), Sao Carlos 13565-905, Brazil; (A.M.C.); (P.R.-S.); (É.F.S.); (R.M.d.A.); (C.D.D.S.)
| | - Carla Cristina Dato
- Nutrition Course, Central Paulista University Center, Sao Carlos 13563-470, Brazil;
| | - Regina V. Oliveira
- Department of Chemistry, Universidade Federal de São Carlos (UFSCar), São Carlos 13565-905, Brazil;
| | - Antônio G. Ferreira
- Department of Chemistry, Universidade Federal de São Carlos (UFSCar), São Carlos 13565-905, Brazil;
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10
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Orea-Tejeda A, Robles-Hernández R, González-Islas D, Jimenez-Gallardo L, Gochicoa-Rangel L, Castorena-Maldonado A, Hernández-Zenteno R, Montañez-Orozco A, Valderrábano-Salas B. Dynapenia and Sarcopenia in Post-COVID-19 Syndrome Hospitalized Patients Are Associated with Severe Reduction in Pulmonary Function. J Clin Med 2023; 12:6466. [PMID: 37892604 PMCID: PMC10607104 DOI: 10.3390/jcm12206466] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 09/29/2023] [Accepted: 09/30/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND After hospital discharge, post-COVID-19 syndrome has been observed to be associated with impaired diffusing capacity, respiratory muscle strength, and lung imaging abnormalities, in addition to loss of muscle mass/strength, sarcopenia, and obesity impact exercise tolerance, pulmonary functions, and overall prognosis. However, the relationship between lung function and the coexistence of obesity with low muscle strength and sarcopenia in post-COVID-19 patients remains poorly investigated. Therefore, our aim was to evaluate the association between lung function and the coexistence of obesity with dynapenia and sarcopenia in post-COVID-19 syndrome patients. METHODS This cross-sectional study included subjects who were hospitalized due to moderate to severe COVID-19, as confirmed by PCR testing. Subjects who could not be contacted, declined to participate, or died before the follow-up visit were excluded. RESULTS A total of 711 subjects were evaluated; the mean age was 53.64 ± 13.57 years, 12.4% had normal weight, 12.6% were dynapenic without obesity, 8.3% had sarcopenia, 41.6% had obesity, 21.2% had dynapenic obesity, and 3.8% had sarcopenic obesity. In terms of pulmonary function, the dynapenic subjects showed decreases of -3.45% in FEV1, -12.61 cmH2O in MIP, and -12.85 cmH2O in MEP. On the other hand, the sarcopenic subjects showed decreases of -6.14 cmH2O in MIP and -11.64 cmH2O in MEP. The dynapenic obesity group displayed a reduction of -12.13% in PEF. CONCLUSIONS In post-COVID-19 syndrome, dynapenia and sarcopenia-both with and without obesity-have been associated with lower lung function.
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Affiliation(s)
- Arturo Orea-Tejeda
- Heart Failure and Respiratory Distress Clinic, Cardiology Service, Instituto Nacional de Enfermedades Respiratorias “Ismael Cosío Villegas”, Mexico City 14080, Mexico; (A.O.-T.)
| | - Robinson Robles-Hernández
- Department of Research in Tobacco Smoking and COPD at Instituto Nacional de Enfermedades Respiratorias “Ismael Cosío Villegas” 2, Mexico City 14080, Mexico;
| | - Dulce González-Islas
- Heart Failure and Respiratory Distress Clinic, Cardiology Service, Instituto Nacional de Enfermedades Respiratorias “Ismael Cosío Villegas”, Mexico City 14080, Mexico; (A.O.-T.)
| | - Luz Jimenez-Gallardo
- Heart Failure and Respiratory Distress Clinic, Cardiology Service, Instituto Nacional de Enfermedades Respiratorias “Ismael Cosío Villegas”, Mexico City 14080, Mexico; (A.O.-T.)
| | - Laura Gochicoa-Rangel
- Department of Pulmonary Physiology at Instituto Nacional de Enfermedades Respiratorias “Ismael Cosío Villegas”, Mexico City 14080, Mexico
| | - Armando Castorena-Maldonado
- Direction for Medical Care in Pneumology at Instituto Nacional de Enfermedades Respiratorias “Ismael Cosío Villegas” 4, Mexico City 14080, Mexico
| | - Rafael Hernández-Zenteno
- COPD Clinic at Instituto Nacional de Enfermedades Respiratorias “Ismael Cosío Villegas”, Mexico City 14080, Mexico
| | - Alvaro Montañez-Orozco
- Heart Failure and Respiratory Distress Clinic, Cardiology Service, Instituto Nacional de Enfermedades Respiratorias “Ismael Cosío Villegas”, Mexico City 14080, Mexico; (A.O.-T.)
| | - Benigno Valderrábano-Salas
- Heart Failure and Respiratory Distress Clinic, Cardiology Service, Instituto Nacional de Enfermedades Respiratorias “Ismael Cosío Villegas”, Mexico City 14080, Mexico; (A.O.-T.)
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11
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Sheraz S, Ferraro FV, Siddiqui FA, Tariq H, Anthony Faghy M, Malik AN. The effects of inspiratory muscle training on balance and functional mobility: a systematic review. Postgrad Med 2023; 135:690-700. [PMID: 37650369 DOI: 10.1080/00325481.2023.2253136] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 08/09/2023] [Accepted: 08/25/2023] [Indexed: 09/01/2023]
Abstract
INTRODUCTION Inspiratory muscle training (IMT) has been widely used in both healthy and diseased populations especially in older adults, and its effects have been proven not only on inspiratory muscle strength but also on dyspnea, exercise capacity, quality of life, and other health parameters. AIM This study aims to review the effects of IMT on balance and functional ability of healthy and diseased populations. METHODS A systematic literature search was conducted on MEDLINE, EMBASE, AMED, and Cochrane Central Register of Controlled Trials (CENTRAL). Randomized control trials having participants > 18 years of age and having balance and functional mobility as primary or secondary outcomes were included. Two independent reviewers screened studies against the eligibility criteria, extracted the data, and assessed the quality of evidence. The protocol was prospectively registered on PROSPERO: CRD42021261652. RESULTS Ten studies were included in the review out of which eight had balance and six had functional mobility as an outcome measure. There was a significant improvement in balance of the participants after treatment with IMT, however the effect on functional mobility was inconclusive. CONCLUSION The review provided evidence of improvement in balance and functional mobility following inspiratory muscle training in both healthy and diseased adults. Future studies should be conducted to determine the optimal protocol and dosage of treatment.
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Affiliation(s)
- Suman Sheraz
- Faculty of Rehabilitation & Allied Health Sciences, Riphah International University, Islamabad, Pakistan
| | | | - Furqan Ahmed Siddiqui
- Foundation University College of Physical Therapy, Foundation University Islamabad, Islamabad, Pakistan
| | - Hina Tariq
- Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, UK
| | - Mark Anthony Faghy
- Biomedical and Clinical Research Theme, School of Human Sciences, University of Derby, Derby, UK
| | - Arshad Nawaz Malik
- Faculty of Rehabilitation & Allied Health Sciences, Riphah International University, Islamabad, Pakistan
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12
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Illidi CR, Romer LM, Johnson MA, Williams NC, Rossiter HB, Casaburi R, Tiller NB. Distinguishing science from pseudoscience in commercial respiratory interventions: an evidence-based guide for health and exercise professionals. Eur J Appl Physiol 2023; 123:1599-1625. [PMID: 36917254 PMCID: PMC10013266 DOI: 10.1007/s00421-023-05166-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 02/19/2023] [Indexed: 03/16/2023]
Abstract
Respiratory function has become a global health priority. Not only is chronic respiratory disease a leading cause of worldwide morbidity and mortality, but the COVID-19 pandemic has heightened attention on respiratory health and the means of enhancing it. Subsequently, and inevitably, the respiratory system has become a target of the multi-trillion-dollar health and wellness industry. Numerous commercial, respiratory-related interventions are now coupled to therapeutic and/or ergogenic claims that vary in their plausibility: from the reasonable to the absurd. Moreover, legitimate and illegitimate claims are often conflated in a wellness space that lacks regulation. The abundance of interventions, the range of potential therapeutic targets in the respiratory system, and the wealth of research that varies in quality, all confound the ability for health and exercise professionals to make informed risk-to-benefit assessments with their patients and clients. This review focuses on numerous commercial interventions that purport to improve respiratory health, including nasal dilators, nasal breathing, and systematized breathing interventions (such as pursed-lips breathing), respiratory muscle training, canned oxygen, nutritional supplements, and inhaled L-menthol. For each intervention we describe the premise, examine the plausibility, and systematically contrast commercial claims against the published literature. The overarching aim is to assist health and exercise professionals to distinguish science from pseudoscience and make pragmatic and safe risk-to-benefit decisions.
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Affiliation(s)
- Camilla R Illidi
- Clinical Exercise and Respiratory Physiology Laboratory, Department of Kinesiology and Physical Education, Faculty of Education, McGill University, Montréal, QC, Canada
| | - Lee M Romer
- Division of Sport, Health and Exercise Sciences, College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, UK
| | - Michael A Johnson
- Exercise and Health Research Group, Sport, Health and Performance Enhancement (SHAPE) Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, Nottinghamshire, UK
| | - Neil C Williams
- Exercise and Health Research Group, Sport, Health and Performance Enhancement (SHAPE) Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, Nottinghamshire, UK
| | - Harry B Rossiter
- Institute of Respiratory Medicine and Exercise Physiology, Division of Respiratory and Critical Care Physiology and Medicine, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, 1124 W. Carson Street, CDCRC Building, Torrance, CA, 90502, USA
| | - Richard Casaburi
- Institute of Respiratory Medicine and Exercise Physiology, Division of Respiratory and Critical Care Physiology and Medicine, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, 1124 W. Carson Street, CDCRC Building, Torrance, CA, 90502, USA
| | - Nicholas B Tiller
- Institute of Respiratory Medicine and Exercise Physiology, Division of Respiratory and Critical Care Physiology and Medicine, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, 1124 W. Carson Street, CDCRC Building, Torrance, CA, 90502, USA.
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13
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The use of respiratory muscle training in patients with pulmonary dysfunction, internal diseases or central nervous system disorders: a systematic review with meta-analysis. Qual Life Res 2023; 32:1-26. [PMID: 35460472 PMCID: PMC9034447 DOI: 10.1007/s11136-022-03133-y] [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] [Accepted: 03/21/2022] [Indexed: 01/12/2023]
Abstract
OBJECTIVE The aim of this systematic review with meta-analysis was to evaluate the effectiveness of RMT in internal and central nervous system disorders, on pulmonary function, exercise capacity and quality of life. METHODS The inclusion criteria were (1) publications designed as Randomized Controlled Trial (RCT), with (2) participants being adults with pulmonary dysfunction caused by an internal disease or central nervous system disorder, (3) an intervention defined as RMT (either IMT or EMT) and (4) with the assessment of exercise capacity, respiratory function and quality of life. For the methodological quality assessment of risk of bias, likewise statistical analysis and meta-analysis the RevMan version 5.3 software and the Cochrane Risk of Bias Tool were used. Two authors independently analysed the following databases for relevant research articles: PubMed, Scopus, Cochrane Library, Web of Science, and Embase. RESULTS From a total of 2200 records, the systematic review includes 29 RCT with an overall sample size of 1155 patients. Results suggest that patients with internal and central nervous system disorders who underwent RMT had better quality of life and improved significantly their performance in exercise capacity and in respiratory function assessed with FVC and MIP when compared to control conditions (i.e. no intervention, sham training, placebo or conventional treatments). CONCLUSION Respiratory muscle training seems to be more effective than control conditions (i.e. no intervention, sham training, placebo or conventional treatment), in patients with pulmonary dysfunction due to internal and central nervous system disorders, for quality of life, exercise capacity and respiratory function assessed with MIP and FVC, but not with FEV1.
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14
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Sato S, Miyazaki S, Tamaki A, Yoshimura Y, Arai H, Fujiwara D, Katsura H, Kawagoshi A, Kozu R, Maeda K, Ogawa S, Ueki J, Wakabayashi H. Respiratory sarcopenia: A position paper by four professional organizations. Geriatr Gerontol Int 2023; 23:5-15. [PMID: 36479799 DOI: 10.1111/ggi.14519] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 11/16/2022] [Accepted: 11/20/2022] [Indexed: 12/13/2022]
Abstract
We defined respiratory sarcopenia as a coexistence of respiratory muscle weakness and decreased respiratory muscle mass. Although respiratory muscle function is indispensable for life support, its evaluation has not been included in the regular assessment of respiratory function or adequately evaluated in clinical practice. Considering this situation, we prepared a position paper outlining basic knowledge, diagnostic and assessment methods, mechanisms, involvement in respiratory diseases, intervention and treatment methods, and future perspectives on respiratory sarcopenia, and summarized the current consensus on respiratory sarcopenia. Respiratory sarcopenia is diagnosed when respiratory muscle weakness and decreased respiratory muscle mass are observed. If respiratory muscle mass is difficult to measure, we can use appendicular skeletal muscle mass as a surrogate. Probable respiratory sarcopenia is defined when respiratory muscle weakness and decreased appendicular skeletal muscle mass are observed. If only respiratory muscle strength is decreased without a decrease in respiratory function, the patient is diagnosed with possible respiratory sarcopenia. Respiratory muscle strength is assessed using maximum inspiratory pressure and maximum expiratory pressure. Ultrasonography and computed tomography are commonly used to assess respiratory muscle mass; however, there are insufficient data to propose the cutoff values for defining decreased respiratory muscle mass. It was jointly prepared by the representative authors and authorized by the Japanese Society for Respiratory Care and Rehabilitation, Japanese Association on Sarcopenia and Frailty, Japanese Society of Respiratory Physical Therapy and Japanese Association of Rehabilitation Nutrition. Geriatr Gerontol Int 2023; 23: 5-15.
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Affiliation(s)
- Susumu Sato
- Department of Respiratory Care and Sleep Control Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | | | - Akira Tamaki
- Department of Physical Therapy, School of Rehabilitation, Hyogo Medical University, Kobe, Japan
| | - Yoshihiro Yoshimura
- Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, Kumamoto, Japan
| | - Hidenori Arai
- National Center for Geriatrics and Gerontology, Obu, Japan
| | - Dai Fujiwara
- Department of Rehabilitation Medicine, Saka General Hospital, Miyagi, Japan
| | - Hideki Katsura
- Department of Respiratory Medicine, Tokyo Women's Medical University, Tokyo, Japan
| | | | - Ryo Kozu
- Department of Physical Therapy Science, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Keisuke Maeda
- Department of Geriatric Medicine, Hospital, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Sumito Ogawa
- Department of Geriatric Medicine, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Jun Ueki
- Clinical Research Unit of Respiratory Pathophysiology, Graduate School of Health Care and Nursing, Juntendo University, Chiba, Japan
| | - Hidetaka Wakabayashi
- Department of Rehabilitation Medicine, Tokyo Women's Medical University Hospital, Tokyo, Japan
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15
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Severin R, Franz CK, Farr E, Meirelles C, Arena R, Phillips SA, Bond S, Ferraro F, Faghy M. The effects of COVID-19 on respiratory muscle performance: making the case for respiratory muscle testing and training. Eur Respir Rev 2022; 31:31/166/220006. [PMID: 36198415 PMCID: PMC9724806 DOI: 10.1183/16000617.0006-2022] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 07/22/2022] [Indexed: 01/28/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection results in multiorgan damage primarily mediated by viral infiltration via angiotensin-converting enzyme-2 receptors on the surface of cells. A primary symptom for many patients is exertional dyspnoea which may persist even beyond recovery from the viral infection. Respiratory muscle (RM) performance was hypothesised as a contributing factor to the severity of coronavirus disease 2019 (COVID-19) symptoms, such as dyspnoea, and outcomes. This was attributed to similarities between patient populations at elevated risk for severe COVID-19 symptoms and those with a greater likelihood of baseline RM weakness and the effects of prolonged mechanical ventilation. More recent evidence suggests that SARS-CoV-2 infection itself may cause damage to the RM, and many patients who have recovered report persistent dyspnoea despite having mild cases, normal lung function or undamaged lung parenchyma. These more recent findings suggest that the role of RM in the persistent dyspnoea due to COVID-19 may be more substantial than originally hypothesised. Therefore, screening for RM weakness and providing interventions to improve RM performance appears to be important for patients with COVID-19. This article will review the impact of SARS-CoV-2 infection on RM performance and provide clinical recommendations for screening RM performance and treatment interventions.
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Affiliation(s)
- Richard Severin
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA,Department of Physical Therapy, Robbins College of Health and Human Sciences, Baylor University, Waco, TX, USA,Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL, USA,Corresponding author: Richard Severin ()
| | - Colin K. Franz
- The Shirley Ryan Ability Lab, Chicago, IL, USA,Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Ellen Farr
- The Shirley Ryan Ability Lab, Chicago, IL, USA,Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Cristiane Meirelles
- Department of Physical Therapy, School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH, USA
| | - Ross Arena
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA,Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL, USA
| | - Shane A. Phillips
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA,Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL, USA
| | - Sam Bond
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA,Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL, USA
| | | | - Mark Faghy
- Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL, USA,Human Sciences Research Centre, University of Derby, Derby, UK
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Scherrenberg M, Marinus N, Giallauria F, Falter M, Kemps H, Wilhelm M, Prescott E, Vigorito C, De Kluiver E, Cipriano G, Dendale P, Hansen D. The need for long-term personalized management of frail CVD patients by rehabilitation and telemonitoring: a framework. Trends Cardiovasc Med 2022:S1050-1738(22)00023-8. [PMID: 35121082 DOI: 10.1016/j.tcm.2022.01.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 01/24/2022] [Accepted: 01/29/2022] [Indexed: 10/19/2022]
Abstract
Due to advances in cardiovascular medicine and preventive cardiology, patients benefit from a better prognosis, even in case of significant disease burden such as acute and chronic coronary syndromes, advanced valvular heart disease and chronic heart failure. These advances have allowed CVD patients to increase their life expectancy, but on the other hand also experience aging-related syndromes such as frailty. Despite being underrecognized, frailty is a critical, common, and co-existent condition among older CVD patients, leading to exercise intolerance and compromised adherence to cardiovascular rehabilitation. Moreover, frail patients need a different approach for CR and are at very high risk for adverse events, but yet are underrepresented in conventional CR. Fortunately, recent advances have been made in technology, allowing remote monitoring, coaching and supervision of CVD patients in secondary prevention programs with promising benefits. Similarly, we hypothesized that such programs should also be implemented to treat frailty in CVD patients. However, considering frail patients' particular needs and challenges, telerehabilitation interventions should thus be appropriately adapted. Our purpose is to provide, for the first time and based on expert opinions, a framework of how such a cardiac telerehabilitation program could be developed and implemented to manage a prevention and rehabilitation program for CVD patients with frailty.
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Affiliation(s)
- Martijn Scherrenberg
- Heart Centre Hasselt, Jessa Hospital, Hasselt, Belgium; UHasselt, Faculty of Medicine and Life Sciences, Diepenbeek, Belgium; Faculty of Medicine and Health Sciences, Antwerp University, Belgium
| | - Nastasia Marinus
- UHasselt, Faculty of Rehabilitation Sciences, BIOMED-REVAL, Hasselt, Belgium
| | | | - Maarten Falter
- Heart Centre Hasselt, Jessa Hospital, Hasselt, Belgium; UHasselt, Faculty of Medicine and Life Sciences, Diepenbeek, Belgium; Faculty of Medicine, Department of Cardiology, KULeuven, Herestraat 49, 3000, Leuven, Belgium
| | - Hareld Kemps
- Department of Cardiology, Máxima Medical Center, The Netherlands; Department of Industrial Design, Technical University Eindhoven, The Netherlands
| | - Matthias Wilhelm
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Eva Prescott
- Department of Cardiology, Bispebjerg University Hospital, University of Copenhagen, Copenhagen, NW, Denmark
| | - Carlo Vigorito
- Department of Translational Medical Sciences, Federico II University of Naples
| | | | | | - Paul Dendale
- Heart Centre Hasselt, Jessa Hospital, Hasselt, Belgium; UHasselt, Faculty of Medicine and Life Sciences, Diepenbeek, Belgium
| | - Dominique Hansen
- Heart Centre Hasselt, Jessa Hospital, Hasselt, Belgium; UHasselt, Faculty of Rehabilitation Sciences, BIOMED-REVAL, Hasselt, Belgium.
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17
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Respiratory Prehabilitation for the Prevention of Postoperative Pulmonary Complications after Major Surgery. CURRENT ANESTHESIOLOGY REPORTS 2021. [DOI: 10.1007/s40140-021-00495-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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18
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Zhang FM, Zhang XZ, Zhu GL, Lv LQ, Yan XL, Wu WX, Wang SL, Chen XL, Zhuang CL, Yu Z. Impact of sarcopenia on clinical outcomes of patients with stage I gastric cancer after radical gastrectomy: A prospective cohort study. Eur J Surg Oncol 2021; 48:541-547. [PMID: 34420825 DOI: 10.1016/j.ejso.2021.08.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 07/27/2021] [Accepted: 08/15/2021] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND The relationships between sarcopenia and postoperative outcomes in patients with early-stage gastric cancer who undergo radical gastrectomy is unclear. We aimed to investigate the predictive value of sarcopenia on adverse outcomes for stage I gastric cancer. METHODS The clinical data of patients who underwent radical gastrectomy for stage I gastric cancer between July 2013 and May 2019 were prospectively collected. Basic sarcopenia components were measured preoperatively. Univariate and multivariate analyses were conducted to evaluate the risk factors for short- and long-term outcomes. RESULTS A total of 507 patients with early-stage gastric cancer were included in the study, and 73 (14.4%) patients were diagnosed as sarcopenia. Patients with sarcopenia had significantly higher incidence of postoperative complications (32.9% vs. 17.5%, P = 0.002), longer postoperative hospital stays (13 days vs. 12 days, P < 0.001), higher hospitalization costs (65210 yuan vs. 55197 yuan, P < 0.001) and one-year mortality (8.2% vs. 1.8%, P = 0.002). During the median follow-up time of 38.8 months, 12 (16.4%) patients dead in the sarcopenic group and 25 (5.8%) patients dead in the non-sarcopenic group. Sarcopenia was an independent risk factor for both short- and long-term clinical outcomes. Moreover, we found that low muscle quantity and low handgrip strength mediated the adverse impacts of sarcopenia on postoperative complications while low muscle quality mediated the adverse impacts of sarcopenia on overall survival. CONCLUSION Sarcopenia was strongly associated with worse short- and long-term clinical outcomes in patients with stage I gastric cancer who undergo radical gastrectomy.
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Affiliation(s)
- Feng-Min Zhang
- Department of Gastrointestinal Surgery, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xian-Zhong Zhang
- Department of Gastrointestinal Surgery, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Guang-Lou Zhu
- Department of Gastrointestinal Surgery, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Lu-Qing Lv
- Department of Gastrointestinal Surgery, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xia-Lin Yan
- Department of Gastrointestinal Surgery, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Wen-Xue Wu
- Department of General Surgery, Shanghai Tenth People's Hospital Chongming Branch Affiliated to Tongji University, Shanghai, China
| | - Su-Lin Wang
- Department of Gastrointestinal Surgery, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xiao-Lei Chen
- Department of Gastrointestinal Surgery, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Cheng-Le Zhuang
- Department of Gastrointestinal Surgery, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.
| | - Zhen Yu
- Department of Gastrointestinal Surgery, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.
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