1
|
Wu P, Hu Y, Yan X. Progress in Research into the Effectiveness of Pulmonary Rehabilitation in Children with Asthma - A Narrative Review. J Asthma Allergy 2024; 17:743-750. [PMID: 39131601 PMCID: PMC11317056 DOI: 10.2147/jaa.s475367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Accepted: 07/29/2024] [Indexed: 08/13/2024] Open
Abstract
Asthma is the most common chronic respiratory disease in children. It has a serious impact on children's physical and mental health. Pulmonary rehabilitation is a multidisciplinary and comprehensive intervention for patients with chronic respiratory disease, whose major components include breathing training, inspiratory muscle training and exercise training. Pulmonary rehabilitation is a multidisciplinary and comprehensive intervention for patients with chronic respiratory diseases, the main components of which are breathing training, inspiratory muscle training and exercise training. Pulmonary rehabilitation can improve the physical and mental condition of patients with chronic respiratory diseases and promote healthy behaviors. However, there is little research on pulmonary rehabilitation in children with asthma. This review comprehensively evaluated the effect of pulmonary rehabilitation in children with asthma at home and abroad, aiming to provide reference for clinical research on pulmonary rehabilitation in children with asthma.
Collapse
Affiliation(s)
- Ping Wu
- School of Medicine, Tongji University, Shanghai, People’s Republic of China
| | - Yijing Hu
- Department of Respiratory Medicine, Shanghai Children’s Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, People’s Republic of China
| | - Xiaoxia Yan
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University, Shanghai, People’s Republic of China
| |
Collapse
|
2
|
Choi I, Choi J, Yong HS, Yang Z. Deep learning-based respiratory muscle segmentation as a potential imaging biomarker for respiratory function assessment. PLoS One 2024; 19:e0306789. [PMID: 39058719 PMCID: PMC11280157 DOI: 10.1371/journal.pone.0306789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 06/24/2024] [Indexed: 07/28/2024] Open
Abstract
Respiratory diseases significantly affect respiratory function, making them a considerable contributor to global mortality. The respiratory muscles play an important role in disease prognosis; as such, quantitative analysis of the respiratory muscles is crucial to assess the status of the respiratory system and the quality of life in patients. In this study, we aimed to develop an automated approach for the segmentation and classification of three types of respiratory muscles from computed tomography (CT) images using artificial intelligence. With a dataset of approximately 600,000 thoracic CT images from 3,200 individuals, we trained the model using the Attention U-Net architecture, optimized for detailed and focused segmentation. Subsequently, we calculated the volumes and densities from the muscle masks segmented by our model and performed correlation analysis with pulmonary function test (PFT) parameters. The segmentation models for muscle tissue and respiratory muscles obtained dice scores of 0.9823 and 0.9688, respectively. The classification model, achieving a generalized dice score of 0.9900, also demonstrated high accuracy in classifying thoracic region muscle types, as evidenced by its F1 scores: 0.9793 for the pectoralis muscle, 0.9975 for the erector spinae muscle, and 0.9839 for the intercostal muscle. In the correlation analysis, the volume of the respiratory muscles showed a strong correlation with PFT parameters, suggesting that respiratory muscle volume may serve as a potential novel biomarker for respiratory function. Although muscle density showed a weaker correlation with the PFT parameters, it has a potential significance in medical research.
Collapse
Affiliation(s)
- Insung Choi
- Department of Integrative Medicine, Major in Digital Healthcare, Yonsei University College of Medicine, Seoul, Republic of Korea
- Department of Radiology, Korea University Guro Hospital, Seoul, Republic of Korea
| | - Juwhan Choi
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Korea University Guro Hospital, Seoul, Republic of Korea
| | - Hwan Seok Yong
- Department of Radiology, Korea University Guro Hospital, Seoul, Republic of Korea
| | - Zepa Yang
- Department of Radiology, Korea University Guro Hospital, Seoul, Republic of Korea
| |
Collapse
|
3
|
Basha MA, Azab AR, Elnaggar RK, Aboelnour NH, Kamel NM, Aloraini SM, Kamel FH. Inspiratory muscle training impact on respiratory muscle strength, pulmonary function, and quality of life in children with chest burn: A randomized controlled trial. Burns 2024:S0305-4179(24)00147-5. [PMID: 38782684 DOI: 10.1016/j.burns.2024.05.007] [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: 09/29/2023] [Revised: 03/10/2024] [Accepted: 05/02/2024] [Indexed: 05/25/2024]
Abstract
PURPOSE Respiratory muscle function is compromised in children recovering from chest wall burns, which potentially leads to more impact on exercise capacity and quality of life. This study investigates the effects of an inspiratory muscle training intervention accompanied with a pulmonary rehabilitation program on respiratory muscle strength, lung function, functional capacity, and quality of life in chest burned children. METHODS Forty children with burns, aged from 10 to 18 years old and total body surface area of 30% to 50%, were randomly allocated to the inspiratory muscle training group (IMT- G: n = 20) or control group (CG: n = 20). They received IMT plus pulmonary rehabilitation or pulmonary rehabilitation with sham IMT, respectively for eight weeks. The outcomes were the respiratory muscle strength measured by maximum inspiratory pressure (MIP) and maximum expiratory pressure (MEP); lung functions (FEV1, FVC and FEV1/FVC ratio); functional capacity as well as Pediatric Quality of Life to measure physical and psychosocial functioning. outcome measures were assessed at before and after intervention (after eight weeks). RESULTS Based on the pre-intervention assessments, we found no significant difference between both groups (p > 0.05). Significant post-intervention differences were reported between both groups in MIP (P = .003), MEP (P = .017), FVC (P = .001), FEV1 (P = .007), FEV1/FVC ratio (P = .028), functional capacity (P = .003), physical domain of QoL (P = .006) and psychological domain of QoL (P = .002) in favor of the IMT group. CONCLUSIONS Eight weeks of inspiratory muscle training combined with pulmonary rehabilitation program improved children with chest burns' respiratory muscles strength, lung functions, functional capacity, and quality of life. Inspiratory muscle training may be employed in burn rehabilitation programs. It is a safe and effective therapy in chest burned children.
Collapse
Affiliation(s)
- Maged A Basha
- Department of Physical Therapy, College of Applied Medical Sciences, Qassim University, Buraydah 51452, P.O. Box 6666, Saudi Arabia; Department of Physical Therapy, El Sahel Teaching Hospital, General Organization for Teaching Hospitals and Institutes, Cairo, Egypt.
| | - Alshimaa R Azab
- Department of Health and Rehabilitation Sciences, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia; Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Ragab K Elnaggar
- Department of Health and Rehabilitation Sciences, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia; Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Nancy H Aboelnour
- Department of Physical Therapy for Surgery, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Noha M Kamel
- Department of Physical Therapy for Surgery, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Saleh M Aloraini
- Department of Physical Therapy, College of Applied Medical Sciences, Qassim University, Buraydah 51452, P.O. Box 6666, Saudi Arabia
| | - FatmaAlzahraa H Kamel
- Department of Physical Therapy, College of Applied Medical Sciences, Qassim University, Buraydah 51452, P.O. Box 6666, Saudi Arabia; Department of Physical Therapy for Surgery, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| |
Collapse
|
4
|
Ibrahim AA, Gabr Ali AMM, Fadulelmulla IA, Ragab MMM, Aldemery AA, Mohamed AR, Dewir IM, Hakami HA, Hussein HM. Using Inspiratory Muscle Training to Improve Respiratory Strength, Functional Capacity, Fatigue, and Stress in Breast Cancer Patients Undergoing Surgery. J Multidiscip Healthc 2024; 17:1931-1941. [PMID: 38706507 PMCID: PMC11070168 DOI: 10.2147/jmdh.s463961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Accepted: 04/22/2024] [Indexed: 05/07/2024] Open
Abstract
Purpose The main aim of the trial was to assess the effectiveness of inspiratory muscle training on respiratory muscle strength, functional capacity, fatigue, and stress in post-surgical breast cancer survivors. Methods Forty-seven females who had undergone unilateral post-mastectomy were randomly assigned to an intervention group (IG; n = 24) and a control group (CG; n = 23). Both groups received aerobic exercise training. In addition, the intervention group received inspiratory muscle training 3 days a week for 8 weeks. Maximum inspiratory and expiratory pressure (Pimax) (Pemex), 6-minute walk test, Handgrip strength by hand-held dynamometer, Fatigue Assessment Scale (FAS), and Perceived Stress Scale pss 10 values were measured before the training and then at the eighth week for both groups. Results No differences were detected between the groups in terms of sample and clinical characteristics 8 weeks post-intervention. In favor of the intervention group, a significant difference with medium to high effect size was found in terms of Pimax, Pemax, FAS, PS, and 6MWT (p < 0.05). However, there was no difference in terms of handgrip strength (p-value: 0.072), with a medium effect size (0.070). Regarding within-group comparisons, IG exhibited substantial differences in all outcome measures (p < 0.05) compared to CG, with the exception of PImax and 6MWT. Conclusion In post-operative breast cancer survivors, respiratory muscle training combined with aerobic training increases respiratory muscle strength and functional ability while lowering stress and tiredness.
Collapse
Affiliation(s)
- Ahmed Abdelmoniem Ibrahim
- Department of Physical Therapy, College of Applied Medical Sciences, University of Ha’il, Ha’il, Saudi Arabia
| | | | | | | | | | - Amany Raafat Mohamed
- Department of Physical Therapy for Internal Medicine & Geriatrics, Faculty of Physical Therapy, Suez University, Suez, Egypt
| | - Ibrahim Metwally Dewir
- Department of Physical Therapy, College of Applied Medical Sciences, Taif University, Taif, Saudi Arabia
| | - Hamad Ali Hakami
- Department of Physical Therapy, Jazan General Hospital, Jazan, Saudi Arabia
| | - Hisham Mohamed Hussein
- Department of Physical Therapy, College of Applied Medical Sciences, University of Ha’il, Ha’il, Saudi Arabia
- Department of Basic Sciences for Physical Therapy, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| |
Collapse
|
5
|
Puzzi VC, Oliveira JMD, Alves TB, Silva JPDC, Pedroso A, Furlanetto KC. Reliability and validity of the London Chest Activity of Daily Living scale for adults with asthma. J Asthma 2024; 61:1-9. [PMID: 37417908 DOI: 10.1080/02770903.2023.2234990] [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: 12/21/2022] [Accepted: 07/05/2023] [Indexed: 07/08/2023]
Abstract
INTRODUCTION Dyspnea during activities of daily living (ADL) is frequently reported by adults with asthma. However, instruments that specifically assess that in people with asthma have not yet been validated. OBJECTIVES To investigate the validity and reliability, including standard error of measurement (SEM) and Minimum Detectable Change (MDC), of the London Chest Activity of Daily Living (LCADL) scale for adults with asthma. METHODS Adults with asthma answered the LCADL scale which was performed twice by the same rater. Spirometry, 6-min walk test (6MWT), St George's Respiratory Questionnaire (SGRQ), modified Medical Research Council (mMRC) dyspnea scale, Asthma Quality of Life questionnaire (AQLQ), Asthma Control Test (ACT), and Glittre-ADL test were assessed. For statistical analyses, Spearman correlation, Wilcoxon test, Intraclass Correlation Coefficient (ICC), Cronbach's alpha coefficient, SEM, MDC were performed. RESULTS Seventy participants were included (30% men, 44 ± 15 years old, BMI 27[23-31]kg/m2, FEV1 80 ± 17%predicted). For convergent validity, the LCADL scale was moderately correlated with SGRQ, AQLQ, and Glittre-ADL (r = 0.57, -0.46, and 0.41 respectively; p < 0.0001). The LCADL scale correlated weakly with the mMRC scale, ACT, and spirometry measures (-0.23 CONCLUSION The LCADL scale is valid and reliable for assessing dyspnea during ADL in adults with asthma.
Collapse
Affiliation(s)
- Vitória Cavalheiro Puzzi
- Graduate Program in Rehabilitation Sciences, Pitágoras-Unopar University (UNOPAR), Londrina, Brazil
- Laboratory of Research in Respiratory Physiotherapy - LFIP, Department of Physiotherapy, Londrina State University, Londrina, Brazil
| | - Joice Mara de Oliveira
- Graduate Program in Rehabilitation Sciences, Pitágoras-Unopar University (UNOPAR), Londrina, Brazil
- Laboratory of Research in Respiratory Physiotherapy - LFIP, Department of Physiotherapy, Londrina State University, Londrina, Brazil
| | - Thainá Bessa Alves
- Graduate Program in Rehabilitation Sciences, Pitágoras-Unopar University (UNOPAR), Londrina, Brazil
- Laboratory of Research in Respiratory Physiotherapy - LFIP, Department of Physiotherapy, Londrina State University, Londrina, Brazil
| | - Jessica Priscila da Conceição Silva
- Graduate Program in Rehabilitation Sciences, Pitágoras-Unopar University (UNOPAR), Londrina, Brazil
- Laboratory of Research in Respiratory Physiotherapy - LFIP, Department of Physiotherapy, Londrina State University, Londrina, Brazil
| | - Ariele Pedroso
- Graduate Program in Rehabilitation Sciences, Pitágoras-Unopar University (UNOPAR), Londrina, Brazil
- Laboratory of Research in Respiratory Physiotherapy - LFIP, Department of Physiotherapy, Londrina State University, Londrina, Brazil
| | - Karina Couto Furlanetto
- Graduate Program in Rehabilitation Sciences, Pitágoras-Unopar University (UNOPAR), Londrina, Brazil
- Laboratory of Research in Respiratory Physiotherapy - LFIP, Department of Physiotherapy, Londrina State University, Londrina, Brazil
| |
Collapse
|
6
|
Kuronen I, Heinijoki J, Sovijärvi A. Effects of low workload respiratory training with steam inhalation on lung function in stable asthma: A controlled clinical study. Clin Physiol Funct Imaging 2024; 44:100-111. [PMID: 37749950 DOI: 10.1111/cpf.12856] [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: 06/30/2023] [Revised: 09/15/2023] [Accepted: 09/22/2023] [Indexed: 09/27/2023]
Abstract
To investigate effects of low workload respiratory muscle training (RMT) on respiratory muscle power and lung function in asthmatics, we recruited asthmatic persons who performed a 4-week training programme. The training included 20 daily ex- and inhalations with counter pressure 30% from the individual maximal expiratory pressure (MEP). Lung function was measured before and after the training programme and a follow-up period. The study also included several subjective endpoints for respiratory symptoms. A significant increase in a training group (n = 27) compared with a control group (n = 20) was seen in MEP (+12.4%, vs. +3.5%, p = 0.086), maximal inspiratory pressure (MIP) (+21.1% vs. +0.82%, p = 0.023), slow vital capacity (VC) (+3.7% vs. +1.5%, p = 0.023) and in forced expiratory time (FET, +15.5%, vs. -5.0%, p = 0.022). After being a control for group A, also group B performed similar RMT as group A. In the combined group (A and B, n = 47) MEP (11.3%, p = 0.003), MIP (19.73%, p < 0.001), VC (4.1%, p < 0.001) and FET (14.7%, p < 0.001) increased significantly from the baseline. Changes in other lung function variables were not indicative. On a scale of 1-5, the subjects perceived improvement in reduction of mucus secretion in the airways (median 3, p < 0.001), alleviation of coughing (median 3, p < 0.001) and reduction in dyspnoea (median 3, p < 0.001). As a conclusion, low workload respiratory training of 4 weeks improved respiratory muscle power and increased VC in patients with stable asthma.
Collapse
Affiliation(s)
| | | | - Anssi Sovijärvi
- Department of Clinical Physiology, University of Helsinki, Helsinki, Finland
| |
Collapse
|
7
|
Huzmeli I, Ozer AY, Akkus O, Yalcin F. The results of inspiratory muscle training on cardiac, respiratory, musculoskeletal, and psychological status in patients with stable angina: a randomized controlled trial. Disabil Rehabil 2023; 45:4074-4085. [PMID: 36382684 DOI: 10.1080/09638288.2022.2146767] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 11/05/2022] [Indexed: 11/17/2022]
Abstract
PURPOSE To determine the effect of inspiratory muscle training (IMT) on respiratory and peripheral muscle strength, functional exercise capacity, health-related quality of life (HRQoL), fatigue, depression, and cardiac functions in patients with stable angina. METHODS A randomized, controlled, single-blinded study. Twenty patients (59.95 ± 7.35 y, LVEF = 58.77 ± 7.49) with stable angina received IMT at the lowest load (10 cmH2O), and 20 patients (55.85 ± 7.60 y, LVEF = 62.26 ± 7.75) received training at 30% of maximal inspiratory pressure (MIP) seven days/8 weeks. Respiratory muscle strength (MIP; maximal expiratory pressure, MEP), peripheral muscle strength, pulmonary functions, functional exercise capacity (6-min walking test; exercise test), fatigue, HRQoL, depression, and cardiac functions were evaluated before and after. RESULTS A statistical difference was found between groups in terms of respiratory and peripheral muscle strength, pulmonary functions, functional exercise capacity (p < 0.05). The results of fatigue, depression, HRQoL, and cardiac functions were similar between the groups (p > 0.05). CONCLUSIONS This study is the first to demonstrate the positive effects of IMT in patients with stable angina. IMT is a safe and effective method and is recommended to be added to cardiopulmonary rehabilitation programs and guidelines, as it results in increased peripheral muscle strength and functional exercise capacity in stable angina patients.Implications for rehabilitationInspiratory muscle training (IMT) is a safe and effective method for coronary artery disease (CAD) patients with stable angina.IMT improved respiratory and peripheral muscle strength, functional exercise capacity, pulmonary functions, and health-related quality of life in CAD patients with stable angina.Perception of depression and fatigue were decreased with IMT in CAD patients with stable angina.
Collapse
Affiliation(s)
- I Huzmeli
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Hatay Mustafa Kemal University, Hatay, Turkey
| | - A Y Ozer
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Marmara University, Istanbul, Turkey
| | - O Akkus
- Department of Cardiology, Tayfur Ata Sokmen Faculty of Medicine, Hatay Mustafa Kemal University, Antakya, Turkey
| | - F Yalcin
- Department of Cardiology, Tayfur Ata Sokmen Faculty of Medicine, Hatay Mustafa Kemal University, Antakya, Turkey
| |
Collapse
|
8
|
Sogard AS, Mickleborough TD. The therapeutic role of inspiratory muscle training in the management of asthma: a narrative review. Am J Physiol Regul Integr Comp Physiol 2023; 325:R645-R663. [PMID: 37720997 DOI: 10.1152/ajpregu.00325.2022] [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: 12/28/2022] [Revised: 09/05/2023] [Accepted: 09/07/2023] [Indexed: 09/19/2023]
Abstract
Asthma is a disorder of the airways characterized by chronic airway inflammation, hyperresponsiveness, and variable recurring airway obstruction. Treatment options for asthma include pharmacological strategies, whereas nonpharmacological strategies are limited. Established pharmacological approaches to treating asthma may cause unwanted side effects and do not always afford adequate protection against asthma, possibly because of an individual's variable response to medications. A potential nonpharmacological intervention that is most available and cost effective is inspiratory muscle training (IMT), which is a technique targeted at increasing the strength and endurance of the diaphragm and accessory muscles of inspiration. Studies examining the impact of IMT on asthma have reported increases in inspiratory muscle strength and a reduction in the perception of dyspnea and medication use. However, because of the limited number of studies and discordant methods between studies more evidence is required to elucidate in individuals with asthma the efficacy of IMT on inspiratory muscle endurance, exercise capacity, asthma control, symptoms, and quality of life as well as in adolescents with differing severities of asthma. Large randomized controlled trials would be a significant step forward in clarifying the effectiveness of IMT in individuals with asthma. Although IMT may have favorable effects on inspiratory muscle strength, dyspnea, and medication use, the current evidence that IMT is an effective treatment for asthma is inconclusive.
Collapse
Affiliation(s)
- Abigail S Sogard
- Department of Kinesiology, School of Public Health-Bloomington, Indiana University, Bloomington, Indiana, United States
| | - Timothy D Mickleborough
- Department of Kinesiology, School of Public Health-Bloomington, Indiana University, Bloomington, Indiana, United States
| |
Collapse
|
9
|
Clemente-Suárez VJ, Mielgo-Ayuso J, Ramos-Campo DJ, Beltran-Velasco AI, Martínez-Guardado I, Navarro Jimenez E, Redondo-Flórez L, Yáñez-Sepúlveda R, Tornero-Aguilera JF. Basis of preventive and non-pharmacological interventions in asthma. Front Public Health 2023; 11:1172391. [PMID: 37920579 PMCID: PMC10619920 DOI: 10.3389/fpubh.2023.1172391] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 09/18/2023] [Indexed: 11/04/2023] Open
Abstract
Asthma is one of the most common atopic disorders in all stages of life. Its etiology is likely due to a complex interaction between genetic, environmental, and lifestyle factors. Due to this, different non-pharmacological interventions can be implemented to reduce or alleviate the symptoms caused by this disease. Thus, the present narrative review aimed to analyze the preventive and non-pharmacological interventions such as physical exercise, physiotherapy, nutritional, ergonutritional, and psychological strategies in asthma treatment. To reach these aims, an extensive narrative review was conducted. The databases used were MedLine (PubMed), Cochrane (Wiley), Embase, PsychINFO, and CinAhl. Asthma is an immune-mediated inflammatory condition characterized by increased responsiveness to bronchoconstrictor stimuli. Different factors have been shown to play an important role in the pathogenesis of asthma, however, the treatments used to reduce its incidence are more controversial. Physical activity is focused on the benefits that aerobic training can provide, while physiotherapy interventions recommend breathing exercises to improve the quality of life of patients. Nutritional interventions are targeted on implement diets that prioritize the consumption of fruits and vegetables and supplementation with antioxidants. Psychological interventions have been proposed as an essential non-pharmacological tool to reduce the emotional problems associated with asthma.
Collapse
Affiliation(s)
- Vicente Javier Clemente-Suárez
- Faculty of Sports Sciences, Universidad Europea de Madrid, Madrid, Spain
- Studies Centre in Applied Combat (CESCA), Toledo, Spain
| | - Juan Mielgo-Ayuso
- Department of Health Sciences, Faculty of Health Sciences, University of Burgos, Burgos, Spain
| | - Domingo Jesús Ramos-Campo
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Science-INEF, Universidad Politécnica de Madrid, Madrid, Spain
| | | | - Ismael Martínez-Guardado
- BRABE Group, Department of Psychology, Faculty of Life and Natural Sciences, Universidad Camilo José Cela, Madrid, Spain
| | | | - Laura Redondo-Flórez
- Department of Health Sciences, Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, Madrid, Spain
| | | | - Jose Francisco Tornero-Aguilera
- Faculty of Sports Sciences, Universidad Europea de Madrid, Madrid, Spain
- Studies Centre in Applied Combat (CESCA), Toledo, Spain
| |
Collapse
|
10
|
Gokcek O, Yurdalan U, Tugay BU, El C, Dogan S. Evaluation of the possible effect of inspiratory muscle training on inflammation markers and oxidative stress in childhood asthma. Eur J Pediatr 2023; 182:3713-3722. [PMID: 37285069 DOI: 10.1007/s00431-023-05047-4] [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: 01/31/2023] [Revised: 05/26/2023] [Accepted: 05/29/2023] [Indexed: 06/08/2023]
Abstract
Airway inflammation characterized as asthma is one of the most common chronic diseases in the world. The aim of this study was to evaluate the possible effect of inspiratory muscle training on inflammation markers and oxidative stress levels in childhood asthma. A total of 105 children (age range 8-17 years), including 70 asthmatics and 35 healthy children, participated in the study. The 70 asthma patients were randomly assigned to the inspiratory muscle training (IMT) group (n = 35) and control group (n = 35), and healthy children were assigned to the healthy group (n = 35). The IMT group was treated with the threshold IMT device for 7 days/6 weeks at 30% of maximum inspiratory pressure. Respiratory muscle strength was evaluated with a mouth pressure measuring device, and respiratory function was evaluated with a spirometer. In addition, CRP, periostin, TGF-β, and oxidative stress levels were analyzed. The evaluation was performed only once in the healthy group and twice (at the beginning and end of 6 weeks) in asthma patients. In the study, there were significant differences between asthma patients and the healthy group in terms of MIP and MEP values, respiratory function, oxidative stress level, periostin, and TGF-β. Post-treatment, differences were observed in the oxidative stress level, periostin, and TGF-β of the IMT group (p < .05). CONCLUSION After 6 weeks of training, IMT positively contributed to reducing the inflammation level and oxidative stress. This suggests that IMT should be used as an alternative therapy to reduce inflammation and oxidative stress. (Trial Registration: The clinical trial protocol number is NCT05296707). WHAT IS KNOWN • It is known that adjunctive therapies given in addition to pharmacological treatment contribute to improving symptom control and quality of life in individuals with asthma. WHAT IS NEW • There are no studies about the effect of respiratory physiotherapy on biomarkers in asthmatic children. The sub-mechanism of improvement in individuals has not been elucidated. • In this context, inspiratory muscle training has a positive effect on inflammation and oxidative stress levels in children with asthma and IMT should be used as an alternative treatment for childhood asthma.
Collapse
Affiliation(s)
- Ozden Gokcek
- Department of Physiotherapy and Rehabilitation, Health Science Faculty, Ege University, İzmir, Turkey.
| | - Ufuk Yurdalan
- Department of Physiotherapy and Rehabilitation, Health Science Faculty, Medipol University, Istanbul, Turkey
| | - Baki Umut Tugay
- Department of Physiotherapy and Rehabilitation, Health Science Faculty, Mugla Sıtkı Kocman University, Istanbul, Turkey
| | - Cigdem El
- Department of Child Health and Diseases, Tayfur Ata Sökmen Medicine Faculty, Hatay Mustafa Kemal University, Hatay, Turkey
| | - Serdar Dogan
- Department of Biochemistry, Tayfur Ata Sökmen Medicine Faculty, Hatay Mustafa Kemal University, Hatay, Turkey
| |
Collapse
|
11
|
Lista-Paz A, Bouza Cousillas L, Jácome C, Fregonezi G, Labata-Lezaun N, Llurda-Almuzara L, Pérez-Bellmunt A. Effect of respiratory muscle training in asthma: A systematic review and meta-analysis. Ann Phys Rehabil Med 2023; 66:101691. [PMID: 35843501 DOI: 10.1016/j.rehab.2022.101691] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 06/19/2022] [Accepted: 06/21/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUND The last systematic review about respiratory muscle training (RMT) in people with asthma was published almost 10 years ago. Since then, several works have been published. OBJECTIVE To review the effect of RMT in people with asthma. METHODS We conducted a systematic review of research included up to September 2021 in PubMed/MEDLINE, PEDro, Scopus, Web of Science, CINAHL, LILACS, Cochrane Central Register of Controlled Trials and ClinicalTrials.gov. We included randomized controlled trials and quasi-experimental studies assessing the effect of RMT on respiratory muscle function, rescue medication, asthma-related symptoms, lung function, exercise capacity, healthcare use, health-related quality of life (HRQoL) and adverse effects in people with asthma. Risk of bias and methodological quality were assessed with the Cochrane Risk of Bias assessment tool and the PEDro scale. Meta-analysis was performed whenever possible; otherwise a qualitative approach was followed. RESULTS Eleven studies (270 participants) were included, 10 with only adults and were included in the meta-analysis. Inspiratory muscle training (IMT) had beneficial effects on maximal inspiratory pressure (PImax: mean difference [MD] 21.95 cmH2O [95% confidence interval [CI] 15.05; 28.85]), with no changes in maximal expiratory pressure (MD 14.97 cmH2O [95%CI -5.65; 35.59]), lung function (forced expiratory volume in 1 sec: MD 0.06 [95%CI -0.14; 0.26] L; force vital capacity: MD 0.39 [95%CI -0.24; 1.02] L) and exercise capacity (standard mean difference [SMD] 1.73 [95%CI -0.61; 4.08]). Subgroup analysis revealed that IMT load >50% PImax and duration >6 weeks were beneficial for exercise capacity. The qualitative analysis suggested that IMT may have benefits on respiratory muscle endurance, rescue medication and exertional dyspnoea, with no adverse effects. CONCLUSIONS This systematic review and meta-analysis showed a significant increase in PImax after IMT in adults with asthma and reinforced the relevance of the dose-response principle of training. More evidence is needed to clarify the effect of IMT in respiratory muscle endurance, rescue medication, exercise capacity, healthcare use and HRQoL. TRIAL REGISTRATION PROSPERO International Prospective Register of Systematic Reviews CRD42020221939; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=221939.
Collapse
Affiliation(s)
- Ana Lista-Paz
- University of A Coruña, Faculty of Physiotherapy, A Coruña, Spain; Psychosocial and Functional Rehabilitation Intervention Research Group, The University of A Coruña, A Coruña, Spain.
| | | | - Cristina Jácome
- Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto (FMUP), Porto, Portugal
| | - Guilherme Fregonezi
- PneumoCardioVascular Lab/HUOL, Hospital Universitário Onofre Lopes, Empresa Brasileira de Serviços Hospitalares and Departamento de Fisioterapia Universidade Federal do Rio Grande do Norte, Natal, Brazil; Laboratório de Inovação Tecnológica em Reabilitação, Departamento de Fisioterapia, Universidade Federal do Rio Grande do Norte, Natal, Brazil
| | - Noé Labata-Lezaun
- Faculty of Medicine and Health Sciences. Universitat Internacional de Catalunya (UIC-Barcelona), Spain; ACTIUM Functional Anatomy Group. Barcelona, Spain
| | - Luis Llurda-Almuzara
- Faculty of Medicine and Health Sciences. Universitat Internacional de Catalunya (UIC-Barcelona), Spain; ACTIUM Functional Anatomy Group. Barcelona, Spain
| | - Albert Pérez-Bellmunt
- Faculty of Medicine and Health Sciences. Universitat Internacional de Catalunya (UIC-Barcelona), Spain; ACTIUM Functional Anatomy Group. Barcelona, Spain
| |
Collapse
|
12
|
Zaki S, Moiz JA, Mujaddadi A, Ali MS, Talwar D. Does inspiratory muscle training provide additional benefits during pulmonary rehabilitation in people with interstitial lung disease? A randomized control trial. Physiother Theory Pract 2023; 39:518-528. [PMID: 35001815 DOI: 10.1080/09593985.2021.2024311] [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] [Indexed: 10/19/2022]
Abstract
BACKGROUND Interstitial lung disease (ILD) encompasses a diverse group of chronic lung conditions which is often characterized by inspiratory muscle weakness (IMW). Despite the potential importance of inspiratory muscle dysfunction in ILD, the effect of inspiratory muscle training (IMT) added to pulmonary rehabilitation (PR) in ILD largely remains unknown. OBJECTIVE The primary objective of the present study was to evaluate the benefits of IMT added to PR on inspiratory muscle strength and secondary objectives were to assess its effects on functional capacity, health-related quality of life (HRQoL), pulmonary function test (PFT) and dyspnea in ILD along with IMW. METHODS Fifty-one participants were randomly allocated into two groups; PR + IMT (n = 26) or PR alone (n = 25). The primary outcome [maximal inspiratory pressure (PImax)] and secondary outcomes [6-min walk distance (6MWD), St. George's Respiratory Questionnaire (SGRQ), PFT and modified Medical Research Council dyspnea scale (mMRC)] were evaluated before and after the 8-weeks intervention. Independent t-test or Mann Whitney-U test was applied for between-group comparisons while for within-group comparison Wilcoxon's Sign Rank test or paired t test was performed. RESULTS At the end of 8 weeks exercise intervention inspiratory muscle strength (PImax + 11.10 cm H2O, p< .001), functional capacity (6MWD, + 47.90 m, p= .001), HRQoL (SGRQ-total - 4 points, p= .038) and dyspnea (mMRC dyspnea scale, -1.27, p< .001) improved significantly in PR+IMT group alone. CONCLUSION Inclusion of IMT to PR may have superior benefits as compared to PR alone in ILD accompanied with IMW.
Collapse
Affiliation(s)
- Saima Zaki
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia, Maulana Mohammad Ali Jauhar Marg, Jamia Nagar, Okhla, New Delhi, 110025, India
| | - Jamal Ali Moiz
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia, Maulana Mohammad Ali Jauhar Marg, Jamia Nagar, Okhla, New Delhi, 110025, India
| | - Aqsa Mujaddadi
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia, Maulana Mohammad Ali Jauhar Marg, Jamia Nagar, Okhla, New Delhi, 110025, India
| | - Mir Shad Ali
- Department of Pulmonary Rehabilitation, Metro Centre for Respiratory Diseases, Metro Hospital and Multispeciality Institute, Noida, Uttar Pradesh, 201301, India
| | - Deepak Talwar
- Department of Pulmonology Allergy Sleep and Critical Care Medicine, Metro Centre for Respiratory Diseases, Metro Hospital and Multispeciality Institute, Noida, Uttar Pradesh, 201301, India
| |
Collapse
|
13
|
Yang S, Zhang Z, Liu Y, Liu E, Luo Z. The Effects of Combined Respiratory Muscle and Exercise Training in Children with Bronchial Asthma: A Randomised Controlled Study. J Asthma Allergy 2023; 16:293-303. [PMID: 36945322 PMCID: PMC10024882 DOI: 10.2147/jaa.s398108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 02/26/2023] [Indexed: 03/15/2023] Open
Abstract
Objective To investigate the effects of combined respiratory muscle and exercise training on inspiratory muscle strength, exercise capacity, spirometry measurements, asthma control the quality-of-life in children with asthma. Methods Fifty children with asthma, who were treated in children's hospital of Chongqing medical university in Chongqing between May and December 2021, were selected and randomly divided into a rehabilitation group and a control group by using a random number table. The control group was given routine drug treatment and health education while the rehabilitation group received a combination of respiratory muscle and exercise training on the basis of control group. Results After three months of treatment, the maximum inspiratory pressure, level of asthma control and quality-of-life in the rehabilitation group were significantly improved when compared with those in the control group (P<0.05); there were no significant differences in the 6-minute walking test and spirometry measurements (P>0.05). After three months of treatment, all outcome indicators in the rehabilitation group were significantly improved when compared to those before treatment (P<0.05). The mean value of maximum inspiratory pressure and some indices of spirometry measurements in the control group were significantly improved when compared to those before treatment (P<0.05). Conclusion Combining respiratory muscle and exercise training on the basis of the routine drug treatment and health education significantly improved inspiratory muscle strength, the level of asthma control and the quality-of-life in children with asthma. More research is needed to explore its role in asthma in the future.
Collapse
Affiliation(s)
- Shuhui Yang
- Department of Respiratory Disease, Children’s Hospital of Chongqing Medical University/ National Clinical Research Center for Child Health and Disorders/ Ministry of Education Key Laboratory of Child Development and Disorders/ Chongqing Key Laboratory of Pediatrics, Chongqing, People’s Republic of China
| | - Zhanmei Zhang
- Department of Respiratory Disease, Children’s Hospital of Chongqing Medical University/ National Clinical Research Center for Child Health and Disorders/ Ministry of Education Key Laboratory of Child Development and Disorders/ Chongqing Key Laboratory of Pediatrics, Chongqing, People’s Republic of China
| | - Yulin Liu
- Department of Respiratory Disease, Children’s Hospital of Chongqing Medical University/ National Clinical Research Center for Child Health and Disorders/ Ministry of Education Key Laboratory of Child Development and Disorders/ Chongqing Key Laboratory of Pediatrics, Chongqing, People’s Republic of China
- Correspondence: Yulin Liu, Email
| | - Enmei Liu
- Department of Respiratory Disease, Children’s Hospital of Chongqing Medical University/ National Clinical Research Center for Child Health and Disorders/ Ministry of Education Key Laboratory of Child Development and Disorders/ Chongqing Key Laboratory of Pediatrics, Chongqing, People’s Republic of China
| | - Zhengxiu Luo
- Department of Respiratory Disease, Children’s Hospital of Chongqing Medical University/ National Clinical Research Center for Child Health and Disorders/ Ministry of Education Key Laboratory of Child Development and Disorders/ Chongqing Key Laboratory of Pediatrics, Chongqing, People’s Republic of China
| |
Collapse
|
14
|
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.
Collapse
|
15
|
Effectiveness of nordic walking in patients with asthma: A study protocol of a randomized controlled trial. PLoS One 2023; 18:e0281007. [PMID: 36893205 PMCID: PMC9997906 DOI: 10.1371/journal.pone.0281007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 01/05/2023] [Indexed: 03/10/2023] Open
Abstract
BACKGROUND Patients with asthma often consider their symptomatology a barrier to exercise, leading to a reduced physical activity level. This study aims to determine whether the effect of a Nordic walking (NW) training program plus education and usual care is superior to educational and usual care only, in terms of exercise tolerance and other health-related outcomes in patients with asthma. The second aim is to explore the patients' experience with the NW program. METHODS A randomized controlled trial will be conducted with 114 adults with asthma recruited in sanitary area of A Coruña, Spain. Participants will be randomized to NW or control groups in blocks of six and in the same proportion in each group. Participants in the NW group will enrol in supervised sessions during eight weeks, three times/week. All participants will receive three educational sessions on asthma self-management plus usual care (S1 Appendix). Outcomes such as exercise tolerance (primary outcome), physical activity level, asthma-related symptoms and asthma control, dyspnea, lung function, handgrip strength, health related quality of life, quality of sleep, treatment adherence and healthcare resources use will be measured pre and postintervention, and at three and six months of follow-up. Participants in the NW group will additionally participate in focus groups. DISCUSSION This is the first study analysing the effect of NW in patients with asthma. NW combined with education and usual care is expected to improve exercise tolerance, but also asthma-related outcomes. If this hypothesis is confirmed, a new community-based therapeutic approach will be available for patients with asthma. TRIAL REGISTRATION Study registered in ClinicalTrials.gov with number of register NCT05482620.
Collapse
|
16
|
Pulmonary rehabilitation of chronic pulmonary diseases (the review of clinical trials, national and international recommendations). КЛИНИЧЕСКАЯ ПРАКТИКА 2022. [DOI: 10.17816/clinpract111742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
The review of data from randomized clinical trials, results of systematic reviews, international and national clinical recommendations on the problem of pulmonary rehabilitation in chronic pulmonary disease was carried out. This analysis of the studies included the databases eLibrary, Medline, PubMed and Cochrane libraries on the problem of pathophysiology and methods of physical rehabilitation of chronic pulmonary disease. The analysis took into account the opinions of expert groups of clinical recommendations developers of the Russian respiratory society, the European respiratory society, and the American thoracic society, presented in this review. The data of studies confirm the clinical effectiveness of physical rehabilitation methods for chronic pulmonary disease that take into account the unique needs of a complex patient. Pulmonary rehabilitation improves the physical activity, quality of life associated with health, reduces the incidence of exacerbations and mortality of patients with chronic pulmonary disease. Increasing the availability and improving pulmonary rehabilitation programs based on individual assessment of the patient's physical capabilities will increase the use of this method of treatment.
Collapse
|
17
|
Inspiratory Muscle Rehabilitation Training in Pediatrics: What Is the Evidence? Can Respir J 2022; 2022:5680311. [PMID: 36033343 PMCID: PMC9410970 DOI: 10.1155/2022/5680311] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 07/04/2022] [Accepted: 07/15/2022] [Indexed: 11/17/2022] Open
Abstract
Pulmonary rehabilitation is typically used for reducing respiratory symptoms and improving fitness and quality of life for patients with chronic lung disease. However, it is rarely prescribed and may be underused in pediatric conditions. Pulmonary rehabilitation can include inspiratory muscle training that improves the strength and endurance of the respiratory muscles. The purpose of this narrative review is to summarize the current literature related to inspiratory muscle rehabilitation training (IMRT) in healthy and diseased pediatric populations. This review highlights the different methods of IMRT and their effects on respiratory musculature in children. Available literature demonstrates that IMRT can improve respiratory muscle strength and endurance, perceived dyspnea and exertion, maximum voluntary ventilation, and exercise performance in the pediatric population. These mechanistic changes help explain improvements in symptomology and clinical outcomes with IMRT and highlight our evolving understanding of the role of IMRT in pediatric patients. There remains considerable heterogeneity in the literature related to the type of training utilized, training protocols, duration of the training, use of control versus placebo, and reported outcome measures. There is a need to test and refine different IMRT protocols, conduct larger randomized controlled trials, and include patient-centered clinical outcomes to help improve the evidence base and support the use of IMRT in patient care.
Collapse
|
18
|
Chen Y, Fu H. Inspiratory Muscle Training for Asthmatic Patients: A Meta-Analysis
of Randomized Controlled Studies. PHYSIKALISCHE MEDIZIN, REHABILITATIONSMEDIZIN, KURORTMEDIZIN 2022. [DOI: 10.1055/a-1510-3422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Abstract
Introduction The efficacy of inspiratory muscle training (IMT) for asthma
control remains controversial. We conduct a systematic review and meta-analysis
to explore the influence of IMT on asthma control.
Methods We search PubMed, EMbase, Web of science, EBSCO, and Cochrane
library databases through May 2020 for randomized controlled trials (RCTs)
assessing the efficacy of IMT for asthma control. This meta-analysis is
performed using the random-effect model.
Results Six RCTs are included in the meta-analysis. Overall, compared with
control group for asthma, IMT can remarkably increase MIP (SMD=3.32;
95% CI=1.73 to 4.91; P<0.0001) and decrease dyspnea
scores (SMD=−0.77; 95% CI=−1.34 to
−0.21; P=0.007), but has no obvious effect on FEV1
(SMD=0.36; 95% CI=−0.74 to 1.45; P=0.52)
or FVC (SMD=2.09; 95% CI=−0.70 to 4.89;
P=0.14).
Conclusions IMT may benefit to the treatment of asthma.
Collapse
Affiliation(s)
- Ying Chen
- Respiratory Department, Xixi Hospital of Hangzhou, Zhejiang,
China
| | - Haibin Fu
- Department of Internal Medicine, Tongde Hospital of Zhejiang Province,
Zhejiang, China
| |
Collapse
|
19
|
Chohan K, Mittal N, McGillis L, Lopez-Hernandez L, Camacho E, Rachinsky M, Mina DS, Reid WD, Ryan CM, Champagne KA, Orchanian-Cheff A, Clarke H, Rozenberg D. A review of respiratory manifestations and their management in Ehlers-Danlos syndromes and hypermobility spectrum disorders. Chron Respir Dis 2021; 18:14799731211025313. [PMID: 34291699 PMCID: PMC8312172 DOI: 10.1177/14799731211025313] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Ehlers-Danlos Syndromes (EDS) and Hypermobility Spectrum Disorders (HSD) are a heterogeneous group of heritable genetic connective tissue disorders with multiple characteristics including joint hypermobility, tissue fragility, and multiple organ dysfunction. Respiratory manifestations have been described in EDS patients, but have not been systematically characterized. A narrative review was undertaken to describe the respiratory presentations and management strategies of individuals with EDS and HSD. METHODS A broad literature search of Medline, Embase, Cochrane Database of Systematic Reviews, and Cochrane CENTRAL was undertaken from inception to November 2020 of all study types, evaluating EDS/ HSD and pulmonary conditions. This narrative review was limited to adult patients and publications in English. RESULTS Respiratory manifestations have generally been described in hypermobile EDS (hEDS), classical and vascular EDS subtypes. Depending on EDS subtype, they may include but are not limited to dyspnea, dysphonia, asthma, sleep apnea, and reduced respiratory muscle function, with hemothorax and pneumothorax often observed with vascular EDS. Respiratory manifestations in HSD have been less frequently characterized in the literature, but exertional dyspnea is the more common symptom described. Respiratory symptoms in EDS can have an adverse impact on quality of life. The respiratory management of EDS patients has followed standard approaches with thoracotomy tubes and pleurodesis for pleural manifestations, vocal cord strengthening exercises, continuous positive pressure support for sleep apnea, and exercise training. Reduced respiratory muscle function in hEDS patients responds to inspiratory muscle training. CONCLUSION Respiratory symptoms and manifestations are described in EDS and HSD, and have generally been managed using conservative non-surgical strategies. Research into the prevalence, incidence and specific respiratory management strategies in EDS and HSD is needed to mitigate some of the associated morbidity.
Collapse
Affiliation(s)
- Karan Chohan
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Nimish Mittal
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,GoodHope Ehlers Danlos Syndrome Clinic, Toronto General Hospital, Toronto, Ontario, Canada.,KITE-Toronto Rehab-University Health Network, Toronto, Ontario, Canada.,Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada.,Department of Anaesthesia and Pain Management, University of Toronto, Toronto, Ontario, Canada
| | - Laura McGillis
- GoodHope Ehlers Danlos Syndrome Clinic, Toronto General Hospital, Toronto, Ontario, Canada
| | - Laura Lopez-Hernandez
- GoodHope Ehlers Danlos Syndrome Clinic, Toronto General Hospital, Toronto, Ontario, Canada
| | - Encarna Camacho
- GoodHope Ehlers Danlos Syndrome Clinic, Toronto General Hospital, Toronto, Ontario, Canada.,Division of Respirology, University Health Network, Toronto, Ontario, Canada
| | - Maxim Rachinsky
- GoodHope Ehlers Danlos Syndrome Clinic, Toronto General Hospital, Toronto, Ontario, Canada
| | - Daniel Santa Mina
- GoodHope Ehlers Danlos Syndrome Clinic, Toronto General Hospital, Toronto, Ontario, Canada.,Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada.,Department of Anaesthesia and Pain Management, University of Toronto, Toronto, Ontario, Canada
| | - W Darlene Reid
- KITE-Toronto Rehab-University Health Network, Toronto, Ontario, Canada.,Physical Therapy, University of Toronto, Toronto, Ontario, Canada.,Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Clodagh Mai Ryan
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,KITE-Toronto Rehab-University Health Network, Toronto, Ontario, Canada.,Division of Respirology, University Health Network, Toronto, Ontario, Canada
| | | | - Ani Orchanian-Cheff
- Library and Information Services, University Health Network, Toronto, Ontario, Canada
| | - Hance Clarke
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,GoodHope Ehlers Danlos Syndrome Clinic, Toronto General Hospital, Toronto, Ontario, Canada.,Department of Anaesthesia and Pain Management, University of Toronto, Toronto, Ontario, Canada
| | - Dmitry Rozenberg
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,GoodHope Ehlers Danlos Syndrome Clinic, Toronto General Hospital, Toronto, Ontario, Canada.,Division of Respirology, University Health Network, Toronto, Ontario, Canada
| |
Collapse
|
20
|
Inspiratory Muscle Training Program Using the PowerBreath ®: Does It Have Ergogenic Potential for Respiratory and/or Athletic Performance? A Systematic Review with Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18136703. [PMID: 34206354 PMCID: PMC8297193 DOI: 10.3390/ijerph18136703] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 06/19/2021] [Accepted: 06/19/2021] [Indexed: 12/28/2022]
Abstract
This systematic review and meta-analysis aim to provide scientific evidence regarding the effects of training on respiratory muscle training’s impact with the PowerBreath®. A systematic analysis based on the PRISMA guides and a conducted research structured around the bases of Web of Science, Scopus, Medline/PubMed, SciELO y Cochrane Library Plus. Six articles published before January 2021 were included. The documentation and quantification of heterogeneity in every meta-analysis were directed through Cochran’s Q test and the statistic I2; additionally, a biased publication analysis was made using funnel plots, whose asymmetry was quantified Egger’s regression. The methodological quality was assessed through McMaster’s. PowerBreath® administering a ≥ 15% resistive load of the maximum inspiratory pressure (PIM) achieves significant improvements (54%) in said pressure within 4 weeks of commencing the inspiratory muscle training. The maximal volume of oxygen (VO2max) considerable enhancements was achieved from the 6 weeks associated with the maximum inspiratory pressure ≥ 21.5% post inspiratory muscle training onwards. Conversely, a significant blood lactate concentration decrement occurred from the 4th week of inspiratory muscle training, after a maximum inspiratory pressure ≥ 6.8% increment. PowerBreath® is a useful device to stimulate sport performance and increase pulmonary function.
Collapse
|
21
|
Chung Y, Huang TY, Liao YH, Kuo YC. 12-Week Inspiratory Muscle Training Improves Respiratory Muscle Strength in Adult Patients with Stable Asthma: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18063267. [PMID: 33809922 PMCID: PMC8004228 DOI: 10.3390/ijerph18063267] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 03/12/2021] [Accepted: 03/18/2021] [Indexed: 11/29/2022]
Abstract
This study aims to investigate and compare the effects of conventional breathing exercises and an inspiratory muscle training intervention on clinical symptoms in asthma patients. Sixty asthma patients (40–65 years old) were randomly assigned to either the conventional breathing exercises (BTE) or inspiratory muscle training (IMT) group for a 12-week intervention period. Outcome measurements were performed before and after the intervention, including the spirometry data, maximal inspiratory and expiratory pressures (PImax and PEmax), asthma control test, asthma control questionnaire, six-minute walk test, and three-day physical activity log, were recorded. PImax expressed as % of predicted value controlled for age and gender in healthy subjects (% predicted) increased by 16.92% (82.45% to 99.38%, p < 0.05) in the BTE group and by 29.84% (71.19% to 101.03%, p < 0.05) in the IMT group. Except for forced vital capacity, which was reduced in the BTE group, all other measured variables improved in both groups, and no statistically significant between-group differences were found. IMT appears to be more effective than breathing exercise intervention in promoting improvements in respiratory muscle strength. IMT may act as an alternative to conventional breathing exercises for middle-aged and elderly asthma patients.
Collapse
Affiliation(s)
- Yi Chung
- College of Human Development and Health, National Taipei University of Nursing and Health Sciences, Taipei 112, Taiwan;
| | - Ting-Yu Huang
- Department of Exercise and Health Science, National Taipei University of Nursing and Health Sciences, Taipei 112, Taiwan; (T.-Y.H.); (Y.-H.L.)
| | - Yi-Hung Liao
- Department of Exercise and Health Science, National Taipei University of Nursing and Health Sciences, Taipei 112, Taiwan; (T.-Y.H.); (Y.-H.L.)
| | - Yu-Chi Kuo
- College of Human Development and Health, National Taipei University of Nursing and Health Sciences, Taipei 112, Taiwan;
- Department of Exercise and Health Science, National Taipei University of Nursing and Health Sciences, Taipei 112, Taiwan; (T.-Y.H.); (Y.-H.L.)
- Correspondence:
| |
Collapse
|
22
|
Lage SM, Pereira DAG, Corradi Magalhães Nepomuceno AL, Castro ACD, Araújo AG, Hoffman M, Silveira BMF, Parreira VF. Efficacy of inspiratory muscle training on inspiratory muscle function, functional capacity, and quality of life in patients with asthma: A randomized controlled trial. Clin Rehabil 2021; 35:870-881. [PMID: 33406892 DOI: 10.1177/0269215520984047] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To evaluate the efficacy of an inspiratory muscle training protocol on inspiratory muscle function, functional capacity, and quality of life in patients with asthma. DESIGN A single-blind, randomized controlled clinical trial. SETTING Community-based. SUBJECTS Patients with asthma, aged between 20 and 70 years old, non-smokers. INTERVENTIONS Participants were randomized into two groups: inspiratory muscle training group performed inspiratory muscle training 5 days a week for 8 weeks, consisting of six sets of 30 breaths per day with a training load ⩾50% of maximal inspiratory pressure, plus an educational program; the control group only received the educational program. MAIN MEASUREMENTS Maximal inspiratory pressure, inspiratory muscle endurance, and the distance performed on the incremental shuttle walking test were assessed pre-intervention, post-intervention and at follow-up (3 months after the end of the intervention). The asthma quality of life questionnaire was applied pre and post-intervention. RESULTS Data from 39 participants were analyzed. Maximal inspiratory pressure in percentage of predicted and endurance test duration were significantly higher post-intervention in the inspiratory muscle training group (∆ post-pre: 50.8% vs 7.3% of predicted - P < 0.001 and ∆ post-pre: 207.9 seconds vs 2.7 seconds - P < 0.001, respectively). There was no significant difference in the incremental shuttle walking distance between groups (∆ post-pre: 30.9 m vs -8.1 m, P = 0.165). Quality of life was perceived as significantly better, without a difference between groups (P > 0.05). CONCLUSIONS About 8 weeks of inspiratory muscle training in patients with controlled asthma significantly increased inspiratory muscle strength and endurance.
Collapse
Affiliation(s)
- Susan Martins Lage
- Rehabilitation Sciences Program, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.,Faculdade Ciências Médicas de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | | | | | | | - Mariana Hoffman
- Rehabilitation Sciences Program, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.,Department of Allergy, Immunology and Respiratory Medicine, Monash University, Melbourne, VIC, Australia
| | - Bruna Mara Franco Silveira
- Rehabilitation Sciences Program, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Verônica Franco Parreira
- Department of Physical Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| |
Collapse
|
23
|
Elnaggar RK. A randomized placebo-controlled study investigating the efficacy of inspiratory muscle training in the treatment of children with bronchial asthma. J Asthma 2020; 58:1661-1669. [PMID: 32900246 DOI: 10.1080/02770903.2020.1821058] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To investigate the efficacy of inspiratory muscle training (IMT) on respiratory functions, respiratory muscle strength, and asthma symptoms in asthmatic children. METHODS In a randomized placebo-controlled assessor-blinded study, 34 children with asthma were randomized to receive either the IMT at 40% of the maximal inspiratory pressure (IPmax) for 20 min/session, thrice/week, over 12 consecutive weeks (IMT group; n = 17) or placebo IMT at 5% of IPmax (placebo group; n = 17). Additionally, both groups received the conventional respiratory rehabilitation (CRR) program. Outcome measurements performed pre- and post-treatment, included respiratory functions [forced expiratory volume at the first second (FEV1), forced vital capacity (FEV), and FEV1/FVC], respiratory muscle strength [represented by IPmax and maximal expiratory pressure (EPmax), and asthma control test (ACT). RESULTS At a significance level adjusted to P<.008, there were significant post-treatment differences between the IMT and placebo groups in FEV1 (P=.003), FVC (P=.001), FEV1/FVC (P=.004), IPmax (P=.002), EPmax (P=.004), and ACT (P=.001) adjusted to the pretreatment values, in favor of the IMT group. CONCLUSION Incorporation of IMT in the CRR program for children with asthma can improve respiratory function, enhance respiratory muscle strength, and improve children's perception of asthma symptoms.
Collapse
Affiliation(s)
- Ragab K Elnaggar
- Department of Physical Therapy and Health Rehabilitation, Collage of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia.,Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| |
Collapse
|
24
|
Respiratory Muscle Strength Training to Improve Vocal Function in Patients with Presbyphonia. J Voice 2020; 36:344-360. [PMID: 32680804 DOI: 10.1016/j.jvoice.2020.06.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 06/03/2020] [Accepted: 06/04/2020] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND OBJECTIVE The effects of presbyphonia are compounded by the decline in respiratory function that occurs with age. Commonly recommended exercises to optimize the use of respiratory muscles during speech, such as diaphragmatic breathing, are unlikely to be intensive enough to induce respiratory changes and impact vocal function. The objective of this study was to assess the effect of adding a targeted intervention, respiratory muscle strength training, to voice exercises in a sample of patients with presbyphonia. METHODS/DESIGN In this prospective, randomized-controlled trial, 12 participants received either (1) vocal function exercises (VFE), (2) VFE combined with inspiratory muscle strength training (IMST), or (3) VFE combined with expiratory muscle strength training (EMST). Data collected prior to and following 4 weekly intervention sessions included respiratory measures (pulmonary function and respiratory muscle strength) and voice measures (videostroboscopy, acoustic, auditory-perceptual, aerodynamic, and self-assessment measures). RESULTS Participants who received IMST improved their voice quality during connected speech (smoothed cepstral peak prominence and ratings of overall voice quality) and their scores on the three self-assessment questionnaires with large to very large within-group effect sizes (|d| = 0.82-1.61). In addition, participants in the IMST group reduced their subglottal pressure with a large effect size (d = -0.92). Participants who received EMST improved their maximum expiratory strength and smoothed cepstral peak prominence with large effect sizes (d = 0.80 and 0.99, respectively) but had limited improvements in other outcomes. Participants who received only VFE decreased their amount of vocal fold bowing, improved their voice quality on a sustained vowel (amplitude perturbation quotient), and improved their Glottal Function Index score with large effect sizes (|d| = 0.74-1.00). CONCLUSION Preliminary data indicate that adding IMST to voice exercises may lead to the greatest benefits in patients with presbyphonia by promoting improved subglottal pressure control as well as increasing air available for phonation, resulting in improved self-assessment outcomes.
Collapse
|
25
|
The Impact of Respiratory Exercises on Voice Outcomes: A Systematic Review of the Literature. J Voice 2020; 34:648.e1-648.e39. [DOI: 10.1016/j.jvoice.2019.01.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 01/22/2019] [Accepted: 01/24/2019] [Indexed: 12/14/2022]
|
26
|
Yilmaz C, Bostancı Ö, Bulut S. Effect of Respiratory Muscle Training on Pitch Range and Sound Duration in Brass Instrument Players and Singers. J Voice 2020; 36:76-82. [PMID: 32451252 DOI: 10.1016/j.jvoice.2020.04.012] [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: 11/25/2019] [Revised: 04/09/2020] [Accepted: 04/13/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVE Effective use of respiratory organs is important for musicians. Therefore, the impact of Respiratory Muscle Training (RMT) on phonation is open to research. The aim of this study was to investigate the measurable effects of RMT on blowing in brass instrumental and on voice performance in singers. METHODS Thirty musicians were recruited and separated into a four groups. The brass instrumental and singers groups were further subdivided into control and RMT groups for a 4 week RMT intervention giving a total four groups: singers experimental (SE; n:10), singers control (SC; n:10), brass instrument players experimental (BIPE; n:5), and BIPC (n:5). The groups selected from the musicians of Samsun State Opera and Ballet Directorate and Samsun Metropolitan Municipality Band Team participated in the study. RESULTS After 4 weeks of RMT application in the study groups, significant increase in all parameters except Forced vital capacity/Forced expiratory volume in 1 second was observed in the values of pulmonary function tests and respiratory muscle strength in subjects with SE and BIPE (P < 0.05). The most significant results of this study are that in addition to changes in the duration of phonation (SE 36%), high-pitch (SE 79%, BIPE 27%) and low-pitch sounds (BIPE 61% and SE 42%), the SE (15%) and BIPE (3%) groups reached higher pitches in the high-pitch notes. CONCLUSIONS It was determined that performance of the highest and lowest pitch sounds within a vocal register in a single breath and phonation times can be improved by RMT.
Collapse
Affiliation(s)
- Coşkun Yilmaz
- Ondokuz Mayıs University, Graduate School of Health Sciences, Samsun, Turkey.
| | - Özgür Bostancı
- Ondokuz Mayıs University, Yasar Dogu Sport Science Faculty, Department of Physical Education and Sports, Samsun, Turkey
| | - Seyhan Bulut
- Ondokuz Mayıs University, State Conservatory, Department of Music, Samsun, Turkey
| |
Collapse
|
27
|
Zampogna E, Zappa M, Spanevello A, Visca D. Pulmonary Rehabilitation and Asthma. Front Pharmacol 2020; 11:542. [PMID: 32435190 PMCID: PMC7219266 DOI: 10.3389/fphar.2020.00542] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 04/09/2020] [Indexed: 12/29/2022] Open
Abstract
Asthma is a chronic inflammatory disease characterized by airflow limitation and variable respiratory symptoms. It is characterized by variable symptoms such as cough, wheeze, chest tightness, and shortness of breath which vary in intensity and time. In order to reach a comprehensive approach of disease management, the importance of non-pharmacological treatment in addition to pharmacological therapy has been recently highlighted. Studies have documented that pulmonary rehabilitation has beneficial effects in patients with asthma, at any stage of the disease, improving exercise capacity, asthma control, and quality of life and reducing wheezing, anxiety, depression, and bronchial inflammation. Although several evidences suggest a role of pulmonary rehabilitation in patients with asthma, additional information is required to identify a specific program in order to improve clinical care based on specific patient’s needs.
Collapse
Affiliation(s)
- Elisabetta Zampogna
- Istituti Clinici Scientifici Maugeri IRCCS, Respiratory Rehabilitation of the Istitute of Tradate (VA), Tradate, Italy
| | - Martina Zappa
- Department of Medicine and Surgery, Respiratory Diseases, University of Insubria, Varese-Como, Italy
| | - Antonio Spanevello
- Istituti Clinici Scientifici Maugeri IRCCS, Respiratory Rehabilitation of the Istitute of Tradate (VA), Tradate, Italy.,Department of Medicine and Surgery, Respiratory Diseases, University of Insubria, Varese-Como, Italy
| | - Dina Visca
- Istituti Clinici Scientifici Maugeri IRCCS, Respiratory Rehabilitation of the Istitute of Tradate (VA), Tradate, Italy.,Department of Medicine and Surgery, Respiratory Diseases, University of Insubria, Varese-Como, Italy
| |
Collapse
|
28
|
|
29
|
Palau P, Domínguez E, Ramón JM, López L, Briatore AE, Tormo JP, Ventura B, Chorro FJ, Núñez J. Home-based inspiratory muscle training for management of older patients with heart failure with preserved ejection fraction: does baseline inspiratory muscle pressure matter? Eur J Cardiovasc Nurs 2019; 18:621-627. [PMID: 31148459 DOI: 10.1177/1474515119855183] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Heart failure with preserved ejection fraction is a clinical syndrome characterised by reduced exercise capacity. Some evidence has shown that a simple and home-based programme of inspiratory muscle training offers promising results in terms of aerobic capacity improvement in patients with heart failure with preserved ejection fraction. This study aimed to investigate whether the baseline inspiratory muscle function predicts the changes in aerobic capacity (measured as peak oxygen uptake; peak VO2) after a 12-week home-based programme of inspiratory muscle training in patients with heart failure with preserved ejection fraction. METHODS A total of 45 stable symptomatic patients with heart failure with preserved ejection fraction and New York Heart Association II-III received a 12-week home-based programme of inspiratory muscle training between June 2015 and December 2016. They underwent cardiopulmonary exercise testing and measurements of maximum inspiratory pressure pre and post-inspiratory muscle training. Maximum inspiratory pressure and peak VO2 were registered in both visits. Multivariate linear regression analysis was used to assess the association between changes in peak VO2 (Δ-peakVO2) and baseline predicted maximum inspiratory pressure (pp-MIP). RESULTS The median (interquartile range) age was 73 (68-77) years, 47% were women and 35.6% displayed New York Heart Association III. The mean peak VO2 at baseline and Δ-peakVO2 post-training were 10.4±2.8 ml/min/kg and +2.2±1.3 ml/min/kg (+21.3%), respectively. The median (interquartile range) of pp-MIP and Δ-MIP were 71% (64-92) and 39.2 (26.7-80.4) cmH2O, respectively. After a multivariate analysis, baseline pp-MIP was not associated with Δ-peakVO2 (β coefficient 0.005, 95% confidence interval -0.009-0.019, P=0.452). CONCLUSIONS In symptomatic and deconditioned older patients with heart failure with preserved ejection fraction, a home-based inspiratory muscle training programme improves aerobic capacity regardless of the baseline maximum inspiratory pressure.
Collapse
Affiliation(s)
- Patricia Palau
- Servicio de Cardiología. Hospital General Universitario de Castellón. Universitat Jaume I, Spain
| | - Eloy Domínguez
- Servicio de Cardiología. Hospital General Universitario de Castellón. Universitat Jaume I, Spain
| | - José María Ramón
- Servicio de Cardiología, Hospital Clínico Universitario, INCLIVA. Universitat de València. Spain
| | - Laura López
- Departamento de Fisioterapia, Universitat de València, Spain
| | - Antonio Ernesto Briatore
- Servicio de Cardiología. Hospital General Universitario de Castellón. Universitat Jaume I, Spain
| | - J Pablo Tormo
- Servicio de Cardiología. Hospital General Universitario de Castellón. Universitat Jaume I, Spain
| | - Bruno Ventura
- Servicio de Cardiología. Hospital General Universitario de Castellón. Universitat Jaume I, Spain
| | - Francisco J Chorro
- Servicio de Cardiología, Hospital Clínico Universitario, INCLIVA. Universitat de València. Spain.,Servicio de Cardiología, Hospital Clínico Universitario, CIBERCV, Spain
| | - Julio Núñez
- Servicio de Cardiología, Hospital Clínico Universitario, INCLIVA. Universitat de València. Spain.,Servicio de Cardiología, Hospital Clínico Universitario, CIBERCV, Spain
| |
Collapse
|