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Dcosta JV, Ochoa D, Sanaur S. Recent Progress in Flexible and Wearable All Organic Photoplethysmography Sensors for SpO 2 Monitoring. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2023; 10:e2302752. [PMID: 37740697 PMCID: PMC10625116 DOI: 10.1002/advs.202302752] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 07/09/2023] [Indexed: 09/25/2023]
Abstract
Flexible and wearable biosensors are the next-generation healthcare devices that can efficiently monitor human health conditions in day-to-day life. Moreover, the rapid growth and technological advancements in wearable optoelectronics have promoted the development of flexible organic photoplethysmography (PPG) biosensor systems that can be implanted directly onto the human body without any additional interface for efficient bio-signal monitoring. As an example, the pulse oximeter utilizes PPG signals to monitor the oxygen saturation (SpO2 ) in the blood volume using two distinct wavelengths with organic light emitting diode (OLED) as light source and an organic photodiode (OPD) as light sensor. Utilizing the flexible and soft properties of organic semiconductors, pulse oximeter can be both flexible and conformal when fabricated on thin polymeric substrates. It can also provide highly efficient human-machine interface systems that can allow for long-time biological integration and flawless measurement of signal data. In this work, a clear and systematic overview of the latest progress and updates in flexible and wearable all-organic pulse oximetry sensors for SpO2 monitoring, including design and geometry, processing techniques and materials, encapsulation and various factors affecting the device performance, and limitations are provided. Finally, some of the research challenges and future opportunities in the field are mentioned.
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Affiliation(s)
- Jostin Vinroy Dcosta
- Mines Saint‐ÉtienneCentre Microélectronique de ProvenceDepartment of Flexible Electronics880, Avenue de MimetGardanne13541France
| | - Daniel Ochoa
- Mines Saint‐ÉtienneCentre Microélectronique de ProvenceDepartment of Flexible Electronics880, Avenue de MimetGardanne13541France
| | - Sébastien Sanaur
- Mines Saint‐ÉtienneCentre Microélectronique de ProvenceDepartment of Flexible Electronics880, Avenue de MimetGardanne13541France
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de Medeiros Nogueira MG, Silva GAG, Marinho MHT, de Fátima Costa Brito O, de Brito Vieira WH, Ururahy MAG, Nogueira IDB, da Silva IS, de Miranda Silva Nogueira PA. Acute effects of NIV on peripheral muscle function and aerobic performance in patients with chronic obstructive pulmonary disease: a pilot study. BMC Pulm Med 2022; 22:399. [PMID: 36333720 PMCID: PMC9635205 DOI: 10.1186/s12890-022-02201-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 10/21/2022] [Indexed: 11/06/2022] Open
Abstract
Background Non-invasive ventilation (NIV) reduces respiratory load and demands on peripheral muscles. Methods This study aims to evaluate the acute effects of bi-level NIV on peripheral muscle function during isokinetic exercise and aerobic performance in chronic obstructive pulmonary disease (COPD) patients. This is a pilot crossover study performed with a non-probabilistic sample of 14 moderate to very severe COPD patients. Procedures carried out in two days. Dyspnea, quality of life, lung function, respiratory muscle strength, functional capacity (6-min walk test—6MWT), and isokinetic assessment of the quadriceps were assessed. Blood samples (lactate, lactate dehydrogenase, and creatine kinase concentration) were also collected. Right after, NIV was performed for 30 min (bi-level or placebo, according to randomization) followed by new blood sample collection, 6MWT, and isokinetic dynamometer tests. Before and after evaluations, the subjective perception of dyspnea and fatigue in the lower limbs was quantified. After a wash-out period of seven days, participants returned, and all assessments were performed again. Results NIV showed improvements in perceived exertion and dyspnea after isokinetic exercise (p < 0.02 and p < 0.05, respectively). Conclusions NIV improves the perception of dyspnea and fatigue during the isokinetic exercise.
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Affiliation(s)
- Mariana Galvão de Medeiros Nogueira
- grid.411233.60000 0000 9687 399XPhysiotherapy, Federal University of Rio Grande Do Norte, Av. Senador Salgado Filho, 3000, Candelária, Caixa Postal: 1524, Natal, Rio Grande Do Norte 59072970 Brazil
| | - Gabriely Azevêdo Gonçalo Silva
- grid.411233.60000 0000 9687 399XPhysiotherapy, Federal University of Rio Grande Do Norte, Av. Senador Salgado Filho, 3000, Candelária, Caixa Postal: 1524, Natal, Rio Grande Do Norte 59072970 Brazil
| | | | - Ozana de Fátima Costa Brito
- grid.411233.60000 0000 9687 399XPhysiotherapy, Federal University of Rio Grande Do Norte, Av. Senador Salgado Filho, 3000, Candelária, Caixa Postal: 1524, Natal, Rio Grande Do Norte 59072970 Brazil
| | - Wouber Hérickson de Brito Vieira
- grid.411233.60000 0000 9687 399XPhysiotherapy, Federal University of Rio Grande Do Norte, Av. Senador Salgado Filho, 3000, Candelária, Caixa Postal: 1524, Natal, Rio Grande Do Norte 59072970 Brazil
| | - Marcela Abbott Galvão Ururahy
- grid.411233.60000 0000 9687 399XDepartment of Clinical and Toxicological Analysis, Federal University of Rio Grande Do Norte, Natal, Rio Grande Do Norte Brazil
| | - Ivan Daniel Bezerra Nogueira
- grid.411233.60000 0000 9687 399XPhysiotherapy, Federal University of Rio Grande Do Norte, Av. Senador Salgado Filho, 3000, Candelária, Caixa Postal: 1524, Natal, Rio Grande Do Norte 59072970 Brazil
| | - Ivanízia Soares da Silva
- grid.411233.60000 0000 9687 399XPhysiotherapy, Federal University of Rio Grande Do Norte, Av. Senador Salgado Filho, 3000, Candelária, Caixa Postal: 1524, Natal, Rio Grande Do Norte 59072970 Brazil
| | - Patrícia Angélica de Miranda Silva Nogueira
- grid.411233.60000 0000 9687 399XPhysiotherapy, Federal University of Rio Grande Do Norte, Av. Senador Salgado Filho, 3000, Candelária, Caixa Postal: 1524, Natal, Rio Grande Do Norte 59072970 Brazil
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Dennis CJ, Menadue C, Schneeberger T, Leitl D, Schoenheit-Kenn U, Hoyos CM, Harmer AR, Barnes DJ, Koczulla RA, Kenn K, Alison JA. Bilevel Noninvasive Ventilation During Exercise Reduces Dynamic Hyperinflation and Improves Cycle Endurance Time in Severe to Very Severe COPD. Chest 2021; 160:2066-2079. [PMID: 34224690 DOI: 10.1016/j.chest.2021.06.050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 06/17/2021] [Accepted: 06/22/2021] [Indexed: 10/21/2022] Open
Abstract
BACKGROUND During exercise, dynamic hyperinflation (DH), measured by a reduction in inspiratory capacity (IC), increases exertional dyspnea and reduces functional capacity in many patients with severe COPD. Although noninvasive ventilation (NIV) during exercise can improve exercise duration, the effect on DH is unclear. RESEARCH QUESTIONS In people with COPD, resting hyperinflation, and evidence of DH during exercise, does bilevel NIV during exercise reduce DH and increase endurance time compared with exercise with no NIV, and does NIV with an individually titrated expiratory positive airway pressure (T-EPAP) reduce DH and increase exercise endurance time more than does NIV with standardized EPAP (S-EPAP) of 5 cm H2O? STUDY DESIGN AND METHODS A randomized crossover trial in which investigators and participants were blinded between NIV interventions was performed. Participants (N = 19; FEV1 of 1.02 ± 0.24 L (39% ± 6% predicted) completed three constant work rate endurance cycle tests in random order-no NIV, NIV with S-EPAP, and NIV with T-EPAP-during exercise. Primary outcomes were isotime IC and exercise endurance time. Outcome measures from each intervention were compared at isotime and at end exercise by using a linear mixed-model analysis. RESULTS Compared with those with no NIV, isotime IC and endurance time were greater with both NIV with S-EPAP (mean difference: 95% CI, 0.19 L [0.10-0.28]; 95% CI, 153 s [24-280], respectively) and T-EPAP (95% CI, 0.22 L [0.13-0.32]; 95% CI, 145 s [28-259], respectively). There was no difference between NIV with S-EPAP and NIV with T-EPAP. INTERPRETATION In people with COPD and DH during exercise, NIV during exercise reduced DH and increased cycle endurance time. An S-EPAP of 5 cm H2O was adequate to obtain these benefits. TRIAL REGISTRY Australian New Zealand Clinical Trials Registry; No.: ACTRN12613000804785; URL: http://www.anzctr.org.au.
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Affiliation(s)
- Clancy J Dennis
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
| | - Collette Menadue
- Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Sydney, NSW, Australia
| | - Tessa Schneeberger
- Institute for Pulmonary Rehabilitation Research, Schoen Klinik Berchtesgadener Land, Schoenau am Koenigssee, Germany; Department of Pulmonary Rehabilitation, Philipps-University of Marburg, German Centre for Lung Research (DZL), Marburg, Germany
| | - Daniela Leitl
- Institute for Pulmonary Rehabilitation Research, Schoen Klinik Berchtesgadener Land, Schoenau am Koenigssee, Germany; Department of Pulmonary Rehabilitation, Philipps-University of Marburg, German Centre for Lung Research (DZL), Marburg, Germany
| | - Ursula Schoenheit-Kenn
- Institute for Pulmonary Rehabilitation Research, Schoen Klinik Berchtesgadener Land, Schoenau am Koenigssee, Germany
| | - Camilla M Hoyos
- School of Psychology, University of Sydney, Sydney, NSW, Australia; Woolcock Institute of Medical Research, Centre for Sleep and Chronobiology, Sydney, NSW, Australia
| | - Alison R Harmer
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - David J Barnes
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia; Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Sydney, NSW, Australia
| | - Rembert A Koczulla
- Institute for Pulmonary Rehabilitation Research, Schoen Klinik Berchtesgadener Land, Schoenau am Koenigssee, Germany; Department of Pulmonary Rehabilitation, Philipps-University of Marburg, German Centre for Lung Research (DZL), Marburg, Germany; Teaching Hospital, Paracelsus Medical University, Salzburg, Austria
| | - Klaus Kenn
- Institute for Pulmonary Rehabilitation Research, Schoen Klinik Berchtesgadener Land, Schoenau am Koenigssee, Germany; Department of Pulmonary Rehabilitation, Philipps-University of Marburg, German Centre for Lung Research (DZL), Marburg, Germany
| | - Jennifer A Alison
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia; Sydney Local Health District, Allied Health, Sydney, NSW, Australia
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Whole-body electrical stimulation as a strategy to improve functional capacity and preserver lean mass after bariatric surgery: a randomized triple-blind controlled trial. Int J Obes (Lond) 2021; 45:1476-1487. [PMID: 33927333 DOI: 10.1038/s41366-021-00812-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 03/10/2021] [Accepted: 04/09/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND/OBJECTIVES Bariatric surgery (BS) is a successful, long-lasting treatment option for obese. The early postoperative (PO) period is followed by dietary restriction and physical inactivity, leading to declines in muscle mass and functional capacity. Whole-body electromyostimulation (WB-EMS) may be a feasible and potential early rehabilitation strategy post BS. The aim was to evaluate the effects of WB-EMS with exercise training (Fe) on functional capacity, body composition, blood biomarkers, muscle strength, and endurance post BS. SUBJECTS/METHODS This is a randomized, triple-blind, sham-controlled trial. Thirty-five volunteers underwent a Roux-en-Y gastric bypass and were randomized into a WB-EMS (WB-EMSG) or control group (ShamG). Preoperative evaluations consisted of maximal and submaximal exercise testing, body composition, blood biomarkers, quadriceps strength, and endurance. After discharge, functional capacity and body composition were obtained. Exercise training protocols in both groups consisted of 14 dynamic exercises, 5 days per week, completing 30 sessions. The WB-EMSG also underwent an electrical stimulation protocol (Endurance: 85 Hz, 350 ms, 6 s of strain, 4 f of rest; Strength: 30 Hz, 350 ms, 4 s of strain, 10 seconds of rest, with bipolar electrical pulse). After intervention, subjects were reevaluated. RESULTS The protocol started on average 6.7 ± 3.7 days after discharge. Both groups presented with a decline in functional capacity after BS (p < 0.05) and a reduction in all body composition measurements (p < 0.05). The exercise training program led to significant improvements in functional capacity (ShamG - PO: 453.8 ± 66.1 m, Post: 519.2 ± 62.8 m; WB-EMSG- PO: 435.9 ± 74.5, Post: 562.5 ± 66.4 m, p < 0.05), however, only the WB-EMSG demonstrated significant changes of distance walked (interaction time vs group effect, p < 0.05). In addition, adiponectin significantly increased only in the WB-EMSG (p < 0.05). The WB-EMSG was also able to preserve muscle strength, endurance, and fatigue index, while the ShamG demonstrated significant decline (p < 0.05). CONCLUSION WB-EMS + Fe can be an attractive and feasible method following BS to enhance functional capacity and prevent deterioration of muscle function in the early PO. CLINICAL TRIAL REGISTRATION ReBEC, RBR-99qw5h, on 20 February 2015.
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Borghi-Silva A, Goulart CDL, Carrascosa CR, Oliveira CC, Berton DC, de Almeida DR, Nery LE, Arena R, Neder JA. Proportional Assist Ventilation Improves Leg Muscle Reoxygenation After Exercise in Heart Failure With Reduced Ejection Fraction. Front Physiol 2021; 12:685274. [PMID: 34234692 PMCID: PMC8255967 DOI: 10.3389/fphys.2021.685274] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 05/21/2021] [Indexed: 12/31/2022] Open
Abstract
Background Respiratory muscle unloading through proportional assist ventilation (PAV) may enhance leg oxygen delivery, thereby speeding off-exercise oxygen uptake ( V . O 2 ) kinetics in patients with heart failure with reduced left ventricular ejection fraction (HFrEF). Methods Ten male patients (HFrEF = 26 ± 9%, age 50 ± 13 years, and body mass index 25 ± 3 kg m2) underwent two constant work rate tests at 80% peak of maximal cardiopulmonary exercise test to tolerance under PAV and sham ventilation. Post-exercise kinetics of V . O 2 , vastus lateralis deoxyhemoglobin ([deoxy-Hb + Mb]) by near-infrared spectroscopy, and cardiac output (Q T ) by impedance cardiography were assessed. Results PAV prolonged exercise tolerance compared with sham (587 ± 390 s vs. 444 ± 296 s, respectively; p = 0.01). PAV significantly accelerated V . O 2 recovery (τ = 56 ± 22 s vs. 77 ± 42 s; p < 0.05), being associated with a faster decline in Δ[deoxy-Hb + Mb] and Q T compared with sham (τ = 31 ± 19 s vs. 42 ± 22 s and 39 ± 22 s vs. 78 ± 46 s, p < 0.05). Faster off-exercise decrease in Q T with PAV was related to longer exercise duration (r = -0.76; p < 0.05). Conclusion PAV accelerates the recovery of central hemodynamics and muscle oxygenation in HFrEF. These beneficial effects might prove useful to improve the tolerance to repeated exercise during cardiac rehabilitation.
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Affiliation(s)
- Audrey Borghi-Silva
- Cardiopulmonary Physiotherapy Laboratory, Federal University of São Carlos (UFSCar), São Paulo, Brazil.,Pulmonary Function and Clinical Exercise Physiology Unit, Division of Respiratory Diseases, Department of Medicine, Federal University of Sao Paulo (UNIFESP), São Paulo, Brazil
| | - Cassia da Luz Goulart
- Cardiopulmonary Physiotherapy Laboratory, Federal University of São Carlos (UFSCar), São Paulo, Brazil
| | - Cláudia R Carrascosa
- Pulmonary Function and Clinical Exercise Physiology Unit, Division of Respiratory Diseases, Department of Medicine, Federal University of Sao Paulo (UNIFESP), São Paulo, Brazil
| | | | - Danilo C Berton
- Pulmonary Physiology Unit, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Dirceu Rodrigues de Almeida
- Division of Cardiology, Department of Medicine, Federal University of Sao Paulo (UNIFESP), São Paulo, Brazil
| | - Luiz Eduardo Nery
- Pulmonary Function and Clinical Exercise Physiology Unit, Division of Respiratory Diseases, Department of Medicine, Federal University of Sao Paulo (UNIFESP), São Paulo, Brazil
| | - Ross Arena
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States
| | - J Alberto Neder
- Pulmonary Function and Clinical Exercise Physiology Unit, Division of Respiratory Diseases, Department of Medicine, Federal University of Sao Paulo (UNIFESP), São Paulo, Brazil.,Respiratory Investigation Unit, Division of Respirology, Department of Medicine, Kingston Health Science Center and Queen's University, Kingston, ON, Canada
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Mead AC, McGlynn ML, Slivka DR. Acute effects of functional dry needling on skeletal muscle function. J Bodyw Mov Ther 2020; 26:123-127. [PMID: 33992232 DOI: 10.1016/j.jbmt.2020.12.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 11/02/2020] [Accepted: 12/05/2020] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Functional dry needling (FDN) is commonly used to treat soft tissue pain-related conditions. Previous research has demonstrated benefits to chronic resistance training; however, objective physiological measures sensitive to acute exercise have not been found. The purpose of this study was to evaluate the acute effects of FDN on muscle strength and endurance. METHODS Ten subjects (height 168 ± 9 cm, mass 68.2 ± 11.3 kg) were tested bilaterally (pre and post) for vastus lateralis (VL) isometric strength, isokinetic fatigue index, muscle electrical activity, and muscle oxygenation. FDN was administered to one leg, while the other served as a control. RESULTS Limited acute effects of functional dry needling were observed (p < 0.05). DISCUSSION FDN does not appear to acutely improve muscle function in healthy young adults. Although there were no improvements in muscle function, there were no adverse effects either, contributing to the safety of FDN healthy populations. CONCLUSION Acute FDN does not appear to enhance muscle performance in a healthy, non-clinical population. Thus, clinicians should consider the population and desired outcome when applying FDN.
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Affiliation(s)
- Austin C Mead
- University of Nebraska at Omaha, School of Health and Kinesiology, United States
| | - Mark L McGlynn
- University of Nebraska at Omaha, School of Health and Kinesiology, United States
| | - Dustin R Slivka
- University of Nebraska at Omaha, School of Health and Kinesiology, United States.
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Bohannon RW. Isokinetic testing of muscle strength of older individuals with chronic obstructive pulmonary disease: An integrative review. ISOKINET EXERC SCI 2020. [DOI: 10.3233/ies-201147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Koch R, Augusto TRDL, Ramos AG, Müller PDT. Inspiratory Muscle Training Potentiates the Beneficial Effects of Proportional Assisted Ventilation on Exertional Dyspnea and Exercise Tolerance in COPD: A Proof-of-Concept Randomized and Controlled Trial. COPD 2020; 17:384-391. [PMID: 32689839 DOI: 10.1080/15412555.2020.1789085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
During pulmonary rehabilitation, a subset of subjects with COPD requires adjunct therapy to achieve high-intensity training. Both noninvasive ventilation (NIV) and inspiratory muscle training (IMT) are available to assist these subjects. We aimed to prime the respiratory muscles before NIV with IMT, anticipating additive effects for maximal exercise tolerance (T lim) and dyspnea/leg fatigue relief throughout the exercise as primary outcomes. Changes in the respiratory pattern were secondary outcomes. COPD subjects performed a total of four identical constant work rate tests on a cycle ergometer at 75% of maximum work rate, under control ventilation (SHAM, 4 cm H2O) or proportional assisted ventilation (PAV, individually adjusted), before and after 10 sessions of high-intensity IMT (three times/week) during 30 days. Two-way RM ANOVA with appropriate corrections were performed. Final analysis in nine subjects showed improved T lim (Δ = 111 s) and lower minute-ventilation (Δ = 4 L.min-1) at exhaustion, when comparing the IMT effects within the PAV modality (p = 0.001 and p = 0.036, respectively) and improved T lim for PAV vs. SHAM (PAV main-effect, p = 0.001; IMT main-effect, p = 0.006; PAV vs. IMT interaction, p = 0.034). In addition, IMT + PAV association, compared to PAV alone, resulted in lower respiratory frequency (IMT main-effect, p = 0.009; time main-effect, p < 0.0001; IMT vs. time interaction, p = 0.242) and lower inspiratory time related to duty cycle (IMT main-effect, p = 0.018; time main-effect, p = 0.0001; IMT vs. time interaction, p = 0.004) throughout exercise. The addition of IMT prior to a PAV-supported aerobic bout potentiates exercise tolerance and dyspnea relief and induces favourable changes in ventilatory pattern in severe COPD during high-intensity training (Brazilian Registry of Clinical Trials, number RBR-6n3dzz).
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Affiliation(s)
- Rodrigo Koch
- Laboratory of Respiratory Pathophysiology (LAFIR), Maria Aparecida Pedrossian Universitary Hospital (HUMAP), Campo Grande, Mato Grosso do Sul, Brazil
| | - Tiago Rodrigues de Lemos Augusto
- Laboratory of Respiratory Pathophysiology (LAFIR), Maria Aparecida Pedrossian Universitary Hospital (HUMAP), Campo Grande, Mato Grosso do Sul, Brazil
| | - Alessandro Gomes Ramos
- Laboratory of Respiratory Pathophysiology (LAFIR), Maria Aparecida Pedrossian Universitary Hospital (HUMAP), Campo Grande, Mato Grosso do Sul, Brazil
| | - Paulo de Tarso Müller
- Laboratory of Respiratory Pathophysiology (LAFIR), Maria Aparecida Pedrossian Universitary Hospital (HUMAP), Campo Grande, Mato Grosso do Sul, Brazil
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Bassi-Dibai D, Dibai-Filho AV, Carvalho LP, de Melo BC, Pedrosa LB, Mendes RG, Caruso FCR, Borghi-Silva A. Obesity, but not metabolic control, is associated with muscle strength and endurance in diabetic older adults. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2019; 25:e1808. [PMID: 31498554 DOI: 10.1002/pri.1808] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 07/11/2019] [Accepted: 08/25/2019] [Indexed: 11/11/2022]
Abstract
OBJECTIVE The objective of this study is to investigate the association between muscle function, body composition, and metabolic control in adults with type 2 diabetes mellitus (DM2). METHODS Forty-eight individuals with DM2 were divided into four groups according to the severity of obesity (body mass index [BMI]: lean [LN, n = 10], overweight [OW, n = 16], obese class I [OBI, n = 15], and obese class II [OBII, n = 7]). Absolute peak torque (TQ), relative peak torque (TQ/body weight [BW]), total work (TW), and fatigue index (FI) were assessed by means of an isokinetic dynamometer during concentric knee extensor contraction. Spearman's correlation coefficients were used to estimate the association between measurements. RESULTS Although OBII had higher insulin levels than both LN and OW groups, no significant differences were found between groups for TQ, TQ/BW, TW, and FI, as well as between metabolic variables and muscle measurements. There was a positive correlation between BMI and TQ (rs = .45) and resistance tests, between BMI and TQ (rs = .43), and TW (rs = .37). CONCLUSION Metabolic variables do not correlate with muscle strength and endurance in DM2. However, severity of obesity measured by the BMI is positively associated with muscle force-generating capacity and endurance.
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Affiliation(s)
- Daniela Bassi-Dibai
- Postgraduate Program in Management and Health Services, Ceuma University, São Luís, Brazil
| | | | - Lívia Pinheiro Carvalho
- Département de Sciences de l'Activité Physique, Université du Québec à Montréal, Montreal, Quebec, Canada
| | | | | | | | | | - Audrey Borghi-Silva
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, Brazil
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Paulus J, Bosquet L, Forthomme B, Donneau AF, Grémeaux V, Croisier JL. Measured and derived parameters of isokinetic fatigability of knee muscles: What can we apply, what should we not? ISOKINET EXERC SCI 2019. [DOI: 10.3233/ies-176210] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- J. Paulus
- Department of Motricity Sciences and Physical Therapy and Rehabilitation, University of Liege, Liege, Belgium
| | - L. Bosquet
- Faculty of Sport Sciences, University of Poitier, Poitiers, France
| | - B. Forthomme
- Department of Motricity Sciences and Physical Therapy and Rehabilitation, University of Liege, Liege, Belgium
- Department of Physical Medicine and Sport Traumatology, University of Liege, Liege, Belgium
| | - A.-F. Donneau
- Department Public Health Sciences, University of Liege, Liege, Belgium
| | - V. Grémeaux
- Pole Rehabilitation, University Hospital Center of Dijon, Dijon, France
| | - J.-L. Croisier
- Department of Motricity Sciences and Physical Therapy and Rehabilitation, University of Liege, Liege, Belgium
- Department of Physical Medicine and Sport Traumatology, University of Liege, Liege, Belgium
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Cui L, Liu H, Sun L. Multidisciplinary respiratory rehabilitation in combination with non-invasive positive pressure ventilation in the treatment of elderly patients with severe chronic obstructive pulmonary disease. Pak J Med Sci 2019; 35:500-505. [PMID: 31086540 PMCID: PMC6500851 DOI: 10.12669/pjms.35.2.459] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 01/26/2019] [Accepted: 01/31/2019] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To explore the effectiveness of multidisciplinary comprehensive respiratory rehabilitation in combination with non-invasive positive pressure ventilation (NIPPV) in the treatment of elderly patients with severe chronic obstructive pulmonary disease (COPD). METHODS Eighty-eight elderly patients with severe COPD who were admitted by the hospital between February 2016 and April 2017 were enrolled and grouped into a control group (n=29), intervention Group-A (n=30) and intervention Group-B (n=29) according to random sampling. Patients in the control group were given medicines and oxygen therapy; intervention Group-A was given NIPVV in addition to medicines and oxygen therapy; intervention Group-B was given multidisciplinary comprehensive respiratory rehabilitation in addition to the treatment as the intervention Group-A. Cardiopulmonary exercise testing, body mass index, BODE index score (airflow obstruction, dyspnea, and exercise capacity index), scoring of quality of life and arterial blood gas analysis were performed before treatment and in the 3rd month after treatment. RESULTS The maximum exercise power (Wmax), maximum oxygen uptake (VO2max), six minutes walking distance (6MWD), modified British Medical Research Council (MMRC), BODE index, score of quality of life, arterial partial pressure of carbon dioxide (PaCO2) and arterial partial pressure of oxygen (PaO2) of intervention Group-A and b were significantly improved after treatment (P<0.05); the differences with the control group had statistical significance (P<0.05). The improvement of 6MWD, MMRC, score of quality of life, PaO2 and PaCO2 of intervention Group-B was superior to that of intervention Group-A. (P<0.05). CONCLUSION Multidisciplinary comprehensive respiratory rehabilitation in combination with NIPPV can further relieve dyspnea of patients, enhance exercise tolerance and quality of life, and facilitate recovery; hence it is worth application and promotion.
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Affiliation(s)
- Limin Cui
- Limin Cui Binzhou People’s Hospital, Shandong, 256610, China
| | - Haixia Liu
- Haixia Liu Binzhou People’s Hospital, Shandong, 256610, China
| | - Lei Sun
- Lei Sun Binzhou People’s Hospital, Shandong, 256610, China
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Delgado André L, Basso-Vanelli RP, Di Thommazo-Luporini L, Angélica Ricci P, Cabiddu R, Pilon Jürgensen S, Ricardo de Oliveira C, Arena R, Borghi-Silva A. Functional and systemic effects of whole body electrical stimulation post bariatric surgery: study protocol for a randomized controlled trial. Trials 2018; 19:597. [PMID: 30382930 PMCID: PMC6211515 DOI: 10.1186/s13063-018-2844-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 08/06/2018] [Indexed: 11/29/2022] Open
Abstract
Background Obesity represents a major public health problem and is the fifth leading risk factor for mortality. Morbid obesity is associated with chronic systemic inflammation which increases the risk of comorbidities. Bariatric surgery (BS) is considered an effective intervention for obese patients. However, BS is associated with dietary restriction, potentially limiting physical activity. Whole-body neuromuscular electrical stimulation (WBS) could represent an innovative option for the rehabilitation of BS patients, especially during the early postoperative phase when other conventional techniques are contraindicated. WBS is a safe and effective tool to combat sarcopenia and metabolic risk as well as increasing muscle mass, producing greater glucose uptake, and reducing the proinflammatory state. Therefore, the objective of this study is to evaluate the effects of WBS on body composition, functional capacity, muscle strength and endurance, insulin resistance, and pro- and anti-inflammatory circulating markers in obese patients undergoing BS. Methods/design The present study is a randomized, double-blind, placebo-controlled, parallel groups clinical trial approved by the Ethics Committee of our Institution. Thirty-six volunteers (body mass index (BMI) > 35 kg/m2) between 18 and 45 years of age will be randomized to the WBS group (WBSG) or control (Sham) group (ShamG) after being submitted to BS. Preoperative assessments will include maximal and submaximal exercise testing, body composition, blood inflammatory markers, and quadriceps strength and endurance. The second day after discharge, body composition will be evaluated and a 6-min walk test (6MWT) will be performed. The WBS or Sham protocol will consist of 30 daily sessions for 6 consecutive weeks. Afterwards, the same assessments that were performed in the preoperative period will be repeated. Discussion Considering the important role of WBS in skeletal muscle conditioning and its value as an aid in exercise performance, the proposed study will investigate this technique as a tool to promote early rehabilitation in these patients, and as a strategy to enhance exercise capacity, weight loss, and peripheral muscle strength with positive systemic effects. The present study is still ongoing, and data will be published after its conclusion. Trial registration REBEC, RBR-99qw5h. Registered on 20 February 2015. Electronic supplementary material The online version of this article (10.1186/s13063-018-2844-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Larissa Delgado André
- Department of Physiotherapy, Federal University of São Carlos, Rod. Washington Luís, km 235, São Carlos, São Paulo, 13565-905, Brazil
| | - Renata P Basso-Vanelli
- Department of Physiotherapy, Federal University of São Carlos, Rod. Washington Luís, km 235, São Carlos, São Paulo, 13565-905, Brazil
| | - Luciana Di Thommazo-Luporini
- Department of Physiotherapy, Federal University of São Carlos, Rod. Washington Luís, km 235, São Carlos, São Paulo, 13565-905, Brazil
| | - Paula Angélica Ricci
- Department of Physiotherapy, Federal University of São Carlos, Rod. Washington Luís, km 235, São Carlos, São Paulo, 13565-905, Brazil
| | - Ramona Cabiddu
- Department of Physiotherapy, Federal University of São Carlos, Rod. Washington Luís, km 235, São Carlos, São Paulo, 13565-905, Brazil
| | - Soraia Pilon Jürgensen
- Department of Physiotherapy, Federal University of São Carlos, Rod. Washington Luís, km 235, São Carlos, São Paulo, 13565-905, Brazil
| | - Claudio Ricardo de Oliveira
- Department of Medicine, Federal University of São Carlos, Rod. Washington Luís, km 235, São Carlos, São Paulo, 13565-905, Brazil
| | - Ross Arena
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Audrey Borghi-Silva
- Cardiopulmonary Physiotherapy Laboratory, Department of Physiotherapy, Federal University of São Carlos, Rod. Washington Luís, km 235, São Carlos, São Paulo, 13565-905, Brazil.
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Gloeckl R, Andrianopoulos V, Stegemann A, Oversohl J, Schneeberger T, Schoenheit‐Kenn U, Hitzl W, Dreher M, Koczulla AR, Kenn K. High‐pressure non‐invasive ventilation during exercise in COPD patients with chronic hypercapnic respiratory failure: A randomized, controlled, cross‐over trial. Respirology 2018; 24:254-261. [DOI: 10.1111/resp.13399] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 08/06/2018] [Accepted: 08/13/2018] [Indexed: 10/28/2022]
Affiliation(s)
- Rainer Gloeckl
- Institute for Pulmonary Rehabilitation ResearchSchoen Klinik Berchtesgadener Land Schoenau am Koenigssee Germany
- Department of Prevention, Rehabilitation and Sports MedicineTechnical University of Munich (TUM) Munich Germany
| | - Vasileios Andrianopoulos
- Institute for Pulmonary Rehabilitation ResearchSchoen Klinik Berchtesgadener Land Schoenau am Koenigssee Germany
| | - Antje Stegemann
- Institute for Pulmonary Rehabilitation ResearchSchoen Klinik Berchtesgadener Land Schoenau am Koenigssee Germany
| | - Julian Oversohl
- Department of Internal MedicinePhilipps‐University of Marburg Marburg Germany
| | - Tessa Schneeberger
- Institute for Pulmonary Rehabilitation ResearchSchoen Klinik Berchtesgadener Land Schoenau am Koenigssee Germany
- Department of Pulmonary RehabilitationPhilipps‐University of Marburg, German Center for Lung Research (DZL) Marburg Germany
| | - Ursula Schoenheit‐Kenn
- Institute for Pulmonary Rehabilitation ResearchSchoen Klinik Berchtesgadener Land Schoenau am Koenigssee Germany
| | - Wolfgang Hitzl
- Research Office (Biostatistics)Paracelsus Medical University Salzburg Austria
- Department of Ophthalmology and OptometryParacelsus Medical University Salzburg Austria
| | - Michael Dreher
- Department of Pneumology and Intensive Care MedicineUniversity Hospital RWTH Aachen Germany
| | - A. Rembert Koczulla
- Institute for Pulmonary Rehabilitation ResearchSchoen Klinik Berchtesgadener Land Schoenau am Koenigssee Germany
- Department of Pulmonary RehabilitationPhilipps‐University of Marburg, German Center for Lung Research (DZL) Marburg Germany
| | - Klaus Kenn
- Institute for Pulmonary Rehabilitation ResearchSchoen Klinik Berchtesgadener Land Schoenau am Koenigssee Germany
- Department of Pulmonary RehabilitationPhilipps‐University of Marburg, German Center for Lung Research (DZL) Marburg Germany
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14
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Lopes AJ, Vigário PS, Hora AL, Deus CA, Soares MS, Guimaraes FS, Ferreira AS. Ventilation distribution, pulmonary diffusion and peripheral muscle endurance as determinants of exercise intolerance in elderly patients with chronic obstructive pulmonary disease. Physiol Res 2018; 67:863-874. [PMID: 30204461 DOI: 10.33549/physiolres.933867] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is a progressive and disabling disease that has been associated with aging. Several factors may potentially impair performance during exercise in elderly patients with COPD. This study was conducted to evaluate what characteristics related to lung function, peripheral muscle strength and endurance can predict the performance of elderly patients with COPD during cardiopulmonary exercise testing (CPET). Forty elderly patients with COPD underwent resting lung function tests, knee isokinetic dynamometry, and CPET. Three models were developed to explain the variability in peak oxygen uptake (VO(2) peak) after controlling for age as an independent confounder. The pulmonary function model showed the highest explained variance (65.6 %); in this model, ventilation distribution (p<0.001) and pulmonary diffusion (0.013) were found to be independent predictors. Finally, the models that included the muscle strength and endurance variables presented explained variances of 51 % and 57.4 %, respectively. In these models that involved muscular dysfunction, however, only the endurance variables were found to be independent predictors (p<0.05). In conclusion, ventilation distribution and pulmonary diffusion, but not the degree of airway obstruction, independently predict CPET performance in elderly patients with COPD. In addition, peripheral muscle endurance, but not strength, also predicts CPET performance in these subjects.
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Affiliation(s)
- A J Lopes
- Rehabilitation Sciences Post-Graduation Program, Augusto Motta University Center, Rio de Janeiro, Brazil.
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Ou YE, Lin ZM, Hua DM, Jiang Y, Huo YT, Luo Q, Chen RC. Evaluation of carbon dioxide rebreathing during exercise assisted by noninvasive ventilation with plateau exhalation valve. Int J Chron Obstruct Pulmon Dis 2017; 12:291-298. [PMID: 28144134 PMCID: PMC5248928 DOI: 10.2147/copd.s121637] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Noninvasive ventilation with a plateau exhalation valve (PEV) is often used as an adjunct to exercise to achieve a physiologic training effect in severe chronic obstructive pulmonary disease (COPD) patients. However, during exercise, with the increase of exhalation flow and respiratory rate and limited capability of PEV to exhale gases out of the circuit, it is still unknown whether CO2 rebreathing occurs in COPD patients ventilated during exercise assisted by single-limb circuit with a PEV. A maximal symptom-limited cycle exercise test was performed while ventilated on pressure support (inspiratory:expiratory pressure 14:4 cmH2O) in 18 male patients with stable severe COPD (mean ± standard deviation, forced expiratory volume in 1 s: 29.5%±6.9% predicted). At rest and during exercise, breathing pattern, mean expiratory flow, mean expiratory flow of PEV, and the mean inspiratory fraction of CO2 (tidal fractional concentration of inspired CO2 [FiCO2]) reinsufflated from the circuit was measured for each breath. In comparison with rest, with the significant increase of mean expiratory flow (0.39±0.15 vs 0.82±0.27 L/s), fractional concentration of end-tidal CO2 (2.6%±0.7% vs 5.5%±0.6%), and the significant decrease of mean expiratory flow of PEV (0.41±0.02 vs 0.39±0.03 L/s), tidal FiCO2 significantly increased at peak exercise (0.48%±0.19% vs 1.8%±0.6%) in patients with stable severe COPD. The inflection point of obvious CO2 rebreathing was 0.67±0.09 L/s (95% confidence interval 0.60–0.73 L/s). Ventilated by a single-limb tubing with PEV caused CO2 rebreathing to COPD patients during exercise. Patients with mean expiratory flow >0.60–0.73 L/s may be predisposed to a higher risk of CO2 rebreathing.
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Affiliation(s)
- Yong-Er Ou
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, People's Republic of China
| | - Zhi-Min Lin
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, People's Republic of China
| | - Dong-Ming Hua
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, People's Republic of China
| | - Ying Jiang
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, People's Republic of China
| | - Ya-Ting Huo
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, People's Republic of China
| | - Qun Luo
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, People's Republic of China
| | - Rong-Chang Chen
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, People's Republic of China
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Bassi D, Mendes RG, Arakelian VM, Caruso FCR, Cabiddu R, Júnior JCB, Arena R, Borghi-Silva A. Potential Effects on Cardiorespiratory and Metabolic Status After a Concurrent Strength and Endurance Training Program in Diabetes Patients - a Randomized Controlled Trial. SPORTS MEDICINE-OPEN 2016; 2:31. [PMID: 27563535 PMCID: PMC4981628 DOI: 10.1186/s40798-016-0052-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Accepted: 07/20/2016] [Indexed: 11/20/2022]
Abstract
Background Concurrent aerobic and resistance training (CART) programs have been widely recommended as an important strategy to improve physiologic and functional performance in patients with chronic diseases. However, the impact of a personalized CART program in patients with type 2 diabetes (T2D) requires investigation. Therefore, the primary aim of the current study is to investigate the impact of CART programs on metabolic profile, glycemic control, and exercise capacity in patients with diabetes. Methods We evaluated 41 subjects with T2D (15 females and 19 males, 50.8 ± 7 years); subjects were randomized into two groups; sedentary (SG) and CART (CART-G). CART was performed over 1.10-h sessions (30-min aerobic and 30-min resistance exercises) three times/week for 12 weeks. Body composition, biochemical analyses, peripheral muscular strength, and cardiopulmonary exercise testing were primary measurements. Results The glycated hemoglobin HbA1c (65.4 ± 17.9 to 55.9 ± 12.7 mmol/mol), cholesterol (198.38.1 ± 50.3 to 186.8 ± 35.1 mg/dl), and homeostasis model assessment insulin resistance (HOMA-IR) (6.4 ± 6.8 to 5.0 ± 1.4) decreased in the CART-G compared to the SG. Although body weight did not significantly change after training, skinfold measurement indicated decreased body fat in the CART-G only. CART significantly enhanced muscle strength compared to the SG (p < 0.05). CART was also associated with significant increase in peak oxygen uptake and maximal workload compared to the SG (p < 0.05). Conclusions These data support CART as an important strategy in the treatment of patients with T2D, producing both physiologic and functional improvements. Trial Registration Ensaiosclinicos.gov.br, RBR492q8z
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Affiliation(s)
- Daniela Bassi
- Cardiopulmonary Physiotherapy Laboratory, Physical Therapy Department, Federal University of Sao Carlos, Rodovia Washington Luis Km 235, Sao Carlos, SP Brazil
| | - Renata Gonçalves Mendes
- Cardiopulmonary Physiotherapy Laboratory, Physical Therapy Department, Federal University of Sao Carlos, Rodovia Washington Luis Km 235, Sao Carlos, SP Brazil
| | | | - Flávia Cristina Rossi Caruso
- Cardiopulmonary Physiotherapy Laboratory, Physical Therapy Department, Federal University of Sao Carlos, Rodovia Washington Luis Km 235, Sao Carlos, SP Brazil
| | - Ramona Cabiddu
- Cardiopulmonary Physiotherapy Laboratory, Physical Therapy Department, Federal University of Sao Carlos, Rodovia Washington Luis Km 235, Sao Carlos, SP Brazil
| | - José Carlos Bonjorno Júnior
- Department of Interunits of Bioengineer, University of São Paulo, São Paulo, SP Brazil ; Department of Medicine, Federal University of São Carlos, São Paulo, SP Brazil
| | - Ross Arena
- Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois Chicago, Chicago, IL USA ; Department of Physical Therapy, College of Applied Health Sciences, University of Illinois Chicago, Chicago, IL USA
| | - Audrey Borghi-Silva
- Cardiopulmonary Physiotherapy Laboratory, Physical Therapy Department, Federal University of Sao Carlos, Rodovia Washington Luis Km 235, Sao Carlos, SP Brazil ; Department of Interunits of Bioengineer, University of São Paulo, São Paulo, SP Brazil
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17
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Carvalho LP, Di Thommazo-Luporini L, Aubertin-Leheudre M, Bonjorno Junior JC, de Oliveira CR, Luporini RL, Mendes RG, Zangrando KTL, Trimer R, Arena R, Borghi-Silva A. Prediction of Cardiorespiratory Fitness by the Six-Minute Step Test and Its Association with Muscle Strength and Power in Sedentary Obese and Lean Young Women: A Cross-Sectional Study. PLoS One 2015; 10:e0145960. [PMID: 26717568 PMCID: PMC4699911 DOI: 10.1371/journal.pone.0145960] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Accepted: 12/10/2015] [Indexed: 11/19/2022] Open
Abstract
Impaired cardiorespiratory fitness (CRF) is a hallmark characteristic in obese and lean sedentary young women. Peak oxygen consumption (VO2peak) prediction from the six-minute step test (6MST) has not been established for sedentary females. It is recognized that lower-limb muscle strength and power play a key role during functional activities. The aim of this study was to investigate cardiorespiratory responses during the 6MST and CPX and to develop a predictive equation to estimate VO2peak in both lean and obese subjects. Additionally we aim to investigate how muscle function impacts functional performance. Lean (LN = 13) and obese (OB = 18) women, aged 20–45, underwent a CPX, two 6MSTs, and isokinetic and isometric knee extensor strength and power evaluations. Regression analysis assessed the ability to predict VO2peak from the 6MST, age and body mass index (BMI). CPX and 6MST main outcomes were compared between LN and OB and correlated with strength and power variables. CRF, functional capacity, and muscle strength and power were lower in the OB compared to LN (<0.05). During the 6MST, LN and OB reached ~90% of predicted maximal heart rate and ~80% of the VO2peak obtained during CPX. BMI, age and number of step cycles (NSC) explained 83% of the total variance in VO2peak. Moderate to strong correlations between VO2peak at CPX and VO2peak at 6MST (r = 0.86), VO2peak at CPX and NSC (r = 0.80), as well as between VO2peak, NSC and muscle strength and power variables were found (p<0.05). These findings indicate the 6MST, BMI and age accurately predict VO2peak in both lean and obese young sedentary women. Muscle strength and power were related to measures of aerobic and functional performance.
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Affiliation(s)
- Lívia Pinheiro Carvalho
- Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Federal University of Sao Carlos, Sao Carlos, Sao Paulo, Brazil
| | - Luciana Di Thommazo-Luporini
- Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Federal University of Sao Carlos, Sao Carlos, Sao Paulo, Brazil
| | | | | | | | | | - Renata Gonçalves Mendes
- Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Federal University of Sao Carlos, Sao Carlos, Sao Paulo, Brazil
| | - Katiany Thais Lopes Zangrando
- Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Federal University of Sao Carlos, Sao Carlos, Sao Paulo, Brazil
| | - Renata Trimer
- Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Federal University of Sao Carlos, Sao Carlos, Sao Paulo, Brazil
| | - Ross Arena
- Integrative Physiology Laboratory, Physical Therapy Department, College of Applied Health Sciences, University of Illinois Chicago, Chicago, Illinois, United States of America
| | - Audrey Borghi-Silva
- Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Federal University of Sao Carlos, Sao Carlos, Sao Paulo, Brazil
- * E-mail:
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18
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Guidelines for the Evaluation and Treatment of Muscle Dysfunction in Patients With Chronic Obstructive Pulmonary Disease. ACTA ACUST UNITED AC 2015. [DOI: 10.1016/j.arbr.2015.04.027] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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19
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Barreiro E, Bustamante V, Cejudo P, Gáldiz JB, Gea J, de Lucas P, Martínez-Llorens J, Ortega F, Puente-Maestu L, Roca J, Rodríguez-González Moro JM. Guidelines for the evaluation and treatment of muscle dysfunction in patients with chronic obstructive pulmonary disease. Arch Bronconeumol 2015; 51:384-95. [PMID: 26072153 DOI: 10.1016/j.arbres.2015.04.011] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Revised: 03/24/2015] [Accepted: 04/23/2015] [Indexed: 01/09/2023]
Abstract
In patients with chronic obstructive pulmonary disease (COPD), skeletal muscle dysfunction is a major comorbidity that negatively impacts their exercise capacity and quality of life. In the current guidelines, the most recent literature on the various aspects of COPD muscle dysfunction has been included. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) scale has been used to make evidence-based recommendations on the different features. Compared to a control population, one third of COPD patients exhibited a 25% decline in quadriceps muscle strength, even at early stages of their disease. Although both respiratory and limb muscles are altered, the latter are usually more severely affected. Numerous factors and biological mechanisms are involved in the etiology of COPD muscle dysfunction. Several tests are proposed in order to diagnose and evaluate the degree of muscle dysfunction of both respiratory and limb muscles (peripheral), as well as to identify the patients' exercise capacity (six-minute walking test and cycloergometry). Currently available therapeutic strategies including the different training modalities and pharmacological and nutritional support are also described.
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Affiliation(s)
- Esther Barreiro
- Servei de Pneumologia, Unitat de Recerca en Múscul i Aparell Respiratori (URMAR), IMIM-Hospital del Mar, CEXS, Universitat Pompeu Fabra, Parc de Recerca Biomèdica de Barcelona (PRBB), Barcelona, España; CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, España.
| | - Víctor Bustamante
- Hospital Universitario Basurto, Osakidetza, Departamento de Medicina, Universidad del País Vasco, Bilbao, España; Servicio de Neumología y Unidad de Investigación, Hospital de Cruces, Universidad del País Vasco , Barakaldo, España
| | - Pilar Cejudo
- Servicio de Neumología y Unidad de Investigación, Hospital de Cruces, Universidad del País Vasco , Barakaldo, España
| | - Juan B Gáldiz
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, España; Hospital Universitario Basurto, Osakidetza, Departamento de Medicina, Universidad del País Vasco, Bilbao, España
| | - Joaquim Gea
- Servei de Pneumologia, Unitat de Recerca en Múscul i Aparell Respiratori (URMAR), IMIM-Hospital del Mar, CEXS, Universitat Pompeu Fabra, Parc de Recerca Biomèdica de Barcelona (PRBB), Barcelona, España; CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, España
| | - Pilar de Lucas
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Hospital Universitario Virgen del Rocío, Sevilla, España
| | - Juana Martínez-Llorens
- Servei de Pneumologia, Unitat de Recerca en Múscul i Aparell Respiratori (URMAR), IMIM-Hospital del Mar, CEXS, Universitat Pompeu Fabra, Parc de Recerca Biomèdica de Barcelona (PRBB), Barcelona, España; CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, España
| | - Francisco Ortega
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, España; Servicio de Neumología y Unidad de Investigación, Hospital de Cruces, Universidad del País Vasco , Barakaldo, España
| | - Luis Puente-Maestu
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Hospital Universitario Virgen del Rocío, Sevilla, España
| | - Josep Roca
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, España; Servicio de Neumología, Hospital General Gregorio Marañón, Universidad Complutense de Madrid, Madrid, España; Servei de Pneumologia, Hospital Clínic de Barcelona, Barcelona, España
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20
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Evans RA, Kaplovitch E, Beauchamp MK, Dolmage TE, Goldstein RS, Gillies CL, Brooks D, Mathur S. Is Quadriceps Endurance Reduced in COPD? Chest 2015; 147:673-684. [DOI: 10.1378/chest.14-1079] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
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Carlin BW, Wiles KS, McCoy RW, Brennan T, Easley D, Thomashow RJ. Effects of a Highly Portable Noninvasive Open Ventilation System on Activities of Daily Living in Patients with COPD. CHRONIC OBSTRUCTIVE PULMONARY DISEASES-JOURNAL OF THE COPD FOUNDATION 2015; 2:35-47. [PMID: 28848829 DOI: 10.15326/jcopdf.2.1.2014.0116] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Background: For patients with chronic obstructive pulmonary disease (COPD), an increase in exercise tolerance and ability to perform activities of daily living (ADLs) can mean an improved quality of life with fewer exacerbations and lower health care expenses. We evaluated a wearable, noninvasive open ventilation (NIOV) system designed to enhance exercise capacity and increase mobility. Methods: Patients with stable, oxygen-dependent COPD were recruited for this prospective, open-label, crossover study. Inclusion criteria included supplemental oxygen use, elevated dyspnea score, and the ability to perform ADLs. Patients performed a selected ADL for as long as tolerable while using standard oxygen therapy. Following a rest period, the same ADL was repeated using the NIOV system. ADL endurance time, oxyhemoglobin saturation measured by pulse oximeter ( SpO2), dyspnea, fatigue, and discomfort scores were recorded. Results: Thirty patients were enrolled and 29 patients completed the study. Mean ADL endurance increased by 85% (13.4 vs. 7.2 min) using NIOV compared with oxygen therapy (p<0.0001). Mean SpO2 was significantly higher during ADLs using NIOV versus oxygen therapy (p<0.0001). Median dyspnea, fatigue, and discomfort scores were significantly lower using NIOV during ADLs compared to oxygen therapy (p<0.01). No device-related adverse events were observed. Conclusions: This study demonstrated that a novel, portable noninvasive open ventilation system can improve ADL performance in the home setting. Compared to standard oxygen therapy, the NIOV system provided statistically and clinically significant increases in ADL endurance time and oxygenation, while decreasing dyspnea, fatigue, and discomfort. The NIOV system appears to offer a practical option for increasing activity and exercise tolerance in oxygen-dependent patients with COPD.
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Affiliation(s)
- Brian W Carlin
- Drexel University School of Medicine, Pittsburgh, Pennsylvania
| | | | | | - Toni Brennan
- Klingensmith HealthCare, Ford City, Pennsylvania
| | - Dan Easley
- Klingensmith HealthCare, Ford City, Pennsylvania
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Márquez-Martín E, Ruiz FO, Ramos PC, López-Campos JL, Azcona BV, Cortés EB. Randomized trial of non-invasive ventilation combined with exercise training in patients with chronic hypercapnic failure due to chronic obstructive pulmonary disease. Respir Med 2014; 108:1741-51. [DOI: 10.1016/j.rmed.2014.10.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Revised: 10/11/2014] [Accepted: 10/14/2014] [Indexed: 10/24/2022]
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Moga AM, de Marchie M, Saey D, Spahija J. Bi-level Positive Airway Pressure (BiPAP) with Standard Exhalation Valve Does Not Improve Maximum Exercise Capacity in Patients with COPD. COPD 2014; 12:46-54. [DOI: 10.3109/15412555.2014.908830] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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24
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Menadue C, Piper AJ, van 't Hul AJ, Wong KK. Non-invasive ventilation during exercise training for people with chronic obstructive pulmonary disease. Cochrane Database Syst Rev 2014; 2014:CD007714. [PMID: 24823712 PMCID: PMC10984247 DOI: 10.1002/14651858.cd007714.pub2] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Exercise training as a component of pulmonary rehabilitation improves health-related quality of life (HRQL) and exercise capacity in people with chronic obstructive pulmonary disease (COPD). However, some individuals may have difficulty performing exercise at an adequate intensity. Non-invasive ventilation (NIV) during exercise improves exercise capacity and dyspnoea during a single exercise session. Consequently, NIV during exercise training may allow individuals to exercise at a higher intensity, which could lead to greater improvement in exercise capacity, HRQL and physical activity. OBJECTIVES To determine whether NIV during exercise training (as part of pulmonary rehabilitation) affects exercise capacity, HRQL and physical activity in people with COPD compared with exercise training alone or exercise training with sham NIV. SEARCH METHODS We searched the following databases between January 1987 and November 2013 inclusive: The Cochrane Airways Group specialised register of trials, AMED, CENTRAL, CINAHL, EMBASE, LILACS, MEDLINE, PEDro, PsycINFO and PubMed. SELECTION CRITERIA Randomised controlled trials that compared NIV during exercise training versus exercise training alone or exercise training with sham NIV in people with COPD were considered for inclusion in this review. DATA COLLECTION AND ANALYSIS Two review authors independently selected trials for inclusion in the review, extracted data and assessed risk of bias. Primary outcomes were exercise capacity, HRQL and physical activity; secondary outcomes were training intensity, physiological changes related to exercise training, dyspnoea, dropouts, adverse events and cost. MAIN RESULTS Six studies involving 126 participants who completed the study protocols were included. Most studies recruited participants with severe to very severe COPD (mean forced expiratory volume in one second (FEV1) ranged from 26% to 48% predicted). There was an increase in percentage change peak and endurance exercise capacity with NIV during training (mean difference in peak exercise capacity 17%, 95% confidence interval (CI) 7% to 27%, 60 participants, low-quality evidence; mean difference in endurance exercise capacity 59%, 95% CI 4% to 114%, 48 participants, low-quality evidence). However, there was no clear evidence of a difference between interventions for all other measures of exercise capacity. The results for HRQL assessed using the St George's Respiratory Questionnaire do not rule out an effect of NIV (total score mean 2.5 points, 95% CI -2.3 to 7.2, 48 participants, moderate-quality evidence). Physical activity was not assessed in any study. There was an increase in training intensity with NIV during training of 13% (95% CI 1% to 27%, 67 participants, moderate-quality evidence), and isoload lactate was lower with NIV (mean difference -0.97 mmol/L, 95% CI -1.58mmol/L to -0.36 mmol/L, 37 participants, moderate-quality evidence). The effect of NIV on dyspnoea or the number of dropouts between interventions was uncertain, although again results were imprecise. No adverse events and no information regarding cost were reported. Only one study blinded participants, whereas three studies used blinded assessors. Adequate allocation concealment was reported in four studies. AUTHORS' CONCLUSIONS The small number of included studies with small numbers of participants, as well as the high risk of bias within some of the included studies, limited our ability to draw strong evidence-based conclusions. Although NIV during lower limb exercise training may allow people with COPD to exercise at a higher training intensity and to achieve a greater physiological training effect compared with exercise training alone or exercise training with sham NIV, the effect on exercise capacity is unclear. Some evidence suggests that NIV during exercise training improves the percentage change in peak and endurance exercise capacity; however, these findings are not consistent across other measures of exercise capacity. There is no clear evidence that HRQL is better or worse with NIV during training. It is currently unknown whether the demonstrated benefits of NIV during exercise training are clinically worthwhile or cost-effective.
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Affiliation(s)
- Collette Menadue
- Royal Prince Alfred HospitalDepartment of Respiratory and Sleep MedicineMissenden RoadCamperdownNSWAustralia2050
| | - Amanda J Piper
- Royal Prince Alfred HospitalDepartment of Respiratory and Sleep MedicineMissenden RoadCamperdownNSWAustralia2050
- Woolcock Institute of Medical Research431 Glebe Point RoadGlebeNSWAustralia2037
| | | | - Keith K Wong
- Royal Prince Alfred HospitalDepartment of Respiratory and Sleep MedicineMissenden RoadCamperdownNSWAustralia2050
- Woolcock Institute of Medical Research431 Glebe Point RoadGlebeNSWAustralia2037
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Hill K, Holland AE. Strategies to enhance the benefits of exercise training in the respiratory patient. Clin Chest Med 2014; 35:323-36. [PMID: 24874128 DOI: 10.1016/j.ccm.2014.02.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Despite the well-established benefits of exercise training in people with chronic respiratory disease, there are a group of people in whom it confers minimal gains. Furthermore, there is increasing recognition of the prevalence of comorbid conditions among people with chronic obstructive pulmonary disease and other respiratory diseases, such as musculoskeletal disorders, which make participation in traditional exercise training programs challenging. This article focuses on several adjuncts or strategies that may be implemented by clinicians during exercise training, with the goal of optimizing the proportion of pulmonary rehabilitation participants who achieve significant and meaningful gains on program completion.
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Affiliation(s)
- Kylie Hill
- School of Physiotherapy and Exercise Science, Faculty of Health Science, Curtin University, GPO Box U1987, Perth, Western Australia 6845, Australia; Lung Institute of Western Australia, Centre for Asthma, Allergy and Respiratory Research, University of Western Australia, Hospital Avenue, Nedlands, Western Australia 6009, Australia; Physiotherapy Department, Royal Perth Hospital, Wellington Street, Perth, Western Australia 6000, Australia.
| | - Anne E Holland
- Department of Physiotherapy, La Trobe University, Level 4, The Alfred Centre, 99 Commercial Road, Melbourne, Victoria 3004, Australia; Department of Physiotherapy, Alfred Health, Commercial Road, Melbourne, Victoria 3004, Australia; Institute for Breathing and Sleep, Studley Road, Heidelberg, Victoria 3084, Australia
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Abstract
Skeletal muscle fatigue is defined as the fall of force or power in response to contractile activity. Both the mechanisms of fatigue and the modes used to elicit it vary tremendously. Conceptual and technological advances allow the examination of fatigue from the level of the single molecule to the intact organism. Evaluation of muscle fatigue in a wide range of disease states builds on our understanding of basic function by revealing the sources of dysfunction in response to disease.
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Affiliation(s)
- Jane A Kent-Braun
- Department of Kinesiology, University of Massachusetts-Amherst, Amherst, Massachusetts, USA.
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Noninvasive Ventilation Improves the Cardiovascular Response and Fatigability During Resistance Exercise in Patients With Heart Failure. J Cardiopulm Rehabil Prev 2013; 33:378-84. [DOI: 10.1097/hcr.0000000000000019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Porszasz J, Cao R, Morishige R, van Eykern LA, Stenzler A, Casaburi R. Physiologic Effects of an Ambulatory Ventilation System in Chronic Obstructive Pulmonary Disease. Am J Respir Crit Care Med 2013; 188:334-42. [DOI: 10.1164/rccm.201210-1773oc] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Ribeiro F, Thériault ME, Debigaré R, Maltais F. Should all patients with COPD be exercise trained? J Appl Physiol (1985) 2013; 114:1300-8. [PMID: 23412902 DOI: 10.1152/japplphysiol.01124.2012] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Exercise training is one of the most powerful interventions to provide symptomatic relief in patients with chronic obstructive pulmonary disease (COPD). The purpose of this minireview is to discuss how exercise training can improve limb muscle dysfunction in this disease. Various exercise training strategies will be outlined, along with their beneficial effects and potential limitations. Strategies to optimize the gains achievable with exercise training will be presented. Whether exercise training may exert deleterious effects in some patients will also be discussed.
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Affiliation(s)
- Fernanda Ribeiro
- Centre de Recherche, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, Canada
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Effects of excess body mass on strength and fatigability of quadriceps in postmenopausal women. Menopause 2012; 19:556-61. [PMID: 22089183 DOI: 10.1097/gme.0b013e3182364e80] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE Obesity is a major public health problem leading to, among other things, reduced functional capacity. Moreover, obesity-related declines in functional capacity may be compounded by the detrimental consequences of menopause. The aim of this study was to understand the potential effects of excess body mass on measures of functional capacity in postmenopausal women. METHODS Forty-five postmenopausal women aged 50 to 60 years were divided into two groups according to body mass index (BMI): obese (BMI, ≥ 30 kg/m(2); n = 19) and nonobese (BMI, 18.5-29.9 kg/m(2); n = 26). To determine clinical characteristics, body composition, bone mineral density, and maximal exercise testing was performed, and a 3-day dietary record was estimated. To assess quadriceps function, isokinetic exercise testing at 60° per second (quadriceps strength) and at 300° per second (quadriceps fatigue) was performed. RESULTS The absolute value of the peak torque was not significantly different between the groups; however, when the data were normalized by body mass and lean mass, significantly lower values were observed for obese women compared with those in the nonobese group (128% ± 25% vs 155% ± 24% and 224% ± 38% vs 257% ± 47%, P < 0.05). The fatigue index did not show any significant difference for either group; however, when the data were normalized by the body mass and lean mass, significantly lower values were observed for obese women (69% ± 16% vs 93% ± 18% and 120% ± 25% vs. 135% ± 23%, P < 0.01). CONCLUSIONS Our results show that despite reduced muscle force, the combination of obesity and postmenopause may be associated with greater resistance to muscle fatigue.
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Moga AM, de Marchie M, Saey D, Spahija J. Mechanisms of non-pharmacologic adjunct therapies used during exercise in COPD. Respir Med 2012; 106:614-26. [PMID: 22341681 DOI: 10.1016/j.rmed.2012.01.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2011] [Revised: 01/04/2012] [Accepted: 01/12/2012] [Indexed: 11/16/2022]
Abstract
Individuals with chronic obstructive pulmonary disease (COPD) are often limited in their ability to perform exercise due to a heightened sense of dyspnea and/or the occurrence of leg fatigue associated with a reduced ventilatory capacity and peripheral skeletal muscle dysfunction, respectively. Pulmonary rehabilitation programs have been shown to improve exercise tolerance and health related quality of life. Additional therapeutic approaches such as non-invasive ventilatory support (NIVS), heliox (He-O(2)) and supplemental oxygen have been used as non-pharmacologic adjuncts to exercise to enhance the ability of patients with COPD to exercise at a higher exercise-intensity and thus improve the physiological benefits of exercise. The purpose of the current review is to examine the pathophysiology of exercise limitation in COPD and to explore the physiological mechanisms underlying the effect of the adjunct therapies on exercise in patients with COPD. This review indicates that strategies that aim to unload the respiratory muscles and enhance oxygen saturation during exercise alleviate exercise limiting factors and improve exercise performance in patients with COPD. However, available data shows significant variability in the effectiveness across patients. Further research is needed to identify the most appropriate candidates for these forms of therapies.
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Affiliation(s)
- A M Moga
- School of Physical and Occupational Therapy, McGill University, 3654 Promenade Sir William Osler, Montreal, Quebec H3G 1Y5, Canada
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Ko FW, Hui DS. The lower the body weight for COPD patients, the more effective is pulmonary rehabilitation? Respirology 2011; 16:187-9. [DOI: 10.1111/j.1440-1843.2010.01887.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Vieira L, Bottaro M, Celes R, de Assis Viegas CA, e Silva CAM. Avaliação muscular isocinética do quadríceps em indivíduos com doença pulmonar obstrutiva crónica. REVISTA PORTUGUESA DE PNEUMOLOGIA 2010. [DOI: 10.1016/s0873-2159(15)30068-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Reddel HK, Upham JW, Salvi SS, Yang IA. Year-in-review 2009: Asthma, COPD and airway biology. Respirology 2010; 15:365-76. [PMID: 20199648 DOI: 10.1111/j.1440-1843.2009.01702.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Helen K Reddel
- Woolcock Institute of Medical Research, University of Sydney, Sydney, New South Wales, Australia
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Siqueira ACB, Borghi-Silva A, Bravo DM, Ferreira EM, Chiappa GR, Neder JA. Effects of hyperoxia on the dynamics of skeletal muscle oxygenation at the onset of heavy-intensity exercise in patients with COPD. Respir Physiol Neurobiol 2010; 172:8-14. [DOI: 10.1016/j.resp.2010.04.020] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2009] [Revised: 04/16/2010] [Accepted: 04/19/2010] [Indexed: 11/16/2022]
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Oliveira CC, Carrascosa CR, Borghi-Silva A, Berton DC, Queiroga F, Ferreira EMV, Nery LE, Alberto Neder J. Influence of respiratory pressure support on hemodynamics and exercise tolerance in patients with COPD. Eur J Appl Physiol 2010; 109:681-9. [DOI: 10.1007/s00421-010-1408-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2010] [Indexed: 11/27/2022]
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Pantoni CBF, Mendes RG, Di Thommazo L, Catai AM, Sampaio LMM, Borghi-Silva A. Acute application of bilevel positive airway pressure influences the cardiac autonomic nervous system. Clinics (Sao Paulo) 2009; 64:1085-92. [PMID: 19936182 PMCID: PMC2780525 DOI: 10.1590/s1807-59322009001100008] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2009] [Accepted: 08/06/2009] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Noninvasive positive pressure has been used to treat several diseases. However, the physiological response of the cardiac autonomic system during bilevel positive airway pressure (Bilevel) remains unclear. OBJECTIVE The aim of this study was to evaluate the heart rate variability (HRV) during Bilevel in young healthy subjects. METHODS Twenty men underwent 10-minute R-R interval recordings during sham ventilation (SV), Bilevel of 8-15 cmH(2)O and Bilevel of 13-20 cmH(2)O. The HRV was analyzed by means of the parallel R-R interval (mean R-Ri), the standard deviation of all R-Ri (SDNN), the root mean square of the squares of the differences between successive R-Ri (rMSSD), the number of successive R-Ri pairs that differ by more than 50 milliseconds (NN50), the percentage of successive R-Ri that differ by more than 50 milliseconds (pNN50), the low frequency (LF), the high frequency (HF) and SD1 and SD2. Additionally, physiological variables, including blood pressure, breathing frequency and end tidal CO(2), were collected. Repeated-measures ANOVA and Pearson correlation were used to assess the differences between the three studied conditions and the relationships between the delta of Bilevel at 13-20 cmH(2)O and sham ventilation of the HRV indexes and the physiological variables, respectively. RESULTS The R-Ri mean, rMSSD, NN50, pNN50 and SD1 were reduced during Bilevel of 13-20 cmH(2)O as compared to SV. An R-Ri mean reduction was also observed in Bilevel of 13-20 cmH(2)O compared to 8-15 cmH(2)O. Both the R-Ri mean and HF were reduced during Bilevel of 8-15 cmH(2)O as compared to SV, while the LF increased during application of Bilevel of 8-15 cmH(2)O as compared to SV. The delta (between Bilevel at 13-20 cmH(2)O and sham ventilation) of ETCO(2) correlated positively with LF, HF, the LF/HF ratio, SDNN, rMSSD and SD1. Acute application of Bilevel was able to alter the cardiac autonomic nervous system, resulting in a reduction in parasympathetic activity and an increase in sympathetic activity and higher level of positive pressure can cause a greater influence on the cardiovascular and respiratory system.
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Affiliation(s)
- Camila Bianca Falasco Pantoni
- Cardiopulmonary Physiotherapy Laboratory, Nucleus of Research in Physical Exercise, Physiotherapy Department - Federal University of São Carlos - São Carlos/SP, Brazil.
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