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Park TS, Kim SH, Shin MJ. Cumulative Effects of Concurrent Inspiratory Muscle Training and Postural Correction Bands on Older Individuals Community Dwellers: A Randomized Study. Yonsei Med J 2024; 65:472-479. [PMID: 39048323 PMCID: PMC11284306 DOI: 10.3349/ymj.2023.0551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 03/29/2024] [Accepted: 04/01/2024] [Indexed: 07/27/2024] Open
Abstract
PURPOSE Posture correction bands (PCBs) have been proposed as aids to help chest expansion and to enhance respiratory function. However, the impact of PCBs on community-based older individuals engaged in inspiratory muscle training (IMT) at home remains unclear. MATERIALS AND METHODS Community-based individuals aged 65 years and older were divided into the PCB group, wearing PCBs, and the NPCB group, not wearing PCBs. The IMT regimen lasted 8 weeks, with sessions 5 times a week, including 4 sets per day and 15 repetitions per set. Training intensity was set at 50% of the maximum inspiratory pressure of each subject. To assess the effects of IMT, respiratory function, 6-minute walk test, and grip strength were measured before, during, and after the training period. Data were analyzed using repeated-measures analysis of variance, with post-hoc evaluation employing Bonferroni correction. RESULTS A total of 40 subjects were evenly divided into the PCB group and the NPCB group, with 20 subjects in each group. No significant difference was observed in respiratory muscle strength based on PCB use. However, during the initial 4 weeks, the PCB group exhibited a trend towards an increase in respiratory muscle strength compared to the NPCB group; this trend, however, did not prove to be statistically significant by the end of the 8-week period. Performance on the 6-minute walk test significantly improved in both groups. CONCLUSION The PCB group exhibited a tendency for increase in respiratory muscle strength in the first 4 weeks; however, ultimately there was no significant difference compared to the NPCB group. CLINICAL TRIAL REGISTRATION This study was registered with the Clinical Research Information Service, part of the World Health Organization's International Clinical Trials Registry Platform (Clinical Research Information Service No. KCT0008075).
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Affiliation(s)
- Tae Sung Park
- Department of Convergence Medical Institute of Technology, Pusan National University Hospital, Busan, Korea
- Department of Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Sang Hun Kim
- Department of Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
- Department of Rehabilitation Medicine, Pusan National University Hospital, Busan, Korea
- Department of Rehabilitation Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Myung-Jun Shin
- Department of Convergence Medical Institute of Technology, Pusan National University Hospital, Busan, Korea
- Department of Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
- Department of Rehabilitation Medicine, Pusan National University Hospital, Busan, Korea
- Department of Rehabilitation Medicine, Pusan National University School of Medicine, Busan, Korea.
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Zarralanga-Lasobras T, Romero-Estarlich V, Carrasco-Paniagua C, Serra-Rexach JA, Mayordomo-Cava J. "Inspiratory muscle weakness in acutely hospitalized patients 75 years and over": a secondary analysis of a randomized controlled trial on the effectiveness of multicomponent exercise and inspiratory muscle training. Eur Geriatr Med 2024; 15:83-94. [PMID: 37755683 DOI: 10.1007/s41999-023-00865-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 09/05/2023] [Indexed: 09/28/2023]
Abstract
PURPOSE The impact of hospitalization for acute illness on inspiratory muscle strength in oldest-old patients is largely unknown, as are the potential benefits of exercise and inspiratory muscle training (IMT) during in-hospital stay. DESIGN AND METHODS This was a sub-study of a randomized clinical trial that evaluated the efficiency of a multicomponent exercise program in preventing hospitalization-associated disability. Patients were randomized into control (CG) and intervention (IG) groups. The intervention included two daily sessions of supervised walking, squat, balance, and IMT. Baseline and discharge maximal inspiratory pressure (MIP) and inspiratory muscle weakness (IMW) were determined. The effect of the intervention on inspiratory muscle strength was assessed by analyzing (1) the differences between groups in baseline and discharge MIP and IMW, (2) the association, patient by patient, between baseline and discharge MIP, and the improvement index (MIP discharge/baseline) in patients with or without IMW. RESULTS In total, 174 patients were assessed (mean age of 87), 57 in CG and 117 in IG. Baseline MIP was lower than predicted in both sexes (women 29.7 vs 44.3; men 36.7 vs 62.5 cmH2O, P < 0.001, baseline vs predicted, respectively). More than 65% of patients showed IMW at admission. In women in IG, the mean MIP was higher at discharge than at admission (P = 0.003) and was the only variable that reached expected reference levels at discharge (Measured MIP 39.2 vs predicted MIP 45 cmH2O, P = 0.883). Patients with IMW on admission showed a statistically significant improvement in MIP after the intervention. CONCLUSION IMW is very prevalent in oldest-old hospitalized with acute illness. Patients might benefit from a multicomponent exercise program including IMT, even during short-stay hospitalization. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov; No.: NTC03604640. May 3, 2018.
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Affiliation(s)
- Teresa Zarralanga-Lasobras
- Department of Geriatrics, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Gregorio Marañón Health Research Institute, C. Castillo de Alarcón, 49, 28692, Villafranca del Castillo, Madrid, Spain
| | | | | | - José Antonio Serra-Rexach
- Department of Geriatrics, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Gregorio Marañón Health Research Institute, C. Castillo de Alarcón, 49, 28692, Villafranca del Castillo, Madrid, Spain
- Biomedical Research Networking Center on Frailty and Healthy Aging, CIBERFES, Madrid, Spain
- Department of Medicine, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Jennifer Mayordomo-Cava
- Gregorio Marañón Health Research Institute, C. Castillo de Alarcón, 49, 28692, Villafranca del Castillo, Madrid, Spain.
- Facultad HM Hospitales de Ciencias de la Salud de la Universidad Camilo José Cela, Madrid, Spain.
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Ribeiro R, Oliveira H, Goes M, Gonçalves C, Dias A, Fonseca C. The Effectiveness of Nursing Rehabilitation Interventions on Self-Care for Older Adults with Respiratory Disorders: A Systematic Review with Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6422. [PMID: 37510654 PMCID: PMC10379407 DOI: 10.3390/ijerph20146422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 07/18/2023] [Accepted: 07/19/2023] [Indexed: 07/30/2023]
Abstract
Background: This research work aimed to summarize the rehabilitation nursing interventions published in the scientific literature that most contribute to effective adherence to self-care in older adults with respiratory diseases. Methods: A systematic literature review with meta-analysis was conducted by searching the EBSCOhost platform (CINAHL Complete, MEDLINE Complete, Cochrane, and MedicLatina) using the PRISMA methodology. Five articles were selected for final analysis. Meta-analysis was carried out using Comprehensive Meta-Analysis (CMA) software, and the results were presented in a forest plot. Results: Thirty-one self-promoting rehabilitation nursing interventions were identified, with the most effective being those related to the assessment of progress in physical capacity/activity tolerance (functional status category/domain) and the assessment of the increase in health-related quality of life (health-related quality of life category/domain). Conclusions: Rehabilitation nursing interventions such as self-management programs led by nurses, community-based and home-based rehabilitation programs, and inspiratory muscle training can effectively reduce and enable the effective control of symptoms associated with respiratory disorders, boosting older adults' empowerment to engage in self-care.
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Affiliation(s)
- Rita Ribeiro
- Nursing Department, University of Évora, 7000-801 Évora, Portugal
| | - Henrique Oliveira
- Institute of Telecommunications, 3840-193 Aveiro, Portugal
- Polytechnic Institute of Beja, 7800-295 Beja, Portugal
| | - Margarida Goes
- Nursing Department, University of Évora, 7000-801 Évora, Portugal
- Comprehensive Health Research Centre (CHRC), University of Évora, 7000-801 Évora, Portugal
| | - Cátia Gonçalves
- Nursing Department, University of Évora, 7000-801 Évora, Portugal
| | - Ana Dias
- Nursing Department, University of Évora, 7000-801 Évora, Portugal
- Comprehensive Health Research Centre (CHRC), University of Évora, 7000-801 Évora, Portugal
| | - César Fonseca
- Nursing Department, University of Évora, 7000-801 Évora, Portugal
- Comprehensive Health Research Centre (CHRC), University of Évora, 7000-801 Évora, Portugal
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Villelabeitia-Jaureguizar K, Calvo-Lobo C, Rodríguez-Sanz D, Vicente-Campos D, Castro-Portal JA, López-Cañadas M, Becerro-de-Bengoa-Vallejo R, Chicharro JL. Low Intensity Respiratory Muscle Training in COVID-19 Patients after Invasive Mechanical Ventilation: A Retrospective Case-Series Study. Biomedicines 2022; 10:2807. [PMID: 36359327 PMCID: PMC9687222 DOI: 10.3390/biomedicines10112807] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 10/26/2022] [Accepted: 11/01/2022] [Indexed: 11/06/2022] Open
Abstract
Worldwide, healthcare systems had to respond to an exponential increase in COVID-19 patients with a noteworthy increment in intensive care units (ICU) admissions and invasive mechanical ventilation (IMV). The aim was to determine low intensity respiratory muscle training (RMT) effects in COVID-19 patients upon medical discharge and after an ICU stay with IMV. A retrospective case-series study was performed. Forty COVID-19 patients were enrolled and divided into twenty participants who received IMV during ICU stay (IMV group) and 20 participants who did not receive IMV nor an ICU stay (non-IMV group). Maximal expiratory pressure (PEmax), maximal inspiratory pressure (PImax), COPD assessment test (CAT) and Medical Research Council (MRC) dyspnea scale were collected at baseline and after 12 weeks of low intensity RMT. A greater MRC dyspnea score and lower PImax were shown at baseline in the IMV group versus the non-IMV group (p < 0.01). RMT effects on the total sample improved all outcome measurements (p < 0.05; d = 0.38−0.98). Intragroup comparisons after RMT improved PImax, CAT and MRC scores in the IMV group (p = 0.001; d = 0.94−1.09), but not for PImax in the non-IMV group (p > 0.05). Between-groups comparison after RMT only showed MRC dyspnea improvements (p = 0.020; d = 0.74) in the IMV group versus non-IMV group. Furthermore, PImax decrease was only predicted by the IMV presence (R2 = 0.378). Low intensity RMT may improve respiratory muscle strength, health related quality of life and dyspnea in COVID-19 patients. Especially, low intensity RMT could improve dyspnea level and maybe PImax in COVID-19 patients who received IMV in ICU.
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Affiliation(s)
| | - César Calvo-Lobo
- Faculty of Nursing, Physiotherapy and Podiatry, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - David Rodríguez-Sanz
- Faculty of Nursing, Physiotherapy and Podiatry, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Davinia Vicente-Campos
- Faculty of Health Sciences, Universidad Francisco de Vitoria, Pozuelo de Alarcón, 28223 Madrid, Spain
| | | | | | | | - José López Chicharro
- Faculty of Nursing, Physiotherapy and Podiatry, Universidad Complutense de Madrid, 28040 Madrid, Spain
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Sanchez-Migallón V, Calvo-Lobo C, Sanchez-Jorge S, Arce M, Vicente A, Bello E, Rodriguez-Sanz D, Becerro-de-Bengoa-Vallejo R, Chicharro JL, Vicente-Campos D. Exercise Physiology at "Conversational Level" Is Not Impaired in Healthy Young Subjects Wearing Masks or Respirators. Respiration 2022; 101:728-737. [PMID: 35512663 DOI: 10.1159/000524490] [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: 11/17/2021] [Accepted: 03/28/2022] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE The aim of this study was to evaluate the effects of the use of both surgical masks and FFP2 respirators on the inspiratory muscle strength, metabolic parameters, heart rate, subjective perceived exertion, and dyspnea perception, before and during 30 min stable load exercise at "conversational level". METHODS A randomized cross-over study was carried out. Nineteen healthy adults completed 3 conditions (without a mask, with a surgical mask or an FFP2 respirator) during a 30-min steady-state test at the lactate threshold intensity. Inspiratory muscle strength was measured before and after the test, and metabolic parameters, heart rate, subjective perceived exertion, and dyspnea perception were collected at baseline, during, and after the test. RESULTS There was a significant reduction in inspiratory muscle strength after the 30-min test in all conditions (control: 6.26 mm Hg, p < 0.5; surgical mask: 8.55 mm Hg, p < 0.01; FFP2 respirator: 12.42 mm Hg, p < 0.001), but without significant differences between them (p = 0.283). Data showed a statistically significant effect for time, but did not show a statistically significant interaction between condition and time for heart rate (p = 0.674), oxygen saturation (p = 0.297), blood lactate level (p = 0.991), rating perceived exertion (p = 0.734) and dyspnea (p = 0.532) comparisons. CONCLUSIONS The present study findings suggested that inspiratory muscle strength and physiological parameters during "conversational level" exercise were not impaired under wearing masks in healthy, nonsmoking young adults.
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Affiliation(s)
| | - César Calvo-Lobo
- Faculty of Nursing, Physical Therapy and Podiatry, Universidad Complutense de Madrid, Madrid, Spain
| | | | - Mónica Arce
- Faculty of Health Sciences, Universidad Francisco de Vitoria, Madrid, Spain
| | - Alejandra Vicente
- Faculty of Health Sciences, Universidad Francisco de Vitoria, Madrid, Spain
| | - Elena Bello
- Faculty of Health Sciences, Universidad Francisco de Vitoria, Madrid, Spain
| | - David Rodriguez-Sanz
- Faculty of Nursing, Physical Therapy and Podiatry, Universidad Complutense de Madrid, Madrid, Spain
| | | | - J L Chicharro
- Faculty of Nursing, Physical Therapy and Podiatry, Universidad Complutense de Madrid, Madrid, Spain
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Hegazy FA, Mohamed Kamel SM, Abdelhamid AS, Aboelnasr EA, Elshazly M, Hassan AM. Effect of postoperative high load long duration inspiratory muscle training on pulmonary function and functional capacity after mitral valve replacement surgery: A randomized controlled trial with follow-up. PLoS One 2021; 16:e0256609. [PMID: 34449776 PMCID: PMC8396720 DOI: 10.1371/journal.pone.0256609] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Accepted: 08/08/2021] [Indexed: 11/27/2022] Open
Abstract
Objectives Although, pre-operative inspiratory muscle training has been investigated and reported to be an effective strategy to reduce postoperative pulmonary complications, the efficacy of postoperative inspiratory muscle training as well as the proper load, frequency, and duration necessary to reduce the postoperative pulmonary complications has not been fully investigated. This study was designed to investigate the effect of postoperative high-load long-duration inspiratory muscle training on pulmonary function, inspiratory muscle strength, and functional capacity after mitral valve replacement surgeries. Design Prospective randomized controlled trial. Methods A total of one hundred patients (mean age 38.3±3.29years) underwent mitral valve replacement surgery were randomized into experimental (n = 50) and control (n = 50) groups. The control group received conventional physiotherapy care, while experimental group received conventional care in addition to inspiratory muscle training, with 40% of the baseline maximal inspiratory pressure targeting a load of 80% by the end of the 8 weeks intervention protocol. Inspiratory muscle training started on the patient’s first day in the inpatient ward. Lung functions, inspiratory muscle strength, and functional capacity were evaluated using a computer-based spirometry system, maximal inspiratory pressure measurement and 6MWT respectively at 5 time points and a follow-up assessment was performed 6 months after surgery. Repeated measure ANOVA and post-hoc analyses were used (p <0.05). Results Group-time interactions were detected for all the studied variables (p<0.001). Between-group analysis revealed statistically significant postoperative improvements in all studied variables in the experimental group compared to the control group (p <0.001) with large effect size of η2 ˃0.14. Within-group analysis indicated substantial improvements in lung function, inspiratory pressure and functional capacity in the experimental group (p <0.05) over time, and these improvements were maintained at follow-up. Conclusion High intensity, long-duration postoperative inspiratory muscle training is highly effective in improving lung function, inspiratory muscle strength, and functional capacity after mitral valve replacement surgeries.
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Affiliation(s)
- Fatma A. Hegazy
- Department of Physiotherapy, Collage of Health Sciences, University of Sharjah, Sharjah, UAE
- Faculty of Physical Therapy, Cairo University, Giza, Egypt
- * E-mail:
| | | | - Ahmed S. Abdelhamid
- Department of Physical Therapy for Musculoskeletal Disorders and Its Surgeries, Faculty of Physical Therapy, South Valley University, Qena, Egypt
| | | | - Mahmoud Elshazly
- Department of Physical Therapy for Surgery, Faculty of Physical Therapy, South Valley University, Qena, Egypt
| | - Ali M. Hassan
- Department of Physical Therapy for Internal Medicine and Geriatrics, Faculty of Physical Therapy, South Valley University, Qena, Egypt
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