The effects on the pulmonary function of normal adults proprioceptive neuromuscular facilitation respiration pattern exercise

Effects of proprioceptive neuromuscular facilitation combined with threshold inspiratory muscle training on respiratory function in neurocritical patients with weaning failure: a randomized controlled trial

The purpose of this study was to determine the effects of combining proprioceptive neuromuscular facilitation (PNF) with threshold inspiratory muscle training (TIMT), compared with TIMT alone, on respiratory function in neurocritical patients who experienced a weaning failure. Forty-seven participants (mostly after a stroke), were randomly divided into the experimental group ( n  = 24) and the control group ( n  = 23). The control group received usual care and TIMT, whereas the experimental group, in addition, underwent four 90-s periods of manual PNF. Both groups performed training in the ICU twice a day for 5 consecutive days. The main outcome measures included maximum inspiratory pressure, diaphragmatic excursions, diaphragm thickening fraction, oxygenation index, and forced expiratory volume in 1 s/forced vital capacity. The results showed a significant group-by-time interaction effect for maximum inspiratory pressure [ F (1, 45) = 17.84, η2  = 0.328, P  < 0.001] and oxygenation index [ F [1, 45) = 5.58, η2  = 0.11, P  = 0.023]. When compared with the control group, the experimental group showed overall significantly higher maximum inspiratory pressure [mean difference = 4.37 cm H 2 O, 95% confidence interval (CI) 0.25-8.50, P  = 0.038]. No other significant group differences were found. Combining PNF with TIMT may improve respiratory function in neurocritical patients with weaning failure. This combination approach may increase the likelihood of survival of neurocritical patients in the ICU.

Feasibility of Chest Wall and Diaphragm Proprioceptive Neuromuscular Facilitation (PNF) Techniques in Mechanically Ventilated Patients

Physical therapy is part of the treatment for patients admitted to ICU. Proprioceptive neuromuscular facilitation (PNF) is one of the physiotherapy concepts including manual techniques and verbal stimulation. The purpose of this paper is to examine the feasibility of PNF techniques in mechanically ventilated (MV) ICU patients. Another aim is to verify whether the technique using resistance during the patient’s inhalation will have a different effect than the technique used to teaching the correct breathing patterns. Methods: Patients admitted to tertiary ICU were enrolled in this study, randomly divided into two groups, and received four 90-second manual breathing stimulations each. The following vital signs were assessed: HR, SBP, DBP, and SpO₂. Results: 61 MV ICU adult patients (mean age 67.8; 25 female and 36 male) were enrolled in this study. No significant differences in HR, SBP, and DBP were observed both for two techniques measured separately and between them. Statistically significant differences were noticed analysing SpO₂ in the rhythmic initiation technique (RIT) group (p-value = 0.013). Conclusions: Short-term PNF interventions did not influence clinically relevant vital parameters among MV patients and seem to be feasible in this group of ICU patients.

Effects of Proprioceptive Neuromuscular Facilitation Stretching Combined with Aerobic Training on Pulmonary Function in COPD Patients: A Randomized Controlled Trial

Background

The proprioceptive neuromuscular facilitation (PNF) stretching could improve the contractile capacity of respiratory muscles, but the effect on pulmonary function, when it is combined with aerobic training, remains unknown.

Objective

To evaluate the effect of PNF combined with aerobic training on respiratory symptoms, pulmonary function and neck/shoulder mobility in patients with COPD.

Design

Randomized controlled trial.

Participants

Fifty-five COPD patients were randomly divided into PNF group (n=28) and control group (n=27).

Intervention

On the basis of conventional treatment, the control group performed 30 min aerobic training on a treadmill, while the PNF group added 10-minute PNF stretching 3 times every training day. Both groups did their training in 5 days per week for 6 weeks.

Measures

Measures were taken before and after 6 weeks of training. COPD Assessment Test (CAT), dyspnea Visual Analog Scale (VAS), forced vital capacity (FVC), forced expiratory volume in first second (FEV₁), inspiratory capacity (IC), inspiratory reserve volume (IRV), 6-minute walk test (6MWT), the range of motion (ROM) of head protraction, shoulder flexion, and the non-dominant pectoralis minor muscle (PmM) length were measured.

Results

All the indicators of both groups were significantly improved after 6 weeks of intervention except for FVC, FEV₁ and PmM length. Compared to the control group, the PNF group showed significant improvement in the CAT score, dyspnea VAS score, IC, IRV, 6MWT, as well as head protraction ROM and shoulder flexion ROM. Furthermore, IC was positively correlated with the head protraction ROM and PmM length (r=0.415, 0.579, P=0.028, 0.001); IRV was positively correlated with the shoulder flexion ROM (r=0.405, P=0.032) in the PNF group.

Conclusion

PNF stretching combined with aerobic training reduces dyspnea and improves some pulmonary function measures, which is associated with neck/shoulder mobility, in COPD patients.

An analysis of pulmonary function in different lying positions in the 20's normal adults

[Purpose] The purpose of this study was to study the changes in pulmonary functions in relation to lying positions of experimental participants. [Subjects and Methods] Twenty participants participated in this experiment. Measurements were taken in the supine position, the left side-lying position, the right side-lying position, and the prone position. Vital capacity (VC) was evaluated using a Fit mate. [Results] A comparison of four lying position showed significant differences in participants’ VC. In comparison of four position, supine and left sidelying, and between supine and right sidelying, and between supine and prone, between left sidelying and prone. [Conclusion] In conclusion, changing the participants lying position produce changes in pulmonary functions. The greatest change occurred with a supine lying position. We presume that ventilation is affected by body structures. The results provide objective data for establishing the most suitable positions for stroke patients performing respiratory exercises.

An explanatory model of functional exercise capacity in patients with systemic sclerosis: considerations for rehabilitation programs

[Purpose] This study aimed to evaluate the impact of lung function and peripheral muscle function on the six-minute walking distance (6MWD) in systemic sclerosis (SS) patients and, thereby, to develop an explanatory model of functional exercise capacity for these individuals. [Methods] In a cross-sectional study, 31 SS patients underwent pulmonary function testing (including spirometry, diffusing capacity for carbon monoxide [DLCO], and respiratory muscle strength), isometric dynamometry with surface electromyography, and the 6MWD. [Results] There was a significant correlation between the 6MWD (% predicted, 6MWD%) and the following parameters: height (r = 0.427) and DLCO (r = 0.404). In contrast, no other independent variable showed a significant correlation with the 6MWD% (r ≤ 0.257). The final prediction model for 6MWD% (adjusted R(2) = 0.456, SE of bias=12%) was 6MWD% Gibbons = -131.3 + 1.16 × heightcm + 0.33 × DLCO% predicted. [Conclusion] In SS patients, body height and pulmonary diffusion are the main determinants of the 6MWD. Our results justify further investigation of the performance of SS patients during exercise, which may increase the understanding of the pathophysiological mechanisms involved in the disease. The impact of these findings in SS patients may be useful for evaluating the effects of rehabilitation programs.

Analysis of the pulmonary functions of normal adults according to pillow height

[Purpose] The purpose of this study is to examine changes in pulmonary functions in relation to the sleeping positions of the experimental subjects. [Subjects and Methods] The subjects for this study were twenty randomly selected males and females from K University. Measurements were taken in the supine position at three different pillow heights: 0 cm, 5 cm, and 10 cm. Pulmonary functions (vital capacity, tidal volume, inspiratory reserve volume, and expiratory reserve volume) were evaluated using a Fit mate. [Results] These findings suggest that a pillow height of 5 cm makes a significant difference in vital capacity (VC). When the three pillow heights were compared, significant differences were seen between 0 cm and 5 cm, and between 5 cm and 10 cm, in terms of vital capacity for the pulmonary functions among the three positions. [Conclusion] In conclusion, changing the positions of the subjects produces changes in pulmonary functions. The greatest change occurred in the 5 cm pillow height. Presumably, ventilation is affected by the body structures. The results will provide objective data to establish the most suitable positions for stroke patients when they perform respiratory exercises.

Effect of complete decongestive therapy and a home program for patients with post mastectomy lymphedema

[Purpose] Post mastectomy lymphedema is common among breast cancer survivors. It leads to physical discomfort and functional impairment. Rehabilitation forms the mainstay of treatment and is multidisciplinary. [Subjects and Methods] Sixty post mastectomy patients were allocated randomly and assigned to either a conventional treatment group (n=30) or a complete decongestive therapy (CDT) group (n=30). The conventional treatment group received manual lymphatic drainage, wore a low elastic compression garment, received glenohumeral mobilization, and performed deep breathing exercises, and the complete decongestive therapy group received CDT from a trained physiotherapist and a daily home program along with the conventional treatment, 5 days a week for 6 weeks. [Results] Arm circumference measurements were taken at five levels: the wrist, mid forearm, elbow, mid-upper arm, and axilla. The upper extremity function was evaluated using the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, and pain was assessed using the visual analogue scale. Measurements were taken at baseline, and at 4th and 6th weeks after the start of intervention. Within and between group comparisons showed significant improvements in the CDT group. [Conclusion] Complete decongestive therapy and a home program assists breast cancer related lymphedema survivors in regaining their lost functions. It also helps to improve their independence in daily activities, reduce their need for caregivers, and thereby improving their quality of life. Therefore, the results of this study showed that the CDT with a home program is an effective treatment for reducing post mastectomy lymphedema.

Cardiopulmonary effects of traditional Thai dance on menopausal women: a randomized controlled trial

[Purpose] This study evaluated the effects of Thai dance on cardiopulmonary factors in menopausal women. [Subjects] Sixty-six menopausal women aged 40 years or more. [Methods] Subjects were randomly assigned to either the Thai dance or control group. The Thai dance group performed a traditional Thai dancing exercise program for 60 minutes, 3 times per week for 6 weeks. The control group received general health guidance. The 6-minutewalk test, peak expiratory flow, forced vital capacity, forced expiratory volume in one second, maximal voluntary ventilation, and chest expansion were assessed at baseline and at the end of the study. [Results] Sixty-six menopausal women were eligible. At the end of the study, all variables were significantly better in the Thai dance group than the control group. Moreover, all variables improved significantly compared to baseline in the Thai dance group but not in the control group. For example, the mean 6-minutewalk test result in Thai dance group at the end of the study was 285.4 m, which was significantly higher than that at baseline (254.8 m) and the control group at baseline (247.0 m). [Conclusion] A 6-week Thai dance program improves cardiorespiratory endurance in menopausal women.

The effects of chest expansion resistance exercise on chest expansion and maximal respiratory pressure in elderly with inspiratory muscle weakness

[Purpose] The aim of this study was to examine the effect of chest expansion resistance exercises (CERE) on chest expansion, maximal inspiratory pressure (MIP), and maximal expiratory pressure (MEP) in elderly people with inspiratory muscle weakness. [Subjects] Thirty elderly people with inspiratory muscle weakness (MIP < 80% of the predicted value) were randomly and equally assigned to a chest expansion resistance exercise (CERE) group, core conditioning exercise (CCE) group, and control group. [Methods] The intervention was applied to the CERE group and CCE group five times per week, 30 minutes each time, for six weeks. A tapeline was used to measure upper and lower chest expansion. MIP and MEP before and after the intervention were measured and compared. [Results] There was significant improvement in upper and lower chest expansion and MIP after the intervention in both the CERE group and the CCE group, whereas the control group did not show any significant difference. MEP did not significantly change in any of the three groups after the intervention. [Conclusion] The CERE group underwent greater changes than the CCE group, which proves that the CERE is more effective for improving elderly people's chest expansion capacity and MIP in elderly people. Therefore, application of the CERE by therapists is recommended if the environment and conditions are appropriate for enhancement of chest expansion capacity and MIP in elderly people.