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Saleem S, Miles A, Allen J. A systematic review of behavioural therapies for improving swallow and cough function in Parkinson's disease. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024; 26:457-474. [PMID: 37534927 DOI: 10.1080/17549507.2023.2215488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/04/2023]
Abstract
PURPOSE This systematic review evaluated the efficacy of therapeutic interventions on improving swallow, respiratory, and cough functions in Parkinson's disease (PD). METHOD A PRISMA systematic search was implemented across six databases. We selected studies reporting pre- and post-assessment data on the efficacy of behavioural therapies with a swallow or respiratory/cough outcome, and excluded studies on medical/surgical treatments or single-session design. Cross-system outcomes across swallow, respiratory, and cough functions were explored. Cochrane's risk of bias tools were utilised to evaluate study quality. RESULT Thirty-six articles were identified and further clustered into four treatment types: swallow related (n = 5), electromagnetic stimulation (n = 4), respiratory loading (n = 20), and voice loading (n = 7) therapies. The effects of some behavioural therapies were supported with high-quality evidence in improving specific swallow efficiency, respiratory pressure/volume, and cough measures. Only eleven studies were rated with a low risk of bias and the remaining studies failed to adequately describe blinding of assessors, missing data, treatment adherence, and imbalance assignment to groups. CONCLUSION Behavioural therapies were diverse in nature and many treatments demonstrated broad cross-system outcome benefits across swallow, respiratory, and cough functions. Given the progressive nature of the condition, the focus of future trials should be evaluating follow-up therapy effects and larger patient populations, including those with more severe disease.
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Affiliation(s)
- Shakeela Saleem
- School of Psychology, The University of Auckland, Auckland, New Zealand
- Department of Disability Studies, University of Kelaniya, Colombo, Sri Lanka
| | - Anna Miles
- School of Psychology, The University of Auckland, Auckland, New Zealand
| | - Jacqueline Allen
- Department of Surgery, The University of Auckland, Auckland, New Zealand
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McMahon L, McGrath D, Blake C, Lennon O. Responsiveness of respiratory function in Parkinson's Disease to an integrative exercise programme: A prospective cohort study. PLoS One 2024; 19:e0301433. [PMID: 38551984 PMCID: PMC10980210 DOI: 10.1371/journal.pone.0301433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 03/15/2024] [Indexed: 04/01/2024] Open
Abstract
INTRODUCTION Respiratory disorders are the most common cause of death in Parkinson's Disease (PD). Conflicting data exist on the aetiology of respiratory dysfunction in PD and few studies examine the effects of exercise-based interventions on respiratory measures. This study was conducted to better understand respiratory dysfunction in PD and to identify measures of dysfunction responsive to an integrative exercise programme. OBJECTIVES The objectives were to compare baseline respiratory measures with matched, published population norms and to examine immediate and longer-term effects of a 12-week integrated exercise programme on these measures. DESIGN Twenty-three people with mild PD (median Hoehn & Yahr = 2) self-selected to participate in this exploratory prospective cohort study. Evaluation of participants occurred at three time points: at baseline; following the 12-week exercise programme and at 4-month follow-up. OUTCOME MEASURES Outcome measures included: Forced Vital Capacity (FVC), Forced Expiratory Volume in 1 second (FEV1), FEV1/FVC ratio, Peak Expiratory Flow (PEF), Inspiratory Muscle Strength (MIP), Expiratory Muscle Strength (MEP), Peak Cough Flow (PCF), and Cardiovascular Fitness measures of estimated VO2 max and 6-Minute Walk Test (6MWT). RESULTS Compared to published norms, participants had impaired cough, reduced respiratory muscle strength, FEV, FVC, PEF and cardiovascular fitness. Post exercise intervention, statistically significant improvements were noted in MEP, cardiovascular fitness, and PEF. However only gains in PEF were maintained at 4-month follow-up. CONCLUSIONS Significant respiratory dysfunction exists, even in the early stages of PD. Metrics of respiratory muscle strength, peak expiratory flow and cardiovascular fitness appear responsive to an integrative exercise programme.
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Affiliation(s)
- Laura McMahon
- Health Sciences Centre, UCD School of Public Health, Physiotherapy and Population Science, University College Dublin, Dublin, Ireland
| | - Denise McGrath
- Health Sciences Centre, UCD School of Public Health, Physiotherapy and Population Science, University College Dublin, Dublin, Ireland
| | - Catherine Blake
- Health Sciences Centre, UCD School of Public Health, Physiotherapy and Population Science, University College Dublin, Dublin, Ireland
| | - Olive Lennon
- Health Sciences Centre, UCD School of Public Health, Physiotherapy and Population Science, University College Dublin, Dublin, Ireland
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Amato A, Baldassano S, Vasto S, Schirò G, Davì C, Drid P, Dos Santos Mendes FA, Caldarella R, D’Amelio M, Proia P. Effects of a Resistance Training Protocol on Physical Performance, Body Composition, Bone Metabolism, and Systemic Homeostasis in Patients Diagnosed with Parkinson's Disease: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192013022. [PMID: 36293598 PMCID: PMC9602560 DOI: 10.3390/ijerph192013022] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 10/08/2022] [Accepted: 10/09/2022] [Indexed: 05/14/2023]
Abstract
Parkinson's disease (PD) is a neurodegenerative disorder characterized by motor impairments and it is correlated with loss of bone mineral density. This study aimed to analyze the effects of resistance training on bone metabolism, systemic homeostasis, body composition, and physical performance in people with PD. Thirteen subjects (age 64.83 ± 5.70) with PD diagnosis were recruited. Participants performed neuromuscular tests, body composition assessment, and blood sample analysis at baseline, and after an 11 weeks-training period. Each training session lasted 90 min, three times a week. The participants had significant improvements in the timed up and go (p < 0.01), sit to stand (p < 0.01), dominant peg-board (p < 0.05), dominant foot-reaction time (p < 0.01), and functional reach tests (p < 0.05). They showed better pressure foot distributions in the left forefoot (p < 0.05) and hindfoot (p < 0.05) and increased cervical right lateral bending angle (p < 0.05). The protocol affects bone metabolism markers osteocalcin (p < 0.05), calcium (p < 0.01), PTH (p < 0.01), the C-terminal telopeptide (CTX) (p < 0.01), and vitamin D (p < 0.05). Eleven weeks of resistance training improved manual dexterity, static and dynamic balance, reaction time, cervical ROM, and reduced bone loss in people with PD.
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Affiliation(s)
- Alessandra Amato
- Sport and Exercise Sciences Research Unit, Department of Psychological, Pedagogical and Educational Sciences, University of Palermo, 90128 Palermo, Italy
| | - Sara Baldassano
- Department of Biological Chemical and Pharmaceutical Sciences and Technologies (STEBICEF), University of Palermo, 90128 Palermo, Italy
- Correspondence: (S.B.); (P.P.)
| | - Sonya Vasto
- Department of Biological Chemical and Pharmaceutical Sciences and Technologies (STEBICEF), University of Palermo, 90128 Palermo, Italy
| | - Giuseppe Schirò
- Department of Biomedicine, Neurosciences and Advanced Diagnostics (Bi.N.D.), University of Palermo, 90127 Palermo, Italy
| | - Chiara Davì
- Department of Biomedicine, Neurosciences and Advanced Diagnostics (Bi.N.D.), University of Palermo, 90127 Palermo, Italy
| | - Patrik Drid
- Faculty of Sport and Physical Education, University of Novi Sad, 21000 Novi Sad, Serbia
| | | | - Rosalia Caldarella
- Department of Laboratory Medicine, “P. Giaccone” University Hospital, 90127 Palermo, Italy
| | - Marco D’Amelio
- Department of Biomedicine, Neurosciences and Advanced Diagnostics (Bi.N.D.), University of Palermo, 90127 Palermo, Italy
| | - Patrizia Proia
- Sport and Exercise Sciences Research Unit, Department of Psychological, Pedagogical and Educational Sciences, University of Palermo, 90128 Palermo, Italy
- Correspondence: (S.B.); (P.P.)
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Machado S, Teixeira D, Monteiro D, Imperatori C, Murillo-Rodriguez E, da Silva Rocha FP, Yamamoto T, Amatriain-Fernández S, Budde H, Carta MG, Caixeta L, de Sá Filho AS. Clinical applications of exercise in Parkinson's disease: what we need to know? Expert Rev Neurother 2022; 22:771-780. [PMID: 36168890 DOI: 10.1080/14737175.2022.2128768] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Exploring the potential of exercise in the rehabilitation process of patients with Parkinson's (PD) may be an interesting treatment perspective. Exercise-induced responses derived from neurotrophic elements appear to ameliorate the decline in neurodegeneration. Despite this understanding, the literature needs to be updated. AREAS COVERED Our review focuses on: a) the key mechanisms of exercise on PD, highlighting mainly the responses related to neuroplasticity; b) the effects induced by different traditional types of exercise, also highlighting the effects of complementary therapies related to movement; c) the volume of exercise required to support efficient results are explored in the context of PD. Additionally, the proposition of new clinical application strategies in the context of PD will also be determined. EXPERT OPINION It is suggested that different intensities of aerobic exercise be explored for the treatment of PD. The results associated with high intensity seem promising for performance, physiological and clinical parameters, such as BDNF production and cognition. On the other hand, the diversification of tasks and repetition of motor gestures appear as consistent arguments to exercise prescription. Finally, for future investigations, the neuromodulation strategy in association with aerobic exercise appears as a potential inducer of benefits on gait and cognitive function.
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Affiliation(s)
- Sergio Machado
- Department of Sports Methods and Techniques, Federal University of Santa Maria, Santa Maria, Brazil.,Physical Activity Neuroscience Laboratory (LABNAF), Neurodiversity Institute, Queimados-RJ, Brazil.,Intercontinental Neuroscience Research Group, Mérida, Mexico
| | - Diogo Teixeira
- Universidade Lusófona, Faculty of Physical Education and Sport, Lisbon, Portugal; Research Center in Sport, Physical Education, and Exercise and Health (CIDEFES), Lisbon, Portugal
| | - Diogo Monteiro
- ESECS, Polytechnic of Leiria, 2411-901 Leiria, Portugal; Research Center in Sport, Health and Human Development (CIDESD), 5000-558, Vila Real, Portugal.,Life Quality Research Centre (CIEQV), Leiria, Portugal
| | - Claudio Imperatori
- Intercontinental Neuroscience Research Group, Mérida, Mexico.,Cognitive and Clinical Psychology Laboratory, Department of Human Sciences European University of Rome, Rome, Italy
| | - Eric Murillo-Rodriguez
- Intercontinental Neuroscience Research Group, Mérida, Mexico.,Laboratorio de Neurociencias Moleculares e Integrativas, Escuela de Medicina, División Ciencias de la Salud, Universidad Anáhuac Mayab, Mexico
| | | | - Tetsuya Yamamoto
- Intercontinental Neuroscience Research Group, Mérida, Mexico.,Graduate School of Technology, Industrial and Social Sciences, Tokushima University, Tokushima, Japan
| | - Sandra Amatriain-Fernández
- Institute for Systems Medicine (ISM) at the Faculty of Human Sciences, Medical School Hamburg, Hamburg, Germany
| | - Henning Budde
- Intercontinental Neuroscience Research Group, Mérida, Mexico.,Institute for Systems Medicine (ISM) at the Faculty of Human Sciences, Medical School Hamburg, Hamburg, Germany
| | - Mauro Giovanni Carta
- Dipartimento di Sanità Pubblica, Università degli studi di Cagliari, Cagliari, Italy
| | - Leonardo Caixeta
- Neurology and Neuropsychiatry Department of Clinical Medicine, Federal University of Goiás, School of Medicine, Goiânia, Brazil
| | - Alberto Souza de Sá Filho
- Intercontinental Neuroscience Research Group, Mérida, Mexico.,Laboratorio de Neurociencias Moleculares e Integrativas, Escuela de Medicina, División Ciencias de la Salud, Universidad Anáhuac Mayab, Mexico.,Department of Physical Education, Paulista University, Goiânia, Brazil
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Effects of an Aquatic Physical Exercise Program on Ventilatory Parameters in People with Parkinson’s Disease. PARKINSON'S DISEASE 2022; 2022:2073068. [PMID: 36091655 PMCID: PMC9452001 DOI: 10.1155/2022/2073068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 08/08/2022] [Indexed: 11/17/2022]
Abstract
Problems in the respiratory system are the main cause of death in Parkinson’s disease (PD). Ventilatory limitations can also be part of a vicious cycle involving physical-functional limitations (e.g., walking difficulties) and the patients’ perception of fatigue. The objective of this study was to analyze the effects of an aquatic physical exercise intervention program on ventilatory parameters, perception of fatigue, and gait capacity in participants with PD. This quasi-experimental study had a single group with repeated measures in four assessments, proposing an aquatic physical exercise intervention program. The inclusion criteria encompassed being in levels 1 to 4 on the Hoehn and Yahr scale and having a medical certificate for the activities. Assessments took place at 3-month intervals between them—the first period was the control, the second following the intervention, and the third period was the follow-up. The intervention had 25 biweekly sessions over 3 months. A total of 13 people (71.3 ± 5.61 years old) participated in the intervention, without significant differences in the control period. Between the intervention assessments, they had statistically significant differences in MIP, MEP, FVC, Tiffeneau index, MVV, and fatigue. The study demonstrated that the aquatic physical exercise intervention was effective for ventilatory outcomes and fatigue in people with PD.
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Gamborg M, Hvid LG, Dalgas U, Langeskov‐Christensen M. Parkinson's disease and intensive exercise therapy - An updated systematic review and meta-analysis. Acta Neurol Scand 2022; 145:504-528. [PMID: 34997759 DOI: 10.1111/ane.13579] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 12/08/2021] [Accepted: 12/21/2021] [Indexed: 01/01/2023]
Abstract
In 2015, Uhrbrand et al. published the first review on Parkinson´s disease (PD) and exercise entirely based on randomized controlled trials (RCT) applying strict exercise definitions. The present review aimed to update the PD literature by assessing the effects of different intensive exercise modalities: resistance training (RT), endurance training (ET), and other intensive exercise modalities (OITM). An updated systematic literature search identified 33 new RCTs. Qualitative and quantitative analyses were performed. A total of 18 RT, 14 ET, and 1 OITM studies were identified (adding to the 8 RT, 6 ET, and 4 OITM studies identified by Uhrbrand et al. in 2015). RT, ET, and OITM were feasible, safe, and did not worsen PD symptoms. Furthermore, RT, ET, and OITM may positively affect functional outcomes (e.g., balance) and depressive symptoms in PD but inconsistencies across these findings warrant cautious conclusions. Meta-analyses showed that RT had a positive impact on muscle strength (standardized mean difference (SMD) = 0.83 [95% CI;0.54, 1.12]), functional capacity (Timed Up and Go Test (TUG): SMD = -0.62 [-1.01, -0.24]), and quality of life (SMD = -0.41 [-0.72, -0.09]), while ET had a positive impact on cardiorespiratory fitness (SMD = 0.27 [0.07, 0.47]) and functional capacity (TUG: SMD = -0.21 [-0.46, 0.04], 6-Min Walk Test: SMD = 0.89 [0.17, 1.62]), and a potentially positive impact on "on-medication" UPDRS-III (SMD = -0.15 [-0.38, 0.09]) and "off-medication" UPDRS-III (SMD = -0.19 [-0.41, 0.04]). In conclusion, RT, ET, and OITM all represent safe, feasible, and beneficial adjunct rehabilitation strategies in PD, with particularly RT and ET showing solid effects.
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Affiliation(s)
- Mads Gamborg
- Exercise Biology Department of Public Health Aarhus University Aarhus Denmark
| | - Lars G. Hvid
- Exercise Biology Department of Public Health Aarhus University Aarhus Denmark
- The Danish MS Hospitals, Ry and Haslev Denmark
| | - Ulrik Dalgas
- Exercise Biology Department of Public Health Aarhus University Aarhus Denmark
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Kaczyńska K, Orłowska ME, Andrzejewski K. Respiratory Abnormalities in Parkinson's Disease: What Do We Know from Studies in Humans and Animal Models? Int J Mol Sci 2022; 23:ijms23073499. [PMID: 35408858 PMCID: PMC8998219 DOI: 10.3390/ijms23073499] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 03/18/2022] [Accepted: 03/22/2022] [Indexed: 12/12/2022] Open
Abstract
Parkinson’s disease (PD) is the second most common progressive neurodegenerative disease characterized by movement disorders due to the progressive loss of dopaminergic neurons in the ventrolateral region of the substantia nigra pars compacta (SNpc). Apart from the cardinal motor symptoms such as rigidity and bradykinesia, non-motor symptoms including those associated with respiratory dysfunction are of increasing interest. Not only can they impair the patients’ quality of life but they also can cause aspiration pneumonia, which is the leading cause of death among PD patients. This narrative review attempts to summarize the existing literature on respiratory impairments reported in human studies, as well as what is newly known from studies in animal models of the disease. Discussed are not only respiratory muscle dysfunction, apnea, and dyspnea, but also altered central respiratory control, responses to hypercapnia and hypoxia, and how they are affected by the pharmacological treatment of PD.
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Osborne JA, Botkin R, Colon-Semenza C, DeAngelis TR, Gallardo OG, Kosakowski H, Martello J, Pradhan S, Rafferty M, Readinger JL, Whitt AL, Ellis TD. Physical Therapist Management of Parkinson Disease: A Clinical Practice Guideline From the American Physical Therapy Association. Phys Ther 2021; 102:6485202. [PMID: 34963139 PMCID: PMC9046970 DOI: 10.1093/ptj/pzab302] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 11/04/2022] [Indexed: 11/16/2022]
Abstract
A clinical practice guideline on Parkinson disease was developed by an American Physical Therapy Association volunteer guideline development group that consisted of physical therapists and a neurologist. The guideline was based on systematic reviews of current scientific and clinical information and accepted approaches for management of Parkinson disease. The Spanish version of this clinical practice guideline is available as a supplement (Suppl. Appendix 1).
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Affiliation(s)
- Jacqueline A Osborne
- Brooks Rehabilitation Hospital, Brooks Institute of Higher Learning, Jacksonville, Florida, USA
| | - Rachel Botkin
- Botkin Rehab Services, Physical Therapy, Columbus, Ohio, USA
| | - Cristina Colon-Semenza
- Department of Kinesiology, Doctor of Physical Therapy Program, University of Connecticut, Storrs, Connecticut, USA
| | - Tamara R DeAngelis
- Boston University Sargent College of Health and Rehabilitation Services, Physical Therapy and Athletic Training, Boston, Massachusetts, USA
| | - Oscar G Gallardo
- Rancho Los Amigos National Rehabilitation Center, Physical Therapy, Downey, California, USA
| | - Heidi Kosakowski
- Address all correspondence to Dr Kosakowski care of the Department of Practice of the American Physical Therapy Association at:
| | | | - Sujata Pradhan
- University of Washington, Rehabilitation Medicine, Seattle, Washington, USA
| | - Miriam Rafferty
- Northwestern University, Center for Education in Health Sciences, Chicago, Illinois, USA
| | | | | | - Terry D Ellis
- Boston University Sargent College of Health and Rehabilitation Services, Physical Therapy and Athletic Training, Boston, Massachusetts, USA
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Strength Training to Prevent Falls in Older Adults: A Systematic Review with Meta-Analysis of Randomized Controlled Trials. J Clin Med 2021; 10:jcm10143184. [PMID: 34300350 PMCID: PMC8304136 DOI: 10.3390/jcm10143184] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 07/09/2021] [Accepted: 07/13/2021] [Indexed: 12/20/2022] Open
Abstract
We performed a systematic review with meta-analysis of randomized controlled trials (RCTs) to assess the effects of strength training (ST), as compared to alternative multimodal or unimodal exercise programs, on the number of falls in older adults (≥60 years). Ten databases were consulted (CINAHL, Cochrane Library, EBSCO, EMBASE, PEDro, PubMed, Scielo, Scopus, SPORTDiscus and Web of Science), without limitations on language or publication date. Eligibility criteria were as follows: RCTs with humans ≥60 years of age of any gender with one group performing supervised ST and a group performing another type of exercise training, reporting data pertaining falls. Certainty of evidence was assessed with Grading of Recommendations, Assessment, Development and Evaluation (GRADE). Meta-analysis used a random effects model to calculate the risk ratio (RR) for number of falls. Five RCTs with six trials were included (n = 543, 76% women). There was no difference between ST and alternative exercise interventions for falls (RR = 1.00, 95% CI 0.77–1.30, p = 0.99). The certainty of evidence was very low. No dose–response relationship could be established. In sum, ST showed comparable RR based on number of falls in older adults when compared to other multimodal or unimodal exercise modalities, but evidence is scarce and heterogeneous, and additional research is required for more robust conclusions. Registration: PROSPERO CRD42020222908.
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10
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He Y, Zhao C, Liu Y. Effects of respiratory muscle training on cough function in neurological disorders: A systematic review with meta-analysis. NeuroRehabilitation 2021; 48:441-449. [PMID: 33967068 DOI: 10.3233/nre-210017] [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] [Indexed: 12/24/2022]
Abstract
BACKGROUND Patients with neurological disorders can present the weakness of respiratory muscle and impaired cough function. Previous studies have shown that respiratory muscle strength training (RMT) is an effective method of improving the strength of respiratory muscle. The effects of RMT on cough function remain controversial. OBJECTIVE We aimed to analyze randomized controlled trials (RCTs) that investigated the effects of RMT on cough function of patients with neurological disorders. METHODS Pubmed, Medline, Embase, and the Cochrane Library were searched electronically for RCTs. Two reviewers independently performed data extraction and quality assessment. Data were analyzed by using RevMan 5.3 software of The Cochrane Collaboration. RESULTS Five studies with 185 participants were included. The mean PEDro score was 6.2 (range 5 to 7), showing moderate methodological quality. Random-effects meta-analyses showed that respiratory muscle training improved peak expiratory cough flow of voluntary cough by 2.16 (95% CI 1.16 to 3.17) and involuntary cough by 2.84 (95% CI 1.29 to 4.39), with statistical significance (P < 0.0001, P = 0.0003). The experimental group had an improvement of 0.19 cmH2O (95% CI -0.12 to 0.5) on the maximal inspiratory pressure, 0.09 cmH2O (95% CI -0.23 to 0.42) on the maximal expiratory pressure, but with no statistical significance (P = 0.23, P = 0.58) between groups. CONCLUSION Respiratory muscle training was considered as an effective method for improving cough function. However, this review was insufficient to conclude whether respiratory muscle training was effective in improving inspiratory and expiratory muscle strength, this was opposite with previous meta-analysis. These effects might due to the small samples and different diseases.
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Affiliation(s)
- Yi He
- Department of Pain and Rehabilitation, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - Chen Zhao
- Department of Orthopedic, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yong Liu
- Department of Pain and Rehabilitation, Xinqiao Hospital, Army Medical University, Chongqing, China
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Sriboonreung T, Leelarungrayub J, Yankai A, Puntumetakul R. Correlation and Predicted Equations of MIP/MEP from the Pulmonary Function, Demographics and Anthropometrics in Healthy Thai Participants aged 19 to 50 Years. CLINICAL MEDICINE INSIGHTS-CIRCULATORY RESPIRATORY AND PULMONARY MEDICINE 2021; 15:11795484211004494. [PMID: 33814938 PMCID: PMC7989129 DOI: 10.1177/11795484211004494] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 03/01/2021] [Indexed: 11/17/2022]
Abstract
Objective: To identify the correlations and possible predicted equations of maximal inspiratory (MIP) and expiratory mouth pressure (MEP) values from pulmonary function test (PFT), demographics, and anthropometrics. Methods: This study involved 217 healthy participants (91 males and 126 females) aged 19 to 50 years. The PFT (forced vital capacity; FVC, forced expiratory volume in 1 second; FEV1, maximal mid-expiratory flow; MMEF, and peak expiratory flow; PEF) was performed by spirometry, whereas MIP and MEP were evaluated by a respiratory pressure meter. Pearson correlation and multiple linear regression, with the stepwise method, were used for statistical analysis. Results: The MIP and MEP had a significant positive correlation with weight, height, body mass index (BMI), and waist circumference. MIP had a significant positive correlation with FVC (%) and PEF (L/s and %), as well as a negative correlation with FEV1/FVC (ratio and %) and MMEF (%). Whereas, MEP showed a significant positive correlation with PEF (L/s and %) and negative correlation with FEV1/FVC (ratio and %) and MMEF (L/s). Finally, the predicted MIP and MEP equations were 103.988−97.70 × FEV1/FVC + 31.292 × Sex (male = 1 and female = 0) + 0.662 × PEF (%) and 47.384 + 3.603 × PEF (L/s)−9.514 × MMEF(L/s) + 30.458 × Sex (male = 1 and female = 0) + 0.534 × PEF (%), respectively. Conclusion: The respiratory muscle strengths can be predicted from the pulmonary function test, and gender data.
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Affiliation(s)
- Thanyaluck Sriboonreung
- Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Jirakrit Leelarungrayub
- Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Araya Yankai
- Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Rungthip Puntumetakul
- Research Center in Back, Neck, Other Joint Pain and Human Performance (BNOJPH), Khon Kaen University, Nai Mueang, Khon Kaen, Thailand
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Characteristics of Physical Exercise Programs for Older Adults in Latin America: A Systematic Review of Randomized Controlled Trials. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18062812. [PMID: 33802095 PMCID: PMC8000929 DOI: 10.3390/ijerph18062812] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 02/13/2021] [Accepted: 02/18/2021] [Indexed: 02/06/2023]
Abstract
AIM To characterize physical exercise programs for older adults in Latin America. METHODS This review was conducted in accordance with the PRISMA statement. A search for randomized controlled trials (RCTs) published between the years 2015 and 2020 was performed in the Scopus, MedLine and SciELO databases. RESULTS A total of 101 RCTs were included. A large percentage of the studies had an unclear risk of bias in the items: selection, performance, detection and attribution. Furthermore, a heterogeneous level of compliance was observed in the CERT items. A total sample of 5013 older adults (79% women) was included. 97% of the studies included older adults between 60-70 years, presenting an adherence to the interventions of 86%. The studies were mainly carried out in older adults with cardiometabolic diseases. Only 44% of the studies detailed information regarding the place of intervention; of these studies, 61% developed their interventions in university facilities. The interventions were mainly based on therapeutic physical exercise (89% of the articles), with a duration of 2-6 months (95% of the articles) and a frequency of 2-3 times a week (95% of the articles) with sessions of 30-60 min (94% of the articles) led by sports science professionals (51% of the articles). The components of physical fitness that were exercised the most were muscular strength (77% of the articles) and cardiorespiratory fitness (47% of the articles). Furthermore, only 48% of the studies included a warm-up stage and 34% of the studies included a cool-down stage. CONCLUSIONS This systematic review characterized the physical exercise programs in older adults in Latin America, as well the most frequently used outcome measures and instruments, by summarizing available evidence derived from RCTs. The results will be useful for prescribing future physical exercise programs in older adults.
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Claus I, Muhle P, Czechowski J, Ahring S, Labeit B, Suntrup-Krueger S, Wiendl H, Dziewas R, Warnecke T. Expiratory Muscle Strength Training for Therapy of Pharyngeal Dysphagia in Parkinson's Disease. Mov Disord 2021; 36:1815-1824. [PMID: 33650729 DOI: 10.1002/mds.28552] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 01/27/2021] [Accepted: 02/08/2021] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Pharyngeal dysphagia in Parkinson's disease (PD) is a common and clinically relevant symptom associated with poor nutrition intake, reduced quality of life, and aspiration pneumonia. Despite this, effective behavioral treatment approaches are rare. OBJECTIVE The objective of this study was to verify if 4 week of expiratory muscle strength training can improve pharyngeal dysphagia in the short and long term and is able to induce neuroplastic changes in cortical swallowing processing. METHODS In this double-blind, randomized, controlled trial, 50 patients with hypokinetic pharyngeal dysphagia, as confirmed by flexible endoscopic evaluation of swallowing, performed a 4-week expiratory muscle strength training. Twenty-five participants used a calibrated ("active") device, 25 used a sham handheld device. Swallowing function was evaluated directly before and after the training period, as well as after a period of 3 month using flexible endoscopic evaluation of swallowing. Swallowing-related cortical activation was measured in 22 participants (active:sham; 11:11) using whole-head magnetencephalography. RESULTS The active group showed significant improvement in the flexible endoscopic evaluation of swallowing-based dysphagia score after 4 weeks and after 3 months, whereas in the sham group no significant changes from baseline were observed. Especially, clear reduction in pharyngeal residues was found. Regarding the cortical swallowing network before and after training, no statistically significant differences were found by magnetencephalography examination. CONCLUSIONS Four-week expiratory muscle strength training significantly reduces overall dysphagia severity in PD patients, with a sustained effect after 3 months compared with sham training. This was mainly achieved by improving swallowing efficiency. The treatment effect is probably caused by peripheral mechanisms, as no changes in the cortical swallowing network were identified. © 2021 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Inga Claus
- Department of Neurology with Institute of Translational Neurology, University Hospital of Muenster, Muenster, Germany
| | - Paul Muhle
- Department of Neurology with Institute of Translational Neurology, University Hospital of Muenster, Muenster, Germany.,Institute for Biomagnetism and Biosignal Analysis, University Hospital Muenster, Muenster, Germany
| | - Judith Czechowski
- Department of Neurology with Institute of Translational Neurology, University Hospital of Muenster, Muenster, Germany
| | - Sigrid Ahring
- Department of Neurology with Institute of Translational Neurology, University Hospital of Muenster, Muenster, Germany
| | - Bendix Labeit
- Department of Neurology with Institute of Translational Neurology, University Hospital of Muenster, Muenster, Germany.,Institute for Biomagnetism and Biosignal Analysis, University Hospital Muenster, Muenster, Germany
| | - Sonja Suntrup-Krueger
- Department of Neurology with Institute of Translational Neurology, University Hospital of Muenster, Muenster, Germany.,Institute for Biomagnetism and Biosignal Analysis, University Hospital Muenster, Muenster, Germany
| | - Heinz Wiendl
- Department of Neurology with Institute of Translational Neurology, University Hospital of Muenster, Muenster, Germany
| | - Rainer Dziewas
- Department of Neurology with Institute of Translational Neurology, University Hospital of Muenster, Muenster, Germany
| | - Tobias Warnecke
- Department of Neurology with Institute of Translational Neurology, University Hospital of Muenster, Muenster, Germany
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Braz de Oliveira MP, Maria Dos Reis L, Pereira ND. Effect of Resistance Exercise on Body Structure and Function, Activity, and Participation in Individuals With Parkinson Disease: A Systematic Review. Arch Phys Med Rehabil 2021; 102:1998-2011. [PMID: 33587899 DOI: 10.1016/j.apmr.2021.01.081] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 01/18/2021] [Accepted: 01/19/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To investigate the effects of resistance exercise (RE) on body structure and function, activity, and participation in individuals with Parkinson Disease (PD) in the mild to moderate stages. DATA SOURCES Medline, Embase, Web of Science, The Cochrane Library, Lilacs, and PEDro were searched from inception until June 2020 using the terms "Parkinson Disease," "Exercise," "Resistance Training," "Muscle Strength," "Cardiorespiratory Fitness," "Postural Balance," "Gait," and "Quality of Life." STUDY SELECTION We included studies conducted in individuals with PD involving RE compared with a control group. Two independent reviewers performed the selection process based on titles, abstracts, and full-text reading. In total, 270 individuals with PD were included from 10 selected studies. DATA EXTRACTION Two reviewers independently extracted characteristics related to participants, intervention and control types, and results. The PEDro scale was used to assess the methodological quality, and the level of evidence was analyzed and synthesized using the Grading of Recommendation, Assessment, Development, and Evaluations approach. DATA SYNTHESIS The level of evidence for body structure and function was low and without effect for lower limb muscle strength; very low and with effect for upper limb muscle strength, cardiorespiratory fitness, and postural balance; and very low and without effect for flexibility after RE training. For activity, the evidence was very low and with effect for gait and very low and without effect for mobility. For participation (ie, quality of life) the evidence was very low and without effect. CONCLUSIONS Although the level of evidence was low to very low, RE was shown to promote improvements in body structure and function (upper limb muscle strength, cardiovascular function, postural balance) and activity (gait). In contrast, RE did not significantly improve participation (quality of life). However, based on the present findings, the practice of RE can be recommended for individuals with PD in the mild to moderate stages.
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Affiliation(s)
- Marcos Paulo Braz de Oliveira
- Physiotherapy Department, Healthy Aging Research Laboratory, Federal University of São Carlos, São Carlos, SP, Brazil.
| | - Luciana Maria Dos Reis
- Physiotherapy Department, Neurofunctional Physiotherapy Laboratory, Federal University of Alfenas, Alfenas, MG, Brazil
| | - Natalia Duarte Pereira
- Physiotherapy Department, Research Group in Functionality and Technological Innovation in NeuroRehabilitation, Federal University of São Carlos, São Carlos, SP, Brazil
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Ortega-Hombrados L, Molina-Torres G, Galán-Mercant A, Sánchez-Guerrero E, González-Sánchez M, Ruiz-Muñoz M. Systematic Review of Therapeutic Physical Exercise in Patients with Amyotrophic Lateral Sclerosis over Time. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18031074. [PMID: 33530383 PMCID: PMC7908444 DOI: 10.3390/ijerph18031074] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 01/17/2021] [Accepted: 01/21/2021] [Indexed: 02/06/2023]
Abstract
Background: the main objective of this study was to analyze the potential short-, medium- and long-term effects of a therapeutic physical exercise (TFE) programme on the functionality of amyotrophic lateral sclerosis (ALS) patients, measured with the Revised Amyotrophic Lateral Sclerosis Functional Scale (ALSFRS-R) scale. Methods: a systematic review of the PubMed, SCOPUS, Cochrane, Scientific Electronic Library Online (Scielo), Physiotherapy Evidence Database (PEDro), Cumulative Index of Nursing and Allied Health Literature (CINAHL) and Medical Literature Analysis and Retrieval System Online (MEDline) databases was carried out. The information was filtered using the following Medical Subjects Heading (MeSH) terms: “Amyotrophic lateral sclerosis”, “Physical Therapy”, and “Physical and Rehabilitation Medicine”. The internal validity of the selected documents was evaluated using the PEDro scale. The study included clinical trials published in the last 5 years in which one of the interventions was therapeutic physical exercise in patients with ALS, using the ALSFRS-R as the main outcome variable and functional variables as secondary variables. Results: 10 clinical trials were analyzed, with an internal validity of 5–7 points. The TFE groups showed significant short-, medium- and long-term differences, obtaining a mean difference of 5.8 points compared to the 7.6 points obtained by the control groups, at six months, measured with ALSFRS-R. In addition, the participants showed significant improvements in functional abilities in the short, medium and long terms. Conclusions: Therapeutic physical exercise could contribute to slowing down the deterioration of the musculature of patients with ALS, thus facilitating their performance in activities of daily living, based on the significant differences shown by these individuals in the short, medium and long term both in subjective perception, measured with ALSFRS-R, and functional capacities.
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Affiliation(s)
- Laura Ortega-Hombrados
- Department of Physiotherapy, Faculty of Health Sciences, University of Málaga, 29071 Málaga, Spain; (L.O.-H.); (E.S.-G.)
| | - Guadalupe Molina-Torres
- Department of Nursing Sciences, Physiotherapy and Medicine, Faculty of Health Sciences, University of Almería, 04120 Almería, Spain;
| | - Alejandro Galán-Mercant
- MOVE-IT Research Group, INIBICA Institute, University of Cádiz, 11110 Cádiz, Spain
- Department of Nursing and Physiotherapy, University of Cádiz, 11003 Cádiz, Spain
- Biomedical Research and Innovation Institute of Cádiz (INIBICA) Research Unit, Puerta del Mar University Hospital, University of Cádiz, 11003 Cádiz, Spain
- Correspondence: (A.G.-M.); (M.G.-S.)
| | - Eduardo Sánchez-Guerrero
- Department of Physiotherapy, Faculty of Health Sciences, University of Málaga, 29071 Málaga, Spain; (L.O.-H.); (E.S.-G.)
- Institute of Biomedicine of Málaga (IBIMA), 29010 Málaga, Spain;
| | - Manuel González-Sánchez
- Department of Physiotherapy, Faculty of Health Sciences, University of Málaga, 29071 Málaga, Spain; (L.O.-H.); (E.S.-G.)
- Institute of Biomedicine of Málaga (IBIMA), 29010 Málaga, Spain;
- Correspondence: (A.G.-M.); (M.G.-S.)
| | - María Ruiz-Muñoz
- Institute of Biomedicine of Málaga (IBIMA), 29010 Málaga, Spain;
- Department of Nursing and Podiatry, Faculty of Health Sciences, University of Málaga, 29071 Málaga, Spain
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McMahon L, Blake C, Lennon O. Nonpharmacological interventions for respiratory health in Parkinson's disease: A systematic review and meta-analysis. Eur J Neurol 2020; 28:1022-1040. [PMID: 33098349 DOI: 10.1111/ene.14605] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 10/15/2020] [Indexed: 12/29/2022]
Abstract
BACKGROUND AND PURPOSE Respiratory dysfunction in Parkinson's disease (PD) is often an underdiagnosed and untreated impairment associated with the disease. Clinically, a reactive approach to respiratory morbidity is taken, rather than preventative approaches that address underlying impairment/s. This systematic review identifies the current evidence to support nonpharmacological interventions to improve respiratory impairments in individuals with PD. METHODS The relevant literature was searched using a customised and systematic strategy. Randomised and nonrandomised control trials of nonpharmacological interventions targeting respiratory outcome measures in PD were included. Outcomes of interest were respiratory morbidity and mortality, respiratory muscle strength, spirometry measures, lung volumes, peak cough flow, and perception of dyspnoea. RESULTS Nonpharmacological interventions included: functional training, generalised strength training, respiratory muscle strength training, aerobic exercise, qigong, yoga, breath stacking, incentive spirometry and singing. Methodological quality of included studies varied. Meta-analyses of nonpharmacological interventions demonstrated significant effects for inspiratory muscle strength (mean difference [MD] 19.68; confidence interval [CI] 8.49, 30.87; z = 3.45; p = 0.0006; I2 = 2%), expiratory muscle strength (MD 18.97; CI 7.79, 30.14; z = 3.33; p = 0.0009; I2 = 23%) and peak expiratory flow (MD 72.21; CI 31.19, 113.24; z = 3.45; p = 0.0006; I2 = 0%). Best-evidence synthesis identified level 1 evidence supporting nonpharmacological interventions for improving peak cough flow and perceived dyspnoea. No studies were identified reporting outcomes of respiratory rate, inspiration:expiration ratio or respiratory morbidity or mortality in PD. CONCLUSIONS Nonpharmacological interventions improved respiratory muscle strength and peak expiratory flow in PD. Additional trials targeting respiratory dysfunction and longitudinal studies examining the relationship between respiratory dysfunction and morbidity and mortality rates in PD are required.
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Affiliation(s)
- L McMahon
- UCD School of Public Health, Physiotherapy and Population Science, Health Sciences Centre, University College Dublin, Dublin, Ireland
| | - C Blake
- UCD School of Public Health, Physiotherapy and Population Science, Health Sciences Centre, University College Dublin, Dublin, Ireland
| | - O Lennon
- UCD School of Public Health, Physiotherapy and Population Science, Health Sciences Centre, University College Dublin, Dublin, Ireland
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