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Czarnecki J, Nowakowska-Domagała K, Mokros Ł. Combined cold-water immersion and breathwork may be associated with improved mental health and reduction in the duration of upper respiratory tract infection - a case-control study. Int J Circumpolar Health 2024; 83:2330741. [PMID: 38509857 PMCID: PMC10962303 DOI: 10.1080/22423982.2024.2330741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 03/11/2024] [Indexed: 03/22/2024] Open
Abstract
A polar plunge is a term referring to an ice-cold water immersion (CWI), usually in the winter period. It is also a part of a specific training program (STP) which currently gains popularity worldwide and was proven to display paradigm-shifting characteristics. The aim of this study was to compare the indices of mental functioning (including depression, anxiety, mindfulness) and duration of upper respiratory tract infection (URTI) measured among the study participants. A set of questionnaires was distributed via the Internet. Participants declaring regular STP practice were selected (N = 77). Two groups were matched based on a case-control principle: the first one (the control group) comprised participants who did not declare nor CWI practice, nor STP practice. The second one comprised participants declaring regular CWI practice only. The CWI only group displayed better mental health indices and shorter URTIs compared to the control group. Moreover, the STP group also displayed better general mental health, less somatic complaints, and shorter URTIs compared to the CWI only group. This study suggests the existence of CWI's potential in boosting mental health and immune system functioning, however when complemented by a specific breathwork, this potential can be increased. However, further research is required.
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Affiliation(s)
- Jan Czarnecki
- Second Department of Psychiatry, Institute of Psychiatry and Neurology, Warsaw, Poland
| | | | - Łukasz Mokros
- Second Department of Psychiatry, Institute of Psychiatry and Neurology, Warsaw, Poland
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Mazur MD, Hamner JW, Anand AN, Taylor JA. Cardiorespiratory Effects of Yogic Versus Slow Breathing in Individuals with a Spinal Cord Injury: An Exploratory Cohort Study. J Integr Complement Med 2024. [PMID: 38507692 DOI: 10.1089/jicm.2023.0641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/22/2024]
Abstract
Background: An intricate physiological and pathophysiological connection exists between the heart and lungs, which is especially important in individuals with spinal cord injury (SCI). While an exercise intervention may seem the best approach to leverage this relationship, the prior work has shown that, despite numerous health benefits, regular exercise training does not improve cardiorespiratory control in individuals with SCI. Breath training presents an alternative intervention that is uniquely accessible, with yogic breathing directly engaging linked fluctuations in respiration and cardiovascular control. In addition, there is evidence across a range of populations that regular yogic breathing reduces cardiovascular disease risk. It is possible that the chronic decrease in breathing frequency associated with regular yogic breathing, rather than the specific yogic breathing techniques themselves, is the primary contributor to the observed risk reduction. Methods: Therefore, in 12 individuals with traumatic SCI from C4 to T8, the authors compared Unpaced and conventional 0.083 Hz (Slow) paced breathing with various yogic breathing techniques including: (1) inspiratory-expiratory breath holds (i.e., Kumbhaka or "Box Breathing"), (2) extended exhalation (1:2 duty cycle), and (3) expiratory resistance via throat constriction (i.e., Ujjayi). Beat-to-beat heart rate and blood pressure were measured as well as end-tidal CO2 and O2 saturation were measured. Statistical analysis was performed using a one-way repeated-measures analysis of variance with post hoc pairwise t tests corrected for multiple comparisons. Results: As expected, all slow breathing patterns markedly increased respiratory sinus arrhythmia (RSA) compared with Unpaced in all (n = 12) individuals. More importantly, Ujjayi breathing appeared to improve ventilatory efficiency over Unpaced breathing in individuals with SCI by increasing O2 saturation (97.6% vs. 96.1%; p = 0.042) and tended to decrease end-tidal CO2 (32 mmHg vs. 35 mmHg; p = 0.08). While other slow breathing patterns demonstrated similar effects, only Ujjayi improved RSA while increasing heart rate and improving ventilatory efficiency. Conclusions: Hence, slow breathing per se can result in important cardiorespiratory changes, but the yogic breathing practice of Ujjayi, with glottic throat resistance, may hold the greatest promise for improving cardiorespiratory control in individuals with SCI (CTR ID No. NCT05480618).
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Affiliation(s)
- Marc D Mazur
- Cardiovascular Research Laboratory, Spaulding Hospital Cambridge, Cambridge, MA, USA
| | - Jason W Hamner
- Cardiovascular Research Laboratory, Spaulding Hospital Cambridge, Cambridge, MA, USA
| | - Amit N Anand
- St. Elizabeth's Medical Center, Brighton, MA, USA
| | - J Andrew Taylor
- Cardiovascular Research Laboratory, Spaulding Hospital Cambridge, Cambridge, MA, USA
- Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA
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Breuer-Asher I, Ritholz MD, Horwitz DL, Manejwala O, Behar E, Fundoiano-Hershcovitz Y. Association of Digital Engagement With Relaxation Tools and Stress Level Reduction: Retrospective Cohort Study. JMIR Form Res 2024; 8:e50506. [PMID: 38502164 PMCID: PMC10988373 DOI: 10.2196/50506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 10/12/2023] [Accepted: 02/27/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND Stress is an emotional response caused by external triggers and is a high-prevalence global problem affecting mental and physical health. Several different digital therapeutic solutions are effective for stress management. However, there is limited understanding of the association between relaxation components and stress levels when using a digital app. OBJECTIVE This study investigated the contribution of relaxation tools to stress levels over time. We hypothesized that participation in breathing exercises and cognitive behavioral therapy-based video sessions would be associated with a reduction in stress levels. We also hypothesized a significant reduction specifically in participants' perceived sense of burden and lack of productivity when engaged with breathing exercises and video sessions. METHODS Stress levels were evaluated in a real-world data cohort using a behavioral health app for digital intervention and monitoring change. This retrospective real-world analysis of users on a mobile platform-based treatment followed users (N=490) who started with moderate and above levels of stress and completed at least 2 stress assessments. The levels of stress were tracked throughout the first 10 weeks. A piecewise mixed effects model was applied to model the trajectories of weekly stress mean scores in 2 time segments (1-6 weeks and 6-10 weeks). Next, a simple slope analysis was used for interpreting interactions probing the moderators: breathing exercises and video sessions. Piecewise mixed-effects models were also used to model the trajectories of specific perceived stress item rates in the stress questionnaire in the 2 segments (1-6 weeks and 6-10 weeks) and whether they are moderated by the relaxation engagements. Simple slope analysis was also used here for the interpretation of the interactions. RESULTS Analysis revealed a significant decrease in stress symptoms (β=-.25; 95% CI -0.32 to -0.17; P<.001) during the period of 1-6 weeks of app use that was maintained during the period of 6-10 weeks. Breathing exercises significantly moderated the reduction in stress symptoms during the period of 1-6 weeks (β=-.07; 95% CI -0.13 to -0.01; P=.03), while engagement in digital video sessions did not moderate stress scores. Engagement in digital video sessions, as well as breathing exercises, significantly moderated the reduction in perceived sense of burden and lack of productivity during weeks 1-6 and remained stable during weeks 6-10 on both items. CONCLUSIONS This study sheds light on the association between stress level reduction and specific components of engagement in a digital health app, breathing exercises, and cognitive behavioral therapy-based video sessions. Our findings provide a basis for further investigation of current and moderating factors that contribute to the personalization of digital intervention. In addition, results may aid in developing a more comprehensive understanding of how digital intervention tools work for mental health and for whom they are most effective.
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Affiliation(s)
| | - Marilyn D Ritholz
- Joslin Diabetes Center, Harvard Medical School, Boston, MA, United States
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Sheikh SS, Athawale V, Fating T. Impact of Multimodal Rehabilitation Protocol in a 20-Year-Old Patient With Cherubism Undergone Facial Surgery: A Rare Case Report. Cureus 2024; 16:e56191. [PMID: 38618375 PMCID: PMC11015988 DOI: 10.7759/cureus.56191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 03/14/2024] [Indexed: 04/16/2024] Open
Abstract
Cherubism, a rare autosomal dominant disorder, presents with symmetrical, painless jaw extension due to fibrous tissue ossification, often referred to as hereditary fibrous dysplasia of the jaw. It typically manifests with progressive mandibular and maxillary swelling from childhood to adolescence, with exacerbation over time. A 20-year-old male presented with facial and jaw swelling, causing restricted jaw movements. Computed tomography confirmed the cherubism diagnosis. Subsequently, the patient underwent oral surgery for bone shaving and shaping. Post-surgery, a five-week physiotherapy regimen was initiated, emphasizing joint mobility preservation through active range-of-motion exercises and proprioceptive neuromuscular facilitation for facial expression and dyspnea alleviation. Following physiotherapy, significant improvements were observed, including enhanced respiratory function, increased cervical muscle strength, improved respiratory clearance, and reduced anxiety and depression levels. This case highlights the importance of physiotherapy in cherubism rehabilitation, a novel approach deserving further exploration.
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Affiliation(s)
- Shifa S Sheikh
- Community Health Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Vrushali Athawale
- Community Health Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Medical Sciences, Wardha, IND
| | - Tejaswini Fating
- Community Health Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Heim MA, Makuch MY. Evaluation of a short in-person and online antenatal educational intervention for high-risk pregnant women linked to antenatal consultation. Eur J Midwifery 2024; 8:EJM-8-03. [PMID: 38239277 PMCID: PMC10795506 DOI: 10.18332/ejm/175927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 03/20/2023] [Accepted: 12/27/2023] [Indexed: 01/22/2024] Open
Abstract
INTRODUCTION The aim of this study was to evaluate a short educational intervention that focused on labor pain (through visual analogue scale, VAS), postpartum anxiety, and birthing experience before and during the SARS-CoV-2 (COVID-19) pandemic. METHODS This was a quasi-experimental study conducted between November 2019 and May 2021 in Brazil in 100 women with a high-risk pregnancy in the third trimester of pregnancy with an intervention group with in-person or virtual sessions (during the COVID-19 pandemic) and a non-intervention group. The antenatal intervention included breathing and relaxation techniques, upright positions, and information about labor. For evaluation, an antenatal questionnaire, State-Trait Anxiety Inventory (STAI) and a postpartum questionnaire were used. For data analysis, Student's t-test, chi-squared and Fisher's exact tests, ANOVA, bivariate, and multivariate regression analysis, were used. RESULTS When comparing the women in the intervention group to the non-intervention group, it was observed that the latter group reported higher fear of pain at labor during antenatal consultations (p<0.013); more women needed analgesia at 0-4 cm dilation (17/40) (p<0.018); the duration of labor was ≥12 hours (37/50) (p<0.037); while the intervention reported having a regular, good or excellent labor period (36/50) (p=0.014). The multiple regression analysis for labor pain showed a significant relationship between mode of delivery (cesarean delivery: RR; SE -21.43; 5.32, p<0.001) and labor pain, and good satisfaction with labor (RR; SE -13.86; 6.40, p=0.033). CONCLUSIONS Women from the intervention group had more satisfaction and less pain during labor than women from the non-intervention group.
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Affiliation(s)
- Maria A. Heim
- Department of Obstetrics and Gynecology, University of Campinas Faculty of Medical Sciences, Sao Paulo, Brazil
| | - Maria Y. Makuch
- Department of Obstetrics and Gynecology, University of Campinas Faculty of Medical Sciences, Sao Paulo, Brazil
- Campinas Reproductive Health Research Center, Sao Paulo, Brazil
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Abdullahi A, Wong TWL, Ng SSM. Efficacy of diaphragmatic breathing exercise on respiratory, cognitive, and motor function outcomes in patients with stroke: a systematic review and meta-analysis. Front Neurol 2024; 14:1233408. [PMID: 38283673 PMCID: PMC10811179 DOI: 10.3389/fneur.2023.1233408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 12/28/2023] [Indexed: 01/30/2024] Open
Abstract
Background Stroke disrupts the functions carried out by the brain such as the control of movement, sensation, and cognition. Disruption of movement control results in hemiparesis that affects the function of the diaphragm. Impaired function of the diaphragm can in turn affect many outcomes such as respiratory, cognitive, and motor function. The aim of this study is to carry out a systematic review and meta-analysis to determine the efficacy of diaphragmatic breathing exercise on respiratory, cognitive, and motor outcomes after stroke. Method The study was registered in PROSPERO (CRD42023422293). PubMED, Embase, Web of Science (WoS), PEDro, Scopus, and CENTRAL databases were searched until September 2023. Only randomized controlled trials comparing diaphragmatic breathing exercise with a control were included. Information on the study authors, time since stroke, mean age, height, weight, sex, and the protocols of the experimental and control interventions including intensity, mean scores on the outcomes such as respiratory, cognitive, and motor functions were extracted. Cochrane risks of bias assessment tool and PEDro scale were used to assess the risks of bias and methodological quality of the studies. Narrative synthesis and meta-analysis were used to summarize the results, which were then presented in tables, risk-of-bias graph, and forest plots. The meta-analysis was carried out on respiratory function [forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FEV1/FVC, peak expiratory flow (PEF)] and motor function (trunk impairment, and internal and external oblique muscles activity). Results Six studies consisting of 151 participants were included. The results of the meta-analyses showed that diaphragmatic breathing exercise is only superior to the control at improving respiratory function, FVC (MD = 0.90, 95% CI = 0.76 to 1.04, P < 0.00001), FEV1 (MD = 0.32, 95% CI = 0.11 to 0.52, P = 0.002), and PEF (MD = 1.48, 95% CI = 1.15 to 1.81, P < 0.00001). Conclusion There is limited evidence suggesting that diaphragmatic breathing exercise may help enhance respiratory function, which may help enhance recovery of function post stroke. Systematic Review Registration PROSPERO, identifier CRD42023422293.
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Affiliation(s)
| | | | - Shamay SM Ng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
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Castro A, Catai AM, Rehder-Santos P, Signini ÉF, de Abreu RM, Da Silva CD, Dato CC, Oliveira RV, Ferreira AG. Insights into the Serum Metabolic Adaptations in Response to Inspiratory Muscle Training: A Metabolomic Approach Based on 1H NMR and UHPLC-HRMS/MS. Int J Mol Sci 2023; 24:16764. [PMID: 38069087 PMCID: PMC10706640 DOI: 10.3390/ijms242316764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 11/17/2023] [Accepted: 11/21/2023] [Indexed: 12/18/2023] Open
Abstract
Inspiratory muscle training (IMT) is known to promote physiological benefits and improve physical performance in endurance sports activities. However, the metabolic adaptations promoted by different IMT prescribing strategies remain unclear. In this work, a longitudinal, randomized, double-blind, sham-controlled, parallel trial was performed to investigate the effects of 11 weeks (3 days·week-1) of IMT at different exercise intensities on the serum metabolomics profile and its main regulated metabolic pathways. Twenty-eight healthy male recreational cyclists (30.4 ± 6.5 years) were randomized into three groups: sham (6 cm·H2O of inspiratory pressure, n = 7), moderate-intensity (MI group, 60% maximal inspiratory pressure (MIP), n = 11) and high-intensity (HI group, 85-90% MIP, n = 10). Blood serum samples were collected before and after 11 weeks of IMT and analyzed by 1H NMR and UHPLC-HRMS/MS. Data were analyzed using linear mixed models and metabolite set enrichment analysis. The 1H NMR and UHPLC-HRMS/MS techniques resulted in 46 and 200 compounds, respectively. These results showed that ketone body metabolism, fatty acid biosynthesis, and aminoacyl-tRNA biosynthesis were upregulated after IMT, while alpha linolenic acid and linoleic acid metabolism as well as biosynthesis of unsaturated fatty acids were downregulated. The MI group presented higher MIP, Tryptophan, and Valine levels but decreased 2-Hydroxybutyrate levels when compared to the other two studied groups. These results suggest an increase in the oxidative metabolic processes after IMT at different intensities with additional evidence for the upregulation of essential amino acid metabolism in the MI group accompanied by greater improvement in respiratory muscle strength.
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Affiliation(s)
- Alex Castro
- Department of Chemistry, Universidade Federal de São Carlos (UFSCar), São Carlos 13565-905, Brazil;
- Biosciences National Laboratory (LNBio), Brazilian Center for Research in Energy and Materials (CNPEM), Campinas 13083-100, Brazil
| | - Aparecida M. Catai
- Department of Physiotherapy, Universidade Federal de São Carlos (UFSCar), Sao Carlos 13565-905, Brazil; (A.M.C.); (P.R.-S.); (É.F.S.); (R.M.d.A.); (C.D.D.S.)
| | - Patrícia Rehder-Santos
- Department of Physiotherapy, Universidade Federal de São Carlos (UFSCar), Sao Carlos 13565-905, Brazil; (A.M.C.); (P.R.-S.); (É.F.S.); (R.M.d.A.); (C.D.D.S.)
| | - Étore F. Signini
- Department of Physiotherapy, Universidade Federal de São Carlos (UFSCar), Sao Carlos 13565-905, Brazil; (A.M.C.); (P.R.-S.); (É.F.S.); (R.M.d.A.); (C.D.D.S.)
| | - Raphael Martins de Abreu
- Department of Physiotherapy, Universidade Federal de São Carlos (UFSCar), Sao Carlos 13565-905, Brazil; (A.M.C.); (P.R.-S.); (É.F.S.); (R.M.d.A.); (C.D.D.S.)
| | - Claudio Donisete Da Silva
- Department of Physiotherapy, Universidade Federal de São Carlos (UFSCar), Sao Carlos 13565-905, Brazil; (A.M.C.); (P.R.-S.); (É.F.S.); (R.M.d.A.); (C.D.D.S.)
| | - Carla Cristina Dato
- Nutrition Course, Central Paulista University Center, Sao Carlos 13563-470, Brazil;
| | - Regina V. Oliveira
- Department of Chemistry, Universidade Federal de São Carlos (UFSCar), São Carlos 13565-905, Brazil;
| | - Antônio G. Ferreira
- Department of Chemistry, Universidade Federal de São Carlos (UFSCar), São Carlos 13565-905, Brazil;
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Puri SN, Jawade S, Deshmukh NS. Virtual Reality Therapy as an Adjunct to Physiotherapy for Postoperative Pain Management: A Case Report of Laparoscopic Open Pyeloplasty for Hydronephrosis. Cureus 2023; 15:e48254. [PMID: 38054124 PMCID: PMC10694782 DOI: 10.7759/cureus.48254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 11/04/2023] [Indexed: 12/07/2023] Open
Abstract
Hydronephrosis occurs when the tubes connecting the kidneys and bladder become blocked. These tubes carry urine from the kidneys, where it is created, to the bladder, where it is stored until elimination. When one or both ureters get blocked, serious complications and symptoms might arise. These symptoms include urinary tract obstruction, urine backflow, kidney distension, increased intra-renal pressure, impaired kidney function, infection risk, urinary incontinence, which is the involuntary loss of urine, and discomfort in the side, abdomen, or groin. This case report describes the effective postoperative management of abdominal surgery with virtual reality therapy (VRT) combined with standard medical care as additional therapy and physical therapy for hydronephrosis in a 22-year-old male patient. After undergoing laparoscopic open pyeloplasty, the patient developed right-sided hydronephrosis due to ureteral stenosis. He had a ureteral stent inserted and received physical therapy, including pelvic floor muscle training, core strengthening, and diaphragmatic breathing exercises. After four weeks of physical therapy, the patient reported improvement in his symptoms, including reduced discomfort and increased urination. These findings imply that physical therapy, in addition to advanced treatment with the help of VRT for hydronephrosis following abdominal surgery, might be beneficial.
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Affiliation(s)
- Saurabh N Puri
- Department of Musculoskeletal Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Swapna Jawade
- Department of Musculoskeletal Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Nikita S Deshmukh
- Department of Musculoskeletal Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Fraile Olivero CA, Jarabo Sarceda JR, Fernández Martín E, Alen Villamayor V, Calatayud Gastardi J, Gómez Martínez AM, Santos P, Arribas Manzanal PD, Cerdán Santacruz C, Hernando Trancho F. The Use of Fissios App© as a Complement to a Face-to-Face Respiratory Physiotherapy Program versus an Attendance-Only Face-to-Face Physiotherapy Program in Patients Scheduled for Thoracic Surgical Procedures Reduces the Risk of Developing Postoperative Pulmonary Complications-A Quasi-Experimental Study. J Clin Med 2023; 12:6774. [PMID: 37959239 PMCID: PMC10650653 DOI: 10.3390/jcm12216774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 10/22/2023] [Accepted: 10/24/2023] [Indexed: 11/15/2023] Open
Abstract
Postoperative pulmonary complications (PPCs) increase the hospital length of stay (LOS) and the cost of healthcare associated with surgical procedures. Strategies to reduce PPCs begin before surgery and continue in the postoperative period. Fissios App© is a smartphone application that contains perioperative medical advice and a structured respiratory physiotherapy program. The objective was to implement the use of this app in a group of patients scheduled for a thoracic surgical procedure and determine its efficacy in reducing PPCs. This was a quasi-experimental study in which all patients attended a face-to-face respiratory physiotherapy program, and the intervention group used Fissios App© as a complement. We prospectively recorded the postoperative evolution of both groups, analyzed the categorical differences and quantitative variables, and created a binary logistic regression model. We recruited 393 patients (131 intervention and 262 control). The intervention group had a lower incidence of PPCs (12.2% versus 24% in the control group, p = 0.006), a shorter LOS (a median of 3 days (IQR = 2-5) versus 4 days (IQR = 3-6, p = 0.001) in the control group), and a reduction in the risk of developing PPCs by 63.5% (OR: 0.365, 95% CI: 0.17-0.78). The use of Fissios App© improved the clinical outcomes after surgery and reduced the probability of developing PPCs.
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Affiliation(s)
- Carlos Alfredo Fraile Olivero
- Thoracic Surgery Department, Hospital Clínico San Carlos, 28040 Madrid, Spain; (J.R.J.S.); (J.C.G.); (A.M.G.M.); (F.H.T.)
| | - José Ramón Jarabo Sarceda
- Thoracic Surgery Department, Hospital Clínico San Carlos, 28040 Madrid, Spain; (J.R.J.S.); (J.C.G.); (A.M.G.M.); (F.H.T.)
| | - Elena Fernández Martín
- Thoracic Surgery Department, Hospital Clínico San Carlos, 28040 Madrid, Spain; (J.R.J.S.); (J.C.G.); (A.M.G.M.); (F.H.T.)
| | - Verónica Alen Villamayor
- Thoracic Surgery Department, Hospital Clínico San Carlos, 28040 Madrid, Spain; (J.R.J.S.); (J.C.G.); (A.M.G.M.); (F.H.T.)
| | - Joaquín Calatayud Gastardi
- Thoracic Surgery Department, Hospital Clínico San Carlos, 28040 Madrid, Spain; (J.R.J.S.); (J.C.G.); (A.M.G.M.); (F.H.T.)
| | - Ana María Gómez Martínez
- Thoracic Surgery Department, Hospital Clínico San Carlos, 28040 Madrid, Spain; (J.R.J.S.); (J.C.G.); (A.M.G.M.); (F.H.T.)
| | - Passio Santos
- Physical Medicine and Rehabilitation Department, Hospital Clínico San Carlos, 28040 Madrid, Spain
| | | | | | - Florentino Hernando Trancho
- Thoracic Surgery Department, Hospital Clínico San Carlos, 28040 Madrid, Spain; (J.R.J.S.); (J.C.G.); (A.M.G.M.); (F.H.T.)
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Fundoiano-Hershcovitz Y, Breuer Asher I, Ritholz MD, Feniger E, Manejwala O, Goldstein P. Specifying the Efficacy of Digital Therapeutic Tools for Depression and Anxiety: Retrospective, 2-Cohort, Real-World Analysis. J Med Internet Res 2023; 25:e47350. [PMID: 37738076 PMCID: PMC10559191 DOI: 10.2196/47350] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 08/01/2023] [Accepted: 09/04/2023] [Indexed: 09/23/2023] Open
Abstract
BACKGROUND Depression and anxiety are the main sources of work and social disabilities as well as health-related problems around the world. Digital therapeutic solutions using cognitive behavioral therapy have demonstrated efficacy in depression and anxiety. A common goal of digital health apps is to increase user digital engagement to improve outcomes. However, there is a limited understanding of the association between digital platform components and clinical outcomes. OBJECTIVE The aim of the study is to investigate the contribution of specific digital engagement tools to mental health conditions. We hypothesized that participation in coaching sessions and breathing exercises would be associated with a reduction in depression and anxiety. METHODS Depression and general anxiety symptoms were evaluated in real-world data cohorts using the digital health platform for digital intervention and monitoring change. This retrospective real-world analysis of users on a mobile platform-based treatment followed two cohorts of people: (1) users who started with moderate levels of depression and completed at least 2 depression assessments (n=519) and (2) users who started with moderate levels of anxiety and completed at least 2 anxiety assessments (n=474). Levels of depression (Patient Health Questionnaire-9) and anxiety (Generalized Anxiety Disorder-7) were tracked throughout the first 16 weeks. A piecewise mixed-effects model was applied to model the trajectories of the Patient Health Questionnaire-9 and the Generalized Anxiety Disorder-7 mean scores in 2 segments (1-6 weeks and 7-16 weeks). Finally, simple slope analysis was used for the interpretation of the interactions probing the moderators: coaching sessions and breathing exercises in both depression and anxiety cohorts. RESULTS Analysis revealed a significant decrease in depression symptoms (β=-.37, 95% CI -0.46 to 0.28; P≤.001) during the period of weeks 1-6 of app use, which was maintained during the period of 7-16 weeks. Coach interaction significantly moderated the reduction in depression symptoms during the period of weeks 1-6 (β=-.03, 95% CI -0.05 to -0.001; P=.02). A significant decrease in anxiety symptoms (β=-.41, 95% CI -0.50 to -0.33; P≤.001) was revealed during the period of 1-6 weeks, which was maintained during the period of 7-16 weeks. Breathing exercises significantly moderated the reduction in anxiety symptoms during the period of 1-6 weeks (β=-.07, 95% CI -0.14 to -0.01; P=.04). CONCLUSIONS This study demonstrated general improvement followed by a period of stability of depression and anxiety symptoms associated with cognitive behavioral therapy-based digital intervention. Interestingly, engagement with a coaching session but not a breathing exercise was associated with a reduction in depression symptoms. Moreover, breathing exercise but not engagement with a coaching session was associated with a reduction of anxiety symptoms. These findings emphasize the importance of using a personalized approach to behavioral health during digital health interventions.
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Affiliation(s)
| | | | - Marilyn D Ritholz
- Joslin Diabetes Center, Harvard Medical School, Boston, MA, United States
| | | | | | - Pavel Goldstein
- Integrative Pain Laboratory (iPainLab), School of Public Health, University of Haifa, Haifa, Israel
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Wang J, Deng N, Qi F, Li Q, Jin X, Hu H. The effectiveness of postoperative rehabilitation interventions that include breathing exercises to prevent pulmonary atelectasis in lung cancer resection patients: a systematic review and meta-analysis. BMC Pulm Med 2023; 23:276. [PMID: 37501067 PMCID: PMC10375623 DOI: 10.1186/s12890-023-02563-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 07/13/2023] [Indexed: 07/29/2023] Open
Abstract
BACKGROUND The main aim of this systematic review was to determine the effectiveness of postoperative rehabilitation interventions that include breathing exercises as a component to prevent atelectasis in lung cancer resection patients. METHODS In this review, we systematically and comprehensively searched the Cochrane Library, PubMed, EMBASE, and Web of Science in English and CNKI and Wanfang in Chinese from 2012 to 2022. The review included any randomized controlled trials focusing on the effectiveness of postoperative rehabilitation interventions that include breathing exercises to prevent pulmonary atelectasis in lung cancer patients. Participants who underwent anatomic pulmonary resection and received postoperative rehabilitation interventions that included breathing exercises as a component were included in this review. The study quality and risks of bias were measured with the GRADE and Cochrane Collaboration tools, and statistical analysis was performed utilizing RevMan 5.3 software. RESULTS The incidence of atelectasis was significantly lower in the postoperative rehabilitation intervention group (OR = 0.35; 95% CI, 0.18 to 0.67; I2 = 0%; P = 0.67) than in the control group. The patients who underwent the postoperative rehabilitation program that included breathing exercises (intervention group) had higher forced vital capacity (FVC) scores (MD = 0.24; 95% CI, 0.07 to 0.41; I2 = 73%; P = 0.02), forced expiratory volume in one second (FEV1) scores (MD = 0.31; 95% CI, 0.03 to 0.60; I2 = 98%; P < 0.01) and FEV1/FVC ratios (MD = 9.09; 95% CI, 1.50 to 16.67; I2 = 94%; P < 0.01). CONCLUSION Postoperative rehabilitation interventions that included breathing exercises decreased the incidence rate of atelectasis and improved lung function by increasing the FVC, FEV1, and FEV1/FVC ratio.
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Affiliation(s)
- Jun Wang
- Department of Rehabilitation Medicine, The Second Xiangya Hospital of Central South University, Renmin Road No. 139, Furong District, Changsha, 410000, Hunan, China
| | - Na Deng
- Department of Adult Rehabilitation, Xiangya Boai Rehabilitation Hospital, Changsha, Hunan, China
| | - Fang Qi
- Hunan University of Traditional Chinese Medicine, Changsha, Hunan, China
| | - Qingbo Li
- Hunan Children's Hospital, Rehabilitation Center, Changsha, Hunan, China
| | - Xuegang Jin
- Qinhuangdao Hospital of Traditional Chinese Medicine, Qinhuangdao, Hebei, China
| | - Huiling Hu
- Department of Rehabilitation Medicine, The Second Xiangya Hospital of Central South University, Renmin Road No. 139, Furong District, Changsha, 410000, Hunan, China.
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Eaton L. Mind-Body Approaches for Managing Distress in Cancer Care. Clin J Oncol Nurs 2023; 27:432-436. [PMID: 37677782 DOI: 10.1188/23.cjon.432-436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/09/2023]
Abstract
Symptoms of distress are common in people living with cancer. Evidence-based interventions for distress management in patients with cancer include mind-body approaches. Deep breathing, progressive muscle relaxation, and min.
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Macovei G, Minea R, Dumitraș IT, Precup CA, Baroiu L, Nechifor A, Armencia AO, Lese AC. Changes in Dento-Facial Morphology Induced by Wind Instruments, in Professional Musicians and Physical Exercises That Can Prevent or Improve Them-A Systematic Review. Life (Basel) 2023; 13:1528. [PMID: 37511903 PMCID: PMC10381963 DOI: 10.3390/life13071528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 06/30/2023] [Accepted: 07/06/2023] [Indexed: 07/30/2023] Open
Abstract
The aim of this study is to highlight the changes that occur regarding dento-facial morphology, facial, and masticatory muscles in musicians who play wind instruments. Anatomical and functional changes may occur after the long-term use of each type of wind instrument. We considered studies of the impact of playing the wind instrument on the masticatory muscle activity and the resulting modifications. Both children and adults can be affected by playing wind instruments in regard to tooth positioning and facial morphology. These changes relate to the type of wind instruments, the type of vowels and tones used by instrumentalists. There most valuable breathing techniques have been identified that improve the redistribution of pressure, with a minimizing effect on the morphological changes in the oral cavity and cephalic extremity, implicitly on the masticatory functional disorders. In addition to these beneficial effects on the stomatognathic system, these breathing techniques favorably increase lung capacity. Furthermore, a series of toning exercises for neck muscles-which are actively involved and overworked by wind instrument-playing artists-was identified. The study concludes that less experienced instrumentalists demonstrate increased facial muscle engagement, possibly leading to excessive strain, while experienced instrumentalists exhibit more optimized patterns of muscle activity. The novelty of this research lies in its interdisciplinary approach to understanding the influence of wind instruments on dento-facial morphology, addressing preventive and corrective measures to mitigate undesirable outcomes.
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Affiliation(s)
- Georgiana Macovei
- Department of Oral and Dental Diagnostics, "Gr. T. Popa" University of Medicine and Pharmacy Iaşi, No. 16, Universității Street, 700115 Iași, Romania
| | - Raluca Minea
- Department of Art History, Artistic Anatomy, Faculty of Visual Arts and Design, "George Enescu" National University of the Arts Iaşi, No. 189, Sărărie Street, 700451 Iaşi, Romania
| | - Iarina Teodora Dumitraș
- Department of Oral and Dental Diagnostics, "Gr. T. Popa" University of Medicine and Pharmacy Iaşi, No. 16, Universității Street, 700115 Iași, Romania
| | - Cosmin Andrei Precup
- Department of Balneology, Medical Recovery and Rheumatology, "V.Babeş"University of Medicine and Pharmacy Timişoara, No. 2,Piața EftimieMurgu Street, 300041 Timișoara, Romania
| | - Liliana Baroiu
- Clinical Medical Department, Faculty of Medicine and Pharmacy," Dunărea de Jos" University of Galați, No.47, Domneasca Street, 800008 Galaţi, Romania
- Infectious Diseases Department, "Sf. Cuv. Parascheva" Clinical Hospital of Infectious Diseases Galaţi, No. 393, Traian Street, 800179 Galaţi, Romania
| | - Alexandru Nechifor
- Clinical Medical Department, Faculty of Medicine and Pharmacy," Dunărea de Jos" University of Galați, No.47, Domneasca Street, 800008 Galaţi, Romania
- Multidisciplinary Integrated Center of Dermatological Interface Research Center (MICDIR), "Dunărea de Jos" University of Galați, No. 47, Domneasca Street, 800008 Galaţi, Romania
| | - Adina Oana Armencia
- Department of Oral and Dental Diagnostics, "Gr. T. Popa" University of Medicine and Pharmacy Iaşi, No. 16, Universității Street, 700115 Iași, Romania
| | - Ana Cristina Lese
- Department of Design, Faculty of Visual Arts and Design, "George Enescu" National University of the Arts Iaşi, No. 189, Sărărie Street, 700451 Iaşi, Romania
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14
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Gerbarg PL, Dickson F, Conte VA, Brown RP. Breath-centered virtual mind-body medicine reduces COVID-related stress in women healthcare workers of the Regional Integrated Support for Education in Northern Ireland: a single group study. Front Psychiatry 2023; 14:1199819. [PMID: 37377478 PMCID: PMC10291294 DOI: 10.3389/fpsyt.2023.1199819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 05/22/2023] [Indexed: 06/29/2023] Open
Abstract
Background During the COVID-19 pandemic, healthcare workers endured prolonged stress affecting their psychological well-being. Objectives: (1) Evaluate the effects of the Breath-Body-Mind Introductory Course (BBMIC) on COVID-related stress among employees of the Regional Integrated Support for Education, Northern Ireland, (2) Reduce the risk of adverse effects from COVID-related stress, and (3) Evaluate the effects of BBMIC on indicators of psychophysiological states and the consistency with hypothesized mechanisms of action. Methods In this single group study, a convenience sample of 39 female healthcare workers completed informed consent and baseline measures: Perceived Stress Scale (PSS), Stress Overload Scale-Short (SOS-S), and Exercise-Induced Feelings Inventory (EFI). Following the online BBMIC 4 h/day for 3 days and the 6 week solo (20 min/day) and group practice (45 min weekly), repeat testing plus the Indicators of Psychophysiological State (IPSS) and Program Evaluation were obtained. Results Baseline (T1) mean PSS score was significantly elevated compared to a normative sample: PSS = 18.2 vs. 13.7 (p < 0.001) and improved significantly 11 weeks post-BBMIC (T4). SOS-S mean score declined from 10.7(T1) to 9.7 at 6 week post-test (T3). The SOS-S proportion of High Risk scores found in 22/29 participants (T1), dropped to 7/29 (T3). EFI mean subscale scores improved significantly from T1 to T2 and T3 for Revitalization (p < 0.001); Exhaustion (p < 0.002); and Tranquility (p < 0.001); but not Engagement (p < 0.289). Conclusion Among RISE NI healthcare workers affected by COVID-related stress, participation in the BBMIC significantly reduced scores for Perceived Stress, Stress Overload, and Exhaustion. EFI Revitalization and Tranquility scores significantly improved. More than 60% of participants reported moderate to very strong improvements in 22 indicators of psychophysiological state, e.g., tension, mood, sleep, mental focus, anger, connectedness, awareness, hopefulness, and empathy. These results are consistent with the hypothesized mechanisms of action whereby voluntarily regulated breathing exercises change interoceptive messaging to brain regulatory networks that shift psychophysiological states of distress and defense to states of calmness and connection. These positive findings warrant validation in larger, controlled studies to extend the understanding of how breath-centered Mind-body Medicine practices could mitigate adverse effects of stress.
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Affiliation(s)
- Patricia L. Gerbarg
- Department of Psychiatry, New York Medical College, Valhalla, NY, United States
| | - Felicity Dickson
- Regional Integrated Support for Education, Belfast, United Kingdom
| | - Vincent A. Conte
- Management Department, Hofstra University, Hempstead, NY, United States
| | - Richard P. Brown
- Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States
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Silva de Sousa A, Pereira da Rocha A, Brandão Tavares DR, Frazão Okazaki JÉ, de Andrade Santana MV, Fernandes Moça Trevisani V, Pereira Nunes Pinto AC. Respiratory muscle training for obstructive sleep apnea: Systematic review and meta-analysis. J Sleep Res 2023:e13941. [PMID: 37258418 DOI: 10.1111/jsr.13941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 04/22/2023] [Accepted: 05/02/2023] [Indexed: 06/02/2023]
Abstract
Obstructive sleep apnea is the most common sleep disorder. This review aims to evaluate the effectiveness and safety of respiratory muscle training in the treatment of patients with obstructive sleep apnea. The study protocol was registered in Prospero Platform (CRD42018096980). We performed searches in the main databases: Medical Literature Analysis and Retrieval System Online (MEDLINE) via Pubmed; Excerpta Medica dataBASE (Embase) via Elsevier; Cochrane Central Register of Controlled Trials (CENTRAL) via Cochrane Library; Latin American and Caribbean Literature on Health Sciences (LILACS) through the Portal of the Virtual Health Library and Physiotherapy Evidence Database (PEDro) for all randomised-controlled trials published before July 2022. The randomised-controlled trials were assessed for risk of bias and certainty of evidence. Thirteen randomised-controlled trials were included. All studies had an overall high risk of bias. Inspiratory muscle training probably improves systolic blood pressure and sleepiness when compared with sham. However, inspiratory muscle training probably does not improve diastolic blood pressure and maximum expiratory pressure, and may not be superior to sham for apnea-hypopnea index, forced expiratory volume in 1 s, forced vital capacity, sleep quality and quality of life. In addition, it is uncertain whether there is any effect of inspiratory muscle training on maximum inspiratory pressure and physical capacity. Inspiratory muscle training may also improve maximum inspiratory pressure and maximum expiratory pressure compared with oropharyngeal exercises. However, it may not be superior for apnea-hypopnea index, sleep quality, sleepiness, quality of life and functional capacity. When associated with physical exercise, inspiratory muscle training may not be superior to physical exercise alone for maximum inspiratory pressure, maximum expiratory pressure, systolic and diastolic blood pressure, and functional capacity. At the same time, when associated with cardiac rehabilitation exercises, inspiratory muscle training may reduce apnea-hypopnea index, improve inspiratory muscle strength, sleepiness and sleep quality compared with cardiac rehabilitation alone. However, it may not be superior for improving quality of life. Regarding expiratory muscle training, it may improve expiratory muscle strength and sleep quality, but not sleepiness when compared with sham. The evidence on the effects of expiratory muscle training in apnea-hypopnea index is very uncertain.
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Affiliation(s)
- André Silva de Sousa
- Programa de Pós- Graduação em Saúde Baseada em Evidências, Universidad Federal de São Paulo, São Paulo, Brazil
| | - Aline Pereira da Rocha
- Programa de Pós- Graduação em Saúde Baseada em Evidências, Universidad Federal de São Paulo, São Paulo, Brazil
| | | | - Jane Érika Frazão Okazaki
- Programa de Pós- Graduação em Saúde Baseada em Evidências, Universidad Federal de São Paulo, São Paulo, Brazil
| | | | - Virgínia Fernandes Moça Trevisani
- Programa de Pós- Graduação em Saúde Baseada em Evidências, Universidad Federal de São Paulo, São Paulo, Brazil
- Universidade de Santo Amaro, São Paulo, Brazil
| | - Ana Carolina Pereira Nunes Pinto
- Programa de Pós- Graduação em Saúde Baseada em Evidências, Universidad Federal de São Paulo, São Paulo, Brazil
- Universidade Federal do Amapá, Macapá, Brazil
- Iberoamerican Cochrane Centre - Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
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16
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Ogbu CE, Oparanma C, Ogbu SC, Ujah OI, Okoli ML, Kirby RS. Trends in the Use of Complementary and Alternative Therapies among US Adults with Current Asthma. Epidemiologia (Basel) 2023; 4:94-105. [PMID: 36975618 PMCID: PMC10048134 DOI: 10.3390/epidemiologia4010010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 03/14/2023] [Accepted: 03/17/2023] [Indexed: 03/29/2023] Open
Abstract
Complementary and Alternative Medicines/Therapies (CAM) are commonly used by US asthma adults, yet little is known about recent trends in their use. Our aim was to report trends in CAM use among US adults with current asthma. We conducted a serial cross-sectional study using nationally representative data from the BRFSS Asthma Call-Back Survey (ACBS) collected between 2008 and 2019 (sample size per cycle, 8222 to 14,227). The exposure was calendar time, as represented by ACBS cycle, while the main outcomes were use of at least one CAM and eleven alternative therapies. We analyzed CAM use overall and by population subgroups based on age, gender, race/ethnicity, income, and daytime and night-time asthma symptoms. Our findings show that there was an increase in the use of at least one CAM from 41.3% in 2008 to 47.9% in 2019 (p-trend < 0.001) and an upward trend in the use of herbs, aromatherapy, yoga, breathing exercises, homeopathy, and naturopathy (p-trend < 0.05). However, the use of vitamins, acupuncture, acupressure, reflexology, and other CAM therapies remained stable (p-trend > 0.05). These trends varied according to population characteristics (age, sex, race, income) and asthma symptoms. In conclusion, our study suggests that CAM use among US adults with current asthma is either increasing or stable, and further studies are needed to explore the factors influencing these trends.
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Affiliation(s)
- Chukwuemeka E Ogbu
- Chiles Center, College of Public Health, University of South Florida, Tampa, FL 33612, USA
| | - Chisa Oparanma
- Department of Medicine, Kharkiv National Medical University, 61022 Kharkiv, Ukraine
| | - Stella C Ogbu
- Department of Biomedical Science, Tulane University School of Medicine, New Orleans, LA 70112, USA
| | - Otobo I Ujah
- Chiles Center, College of Public Health, University of South Florida, Tampa, FL 33612, USA
| | - Menkeoma L Okoli
- Department of Internal Medicine, Christus Health, Texas A&M University, Longview, TX 75601, USA
| | - Russell S Kirby
- Chiles Center, College of Public Health, University of South Florida, Tampa, FL 33612, USA
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Tanaka M, Kakuma T, Asada T. Utility of paced breathing tablet guidance apparatus with real-time feedback on autonomic function for individuals with mild cognitive impairment: a pilot study. Psychogeriatrics 2023; 23:434-441. [PMID: 36878855 DOI: 10.1111/psyg.12950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 01/25/2023] [Accepted: 02/16/2023] [Indexed: 03/08/2023]
Abstract
BACKGROUND Mild cognitive impairment (MCI) individuals also show significant parasympathetic deficits, while autonomic nervous system (ANS) flexibility can strengthen cognitive and brain function. Paced (or slow) breathing has significant effects on the ANS and is associated with relaxation and well-being. However, paced breathing requires considerable time and practice, a significant barrier to its widespread adoption. Feedback systems appear promising to make practice more time-efficient. A tablet guidance system providing real-time feedback on autonomic function was developed for MCI individuals and tested for efficacy. METHODS In this single-blind study, 14 outpatients with MCI practised with the device for 5 min twice a day for 2 weeks. The active group received feedback (FB+), whereas the placebo group (FB-) did not. Coefficient of variation of R-R intervals as the outcome indicator was measured immediately after the first intervention (T1 ), the end of the 2-week intervention (T2 ), and 2 weeks later (T3 ). RESULTS The mean outcome of the FB- group remained unchanged during the study period, whereas the outcome value of the FB+ group increased and retained the intervention effect for an additional 2 weeks. CONCLUSIONS Results indicate this FB system-integrated apparatus may be useful for MCI patients for effectively learning paced breathing.
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Affiliation(s)
| | - Tatsuyuki Kakuma
- Biostatistics Centre, Kurume University School of Medicine, Kurume, Japan
| | - Takashi Asada
- Tokyo Medical and Dental University, Tokyo, Japan.,Memory Clinic Ochanomizu, Tokyo, Japan
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Ramalingam V, Cheong SK, Lee PF. Study of EEG alpha wave response on the effects of video-guided deep breathing on pain rehabilitation. Technol Health Care 2023; 31:37-46. [PMID: 35723127 DOI: 10.3233/thc-213531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND Athletes with chronic ankle pain (CAP) are more inclined to suffer from physical and psychological pain depending on the severity of the injuries, which might trigger the powerless feeling on future sports participation. Therefore, an efficient and simple method is useful to integrate into conventional physiotherapy (CP) for maintaining mental wellness. OBJECTIVE This research aimed to verify the effects and progress of video-guided deep breathing (DB) integrated into CP through study on the changes of alpha waves and pain scale. METHODS Alpha waves were recorded using an electroencephalogram (EEG) and a visual analogue scale (VAS) to assess pain intensity before and after the intervention (6 weeks). Thirty CAP participants were recruited and randomly assigned to two groups: group A for video-guided DB integration into their CP and group B for CP. The effects of pre and post intervention were analyzed using a paired t-test with statistical significance set at p< 0.05. RESULTS Profound results from the research have shown that the participants who received both the DB+CP revealed a significant increase in alpha wave (p< 0.05) at occipital region. CONCLUSION The significant result reveals an increase in alpha waves in the occipital region after 6 weeks and indicates that the video-guided DB with a smartphone application is able to produce a change in CAP participants. This supports the DB integration to the CP for altering the pain perception.
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Affiliation(s)
| | - Soon Keng Cheong
- Faculty of Medicine and Health Sciences, University Tunku Abdul Rahman, Bandar Sungai Long, Kajang, Selangor, Malaysia
| | - Poh Foong Lee
- Lee Kong Chian Faculty of Engineering and Science, University Tunku Abdul Rahman, Bandar Sungai Long, Kajang, Selangor, Malaysia
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Gerbarg PL, Cruz-Cordero YL, Conte VA, García ME, Braña A, Estape ES, Brown RP. Breath-Body-Mind Core Techniques to Manage Medical Student Stress. J Med Educ Curric Dev 2023; 10:23821205231212056. [PMID: 37953880 PMCID: PMC10637144 DOI: 10.1177/23821205231212056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 10/18/2023] [Indexed: 11/14/2023]
Abstract
Objectives This pilot study evaluated the feasibility of a live, interactive, synchronous, online, manualized intervention, Breath-Body-Mind Introductory Course (BBM-IC), for medical students. BBM-IC includes breathing, movement, and attention-focus techniques for stress management and better emotion regulation, energy, sleep, and mental focus. Methods Medical students attending a 2-h BBM demonstration were invited to participate in the 12-h BBM-IC and weekly 45-min 6-week group practice. Measures were obtained using Survey Monkey: patient health questionnaire (PHQ9), generalized anxiety disorder-7 (GAD-7), exercise-induced feeling inventory (EFI), sleep quality scale (SQS), and body perception questionnaire-short form (BPQ-SF) at pre-BBM-IC (T1), post-BBM-IC (T2), and 6 weeks post (T3). Perceived stress scale (PSS) and meditation practices questionnaire (MPQ) were measured at baseline (T1) only. Results Twelve medical students participated in BBM-IC 4-h daily for 3 days. Six attended practice sessions and completed 6-week post-tests. Mean scores comparison identified two variable sets with significant improvements: EFI tranquility (p < .005) and supradiaphragmatic reactivity (p < .040). Two measures reached near significance: SQS (p ≤ .060) and PHQ9 (p ≤ .078). Conclusion This pilot study provided preliminary evidence that BBM-IC may reduce stress and anxiety symptoms while improving mood, energy, mental focus, and other correlates of psychophysiological state in medical students. Taking time for self-care is challenging for medical students, as reflected in the small study enrollment. Designating time for BBM as a requirement within the medical curriculum would probably enable more students to participate and acquire skills to reduce the effects of stress on their physical and psychological health, as well as the health of their patients.
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Affiliation(s)
| | - Yaidy L Cruz-Cordero
- Student Programs Coordination Office, San Juan Bautista School of Medicine, Caguas, Puerto Rico
| | - Vincent A Conte
- Frank G. Zarb School of Business, Hofstra University, Hempstead, New York, USA
| | - Martha E García
- Health Humanities Program, San Juan Bautista School of Medicine, Caguas, Puerto Rico
| | - Angel Braña
- Student Programs Coordination Office, San Juan Bautista School of Medicine, Caguas, Puerto Rico
| | - Estela S Estape
- Research Center, San Juan Bautista School of Medicine, Caguas, Puerto Rico
| | - Richard P Brown
- Department of Clinical Psychiatry, Columbia University, Vagelos College of Physicians and Surgeons, New York, USA
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20
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Ponomarenko GN, Nefedova EO, Kantemirova RK. [Therapeutic effects of medical rehabilitation in patients suffered from coronary heart disease with lower limb amputation]. Vopr Kurortol Fizioter Lech Fiz Kult 2023; 100:5-13. [PMID: 37427815 DOI: 10.17116/kurort20231000315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
Disabled persons, who have undergone lower limb amputation (LLA) due to obliterating atherosclerosis, are a special group among patients with coronary heart disease (CHD). In the developed countries, 25-35% of patients was performed high LLA in the first year of critical ischemia, ant the number of interventions is steadily increasing. The development of personalized medical rehabilitation programs (MR) for such patients is relevant. OBJECTIVE To scientifically substantiate the therapeutic effects of MR in patients with CHD and LLA. MATERIAL AND METHODS The research design was a prospective cohort comparative study of MR therapeutic effects. The research subject was a change of physical activity tolerance (PAT) in patients during the implementation of recommended MR programs. The study object was 102 patients aged from 45 to 74 years. All patients were distributed by the random numbers method. The examined sample of patients was divided into two clusters. The first cluster consisted of 52 patients with CHD and LLA: study group included 1 - 26 patients, who were performed MR (kinesitherapy, manual mechanokinesitherapy, breathing exercises) and comparison group consisted of 1 - 26 patients, who were performed the preparation to prosthetics). The second cluster included 50 patients with CHD (study group consisted of 2 - 25 patients, who were performed MR and pharmacotherapy, and comparison group consisted of 2 - 25 patients, who were performed only pharmacotherapy). Clinical, instrumental and laboratory methods of examination were used in the research, as well as indicators of psychophysiological status and life quality, subjected to adequate statistical analysis. RESULTS Dosed physical activities improve clinical and psychophysical statuses, as well as life quality of patients with CHD and LLA, increase contractility and optimize diastolic myocardial function, raise PAT, improve central and intracardial hemodynamics levels, neurohumoral regulation and lipid metabolism. The efficacy of personalized MR programs for patients with CHD and LLA is 88%, and standardized programs is 76%. The determinants of MR efficacy are base PAT values, as well as indicators of myocardial contraction and diastolic function. CONCLUSION The MR in patients with CHD and LLA forms obvious cardiotonic, vegetative correcting and lipid lowering healing effects.
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Affiliation(s)
- G N Ponomarenko
- G.A. Albrecht Federal Scientific Centre for Rehabilitation of Disabled Persons, St. Petersburg, Russia
- I.I. Mechnikov Northwestern State Medical University, St. Petersburg, Russia
| | - E O Nefedova
- G.A. Albrecht Federal Scientific Centre for Rehabilitation of Disabled Persons, St. Petersburg, Russia
| | - R K Kantemirova
- G.A. Albrecht Federal Scientific Centre for Rehabilitation of Disabled Persons, St. Petersburg, Russia
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Heim MA, Makuch MY. Breathing Techniques During Labor: A Multinational Narrative Review of Efficacy. J Perinat Educ 2023; 32:23-34. [PMID: 36632511 PMCID: PMC9822559 DOI: 10.1891/jpe-2021-0029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
We conducted a narrative review to assess the use and effectiveness of breathing techniques for pain control as the only non-pharmacological resource during labor and childbirth. A search was conducted using PubMed, PEDro, SciELO, and Scopus with publications between January 2005 and September 2021 in English, Portuguese, or Spanish. Seven publications were selected. Most of the articles reported on the use of slow and deep breathing during contractions in the first stage of labor and breathing associated with pushing-down efforts in the second stage. The information regarding the moment when guidance on the use of the techniques was provided varied across studies. According to the reviewed papers, breathing techniques offer benefits for women in labor without adverse effects on newborns.
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Hun Kim S, Beom Shin Y, Shin MJ, Hui Hong C, Huh S, Yoo W, Lee K. Effects of walking with a portable oxygen concentrator on muscle oxygenation while performing normal or pursed-lip breathing in patients with interstitial lung disease: a randomized crossover trial. Ther Adv Respir Dis 2023; 17:17534666231186732. [PMID: 37462163 DOI: 10.1177/17534666231186732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND In patients with interstitial lung disease (ILD), decreased oxygen saturation (SpO2) reduces physical performance and causes exertional dyspnea. Portable oxygen concentrator (POC) and pursed-lip breathing (PLB) have the potential to improve these parameters in ILD patients. OBJECTIVE To evaluate the effects of PLB while using a POC during walking in ILD patients. DESIGN Prospective, randomized crossover trial. METHODS We compared two breathing techniques. Participants not trained in PLB received a familiarization session before the first 6-min walking test (6MWT). During the first visit, patients performed the 6MWT under natural breathing (NB1) without oxygen (O2); during the second visit, they performed the 6MWT twice, once each with PLB (PLB1) and natural breathing (NB2) under O2 supplementation, to compare the effectiveness of NB and PLB. RESULTS Twenty participants were recruited; half had exercise-induced desaturation (EID) and half normal SpO2. In the normoxemia group (NG), the difference in the 6-min walking distance (6MWD) between NB1 and PLB1 was 28.8 ± 24.0 m, indicating reduced exercise capacity in PLB1. There were no significant differences in the quadriceps tissue saturation index (TSI), SpO2, and 6MWD between the PLB1 and NB2 in any patient or subgroup. All participants showed a significant increase in the SpO2 at rest, nadir SpO2, and mean SpO2 during the 6MWT with PLB and NB2 using a POC than with NB1. TSI showed a significant improvement at the beginning of 6MWT in ILD patients with EID in the PLB and NB2 condition. CONCLUSION Acute exposure to PLB did not improve symptoms, muscle oxygenation, or SpO2; however, it decreased the walking distance in the normoxemia group. POC improved leg muscle oxygenation in ILD patients with EID. The use of PLB and POC should be prescribed according to disease characteristics and severity.
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Affiliation(s)
- Sang Hun Kim
- Department of Rehabilitation Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Yong Beom Shin
- Department of Rehabilitation Medicine and Biomedical Research Institute, Pusan National University Hospital and Pusan National University School of Medicine, Busan, Republic of Korea
| | - Myung-Jun Shin
- Department of Rehabilitation Medicine and Biomedical Research Institute, Pusan National University Hospital and Pusan National University School of Medicine, Busan, Republic of Korea
| | - Cho Hui Hong
- Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
- Department of Physical Therapy, Graduate School, Kyungsung University, Busan, Republic of Korea
| | - Sungchul Huh
- Department of Rehabilitation Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Wanho Yoo
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Pusan National University Hospital, Busan, Republic of Korea
| | - Kwangha Lee
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Pusan National University Hospital, 179, Gudeok-ro, Seo-gu, Busan 49241, Republic of Korea. Department of Internal Medicine, Pusan National University School of Medicine, Busan, Republic of Korea
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Su H, Zhang J, Liu Y, Peng H, Zhang L. Pre and postoperative nurse-guided incentive spirometry versus physiotherapist-guided pre and postoperative breathing exercises in patients undergoing cardiac surgery: An evaluation of postoperative complications and length of hospital stay. Medicine (Baltimore) 2022; 101:e32443. [PMID: 36596066 PMCID: PMC9803493 DOI: 10.1097/md.0000000000032443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Atelectasis is the most occurring postoperative complication after cardiac surgeries. Postoperative respiratory exercises and incentive spirometry led to decrease in postoperative complications, especially atelectasis and hospital stay. The objectives of the study were to evaluate postoperative complications and length of hospital stay of patients who received pre and postoperative nurse-guided incentive spirometry against those of patients who received pre and postoperative breathing exercises by the physiotherapist in patients who underwent cardiac surgery. Data of patients who received 2 days preoperative and 2 days postoperative nurse-guided incentive spirometry with a spirometer (PPN cohort, n = 102) or received 2 days preoperative and 2 days postoperative breathing exercises by physiotherapist without spirometer (PPP cohort, n = 105), or 2 days postoperative physiotherapist-guided breathing exercises only without spirometer (PPB cohort, n = 114) were collected and analyzed. The acute or chronic collapse of part or entire lung was defined as atelectasis. The length of stay in the hospital was from the day of admission to discharge. Patients of the PPN cohort had fewer numbers of incidences of atelectasis, dyspnea, and sweating >1 day after operations compared to those of the PPB and the PPP cohorts (P < .05 for all). The partial pressure of oxygen and oxygen saturation of arterial blood ≥6 hours after operations reported higher, the duration of ventilation was shorter, and numbers of re-intubation processes reported fewer for patients of the PPN cohort than those of the PPB and the PPP cohorts (P < .05 for all). The hospital length of the stay of patients in the PPN cohort was fewer than those of the PPB and the PPP (P < .0001 for both) cohorts. Pre and postoperative nurse-guided incentive spirometry with a spirometer following cardiac surgeries would have better postoperative pulmonary outcomes and fewer hospital stays than those of postoperative-only or pre and postoperative physiotherapist-guided breathing exercises (level of evidence: IV; technical efficacy stage: 5).
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Affiliation(s)
- Hui Su
- Department of Cardiac Surgery, Xingtai People’s Hospital, Xingtai, Hebei, China
- * Correspondence: Hui Su, Department of Cardiac Surgery, Xingtai People’s Hospital, No. 818 of Xiangdu North Road, Xingtai, Hebei 054001, China (e-mail: )
| | - Jun Zhang
- Department of Cardiac Surgery, Xingtai People’s Hospital, Xingtai, Hebei, China
| | - Yunxue Liu
- Department of Cardiac Surgery, Xingtai People’s Hospital, Xingtai, Hebei, China
| | - Hui Peng
- Department of Cardiac Surgery, Xingtai People’s Hospital, Xingtai, Hebei, China
| | - Longfei Zhang
- Department of Cardiac Surgery, Xingtai People’s Hospital, Xingtai, Hebei, China
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Kulkarni A, Kamath Y, Shetty L, Kuzhuppilly NIR. The Effect of Specific Techniques of Nasal Breathing [Pranayama] on Intra-Ocular Pressure in Normal Individuals, a Randomized Trial. Clin Ophthalmol 2022; 16:4047-4054. [PMID: 36532821 PMCID: PMC9748160 DOI: 10.2147/opth.s389495] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Accepted: 11/07/2022] [Indexed: 08/30/2023] Open
Abstract
PURPOSE Glaucoma is an optic neuropathy where intraocular pressure is the only modifiable risk factor. Yoga is thought to adversely affect intra-ocular pressure (IOP) but we do not know if yogic breathing exercises can influence IOP. With this study, we aimed to determine the effect of specific nasal breathing techniques on intra-ocular pressure in normal individuals. PATIENTS AND METHODS One hundred and sixty-four normal subjects were randomly assigned to one of four specific breathing groups - right nostril breathing (RNB), left nostril breathing (LNB), alternate nostril breathing (ANB), normal breathing (NB). The IOP was measured in both eyes at baseline and following the breathing exercise; and the change was analyzed. RESULTS Eighty-five women and 79 men participated and there was no significant difference in baseline age or IOP between the groups. In RNB, IOP reduced significantly in both right and left eyes, from 14.3 ± 3.0mmHg to 13.9 ± 2.6mmHg, (p=0.022) and from 14.7 ± 3.2mmHg to 14.2 ± 3mmHg (p=0.016) respectively. In LNB, there was no significant IOP change in the right eye, whereas in the left eye, there was a significant reduction from 14.2 ± 2.7mmHg to 13.3 ± 2.5mmHg (p< 0.0001). There was no significant IOP change in ANB and NB. CONCLUSION Specific breathing techniques like right and left nostril breathing, alternate nostril breathing are safe and do not raise IOP in normal subjects. Additionally, right and left nostril breathing techniques have a beneficial effect of lowering IOP.
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Affiliation(s)
- Alisha Kulkarni
- Department of Ophthalmology, Kasturba Medical College Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Yogish Kamath
- Department of Ophthalmology, Kasturba Medical College Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Lavya Shetty
- Division of Yoga, Centre for Integrative Medicine & Research, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Neetha I R Kuzhuppilly
- Department of Ophthalmology, Kasturba Medical College Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Li Y, Ji Z, Wang Y, Li X, Xie Y. Breathing Exercises in the Treatment of COPD: An Overview of Systematic Reviews. Int J Chron Obstruct Pulmon Dis 2022; 17:3075-3085. [PMID: 36514332 PMCID: PMC9741817 DOI: 10.2147/copd.s385855] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 11/24/2022] [Indexed: 12/12/2022] Open
Abstract
Background The effectiveness of breathing exercises in the treatment of chronic obstructive pulmonary disease (COPD) has been demonstrated in several systematic reviews (SRs), but a comprehensive review is still lacking. The aim of this study was to synthesize evidence from SRs, to summarise the effects of breathing exercises interventions for COPD patients. Methods We conducted an overview of the SRs of breathing exercises in the treatment of COPD. We include Systematic Reviews of randomized-controlled clinical trials. In the included COPD, control of breathing exercises alone was the only variable and no restriction was placed on relevant outcome measures. The SRs were screened by computer retrieval from the Chinese National Knowledge Infrastructure (CNKI), WanFang database, Chinese Science and Technology Journal Database (CSTJ), Chinese Biological Medicine (CBM), MEDLINE (PubMed), Embase, Cochrane library, and Web of Science. The Risk of Bias in Systematic reviews (ROBIS) tool, the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement, a Measure Tool to Assess Systematic Reviews (AMSTAR) 2, and the Grades of Recommendations, Assessment, Development and Evaluation (GRADE) were used to evaluate the risk of bias, reporting quality, methodology quality, and evidence quality. Results Nine SRs met the inclusion criteria and were included in the overview, 4 SRs in Chinese, and 3 SRs in English. All the SRs were published between 2015-2021. According to the ROBIS tool, 4 SRs (57.14%) were rated as low risk of bias. The PRISMA scale showed that 5 SRs had some defects, and 2 SRs were relatively complete. Reporting deficiencies exist primarily in protocol and registration (28.6%), search (42.9%), risk of bias across studies (0%), additional analyses (42.9%), and funding (28.6%). Based on the AMSTAR-2 scale, 3 SRs were low quality, and the other 4 SRs were very low. The result of evidence quality assessment showed that among the 34 outcomes involved in the 7 studies, 19 were low-level outcomes, 15 were very low-level outcomes, and there were no moderate and high-level quality outcomes. Limitations and publication bias were two major factors that reduced the quality of evidence. Conclusion Breathing exercises in certain can improve pulmonary function, exercise endurance, dyspnea, quality of life, and respiratory muscle strength of COPD patients. However, there is an urgent need for high-quality studies to guide clinical practice due to certain deficiencies in reporting quality and the low quality of methodology and outcomes.
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Affiliation(s)
- Yiting Li
- The First Clinical Medical College, Henan University of Chinese Medicine, Zhengzhou, Henan, People’s Republic of China
| | - Zile Ji
- The First Clinical Medical College, Henan University of Chinese Medicine, Zhengzhou, Henan, People’s Republic of China
| | - Yan Wang
- The First Clinical Medical College, Henan University of Chinese Medicine, Zhengzhou, Henan, People’s Republic of China
| | - Xuanlin Li
- The First Clinical Medical College, Henan University of Chinese Medicine, Zhengzhou, Henan, People’s Republic of China
| | - Yang Xie
- Department of Respiratory Diseases, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, Henan, People’s Republic of China,Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases Co-Construction by Henan Province & Education Ministry of P.R. China, Henan University of Chinese Medicine, Zhengzhou, People’s Republic of China,Henan Key Laboratory of Chinese Medicine for Respiratory Disease, Henan University of Chinese Medicine, Zhengzhou, People’s Republic of China,Correspondence: Yang Xie, Department of Respiratory Medicine, The First Affiliated Hospital of Henan University of Chinese Medicine, No. 19 Renmin Road, Zhengzhou, Henan, 450046, People’s Republic of China, Email
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26
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Park SH, Oh YJ, Seo JH, Lee MM. Effect of stabilization exercise combined with respiratory resistance and whole body vibration on patients with lumbar instability: A randomized controlled trial. Medicine (Baltimore) 2022; 101:e31843. [PMID: 36401488 PMCID: PMC9678632 DOI: 10.1097/md.0000000000031843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Lumbar stability exercise promotes deep muscle functions, and it is an effective intervention method for increasing proprioceptive sensation. This study aims to explore and compare the effects of lumbar stability exercise with respiratory resistance and whole body vibration on patients with lumbar instability. METHODS This study is a 3-group randomized control trial. Through screening tests, 48 patients with lumbar instability were selected and randomly assigned to SE group (n = 16), stabilization exercise program using respiratory resistance (SER) group (n = 16), and stabilization exercise program using respiratory resistance and whole body vibration (SERW) group (n = 16). In order to compare the effects depending on the intervention methods, quadruple visual analogue scale (QVAS), Functional Ability Roland-Morris low back pain and disability questionnaire ([RMDQ], center of pressure path length, velocity, and area), Korean version of fear-avoidance beliefs questionnaire, and Pulmonary Function were used for measurement. RESULTS All of the groups showed significant improvements in QVAS, RMDQ, Korean version of fear-avoidance beliefs questionnaire, and balance abilities before and after the interventions. The SER group and SERW group showed a significant difference in QVAS and RMDQ than the SE group (P < .05). In addition, balance ability showed a significant difference in SERW group (P < .05), where only the SER group showed a significant difference in pulmonary function indexes including forced vital capacity, forced expiratory volume in 1 second, maximum inspiratory pressure, and maximum expiratory pressure (P < .05). CONCLUSION Stabilization exercise program using respiratory resistance and whole-body vibration administered according to the purpose of intervention methods may be effective exercise programs for people with lumbar instability.
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Affiliation(s)
- Sam-Ho Park
- Department of Rehabilitation and Assistive Technology, National Rehabilitation Research Institute, National Rehabilitation Center, Republic of Korea
| | - Youn-Jung Oh
- Department of Physical Therapy, Graduate School, Daejeon University, Republic of Korea
| | - Jin-Hyuk Seo
- Department of Physical Therapy, Graduate School, Daejeon University, Republic of Korea
| | - Myung-Mo Lee
- Department of Physical Therapy, Daejeon University, Republic of Korea
- * Correspondence: Myung-Mo Lee, Department of Physical Therapy, Daejeon University, 62, Daehak-ro, Dong-gu, Daejeon city 34520, Republic of Korea (e-mail: )
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27
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Vicente-Campos D, Sanchez-Jorge S, Chicharro JL, Becerro-de Bengoa-Vallejo R, Rodriguez-Sanz D, García AR, Rivoire M, Benet A, Boubekeur S, Calvo-Lobo C. POWERbreathe ® Inspiratory Muscle Training in Amyotrophic Lateral Sclerosis. J Clin Med 2022; 11:jcm11226655. [PMID: 36431132 PMCID: PMC9698064 DOI: 10.3390/jcm11226655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 10/19/2022] [Accepted: 11/08/2022] [Indexed: 11/11/2022] Open
Abstract
Inspiratory muscle training may benefit respiratory function, cardiocirculatory parameters, quality of life and functionality in neuromuscular diseases. This pilot study aimed to demonstrate the POWERbreathe® inspiratory muscle training effects on maximum inspiratory pressure (PImax), heart rate (HR) and HR variability, as well as the quality of life impairment and functionality in patients with Amyotrophic Lateral Sclerosis (ALS). A pilot single-blinded, non-randomized controlled clinical trial was carried out. A total of 20T ALS patients were enrolled and divided into experimental (n = 10) and control (n = 10) groups. The experimental group received POWERbreathe® inspiratory muscle training in conjunction with usual care, and the control group received only usual care for 8 weeks. PImax (measured by POWERbreathe® KH1), HR and HR variability (evaluated by Polar H7), quality of life impairment [measured by the Amyotrophic Lateral Sclerosis Assessment Questionnaire—40 items (ALSAQ-40)] and functionality [assessed by the ALS Functional Rating Scale Revised (ALSFRS-R)] were collected at baseline and after 8 weeks of intervention. We detected statistically significant differences (p < 0.05) with an effect size ranging from medium to large (Cohen’s d = 0.72−1.37); relative to the control group, the experimental group had an increased PImax (mean difference = 10.80 cm H2O; 95% CI = 3.42−18.17) and ALSFRS-R score (mean difference = 5.30 points; 95% CI = −0.03−10.63) and reduced HR (mean difference = −8.80 beats-per-minute; 95% CI = −20.27−2.67) and R-R interval (mean difference = 78.30 ms; 95% CI = 2.89−153.70). POWERbreathe® inspiratory muscle training, in addition to usual care, may improve inspiratory strength and heart rate in patients with ALS. These results encourage larger and longer trials investigating potential clinically relevant benefits of inspiratory muscle training to these patients over the disease course.
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Affiliation(s)
- Davinia Vicente-Campos
- Faculty of Health Sciences, Universidad Francisco de Vitoria, Pozuelo de Alarcón, 28223 Madrid, Spain
| | - Sandra Sanchez-Jorge
- Faculty of Health Sciences, Universidad Francisco de Vitoria, Pozuelo de Alarcón, 28223 Madrid, Spain
- Correspondence: ; Tel.: +34-913-51-03-03
| | - J. L. Chicharro
- Grupo FEBIO, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | | | - David Rodriguez-Sanz
- Faculty of Nursing, Physical Therapy and Podiatry, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Arianne R. García
- Faculty of Health Sciences, Universidad Francisco de Vitoria, Pozuelo de Alarcón, 28223 Madrid, Spain
| | - Marie Rivoire
- Faculty of Health Sciences, Universidad Francisco de Vitoria, Pozuelo de Alarcón, 28223 Madrid, Spain
| | - Astrid Benet
- Faculty of Health Sciences, Universidad Francisco de Vitoria, Pozuelo de Alarcón, 28223 Madrid, Spain
| | - Sofía Boubekeur
- Faculty of Health Sciences, Universidad Francisco de Vitoria, Pozuelo de Alarcón, 28223 Madrid, Spain
| | - César Calvo-Lobo
- Faculty of Nursing, Physical Therapy and Podiatry, Universidad Complutense de Madrid, 28040 Madrid, Spain
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Moreira J, Fonseca P, Miguel S. A Pilot Study on a Nurse Rehabilitation Program: Could It Be Applied to COVID-19 Patients? Int J Environ Res Public Health 2022; 19:14365. [PMID: 36361244 PMCID: PMC9654829 DOI: 10.3390/ijerph192114365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 10/25/2022] [Accepted: 10/25/2022] [Indexed: 06/16/2023]
Abstract
(1) Background: An aging population, pollution and an increase in life habits that are harmful to respiratory health, and more recently the COVID-19 pandemic, have led to an increase in chronic respiratory diseases. Thus, this pilot study aims to describe an intervention program on the training of respiratory patients to maintain airway permeability and preventing complications. (2) Methods: An observational, analytical, and prospective study was proposed. After the initial evaluation of each user during hospitalization, the program started with two sessions, at discharge for the second phase, and fifteen days after discharge for the third phase. Throughout the program's implementation, the modified Medical Research Council scale and the Barthel Index were applied. (3) Results: The population studied aged between 39 and 76 years, diagnosed with pneumonia or chronic obstructive pulmonary disease, showed a significant improvement in the degrees of dyspnea and levels of functionality, as well as an adequate level of learning. (4) Conclusions: This program positively impacted the patients' independence by reducing dyspnea and increasing functionality of the patients included in this study. The set of exercises and techniques can be replicated at home and may be fundamental in the management of respective recovery, as well as in the COVID-19 pandemic.
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Affiliation(s)
- José Moreira
- Nursing Department, University of Évora, Largo do Senhor da Pobreza, 7000-811 Évora, Portugal
- Comprehensive Health Research Centre, 1600-560 Lisbon, Portugal
- National School of Public Health, 1600-560 Lisbon, Portugal
| | | | - Susana Miguel
- Department of Head and Neck Surgery and Endocrinology, Portuguese Institute of Oncology, 1099-023 Lisbon, Portugal
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Vermeylen S, Honinx E, Broes S, Vandenhoudt H, De Witte NAJ. Evaluation of a tactile breath pacer for sleep problems: A mixed method pilot study. Front Digit Health 2022; 4:908159. [PMID: 36274653 PMCID: PMC9581241 DOI: 10.3389/fdgth.2022.908159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 09/12/2022] [Indexed: 11/07/2022] Open
Abstract
Sleep problems, like insomnia, are a prevalent condition associated with major health risks. Prevention and treatment of sleep problems are thus essential to preserve physical and mental health. Previous work supports the effectiveness of breathing guidance for sleep problems and recommends breathing exercises as an effective intervention for insomnia. While new technologies can support breathing guidance, such novel devices should be assessed for effectiveness and usability to facilitate implementation and continued use. The current pilot study investigates the acceptability and usability of a mobile tactile breathing device and explores its potential impact on subjective sleep quality. In this mixed-method pilot study, 39 participants tested the breathing device for one month in naturalistic circumstances. We collected their experiences, subjective sleep quality, and feedback regarding the usability of the device and the accompanying app through a survey in a pre-post design. The results show that the breathing device is an acceptable solution for sleep problems and participants particularly appreciate the standalone function and design. Nevertheless, important points of attention, such as the size of the device, were also identified. Explorative analyses suggest that subjective sleep quality improved after using the device and accompanying app. The current study supports the usability and acceptability of a tactile breath pacer and provides preliminary evidence supporting a positive impact of the technology on the sleep quality of participants. Recommendations for developers of breathing technologies and eHealth are devised based on the findings.
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Affiliation(s)
- Sascha Vermeylen
- LiCalab, Thomas More University of Applied Sciences, Geel, Belgium
| | | | | | | | - Nele A. J. De Witte
- LiCalab, Thomas More University of Applied Sciences, Geel, Belgium,Correspondence: Nele A. J. De Witte
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Arnal-Gómez A, Saavedra-Hernández M, Martinez-Millana A, Espí-López GV. Clinical Changes of Respiratory Parameters in Institutionalized Older Adults after a Physiotherapy Program Combining Respiratory and Musculoskeletal Exercises. Healthcare (Basel) 2022; 10. [PMID: 36141292 DOI: 10.3390/healthcare10091680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 08/29/2022] [Accepted: 08/31/2022] [Indexed: 01/08/2023] Open
Abstract
Nowadays pulmonary diseases are an increasingly important cause of morbidity and mortality. Diaphragmatic breathing is a controlled-breathing technique that aims to optimize thoracoabdominal movements. The aim of this study was to apply a respiratory and musculoskeletal physiotherapy program in institutionalized older adults and to assess the effects on their pulmonary function tests and oxygen saturation. A randomized double-blind clinical trial was conducted with thirty institutionalized older adults, randomly assigned to a control group (CG), who conducted musculoskeletal exercises; or an experimental group (EG) who, in addition, carried out diaphragmatic breathing, administered for eight weeks, three times/week. Outcomes were pulmonary function variables (forced vital capacity, FVC; forced expired volume at 1 s, FEV1; the FEV1/FVC ratio) and oxygen saturation (SpO2) before and after treatment. Normality of the distributions was tested with Saphiro-Wilk and the pre-post improvement was assessed with a two-sample Mann-Whitney test. Significance level was corrected for multiple comparisons using Benjamini-Hochberg correction (p < 0.04). There was a clinically significant improvement of FVC and FEV1 for the EG. Moreover, the EG showed a statistically significant increase of SpO2 (p = 0.028) after treatment when compared to CG. A physiotherapy program combining breathing and musculoskeletal exercises, improved respiratory parameters in institutionalized older adults.
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Habu H, Mitsuhashi T, Tokinobu A, Yorifuji T, Takao S. Effects of Tanden Breathing on Constipation: A Randomized Controlled Trial. Acta Med Okayama 2022; 76:391-398. [PMID: 36123153 DOI: 10.18926/amo/63893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Tanden breathing, an ancient health technique, involves expiratory abdominal pressure breathing is practiced in Japan. In this study we examined the ability of Tanden breathing to relieve constipation. The study was designed as a stratified-block randomized controlled trial enrolling 20 participants. Nineteen were female and one was male, none were elderly. During the 6-week intervention period, the participants performed video-guided Tanden breathing about 10 min once day. We evaluated constipation using the Constipation Assessment Scale (CAS). There were significant differences in the mean CAS score between time points (baseline, 3 weeks after baseline, 6 weeks after baseline), groups (intervention and control), and their interaction (time×group) using repeated-measures analysis of variance. The control group showed no change in the mean CAS score; the mean CAS scores of the intervention group changed from 7.2 at baseline to 3.9 at 3 weeks and 3.1 at 6 weeks after baseline. A regression analysis of the difference in the mean CAS between baseline and 6 weeks later showed that the CAS of the intervention group was 4.3 points lower than that of the control group (95% confidence interval, 2.5-6.1). The results suggested that Tanden breathing is effective in relieving constipation among young women.
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Affiliation(s)
- Hiroshi Habu
- Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | | | - Akiko Tokinobu
- Department of Epidemiology and Public Health, Ehime University Graduate School of Medicine
| | - Takashi Yorifuji
- Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | - Soshi Takao
- Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
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Marugán-Rubio D, Chicharro JL, Becerro-de-Bengoa-Vallejo R, Losa-Iglesias ME, Rodríguez-Sanz D, Vicente-Campos D, Molina-Hernández N, Calvo-Lobo C. Effectiveness of Ultrasonography Visual Biofeedback of the Diaphragm in Conjunction with Inspiratory Muscle Training on Muscle Thickness, Respiratory Pressures, Pain, Disability, Quality of Life and Pulmonary Function in Athletes with Non-Specific Low Back Pain: A Randomized Clinical Trial. J Clin Med 2022; 11. [PMID: 35893409 DOI: 10.3390/jcm11154318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 07/18/2022] [Accepted: 07/21/2022] [Indexed: 12/04/2022] Open
Abstract
Diaphragmatic weakness and thickness reduction have been detected in athletes with lumbopelvic pain (LPP). Strength training of inspiratory muscles may be necessary for athletes with LPP. Inspiratory muscle training (IMT) and visual biofeedback by rehabilitative ultrasound imaging (RUSI) have been proposed as possible interventions. Here, we determine the effectiveness of visual biofeedback by RUSI with a proposed novel thoracic orthotic device to facilitate diaphragmatic contraction in conjunction with high-intensity IMT in athletes with non-specific LPP. A single-blinded, parallel-group, randomized clinical trial was performed (NCT04097873). Of 86 participants assessed for eligibility, 64 athletes with non-specific LPP (39 males and 25 females; mean age, 33.15 ± 7.79 years) were recruited, randomized, analyzed and received diaphragm visual biofeedback by RUSI in conjunction with high-intensity IMT (RUSI+IMT; n = 32) or isolated high-intensity IMT (IMT; n = 32) interventions for 8 weeks. Diaphragmatic thickness during normal breathing, maximum respiratory pressures, pain intensity, pressure pain threshold on lumbar musculature, disability by the Roland−Morris questionnaire, quality of life by the SF-12 questionnaire and spirometry respiratory parameters were assessed at baseline and after the 8-week intervention. There were significant differences (p = 0.015), within a medium effect size (Cohen’s d = 0.62) for the forced expiratory volume in 1-s (FEV1), which was increased in the RUSI+IMT intervention group relative to the IMT alone group. Adverse effects were not observed. The rest of the outcomes did not show significant differences (p > 0.05). Diaphragm visual biofeedback by RUSI with the proposed novel thoracic orthotic device in conjunction with high-intensity IMT improved lung function by increasing FEV1 in athletes with non-specific LPP.
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Elnaggar RK, Osailan AM, Elbanna MF. The rationale of applying inspiratory/expiratory muscle training within the same respiratory cycle in children with bronchial asthma: A placebo-controlled randomized clinical investigation. J Asthma 2022; 60:900-911. [PMID: 35849445 DOI: 10.1080/02770903.2022.2103708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Objective: Even though positive implications of inspiratory muscle training (In-MT) have been established in children and adolescents with bronchial asthma (C/AwBA), the role of combined inspiratory and expiratory muscle training (Ex-MT) within the same respiratory cycle (In/Ex-SC) is still unknown. This study was, therefore, set out to explore the effect of In/Ex-SC on respiratory muscle strength, pulmonary functions, and control of asthma symptoms in C/AwBA.Methods: This was a placebo-controlled randomized clinical investigation that included 51 C/AwBA (12-18 years). Participants were assigned randomly into three groups: Placebo, In-MT only, or combined In/Ex-SC training (n = 17, each group). The training was conducted for ∼35 min, thrice/week over 12 weeks. The maximal inspiratory (IPmax) and expiratory (EPmax) pressure (indicating the strength of the inspiratory and expiratory muscles, respectively), pulmonary functions [forced expiratory volume in one second (FEV1), forced vital capacity (FVC), and FEV1/FVC index], and asthma control test (ACT) were assessed before and after the intervention.Results: The In/Ex-SC yielded larger increases in IPmax and EPmax than either the Placebo training (P=.031 and P=.009 respectively) or the In-MT (P=.029 and P=.032 respectively). Further, In/Ex-SC produced favorable improvement in FEV1, FVC, and FEV1/FVC compared to the Placebo training (P=.001, P=.004, and P=.0005 respectively) or In-MT (P=.038, P=.037, and P=.025 respectively) training. Furthermore, In/Ex-SC led to better control of asthma symptoms than the Placebo (P<.001) or In-MT (P=.002) training.Conclusion: This study provides evidence that combined In/Ex-SC can considerably improve respiratory muscle strength, enhance pulmonary function, and promote control over asthma symptoms in C/AwBA.
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Affiliation(s)
- Ragab K Elnaggar
- Department of Physical Therapy and Health Rehabilitation, Collage of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia.,Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Ahmad M Osailan
- Department of Physical Therapy and Health Rehabilitation, Collage of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Mohammed F Elbanna
- Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt.,Department of Physical Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
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Kepenek-Varol B, Zeren M, Dinçer R, Erkaya S. Breathing and Relaxation Exercises Help Improving Fear of COVID-19, Anxiety, and Sleep Quality: A Randomized Controlled Trial. J Integr Complement Med 2022; 28:579-586. [PMID: 35467962 DOI: 10.1089/jicm.2021.0381] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Objective: To investigate the effects of breathing and relaxation exercises performed via telerehabilitation on fear, anxiety, sleep quality, and quality of life of individuals without coronavirus disease 2019 (COVID-19) during the ongoing pandemic. Design: A prospective, randomized, controlled single-blind study. Methods: Fifty participants who had not been exposed to the COVID-19 virus earlier were randomly divided into experimental (n = 25) and control groups (n = 25). Both groups received an information session about COVID-19 once at the start of the study via a mobile phone video application. The experimental group also performed a breathing and relaxation exercise program twice daily (morning and evening), 7 days per week, for 4 weeks; one session of the program was conducted under the remote supervision of a physiotherapist as telerehabilitation, and the remaining sessions were performed as a home program. The Fear of COVID-19 Scale (FCV-19S), which was the primary outcome measure, The Hamilton Anxiety Rating Scale (HAMA), Pittsburgh Sleep Quality Index (PSQI), and EQ-5D-3L were administered to both groups. Results: The FCV-19S, HAMA, and PSQI were statistically significantly improved to compare the controls, with a large effect size (ηp2 = 0.135, 0.313, and 0.200, respectively). The EQ-5D-3L index and EQ-5D-3L visual analog scale were not statistically significantly different compared with the controls; however, a small effect size was detected for the differences between the two groups (ηp2 = 0.056 and 0.013, respectively). Conclusion: Breathing and relaxation exercises appear to be an effective and feasible approach to support mental health and sleep quality during the COVID-19 pandemic. Especially in highly contagious diseases such as COVID-19, telerehabilitation approaches may be useful for safely reaching individuals by eliminating human-to-human contact. Clinical Trial Registration number: NCT04910932.
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Affiliation(s)
- Büşra Kepenek-Varol
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Nuh Naci Yazgan University, Kayseri, Turkey
| | - Melih Zeren
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Izmir Bakircay University, Izmir, Turkey
| | - Rukiye Dinçer
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Nuh Naci Yazgan University, Kayseri, Turkey
| | - Seval Erkaya
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Nuh Naci Yazgan University, Kayseri, Turkey
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Tatsios PI, Grammatopoulou E, Dimitriadis Z, Papandreou M, Paraskevopoulos E, Spanos S, Karakasidou P, Koumantakis GA. The Effectiveness of Spinal, Diaphragmatic, and Specific Stabilization Exercise Manual Therapy and Respiratory-Related Interventions in Patients with Chronic Nonspecific Neck Pain: Systematic Review and Meta-Analysis. Diagnostics (Basel) 2022; 12:1598. [PMID: 35885502 PMCID: PMC9316964 DOI: 10.3390/diagnostics12071598] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 06/21/2022] [Accepted: 06/27/2022] [Indexed: 11/16/2022] Open
Abstract
Patients with nonspecific chronic neck pain (NSCNP) exhibit respiratory dysfunction. This systematic review aimed to analyze randomized controlled trials (RCTs) investigating the effect of spinal and/or diaphragmatic and/or specific stabilization exercise manual therapy and/or respiratory exercises on musculoskeletal and respiratory diagnostic outcomes in patients with NSCNP. A systematic search and selection of RCTs was performed in three scientific databases (Pubmed, Scopus, and Physiotherapy Evidence Database (PEDro)) and one search engine (Google Scholar) from inception to April 2022. Relevant studies published in the English language were extracted, evaluated, and independently rated for methodological quality (PEDro scale). The quality of the evidence was assessed with the GRADE approach. Out of 1089 studies collected in total, 1073 were excluded (i.e., did not meet the inclusion criteria or were duplicates). Sixteen RCTs were finally included, rated on 5.62/10 (PEDro score) on average for methodological quality. Overall, there was sparse evidence that spinal and/or diaphragmatic manual therapy and/or trunk stabilization exercises and/or respiratory exercises significantly improved pain, disability, and respiratory outcomes in patients with NSCNP immediately post-treatment. However, the clinical heterogeneity between studies was significant, and the level of certainty of the evidence was low to very low. More, high-quality RCTs are required, contributing to the holistic diagnostic monitoring and management of patients with NSCNP.
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Affiliation(s)
- Petros I. Tatsios
- Physiotherapy Department, School of Health & Care Sciences, University of West Attica (UNIWA), 12243 Athens, Greece; (E.G.); (M.P.); (E.P.); (P.K.); (G.A.K.)
- Laboratory of Advanced Physiotherapy, Physiotherapy Department, School of Health & Care Sciences, University of West Attica (UNIWA), 12243 Athens, Greece
| | - Eirini Grammatopoulou
- Physiotherapy Department, School of Health & Care Sciences, University of West Attica (UNIWA), 12243 Athens, Greece; (E.G.); (M.P.); (E.P.); (P.K.); (G.A.K.)
- Laboratory of Advanced Physiotherapy, Physiotherapy Department, School of Health & Care Sciences, University of West Attica (UNIWA), 12243 Athens, Greece
| | - Zacharias Dimitriadis
- Health Assessment & Quality of Life Laboratory, Physiotherapy Department, University of Thessaly, 35100 Lamia, Greece;
| | - Maria Papandreou
- Physiotherapy Department, School of Health & Care Sciences, University of West Attica (UNIWA), 12243 Athens, Greece; (E.G.); (M.P.); (E.P.); (P.K.); (G.A.K.)
- Laboratory of Advanced Physiotherapy, Physiotherapy Department, School of Health & Care Sciences, University of West Attica (UNIWA), 12243 Athens, Greece
| | - Eleftherios Paraskevopoulos
- Physiotherapy Department, School of Health & Care Sciences, University of West Attica (UNIWA), 12243 Athens, Greece; (E.G.); (M.P.); (E.P.); (P.K.); (G.A.K.)
- Laboratory of Advanced Physiotherapy, Physiotherapy Department, School of Health & Care Sciences, University of West Attica (UNIWA), 12243 Athens, Greece
| | - Savvas Spanos
- Human Performance & Rehabilitation Laboratory, Physiotherapy Department, University of Thessaly, 35100 Lamia, Greece;
| | - Palina Karakasidou
- Physiotherapy Department, School of Health & Care Sciences, University of West Attica (UNIWA), 12243 Athens, Greece; (E.G.); (M.P.); (E.P.); (P.K.); (G.A.K.)
| | - George A. Koumantakis
- Physiotherapy Department, School of Health & Care Sciences, University of West Attica (UNIWA), 12243 Athens, Greece; (E.G.); (M.P.); (E.P.); (P.K.); (G.A.K.)
- Laboratory of Advanced Physiotherapy, Physiotherapy Department, School of Health & Care Sciences, University of West Attica (UNIWA), 12243 Athens, Greece
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Cordeiro ALL, Carvalho BSCD, Silva EGD, Santos NDS, de Melo TA, Guimarães ARF, Petto J. Inspiratory muscle training and functional capacity following coronary artery bypass grafting in high-risk patients: A pilot randomized and controlled trial. J Clin Transl Res 2022; 8:266-271. [PMID: 35975188 PMCID: PMC9373720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Revised: 02/04/2022] [Accepted: 05/01/2022] [Indexed: 01/07/2023] Open
Abstract
Background Coronary artery bypass graft (CABG) surgery is associated with worsened functional capacity, pulmonary complications, and increased length of hospital stay. These negative effects are exacerbated in patients who are at high risk of post-operative (PO) pulmonary complications before CABG. Inspiratory muscle training (IMT) has been shown to benefit CABG patients in their recovery process. However, in high-risk patients, there is little evidence to support the post-operative implementation of IMT for purposes of faster recovery. Aim The aim of the study was to test the hypothesis that IMT improves the functional capacity, pulmonary complications, and length of hospital stay in patients prone to pulmonary complications who had undergone CABG. Methods This is a pilot clinical trial carried out with patients at high risk for pulmonary complications in the PO phase. In the pre-operative period, maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), and 6-min walk test (6MWT) were determined and administered. On the first PO day, patients were divided into two groups: A control group (CG) that received routine intervention and an IMT group that, in addition to routine care, was subjected to an IMT protocol until hospital discharge. On the day of discharge, the patients were reassessed with respect to ventilatory muscle strength, functional capacity, PO complications, and length of stay. Results Twenty-nine patients were evaluated, 15 in the CG and 14 in the IMT group. No significant differences were observed in relation to MIP (difference between the mean of -7 cmH2O; 95% CI = -16.52-2.52), MEP (difference between the mean of -7cm H2O; 95% CI = -15.39-1.39), and in the 6MWT (difference between the mean of -9 m; 95% CI = -43.71-25.71). There was a decrease in the length of stay in the IMT group compared to the CG (9 ± 3 vs. 12 ± 4 days; P = 0.04). The IMT group had a lower rate of atelectasis and pneumonia. Conclusion IMT does not minimize the loss of functional capacity, but it reduces pulmonary complications and the length of stay of patients undergoing CABG who are preoperatively at a high risk of pulmonary complications. Relevance for Patients The increase in ventilatory muscle strength, associated with IMT, can reduce PO pulmonary complications, resulting in shorter hospital stays, and improved quality of life.
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Affiliation(s)
- André Luiz Lisboa Cordeiro
- 1Department of Physiotherapy, Faculdade Nobre, Feira de Santana, Brazil,2Department of Medicine and Human Health, Escola Bahiana de Medicina e Saúde Pública, Salvador, Brazil,Corresponding author: André Luiz Lisboa Cordeiro, Red Bird Street, without number, Condomínio Salvador Dali, House 47, Feira de Santana, Bahia - Brazil.
| | | | | | | | - Thiago Araújo de Melo
- 3Department of Health, Unisba - Centro Universitário Social da Bahia, Salvador, Brazil,4Department of Physiotherapy, Uniatenas - Faculdade Atenas, Salvador, Brazil
| | | | - Jefferson Petto
- 2Department of Medicine and Human Health, Escola Bahiana de Medicina e Saúde Pública, Salvador, Brazil
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Affiliation(s)
- Verah Harper
- Department of Allergy, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - James Trayer
- Department of Paediatric Allergy, Imperial College Healthcare NHS Trust, London, UK
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Chen J, Peng LH, Min S. Implementation of perioperative breathing exercises and its effect on postoperative pulmonary complications and long-term prognosis in elderly patients undergoing laparoscopic colorectal surgery: A randomized controlled trial. Clin Rehabil 2022; 36:1229-1243. [PMID: 35635180 DOI: 10.1177/02692155221097762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE This study was to investigate the impact of breathing exercises on recovery in elderly patients receiving laparoscopic colorectal surgery. DESIGN A prospective randomized controlled trial. SETTING University hospital. SUBJECT A total of 264 elder patients undergoing laparoscopic colorectal surgery participated in this study. INTERVENTION Patients in intervention group received respiratory-related exercises based on standardized enhanced recovery after surgery strategies from admission to 90 days after surgery. The control group received perioperative standardized enhanced recovery after surgery strategies without formatted breathing exercises. MAIN MEASURES The primary outcome was the incidence of postoperative pulmonary complications. The secondary outcomes included 6-minute walking distance, surgery-related complications, length of stay, mortality postoperatively, and hospitalization costs. RESULTS Completion rate of breathing exercise in intervention group was over 80% till 90 days postoperatively. The incidence of postoperative pulmonary complications was lower in breathing exercises group (17/132 [12.9%] vs. 43/132 [32.6%], p < 0.001). The mean value of 6-minute walking distance increased more in intervention group compared with baseline values preoperatively (44.2 ± 4.3 vs. 3.2 ± 0.2, p < 0.001). On 90 days postoperatively, the mean value of 6-minute walking distance in breathing exercises group increased by 18.8 m compared with its baseline (557.0 ± 133.5 vs. 538.2 ± 112.7, p = 0.022), while that of control group decreased by 53.2 m from baseline (481.9 ± 102.5 vs. 535.1 ± 123.4, p < 0.001). Patients who received breathing exercises had shorter length of stay and lower hospitalization costs (p < 0.050). CONCLUSIONS Perioperative breathing exercises helped prevent postoperative pulmonary complications and improve long-term prognosis in elderly patients undergoing laparoscopic colorectal surgery.
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Affiliation(s)
- Jing Chen
- The Department of Anesthesia and Pain Medicine, 117972The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Li-Hua Peng
- The Department of Anesthesia and Pain Medicine, 117972The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Su Min
- The Department of Anesthesia and Pain Medicine, 117972The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Gholamrezaei A, Van Diest I, Aziz Q, Pauwels A, Tack J, Vlaeyen JWS, Van Oudenhove L. Effect of slow, deep breathing on visceral pain perception and its underlying psychophysiological mechanisms. Neurogastroenterol Motil 2022; 34:e14242. [PMID: 34378834 DOI: 10.1111/nmo.14242] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 07/09/2021] [Accepted: 07/22/2021] [Indexed: 01/09/2023]
Abstract
BACKGROUND Studies using somatic pain models have shown the hypoalgesic effects of slow, deep breathing. We evaluated the effect of slow, deep breathing on visceral pain and explored putative mediating mechanisms including autonomic and emotional responses. METHODS Fifty-seven healthy volunteers (36 females, mean age = 22.0 years) performed controlled, deep breathing at a slow frequency (6 breaths per minute), controlled breathing at a normal frequency (14 breaths per minute; active control), and uncontrolled breathing (no-treatment control) in randomized order. Moderate painful stimuli were given during each condition by delivering electrical stimulation in the distal esophagus. Participants rated pain intensity after each stimulation. Heart rate variability and self-reported arousal were measured during each condition. KEY RESULTS Compared to uncontrolled breathing, pain intensity was lower during slow, deep breathing (Cohen's d = 0.40) and normal controlled breathing (d = 0.47), but not different between slow, deep breathing and normal controlled breathing. Arousal was lower (d = 0.53, 0.55) and heart rate variability was higher (d = 0.70, 0.86) during slow, deep breathing compared to the two control conditions. The effect of slow, deep breathing on pain was not mediated by alterations in heart rate variability or arousal but was moderated by pain catastrophizing. CONCLUSIONS AND INFERENCES Slow, deep breathing can reduce visceral pain intensity. However, the effect is not specific to the slow breathing frequency and is not mediated by autonomic or emotional responses, suggesting other underlying mechanisms (notably distraction). Whether a long-term practice of slow, deep breathing can influence (clinical) visceral pain warrants to be investigated.
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Affiliation(s)
- Ali Gholamrezaei
- Laboratory for Brain-Gut Axis Studies (LaBGAS), Translational Research Center for Gastrointestinal Disorders (TARGID), Department of Chronic Diseases, Metabolism and Ageing, KU Leuven, Leuven, Belgium.,Health Psychology Research Group, KU Leuven, Leuven, Belgium.,Pain Management Research Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Ilse Van Diest
- Health Psychology Research Group, KU Leuven, Leuven, Belgium
| | - Qasim Aziz
- Centre for Neuroscience and Trauma, Blizard Institute, Wingate Institute of Neurogastroeneterology, Queen Mary University of London, London, UK
| | - Ans Pauwels
- Gastrointestinal Sensitivity and Motility Research Group, Translational Research Center for Gastrointestinal Disorders (TARGID), Department of Chronic Diseases, Metabolism and Ageing, KU Leuven, Leuven, Belgium
| | - Jan Tack
- Gastrointestinal Sensitivity and Motility Research Group, Translational Research Center for Gastrointestinal Disorders (TARGID), Department of Chronic Diseases, Metabolism and Ageing, KU Leuven, Leuven, Belgium
| | - Johan W S Vlaeyen
- Health Psychology Research Group, KU Leuven, Leuven, Belgium.,Experimental Health Psychology, Maastricht University, Maastricht, The Netherlands
| | - Lukas Van Oudenhove
- Laboratory for Brain-Gut Axis Studies (LaBGAS), Translational Research Center for Gastrointestinal Disorders (TARGID), Department of Chronic Diseases, Metabolism and Ageing, KU Leuven, Leuven, Belgium
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Perin C, Mazzucchelli M, Piscitelli D, Braghetto G, Meroni R, Cornaggia CM, Cerri CG. Feasibility of a standardized protocol for respiratory training with intermitted positive pressure breathing ventilator application in dysphonia and dysarthria. Eur J Phys Rehabil Med 2022; 58:218-224. [PMID: 34652084 PMCID: PMC9980488 DOI: 10.23736/s1973-9087.21.06946-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Brain damage can affect several functions related to speech production leading to dysphonia and dysarthria. Most rehabilitation treatments focus on articulation training rather than on pneumophonic coordination and respiratory muscle strength. Respiratory training using an intermitted positive pressure breathing (IPPB) ventilator can be used for this last purpose; no agreement on a standard protocol has been reached to date. AIM To evaluate the feasibility and the effectiveness of a standardized incremental protocol of respiratory training using IPPB to treat dysphonia and dysarthria. DESIGN Case series study. SETTING Neuropsychological Rehabilitation Unit in an Italian Neurorehabilitation Division. POPULATION Thirty-two subjects with dysphonia and dysarthria resulting from neurological lesion. METHODS Participants were assessed using clinical evaluation scales (GIRBAS scale of dysphonia, Robertson dysarthria profile), respiratory function test, and arterial blood gas analysis in air. The evaluations were performed at baseline and after 20 sessions of respiratory training with IPPB. The protocol provided a default increment of ventilator parameters. All subjects also underwent a standard speech and language therapy treatment. A satisfaction survey to assess acceptability and the Goal Attainment Scale were applied. RESULTS All participants fulfilled the protocol. No complications or discomfort were reported. Subjects' satisfaction at survey was 97.7%. After respiratory training, all respiratory function parameters increased, but only maximal voluntary ventilation (MVV), maximum inspiratory pressure (MIP), and maximum expiratory pressure (MEP) were statistically significant (P<0.05). Clinical evaluation scales significantly improved (P<0.05). Correlation between respiratory function parameters and clinical evaluation scales showed a moderate correlation between MVV, MEP, MIP, and Robertson dysarthria profile (P<0.01). A weak correlation was found between MIP, MVV, and GIRBAS scale (P<0.05). CONCLUSIONS Our protocol showed to be practical and well-tolerated. After respiratory training, MVV, MIP and MEP improved in significantly. Clinical scale scores improved in all participants. CLINICAL REHABILITATION IMPACT Respiratory training using IPPB ventilator can be useful in implementing speech and language treatments in subjects with dysphonia and dysarthria linked to brain injury.
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Affiliation(s)
- Cecilia Perin
- School of Medicine and Surgery, University of Milan - Bicocca, Monza, Monza e Brianza, Italy.,Istituti Clinici Zucchi, Carate Brianza, Monza e Brianza, Italy
| | - Miryam Mazzucchelli
- School of Medicine and Surgery, University of Milan - Bicocca, Monza, Monza e Brianza, Italy - .,Istituti Clinici Zucchi, Carate Brianza, Monza e Brianza, Italy
| | - Daniele Piscitelli
- School of Medicine and Surgery, University of Milan - Bicocca, Monza, Monza e Brianza, Italy.,School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
| | - Giacomo Braghetto
- School of Medicine and Surgery, University of Milan - Bicocca, Monza, Monza e Brianza, Italy
| | - Roberto Meroni
- School of Medicine and Surgery, University of Milan - Bicocca, Monza, Monza e Brianza, Italy.,Istituti Clinici Zucchi, Carate Brianza, Monza e Brianza, Italy.,Department of Physiotherapy, LUNEX International University of Health, Exercise and Sports, Differdange, Luxembourg
| | - Cesare M Cornaggia
- School of Medicine and Surgery, University of Milan - Bicocca, Monza, Monza e Brianza, Italy.,Istituti Clinici Zucchi, Carate Brianza, Monza e Brianza, Italy
| | - Cesare G Cerri
- School of Medicine and Surgery, University of Milan - Bicocca, Monza, Monza e Brianza, Italy.,Istituti Clinici Zucchi, Carate Brianza, Monza e Brianza, Italy
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Vinolo-Gil MJ, Martín-Valero R, Martín-Vega FJ, Rodríguez-Huguet M, Perez-Cabezas V, Gonzalez-Medina G. Respiratory Physiotherapy Intervention Strategies in the Sequelae of Breast Cancer Treatment: A Systematic Review. Int J Environ Res Public Health 2022; 19:3800. [PMID: 35409486 DOI: 10.3390/ijerph19073800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 03/10/2022] [Accepted: 03/19/2022] [Indexed: 02/05/2023]
Abstract
Breast cancer treatments can trigger respiratory sequelae. Respiratory physiotherapy helps to eliminate or mitigate the sequelae by optimizing respiratory function. This systematic review aims to synthesize the scientific evidence and assess its quality regarding the use of respiratory physiotherapy in the sequelae of breast cancer. The Cochrane Library, Physiotherapy Evidence Database, PubMed, Web of Science, Scientific Electronic Library Online, Cumulative Index of Nursing and Allied Literature Complete, and Scopus were searched. Study quality was determined using the PEDro scale, STROBE Statement, and Single-Case Experimental Design Scale. Ten studies, six clinical trials, one case study, and three observational studies were selected. The mean methodological quality of the clinical trials was 5.6, that of the case study was 7, and that of the observational studies was 56%. Respiratory physiotherapy has been observed to improve respiratory capacity, lung function, respiratory muscle strength, effort tolerance, dyspnea, fatigue, thoracic mobility, upper limb volume, sleep quality and quality of life, as well as sensitivity to adverse physiological reactions, nausea, vomiting, and anxiety. However, it is not effective for vasomotor symptoms. More clinical trials are needed. These studies should homogenize the techniques used, as well as improve their methodological quality.
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Csepregi É, Gyurcsik Z, Veres-Balajti I, Nagy AC, Szekanecz Z, Szántó S. Effects of Classical Breathing Exercises on Posture, Spinal and Chest Mobility among Female University Students Compared to Currently Popular Training Programs. Int J Environ Res Public Health 2022; 19. [PMID: 35329415 DOI: 10.3390/ijerph19063728] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 03/17/2022] [Accepted: 03/18/2022] [Indexed: 01/10/2023]
Abstract
Worldwide, university students’ physical health and posture are declining due to a sedentary lifestyle. The aim of our study was to evaluate the effectiveness of physiotherapeutic breathing exercises on posture and spinal mobility among healthy female university students compared to other training methods. Sixty-one female students of the University of Debrecen were assigned to breathing exercise (BE; n = 15), yoga (Y; n = 16), Pilates (P; n = 15) programmes and interval-training (IT; n = 15). Each training session lasted one hour, performed twice a week for 7 weeks. Students were assessed using standardized clinical tests. All programmes resulted in significant improvement in chest expansion. Results of Schober’s test showed substantial improvement using BE (p < 0.05), Y, P (p ≤ 0.01) programmes. Significant changes in occiput-to-wall distance (Y, P p ≤ 0.01) (BE p ≤ 0.001) were observed in three groups except the IT group. Fingertip-to-floor test (Y, P p < 0.05) results showed significant changes in two groups. The most outstanding effects on lateral flexion were achieved using BE (right, left p ≤ 0.001) programme. A comparison with results achieved using yoga and Pilates revealed that the physiotherapeutic breathing exercise programme is an equally effective method to significantly improve spinal mobility and correct postural problems in healthy young women.
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de Freitas Gonçalves KS, Queiroz Godoy Daniel AC, Tatagiba Lamas JL, Ceretta Oliveira H, Silveira RCCP, Cloutier L, Velludo Veiga E. Device- and Nondevice-Guided Slow Breathing to Reduce Blood Pressure in Patients with Hypertension: Protocol for a Systematic Review and Meta-analysis. JMIR Res Protoc 2022; 11:e33579. [PMID: 35254284 PMCID: PMC8933807 DOI: 10.2196/33579] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 11/23/2021] [Accepted: 12/22/2021] [Indexed: 01/01/2023] Open
Abstract
Background Physiotherapy can include both device-guided slow breathing (DGSB) and nondevice-guided slow breathing (NDGSB) in the treatment of systemic arterial hypertension. Objective The aim of this study is to summarize the effects of DGSB on blood pressure levels of patients with hypertension based on the published literature to date. Methods A systematic search of all published randomized controlled trials (RCTs) on the effects of device-guided and nondevice-guided slow breathing in patients with hypertension, without language restriction, was carried out up to a publication date of January 2020 in nine databases: PubMed/MEDLINE, Latin American and Caribbean Health Sciences Literature (LILACS), EMBASE, CENTRAL (Cochrane Central Register of Controlled Trials), Physiotherapy Evidence Database (PEDro), CINAHL (Cumulative Index to Nursing and Allied Health Literature), Scopus, Web of Science, and Livivo. Clinical trial records databases (ClinicalTrials.gov), and bases for the open gray literature, including Gray Literature Report and ProQuest Central (Citation, Abstract or Indexing, and Dissertations and Theses), were also searched for potentially eligible RCTs. The quality assessment of the included studies will be performed using the Cochrane Risk of Bias Tool for Randomized Trials. The overall quality of the evidence for each outcome will be assessed using the GRADE (Grading of Recommendations, Development and Evaluation) system. Results As of December 2021, the review was completed and all data from continuous variables referring to blood pressure values (mmHg) were synthesized. Conclusions This systematic review will provide a summary of the current evidence on the effects of both DGSB and NDGSB on blood pressure levels. This information can contribute to decision-making by health professionals related to the use of these interventions in patients with hypertension. Trial Registration PROSPERO (Prospective International Register of Systematic Reviews) CRD42020147554; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=147554 International Registered Report Identifier (IRRID) RR1-10.2196/33579
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Affiliation(s)
| | | | | | | | - Renata C C P Silveira
- WHO Collaborating Centre for Nursing Research Development, University of São Paulo, Ribeirão Preto, Brazil
| | - Lyne Cloutier
- Département des sciences infirmières, Université du Québec à Trois-Rivières, Quebec, QC, Canada
| | - Eugenia Velludo Veiga
- WHO Collaborating Centre for Nursing Research Development, University of São Paulo, Ribeirão Preto, Brazil
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Baljon K, Romli MH, Ismail AH, Khuan L, Chew BH. Effectiveness of Breathing Exercises, Foot Reflexology and Massage (BRM) on Maternal and Newborn Outcomes Among Primigravidae in Saudi Arabia: A Randomized Controlled Trial. Int J Womens Health 2022; 14:279-295. [PMID: 35241937 PMCID: PMC8887672 DOI: 10.2147/ijwh.s347971] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Accepted: 02/08/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Labor pain and anxiety are important concerns during labor, especially among the primigravidae. It may increase the duration of labor, increase stress hormones, and affect maternal and new-born related outcomes. This study examined the effectiveness of combined breathing exercises, foot reflexology, and massage (BRM) interventions on labor pain, anxiety, labor duration, stress hormone levels, maternal satisfaction, maternal vital signs, and the new-born's APGAR scores. PARTICIPANTS AND METHODS This single-blind-parallel randomized controlled trial (RCT) was conducted at the Maternity and Children Hospital (MCH), Makkah, Saudi Arabia, by recruiting primigravidae aged 20 to 35 years, without any medical complications, and who were block-randomized at six-centimeter cervical dilation and stratified by intramuscular pethidine. The intervention is BRM compared to standard care. The labor pain was measured via present behavioral intensity (PBI) and visual analogue scale (VAS), and the anxiety was measured via Anxiety Assessment Scale for Pregnant Women in Labor (AASPWL). The secondary outcomes were duration of labor, maternal stress hormone levels, maternal vital signs, maternal satisfaction, fetal heart rate, and APGAR scores. All outcomes were measured at multiple time-points during and after contraction at baseline, during BRM intervention, at 60, 120, and 180 minutes post-intervention. Generalized linear mixed models were used to estimate the intervention effects over time. RESULTS A total of 225 participants were randomized for the control (n = 112) and intervention group (113). BRM lowered the labor pain intensity at 60 minutes after intervention during (1.3 vs 3.5, F = 102.5, p < 0.001) and after contraction (0.4 vs 2.4, F = 63.6, p < 0.001) and also lowered anxiety (2.9 vs 4.2, F = 80.4, p < 0.001). BRM correspondingly lowered adrenocorticotropic (ACTH) (133 vs 209 pg/mL, p < 0.001), cortisol (1231 vs 1360 nmol/mL, p = 0.003), and oxytocin (159 vs 121 pg/mL, p < 0.001). It also shortened the labor duration (165 vs 333 minutes, p < 0.001), improved vital signs, which resulted in higher APGAR scores, and increased maternal satisfaction. CONCLUSION The labor unit management could consider adopting BRM as one of the non-pharmacological analgesia for healthy women in labor. TRIAL REGISTRATION ISRCTN87414969, registered 3 May 2019.
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Affiliation(s)
- Kamilya Baljon
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, 43400, Selangor, Malaysia
- Department of Nursing, Nursing College, Umm, Al-Qura University, Makkah, Saudi Arabia
| | - Muhammad Hibatullah Romli
- Department of Rehabilitation Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, 43400, Selangor, Malaysia
| | - Adibah Hanim Ismail
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, 43400, Selangor, Malaysia
| | - Lee Khuan
- Department of Nursing, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, 43400, Malaysia
| | - Boon-How Chew
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, 43400, Selangor, Malaysia
- Clinical Research Unit, Hospital Pengajar Universiti Putra Malaysia (HPUPM Teaching Hospital), Serdang, 43400, Selangor, Malaysia
- Correspondence: Boon-How Chew, Department of Family Medicine, Faculty of Medicine and Health Sciences, University Putra Malaysia, Serdang, 43400, Selangor, Malaysia, Tel +60 3-89472520, Fax +60 3-89472328, Email ;
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Öner Cengiz H, Ayhan M, Güner R. Effect of deep breathing exercise with Triflo on dyspnoea, anxiety and quality of life in patients receiving covid-19 treatment: A randomized controlled trial. J Clin Nurs 2021; 31:3439-3453. [PMID: 34897869 DOI: 10.1111/jocn.16171] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 10/18/2021] [Accepted: 11/25/2021] [Indexed: 01/20/2023]
Abstract
AIMS AND OBJECTIVES Determination of the effect of deep breathing exercise applied with Triflo on dyspnoea, anxiety and quality of life in patients who are hospitalized for COVID-19 and have dyspnoea. BACKROUND COVID-19 is a viral infection that can cause severe pulmonary disease. Deep breathing exercise with Triflo in patients with COVID-19 may contribute to the reduction/elimination of dyspnoea and anxiety, and improvement of respiratory and quality of life. DESIGN The study was a randomized controlled clinical trial and conducted in accordance with the Consolidated Standards of Reporting Trials (CONSORT) 2010 guidelines. METHODS The study was conducted in the clinic of COVID-19 of a tertiary hospital. A total of 44 eligible participants were enrolled from January to April 2021. Primary outcomes included oxygen saturation in the blood, respiratory assessment and dyspnoea level. Secondary outcomes included anxiety and quality of life. In the statistical analysis of the data, the independent sample t-test, Wilcoxon test, Mann-Whitney U test and Spearman correlation were used to examine the intervention effect on primary outcomes and secondary outcomes, according to numbers, percentage, mean, standard deviation and conformity to normal distribution. RESULTS It was determined that the patients in the deep breathing group had a statistically significant shorter hospitalization time (3.04 ± 0.65), higher SpO2 level (97.05 ± 1.46) and higher quality of life (77.82 ± 6.77) compared with the patients in the usual care group (p < 0.05). CONCLUSIONS Deep breathing exercise with Triflo increases the SpO2 level and quality of life in patients with COVID-19 and contributes to a decrease in dyspnoea and anxiety levels. Moreover, the duration of hospital stay is shortened in patients who are applied deep breathing exercise with Triflo. RELEVANCE TO CLINICAL PRACTICE With deep breathing exercise applied with Triflo, respiratory rate reaches normal limits in a short time, SpO2 levels increase significantly, and quality of life improves significantly in patients with COVID-19 pneumonia. CLINICAL TRIALS REGISTRATION NUMBER: https://clinicaltrials.gov; NCT04696562.
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Affiliation(s)
- Hatice Öner Cengiz
- Department of Midwifery, Faculty of Nursing, Ankara University, Ankara, Turkey
| | - Müge Ayhan
- Department of Infectious Diseases and Clinical Microbiology, Ankara City Hospital, Ankara, Turkey
| | - Rahmet Güner
- Department of Infectious Diseases and Clinical Microbiology, Ankara Yıldırım Beyazıt University, Ankara City Hospital, Ankara, Turkey
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Lista-Paz A, Sancho Marín S, Souto Camba S, Jácome C, González Doniz L. Comparison of Two Protocols for the Assessment of Maximal Respiratory Pressures: Spanish Society of Pulmonology and Thoracic Surgery Versus American Thoracic Society/European Respiratory Society. Cureus 2021; 13:e19129. [PMID: 34868768 PMCID: PMC8627690 DOI: 10.7759/cureus.19129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/29/2021] [Indexed: 11/05/2022] Open
Abstract
Background The measurement of maximal respiratory pressures (MRPs) is commonly used to assess respiratory muscle strength. However, in Spain, there is no consensus on which is the most adequate measurement protocol, as theSpanish Society of Pneumology and Thoracic Surgery (SEPAR) protocol differs from the one endorsed by the American Thoracic Society/European Respiratory Society(ATS/ERS). This study compared the absolute and predictive values of maximal expiratory and inspiratory pressures (MEP and MIP) in healthy adults obtained with the two protocols. Methods A cross-sectional study with a sample of healthy adults was conducted. Lung function and MRPs were assessed. MEP and MIP were measured using a digital manometer according to the SEPAR and ATS/ERS. Protocols were applied in random order by the same trained physiotherapist. The comfort experienced with each protocol was assessed through a short questionnaire. Paired t-tests were used to compare the results from both protocols. Results A total of 31 subjects (mean age 35.7±12.4 years; 14 females; FEV1=108.3±10.5%; FVC=103.7±10%) were included. There was a significant difference between MRPs favouring the SEPAR protocol, with the mean difference being 34.9±28.1 cmH2O (p˂0.001) for MEP and 8±11.6 cmH2O (p=0.001) for MIP. ATS/ERS protocol was, however, considered more comfortable than SEPAR (p<0.005). Conclusions This study shows that, in healthy adults, higher MRPs are obtained using the SEPAR protocol. Yet, the ATS/ERS protocol is experienced as more comfortable. Future studies are needed to analyse the application of both protocols in other populations and their associated comfort.
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Affiliation(s)
- Ana Lista-Paz
- Faculty of Physiotherapy, The University of A Coruña, A Coruña, ESP
| | | | | | - Cristina Jácome
- Faculty of Medicine, University of Porto (FMUP), Center for Health Technology and Services Research (CINTESIS), Porto, PRT
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Piotrowska M, Okrzymowska P, Kucharski W, Rożek-Piechura K. Application of Inspiratory Muscle Training to Improve Physical Tolerance in Older Patients with Ischemic Heart Failure. Int J Environ Res Public Health 2021; 18:ijerph182312441. [PMID: 34886168 PMCID: PMC8657106 DOI: 10.3390/ijerph182312441] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 11/20/2021] [Accepted: 11/24/2021] [Indexed: 11/23/2022]
Abstract
Regardless of the management regime for heart failure (HF), there is strong evidence supporting the early implementation of exercise-based cardiac rehabilitation (CR). Respiratory therapy is considered to be an integral part of such secondary prevention protocols. The aim of the study was to evaluate the effect of inspiratory muscle training (IMT) on exercise tolerance and the functional parameters of the respiratory system in patients with heart failure involved in cardiac rehabilitation. The study included 90 patients with HF who took part in the second-stage 8-week cycle of cardiac rehabilitation (CR). They were randomly divided into three groups: Group I underwent CR and IMT; Group II only CR; and patients in Group III underwent only the IMT. Before and after the 8-week cycle, participants were assessed for exercise tolerance and the functional parameters of respiratory muscle strength. Significant statistical improvement concerned the majority of the hemodynamic parameters, lung function parameters, and respiratory muscle strength in the first group. Moreover, the enhancement in the exercise tolerance in the CR + IMT group was accompanied by a negligible change in the HRpeak. The results confirm that the addition of IMT to the standard rehabilitation process of patients with heart failure can increase the therapeutic effect while influencing some of the parameters measured by exercise electrocardiography and respiratory function.
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Affiliation(s)
- Monika Piotrowska
- Department of Physiotherapy in Internal Disease, Wroclaw University of Health and Sport, Al. I.J. Paderewskiego 35, Building P4, 51-612 Wrocław, Poland; (M.P.); (K.R.-P.)
| | - Paulina Okrzymowska
- Department of Physiotherapy in Internal Disease, Wroclaw University of Health and Sport, Al. I.J. Paderewskiego 35, Building P4, 51-612 Wrocław, Poland; (M.P.); (K.R.-P.)
- Correspondence:
| | - Wojciech Kucharski
- Department of Human Biology, Wroclaw University of Health and Sport Sciences, Al. I.J. Paderewskiego 35, Building P4, 51-612 Wrocław, Poland;
- Cardiac Rehabilitation Unit, Hospital of Vratislavia Medica, Saint John Paul II, ul. Lekarska 1, 51-134 Wrocław, Poland
| | - Krystyna Rożek-Piechura
- Department of Physiotherapy in Internal Disease, Wroclaw University of Health and Sport, Al. I.J. Paderewskiego 35, Building P4, 51-612 Wrocław, Poland; (M.P.); (K.R.-P.)
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Obradović J, Sulik MJ, Armstrong-Carter E. Taking a few deep breaths significantly reduces children's physiological arousal in everyday settings: Results of a preregistered video intervention. Dev Psychobiol 2021; 63:e22214. [PMID: 34813098 DOI: 10.1002/dev.22214] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 10/20/2021] [Accepted: 10/23/2021] [Indexed: 11/05/2022]
Abstract
This preregistered, randomized field experiment tested the effectiveness of a brief deep breathing intervention on children's concurrent physiological arousal in naturalistic settings (N = 342; Mage = 7.48 years; 46% female; 53% Asian, 26% White; 21% other race/ethnicity). The treatment consisted of an animated video that introduced deep breathing as a self-regulation strategy and scaffolded the child in taking a few slow-paced breaths, while the control group watched an informational video featuring similar animated images. Respiratory sinus arrhythmia (RSA) and heart rate (HR) were measured while children were sitting still (baseline) and subsequently while watching 1-min videos. Relative to baseline arousal, RSA increased and HR decreased only in response to the deep-breathing treatment video. Effects were larger in the second 30-s epoch of the video, which included most of the deep breathing practice. RSA fully mediated the intervention's effects on HR. By analyzing all children exposed to intervention video regardless of their engagement in the deep breathing practice (intention-to-treat design) and by using easily scalable treatment videos, the study identifies an effective and pragmatic approach to reducing children's physiological arousal in everyday, group settings. Implications for advancing applied developmental psychophysiological research are discussed.
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Affiliation(s)
- Jelena Obradović
- Graduate School of Education, Stanford University, Stanford, California, USA
| | - Michael J Sulik
- Graduate School of Education, Stanford University, Stanford, California, USA
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Rodríguez-Blanco C, Bernal-Utrera C, Anarte-Lazo E, Saavedra-Hernandez M, De-La-Barrera-Aranda E, Serrera-Figallo MA, Gonzalez-Martin M, Gonzalez-Gerez JJ. Breathing exercises versus strength exercises through telerehabilitation in coronavirus disease 2019 patients in the acute phase: A randomized controlled trial. Clin Rehabil 2021; 36:486-497. [PMID: 34783270 DOI: 10.1177/02692155211061221] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To compare the effectiveness of two different exercise-based programs through telerehabilitation in patients with coronavirus disease 2019. DESIGN Randomized, controlled, parallel, double-blinded, three-arm clinical trial. SETTING Patients' homes through telerehabilitation devices. SUBJECTS Subjects with coronavirus disease 2019 in the acute phase. INTERVENTIONS Subjects were divided into three groups: breathing exercises group, strength exercises group or no treatment/control group. MAIN MEASURES We analysed visual analogue scale for fatigue, 6-minute walking test, 30-seconds sit-to-stand test, multidimensional dyspnoea-12 questionnaire and Borg scale at baseline and 14 days later. RESULTS From 93 subjects recruited, 88 were enrolled, and 77 patients (mean [SD] age 39.40 [11.71]) completed the 14-days intervention and were included in the analysis: 26 in strength exercises group, 29 in breathing exercises group and 22 in control group. The intergroup analysis shows significant differences between the study groups and control group in all variables (p < 0.05); Borg scale, multidimensional dyspnoea-12 questionnaire (pre-post intervention score: strength exercises group: 7.85 [6.82] - 4.54[4.82], breathing exercises group: 11.04 [6.49] - 5.32 [3.63], control group: 10.27 [6.49] - 10.59[6.58]), visual analogue scale for fatigue, 6-minute walking test and 30-seconds sit-to-stand test (pre-post intervention score: strength exercises group: 12.19 [4.42] - 13.58 [5.37], breathing exercises group: 11.18 [3.42] - 12.79 [4.00], control group: 10.45 [2.15] - 9.86[1.88]). The greatest effect sizes were found in the variables Borg Scale (R2 = 0.548) and multidimensional dyspnoea-12 questionnaire (R2 = 0.475). CONCLUSIONS Strength exercises group and breathing exercises group obtained significant improvements in fatigue, dyspnoea, perceived effort, and physical state, compared to control group, although the greatest benefits were found for dyspnoea and aerobic capacity in breathing exercises group.
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Affiliation(s)
- Cleofas Rodríguez-Blanco
- Fisiosur I + D Research Institute, Garrucha, Spain.,Physiotherapy Department, Faculty of Nursing, Physiotherapy and Podiatry, 16778University of Seville, Spain
| | - Carlos Bernal-Utrera
- Fisiosur I + D Research Institute, Garrucha, Spain.,Physiotherapy Department, Faculty of Nursing, Physiotherapy and Podiatry, 16778University of Seville, Spain
| | | | - Manuel Saavedra-Hernandez
- Fisiosur I + D Research Institute, Garrucha, Spain.,Department Nursing, Physiotherapy and Medicine, Faculty of Almeria, 16721University of Almeria, Spain
| | | | | | | | - Juan Jose Gonzalez-Gerez
- Fisiosur I + D Research Institute, Garrucha, Spain.,Department Nursing, Physiotherapy and Medicine, Faculty of Almeria, 16721University of Almeria, Spain
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Atilgan ED, Tuncer A. The effects of breathing exercises in mothers of children with special health care needs:A randomized controlled trial. J Back Musculoskelet Rehabil 2021; 34:795-804. [PMID: 33896815 DOI: 10.3233/bmr-200327] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND OBJECTIVE Caring for a child with a disability affects musculoskeletal system pain, fatigue, sleep quality, and anxiety of the mothers. The purpose of the study was to determine the effectiveness of breathing exercises in mothers with chronic non-specific low back pain (NLBP). METHODS Forty-three mothers with chronic NLBP were randomly assigned to the experimental group (n= 23) and the control group (n= 20). The experimental group received breathing exercises with core stabilization exercises (BSET) for three sessions a week for 8 weeks, and the control group performed stabilization exercises (SET) only, for the same period. Pain severity, fatigue, anxiety, and sleep quality were evaluated before and after the treatment programs. RESULTS After the treatment programs, significant differences were observed in pain, fatigue, and sleep quality in both groups (p< 0.05). However, the BSET group showed a significantly better improvement in anxiety levels and sleep quality than the SET group (p< 0.05). CONCLUSIONS The improvements in pain, fatigue and sleep quality were seen in both groups after treatment programs. It is recommended breathing exercises are added to core stabilization programs to provide greater improvements in anxiety level and sleep quality for mothers of children with disabilities, who have NLBP.
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Affiliation(s)
| | - A Tuncer
- Department of Physiotherapy and Rehabilitation, Hasan Kalyoncu University, Gaziantep, Turkey
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