Effects of 12 weeks of inspiratory muscle training and whole body vibration on the inflammatory profile, BDNF and muscular system in pre-frail elderly women: A randomized controlled trial.

AIM: to investigate the effects of the whole body vibration (WBV) and inspiratory muscle training (IMT) on the inflammatory profile and in muscle mass and strength in pre-frail older women. METHODS: this study was a randomized double-blind trial. Forty two older women aged 60-80 years were randomly allocated to IMT + WBV (G1), IMTsham + WBV (G2) or Sham groups (G3). During 12 weeks G1 received both trainings, whereas G2 received WBV alone and G3 received IMT with a low fixed load and were positioned at the vibratory platform without therapeutic effect. Participants were evaluated before and after the intervention for the following outcomes: Brain-derived neurotrophic factor (BDNF) and inflammatory biomarkers (IB), respiratory (RT) and quadriceps thickness (QT) and diaphragmatic mobility (DM) using muscle ultrasound, body composition (BC) using a bioelectrical impedance scale and inspiratory muscle strength (IMS). RESULTS: after the training, G1 (114.93 ± 21.29) improved IMS (p<0.005) compared with G2 (91.29 ± 23.10) and G3 (85.21 ± 27.02). There was also a significant improve on time of the DM (p<0.001) and RT (p=0.006) for G1 (8.59 ± 3.55 and 11.11 ± 12.66) compared with G2 (1.05 ± 3.09 and 1.10 ± 10.60) and G3 (0.40 ± 2.29 and -1.85 ± 7.45). BDNF, IB, QT and BC were similar between groups. CONCLUSIONS: IMT associated with WBV is effective to improve in increasing IMS, RT and DM in pre-frail older women. However, these interventions do not modify BDNF, IB, QT or BC in this population.

Inspiratory muscle training in addition to whole body vibration for functional and physical outcomes in pre-frail older women: a randomized controlled trial.

BACKGROUND: to investigate the efficacy of addition of inspiratory muscle training (IMT) to the whole body vibration (WBV) on functional outcomes, physical performance, muscle strength and metabolism in pre-frail older women. METHODS: this study was a randomized double-blind trial. Forty-two older women aged 60-80 years who meet the Cardiovascular Health Study frailty criteria for pre-frailty were randomly allocated to IMT + WBV, IMTsham + WBV or Sham groups. IMT + WBV group received 12 weeks of both trainings, whereas IMTsham + WVB received 12 weeks of WBV alone. Sham group received 12 weeks of IMT with a low fixed load and were positioned at the vibratory platform without therapeutic effect. Participants were evaluated before and after the intervention for the following outcomes: 6-min walk test distance (6MWD), balance using Tinetti test, functional mobility using timed up and go test (TUG), handgrip strength (HGS) and peripheral muscle metabolism (glucose and lactate levels). RESULTS: after the training, both groups IMT + WBV and IMTsham + WBV improved 6MWD [mean percentage changes = 20.31 (SD = 14.62) and 13.02 (SD = 12.14), respectively] compared with Sham [0.27 (SD = 6.51)], P <0.01. There was also a significant decrease of mean percentage changes on time of the TUG for IMT + WBV [-21.87 (SD = 7.87)] and IMTsham + WBV [-11.15 (SD = 13.64)] compared with Sham [-4.25 (SD = 13.25)], P <0.01. IMT + WBV group improved balance when compared with IMTsham + WBV and Sham groups (P <0.05 and < 0.01, respectively). HGS and levels of lactate and glucose were similar between groups. CONCLUSIONS: the addition of IMT to the WBV was effective to improve functionality, balance and physical performance in pre-frail older women.

Effects of physical exercise on the autonomic nervous system in patients with coronary artery disease: a systematic review.

BACKGROUND: Imbalance in autonomic modulation can occur after a cardiac event, which can lead to deleterious consequences. Exercise has proven to be a therapy which affects this modulation and can be assessed through heart rate variability (HRV). AREAS COVERED: The objective of this systematic review was to investigate the effects of physical exercise on heart rate variability in individuals with coronary artery disease (CAD). The PubMed, PEDro, Scielo, Lilacs and Cochrane databases were systematically searched, for articles which performed supervised exercises in phase II of cardiac rehabilitation in patients with CAD. EXPERT OPINION: Given the differences between studies on interventions and population characteristics, it is difficult to justify similarities or divergences in terms of results. In addition to the variation in sample size, intervention duration, carrying out an additional program at home, and patients with different clinical presentations, it can be inferred that responses to exercise may vary for certain types/clinical profile of individuals with CAD. Thus, it is necessary to carry out more studies with greater methodological rigor, greater standardization of the variables studied and the evaluation forms, in order to increase the veracity of the results and the consequent clinical relevance and therapeutic application.

Impact of moderate-severe persistent allergic rhinitis on thoraco-abdominal kinematics and respiratory muscle function.

Objective: To assess thoraco-abdominal kinematics, respiratory muscle strength and electromyographic activity of the diaphragm (EAdi) in moderate-severe allergic rhinitis (AR) patients. Methods: A cross-sectional study involving 40 individuals (20 in the AR group) and 20 in the control group [CG]) was conducted. Ventilatory pattern and chest wall volume distribution (optoelectronic plethysmography), respiratory muscle strength (manovacuometry and sniff nasal inspiratory pressure [SNIP]), and EAdi were assessed in both groups. Results: The AR patients had impaired thoraco-abdominal kinematics (reduced total chest wall volume) (p = 0.004), lower values of total respiratory cycle time (p = 0.014) and expiratory time (p = 0.006). They also presented an increase of percentage contribution of the abdominal rib cage (p = 0.475) and respiratory rate (p = 0.019). A positive correlation among pulmonary rib cage tidal volume and MIP (r = 0.544; p < 0.001), SNIP (r = 0.615; p < 0.001), and MEP (r = 0.604; p < 0.001) was observed. After adjusting for age, BMI and gender through multivariate analysis, the individuals with AR presented lower values ​​of MIP (ß = -24.341; p < 0.001), MEP (ß = -0.277; p < 0.001), SNIP (ß = -34.687; p < 0.001) and RMS (ß = -0.041; p = 0.017). Conclusions: The individuals with moderate-severe persistent AR had worse respiratory muscle strength, diaphragm activation and chest wall volume distribution with a higher abdominal contribution to tidal volume than the control group. These findings reinforce the notion that the upper and lower airways work in an integrated and synergistic manner.