Effects of whole-body vibration exercise on functional capacity, muscle strength, and quality of life in individuals with severe chronic obstructive pulmonary disease: a systematic review and meta-analysis.

BACKGROUND: Whole body vibration (WBV) exercise is a therapy used for individuals with low tolerance to conventional exercises, such as patients with chronic obstructive pulmonary disease (COPD). This study aimed to assess the impact of WBV exercise on the functional capacity, muscle strength, and health-related quality of life (HRQoL) in severe COPD patients. METHODS: Studies published until March 2024 were reviewed, encompassing randomized clinical trials (RCTs) without temporal or linguistic constraints, comparing WBV exercise with other interventions. The PubMed/MEDLINE, Scopus, Cochrane Airways Trials Register, and CINAHL databases were queried. The Revised Cochrane risk-of-bias tool for randomized trials 2.0A was employed for quality assessment. RESULTS: Among 351 screened studies, 7 met the criteria, totaling 356 participants (WBV group, n = 182; control group, n = 174). Meta-analysis revealed a significant mean difference of 41.36 m [95%CI (13.28-69.44); p = .004] in the 6-minute walk test distance favoring the WBV group for functional capacity. Lower limb muscle strength improved in 57.14% of included studies. HRQoL meta-analysis demonstrated a 1.13-point difference [95%CI -1.24-3.51; p = .35] favoring WBV, although group differences were not significant. A mean difference of 2.31 points favored the control group in health condition [95%CI (-1.32-5.94); p = .021]. CONCLUSION: WBV exercise is recognized as a promising therapeutic modality for severe COPD patients, notably enhancing functional capacity. Although heterogeneous study protocols weaken the evidence for clinically relevant outcomes, improvements in lower limb muscle strength and HRQoL were also observed, differences between groups were not significant.

Effectiveness of an adapted diving mask (Owner mask) for non-invasive ventilation in the COVID-19 pandemic scenario: study protocol for a randomized clinical trial.

BACKGROUND: Non-invasive ventilation (NIV) is indicated to avoid orotracheal intubation (OTI) to reduce hospital stay and mortality. Patients infected by SARS-CoV2 can progress to respiratory failure (RF); however, in the initial phase, they can be submitted to oxygen therapy and NIV. Such resources can produce aerosol and can cause a high risk of contagion to health professionals. Safe NIV strategies are sought, and therefore, the authors adapted diving masks to be used as NIV masks (called an Owner mask). OBJECTIVE: To assess the Owner mask safety and effectiveness regarding conventional orofacial mask for patients in respiratory failure with and without confirmation or suspicion of COVID-19. METHODS: A Brazilian multicentric study to assess patients admitted to the intensive care unit regarding their clinical, sociodemographic and anthropometric data. The primary outcome will be the rate of tracheal intubation, and secondary outcomes will include in-hospital mortality, the difference in PaO2/FiO2 ratio and PaCO2 levels, time in the intensive care unit and hospitalization time, adverse effects, degree of comfort and level of satisfaction of the mask use, success rate of NIV (not progressing to OTI), and behavior of the ventilatory variables obtained in NIV with an Owner mask and with a conventional face mask. Patients with COVID-19 and clinical signs indicative of RF will be submitted to NIV with an Owner mask [NIV Owner COVID Group (n = 63)] or with a conventional orofacial mask [NIV orofacial COVID Group (n = 63)], and those patients in RF due to causes not related to COVID-19 will be allocated into the NIV Owner Non-COVID Group (n = 97) or to the NIV Orofacial Non-COVID Group (n = 97) in a randomized way, which will total 383 patients, admitting 20% for loss to follow-up. DISCUSSION: This is the first randomized and controlled trial during the COVID-19 pandemic about the safety and effectiveness of the Owner mask compared to the conventional orofacial mask. Experimental studies have shown that the Owner mask enables adequate sealing on the patient's face and the present study is relevant as it aims to minimize the aerosolization of the virus in the environment and improve the safety of health professionals. TRIAL REGISTRATION: Brazilian Registry of Clinical Trials (ReBEC): RBR - 7xmbgsz . Registered on 15 April 2021.

Is whole body vibration an alternative physical training method for renal transplant recipients?

OBJECTIVE: To evaluate the effect of a 12-week whole-body vibration (WBV) training program on quadriceps muscle strength, quadriceps thickness, the 6-min walk test (6MWT), respiratory muscle strength and quality of life in adults with a kidney transplant. METHOD: Five renal transplant recipients (age: 43-52 years; body mass: 67.1 kg; height: 1.60 m) were examined individually before and after a 12-week WBV program (two weekly sessions, 35 Hz frequency, 2-4 mm amplitude) using quadriceps strength, quadriceps thickness, 6-min walking test, inspiratory muscle strength and quality of life. RESULTS: There were no complications during WBV protocol, and the program was considered safe. Two of the participants changed quadriceps muscle strength, and one increased muscle thickness. Inspiratory muscle strength improved in one participant. The distance covered on 6MWT increased for two participants. Most of the subjects (P3, P4 and P5) reported improved quality of life, mainly regarding pain and social aspects. CONCLUSION: The protocol improved the physical function and quality of life in some of the patients. However, WBV training prescription should be adjusted according to individual needs. Thus, studying the use of WBV in this patient group is necessary to understand and apply the benefits for this population.

Effects of daily inspiratory muscle training on respiratory muscle strength and chest wall regional volumes in haemodialysis patients: a randomised clinical trial.

Purpose: Evaluating the effects of interdialytic daily inspiratory muscle training (IMT) on respiratory muscle strength, chest wall regional volumes, diaphragmatic mobility and thickness, pulmonary function, functional capacity, and quality of life (QoL) in haemodialysis (HD) patients.Method: A randomised, and double-blind clinical trial composed of 24 chronic kidney disease patients undergoing HD. Patients were allocated into the IMT group (n = 12) or sham group (n = 12) and performed daily IMT twice per day with a load of 50% inspiratory muscle strength for the IMT group and 5 cmH2O for the sham group during 8 weeks. Respiratory muscle strength, diaphragm thickness and mobility, chest wall regional volumes, functional capacity, and QoL were measured.Results: At the end of the study, an increase in inspiratory and expiratory muscle strength was observed for both groups, but no significant difference was found between them. Changed volume distribution was also observed in the IMT group, with significantly increased inspiratory capacity in the pulmonary compartment compared to the sham group.Conclusions: Daily interdialytic IMT promoted a change in chest wall regional volumes, with an increase in the inspiratory capacity of the pulmonary rib cage. Both groups had increased inspiratory and expiratory muscle strength with daily respiratory exercise.Trial registration: www.ClinicalTrials.gov; study number: NCT02599987; name of trial registry: IMT in Patients with End-stage Renal Disease.Implications for rehabilitationMuscular impairment in chronic kidney disease patients results from a series of common alterations, affecting respiratory muscles.Patients with chronic kidney disease have low values of diaphragmatic thickness.The daily inspiratory muscle training (IMT) or breathing exercise over a period of 8 weeks provided increased respiratory muscle strength.The daily inspiratory muscle training presented a change in tri-compartment distribution of lung volume compared to the sham group, with increased inspiratory capacity of the pulmonary rib cage.

Whole body vibration to attenuate reduction of explosive force in chronic kidney disease patients: a randomized controlled trial.

To investigate whether whole body vibration (WBV) training increases the explosive force of the knee extensors in chronic kidney disease (CKD) patients. Fourteen CKD patients undergoing hemodialysis were randomly allocated in WBV training or Sham group. Explosive force parameters (contractile impulse [CImp] and relative rate of force development [RFDr]) obtained in early (30 and 50 msec) and late phases (100 and 200 msec) of the knee extensors force/time curve. CImp and RFDr obtained at the early phase of force/time curve reduced after the intervention period, with a smaller decline for WBV (CImp at 50 msec [~-15% and -51%, P=0.038], RFDr at 30 msec [~-22% and -52%, P=0.044] and RFDr at 50 msec [~-11% and -54%; P=0.008]). In the late phase there was a lower decline for WBV group compared to Sham group, respectively: CImp: 100 msec (~-8% and -55%, P=0.025), 200 msec (~-3% and -46%, P= 0.025); RFDr 100 msec (~0.01% and -56%, P=0.033), 200 msec (~-5% and -36%, P=0.004). Three months of WBV training may attenuate the explosive force reduction in CKD patients.

Inspiratory muscle training improves respiratory muscle strength, functional capacity and quality of life in patients with chronic kidney disease: a systematic review.

QUESTION: Does inspiratory muscle training improve respiratory muscle strength, functional capacity, lung function and quality of life of patients with chronic kidney disease? Does inspiratory muscle training improve these outcomes more than breathing exercises? DESIGN: Systematic review and meta-analysis of randomised trials. PARTICIPANTS: People with chronic kidney disease undergoing dialysis treatment. OUTCOME MEASURES: The primary outcomes were: maximal inspiratory pressure, maximal expiratory pressure, and distance covered on the 6-minute walk test. The secondary outcomes were: forced vital capacity, forced expiratory volume in the first second (FEV1), and quality of life. RESULTS: The search identified four eligible studies. The sample consisted of 110 participants. The inspiratory muscle training used a Threshold® or PowerBreathe® device, with a load ranging from 30 to 60% of the maximal inspiratory pressure and lasting from 6 weeks to 6 months. The studies showed moderate to high risk of bias, and the quality of the evidence was rated low or very low, due to the studies' methodological limitations. The meta-analysis showed that inspiratory muscle training significantly improved maximal inspiratory pressure (MD 23 cmH2O, 95% CI 16 to 29) and the 6-minute walk test distance (MD 80m, 95% CI 41 to 119) when compared with controls. Significant benefits in lung function and quality of life were also identified. When compared to breathing exercises, significant benefits were identified in maximal expiratory pressure (MD 6 cmH2O, 95% CI 2 to 10) and FEV1 (MD 0.24litres 95% CI 0.14 to 0.34), but not maximal inspiratory pressure or forced vital capacity. CONCLUSION: In patients with chronic renal failure on dialysis, inspiratory muscle training with a fixed load significantly improves respiratory muscle strength, functional capacity, lung function and quality of life. The evidence for these benefits may be influenced by some sources of bias. REGISTRATION: PROSPERO (CRD 42015029986). [de Medeiros AIC, Fuzari HKB, Rattesa C, Brandão DC, de Melo Marinho PÉ (2017) Inspiratory muscle training improves respiratory muscle strength, functional capacity and quality of life in patients with chronic kidney disease: a systematic review. Journal of Physiotherapy 63: 76-83].

Respiratory muscle strength, the six-minute walk test and quality of life in Chagas cardiomyopathy.

BACKGROUND AND PURPOSE: Patients with heart failure disease develop respiratory and functional limitations and suffer from the negative influence on their quality of life. This study was designed to evaluate respiratory muscle strength and its relationship to functional capacity, quality of life and rate of perceived exertion in patients with Chagas cardiomyopathy. METHODS: We evaluated 32 patients divided into groups with and without Chagas heart disease. We measured the Minnesota Living with Heart Failure Questionnaire, the maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), distance walked during the 6-minute walk test, rating of perceived exertion (RPE), heart rate, blood pressure, respiratory rate, oxygen saturation and ejection fraction (EF). RESULTS: The group with Chagas heart disease showed decreased quality of life (overall score: p = 0.001; physical domain: p = 0.002; role-emotional domain: p = 0.031 and general health domain: p < 0.001) and MIP (p < 0.001) when compared with the control group. There was no difference between the distance walked in both groups. The RPE was greater in the group with Chagas heart disease (p = 0.001). The MIP correlated with MEP (r = 0.631, p = 0.009) and EF (r = 0.524, p = 0.037). CONCLUSION: The inspiratory muscle strength is reduced, and the decreased quality of life has a negative influence on the physical and emotional aspects of the patients with Chagas cardiomyopathy. No correlation was found between perceived exertion and the reduction of respiratory muscle strength.