A double-blind, randomized, placebo-controlled trial on the effect of Ashwagandha (Withania somnifera dunal.) root extract in improving cardiorespiratory endurance and recovery in healthy athletic adults.

ETHNOPHARMACOLOGICAL RELEVANCE: Ashwagandha is a reputed herb in traditional Ayurveda, used for various ailments and improving general well-being. Improved cardiorespiratory endurance can aid in attaining better physiological, metabolic, and functional abilities in humans. According to Ayurveda, Ashwagandha has such potential to improve human health. AIM OF THE STUDY: This study aimed to evaluate the efficacy and safety of Ashwagandha root extract in enhancing cardiorespiratory endurance in healthy athletic adults. MATERIALS AND METHODS: Fifty healthy athletic adults were selected randomly and equally allocated to Ashwagandha and placebo groups. The Ashwagandha group received 300 mg of Ashwagandha root extract capsules, twice daily, for 8-weeks. Cardiorespiratory endurance was assessed by measuring the maximum aerobic capacity (VO2 max). Estimation of stress management was done through Total Quality Recovery Scores (TQR), Recovery-Stress Questionnaire for Athletes (RESTQ), and Daily Analysis of Life Demands for Athletes (DALDA) questionnaires along with the antioxidant level measurement. RESULTS: At the end of the study, a statistically significant improvement in VO2 max outcome was observed in the Ashwagandha group when compared to the placebo group (P = 0.0074). The subjects in the Ashwagandha group also displayed a statistically significant increase at the end of the study when compared to the baseline (P < 0.0001). Significantly improved TQR scores were observed in the Ashwagandha group members compared to their placebo counterparts (P < 0.0001). DALDA questionnaire analysis in the Ashwagandha group was found statistically significant (P < 0.0001) compared to the placebo group. RESTQ assessment also yielded better outcomes, especially for fatigue recovery (P < 0.0001), lack of energy (P < 0.0001), and fitness analysis (P < 0.0001). The enhanced antioxidant level was significant (P < 0.0001) in the Ashwagandha group. CONCLUSION: The present findings suggest that Ashwagandha root extract can successfully enhance cardiorespiratory endurance and improve the quality of life in healthy athletic adults. No adverse events were reported by any of the subjects in this study.

Efficacy of Shenling Baizhu San on stable chronic obstructive pulmonary disease patients: A systematic review and meta-analysis.

ETHNOPHARMACOLOGICAL RELEVANCE: Shenling Baizhu San (SBS) as a classic Chinese medicine prescription, has been extensively used in gastrointestinal diseases, such as ulcerative colitis and chronic diarrhea. In recent years, SBS has shown a beneficial effect on chronic obstructive pulmonary disease (COPD) patients. However, clinical trials had shown conflicting results of SBS on improving pulmonary function and other related indicators of patients with stable COPD. The efficacy of SBS on stable COPD patients has not been fully assessed. AIM OF THE STUDY: To determine whether the SBS used in the treatment of gastrointestinal disease was effective to treat COPD, we assessed the clinical evidence and efficacy of SBS supplemental treatment on stable COPD patients by a systematic review and meta-analysis of clinical trials. MATERIALS AND METHODS: Nine electronic databases were searched to include clinical trials (published until August 31, 2020) with SBS as a supplementation treatment on stable COPD. Mean difference (MD) was used to evaluate continuous variables, odds ratio (OR) was calculated to evaluate dichotomous. The Egger's test was applied for publication bias. RESULTS: A total of 770 COPD participants from 11 trials that met the inclusion criteria were included. The meta-analysis showed that modified SBS could improve the exercise endurance, life quality scores of stable COPD patients, and also showed the potential benefits to pulmonary function of COPD patients than original SBS. CONCLUSION: The methodological quality of included trials may limit the conclusions that indicate that modified SBS may have a promising treatment for improving FEV1/FVC and MVV, increasing exercise endurance and life quality scores on stable COPD patients.

Fisioterapia aquática em indivíduos com distrofia muscular: uma revisão sistemática do tipo escopo / Fisioterapia acuática en individuos con distrofia muscular: una revisión sistemática de alcance / Aquatic physical therapy in individuals with muscular dystrophy: systematic scoping review

RESUMO O objetivo deste estudo foi mapear o uso da fisioterapia aquática em indivíduos com distrofias musculares, de forma a caracterizar as intervenções no meio aquático e identificar componentes mensurados (variáveis estudadas e instrumentos utilizados nos estudos). A revisão sistemática do tipo de escopo incluiu estudos experimentais, descritivos e observacionais (em inglês, português e espanhol). As buscas foram realizadas nas plataformas Medline (PubMed), CINAHL, Embase, PEDro, Lilacs, ERIC, Scopus, Web of Science e Google Scholar. Os dados extraídos foram alocados em três categorias: (1) caracterização dos registros, (2) informações referentes a fisioterapia aquática e (3) componentes mensurados. Foram encontrados 556 registros e, destes, selecionados 20. As amostras dos estudos selecionados incluíram, na maioria, indivíduos com distrofia muscular de Duchenne, com idade entre 5 e 22 anos, que fizeram fisioterapia aquática com duração média de 45 minutos uma ou duas vezes por semana, por 21 semanas. Essas características corroboram estudos feitos em diferentes populações. A maioria dos estudos investigou alterações pulmonares e controle postural/desempenho funcional, poucos avaliaram os efeitos no sistema cardíaco. Recomenda-se usar a Egen Klassifikation, a North Star Ambulatory Assessment e fazer o teste de caminhada de seis minutos.

RESUMEN El presente estudio tuvo el objetivo de mapear la práctica de fisioterapia acuática por individuos con distrofias musculares, para caracterizar las intervenciones en el medio acuático e identificar los componentes medidos (variables estudiadas e instrumentos utilizados en los estudios). La revisión sistemática de alcance incluyó estudios experimentales, descriptivos y observacionales (en inglés, portugués y español). Se llevaron a cabo las búsquedas en Medline (PubMed), CINAHL, Embase, PEDro, Lilacs, ERIC, Scopus, Web of Science y Google Scholar. Los datos obtenidos se asignaron en tres categorías: (1) caracterización de registros; (2) informaciones sobre fisioterapia acuática; y (3) componentes medidos. Se encontraron 556 registros, de los cuales se seleccionaron 20. Las muestras de los estudios seleccionados incluyeron mayoritariamente a individuos con distrofia muscular de Duchenne, con edades entre 5 y 22 años, y que se habían sometido a sesiones de fisioterapia acuática con un promedio de duración de 45 minutos, una o dos veces por semana, durante 21 semanas. Estas características confirman estudios realizados con diferentes poblaciones. La mayoría de los estudios han investigado las alteraciones pulmonares y el control postural/rendimiento funcional, pero pocos han evaluado los efectos sobre el sistema cardíaco. Se recomienda emplear la Egen Klassifikation, la North Star Ambulatory Assessment y aplicar la prueba de caminata de seis minutos.

ABSTRACT The aim of this study is to map the use of aquatic physical therapy in individuals with muscular dystrophy, to characterize aquatic physical therapy intervention and identify measured components (variables and measurement instruments used) by the studies. A systematic scoping review included experimental, descriptive and observational studies (in English, Portuguese and Spanish languages). The searches were carried out on MEDLINE (PubMed), CINAHL, Embase, PEDro, Lilacs, ERIC, Scopus, Web of Science, Google Scholar. The extracted data were characterized into three categories: (1) characterization of the records, (2) information referring to aquatic physical therapy, and (3) measured components. There were 556 studies records and 20 records were selected. The studies samples included mostly individuals with Duchenne muscular dystrophy, aged between 5 and 22 years old. Aquatic physical therapy sessions lasted about 45 minutes, and one or two sessions per week were carried out for 21 weeks. That corroborates studies conducted in different populations. Most of the studies investigated pulmonary system and postural control/ functional ability, and a few studies evaluated cardiac system. Egen Klassifikation and North Star Ambulatory Assessment are recommended, and also to perform 6-minute walk test.

The effects of the neck stabilization exercise on the muscle activity of trunk respiratory muscles and maximum voluntary ventilation of chronic stroke patients.

BACKGROUND: Unstable neck posture, muscle imbalance, and segmental instability can cause neck pain and decrease the respiratory function. OBJECTIVE: To examine effects of a neck stabilization exercise on respiratory muscle activity and maximal voluntary ventilation (MVV) in patients with a chronic stroke. METHODS: A total of 40 patients with a chronic stroke participated in this study. They were randomly divided into two groups (20 in each group). However, ten patients dropped out of the experiment (5 in each group). The experimental group (n= 15) performed a 15-minute neck stabilization exercise and a 15-minute breathing retraining exercise in addition to a rehabilitation exercise treatment. The control group (n= 15) completed a 30-minute breathing retraining exercise in addition to a rehabilitation exercise treatment. Exercises were conducted for 30 minutes a day, five times a week, for a total of six weeks. Activities of major respiratory muscles and MVV were measured before and after the experiment. RESULTS: Both the experimental group and the control group showed significant difference in activities of major respiratory muscles and MVV before and after the experiment (p< 0.05). The experimental group showed a significantly higher increase compared to the control group (p< 0.05). CONCLUSIONS: The application of a combination of a neck stabilization exercise and a breathing retraining exercise to patients with a chronic stroke can increase activity of respiratory muscles and MVV.

Effects of a Progressive Stabilization Exercise Program Using Respiratory Resistance for Patients with Lumbar Instability: A Randomized Controlled Trial.

BACKGROUND This study investigated the effects of progressive stabilization exercise program carried out with respiratory resistance in patients with lumbar instability. MATERIAL AND METHODS Forty-three patients with lumbar instability were randomly assigned to experimental (n=20) and control groups (n=23). The experimental group performed progressive lumbar stabilization exercises along with respiratory resistance, and the control group only performed progressive lumbar stabilization exercises, for 40 min per session, 3 sessions a week, for 4 weeks. Numeric rating scale (NRS), Korean-Oswestry disability index (K-ODI), static balance ability, Fear-Avoidance Beliefs Questionnaire (FABQ), and pulmonary function test (PFT) were performed before and after the intervention program for comparison. RESULTS The 2 groups showed significant differences in NRS, K-ODI, balance ability, and FABQ after the interventions (p<0.05), but greater improvements were shown by the experimental group in balance ability and FABQ values. PFT results in the experimental group showed a significant increase (p<0.05) in forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and maximum voluntary ventilation (MVV). The experimental group showed a greater improvement (p<0.05) in FVC and MVV compared to the control group. CONCLUSIONS Progressive stabilization exercise program with respiratory resistance is an effective method with clinical significance in pain reduction, psychosocial stability, and enhancement of motor and respiratory functions.

The effect of Baduanjin qigong combined with CBT on physical fitness and psychological health of elderly housebound.

BACKGROUND: To investigate the effectiveness of Baduanjin qigong combined with cognitive-behavior therapy (CBT) on the physical fitness and psychological health of elderly housebound. MATERIALS AND METHODS: The 120 elderly housebound were randomly divided into 3 intervention groups: Baduanjin training, Baduanjin training combined with CBT, and CBT. The interventions were conducted by means of home visits over 6 months. Spirometry, SF-36 health survey of quality of life, and Lawton and Brody Instrumental Activities of Daily Living Scale (IADL) were used to collect physical health data, and self-evaluation of overall health status, self-evaluation of loneliness, and short-form geriatric depression scale (GDS-15) were used to collect mental health data at baseline, 3 months, and 6 months after intervention. Data was analyzed by repeated measures analysis of variance (rANOVA) and chi-squared test (χ test). RESULTS: Forced vital capacity (FVC), maximum voluntary ventilation (MVV), quality of life (QOL), and self-reported health status were significantly increased (P < .05) in the group receiving joint Baduanjin and CBT intervention at 3 months and 6 months, as compared to the Baduanjin only group or the CBT only group. Activities of daily living (ADL), self-evaluated loneliness, and level of depression were significantly lowered (P < .05) in the group receiving joint Baduanjin and CBT intervention at 3 months and 6 months, as compared to the Baduanjin only group or the CBT only group. CONCLUSIONS: Physical and psychological statuses of elderly housebound were significantly improved by Baduanjin training combined with CBT. The effect of the combined intervention exceeded that of CBT or Baduanjin alone.

Respiratory muscle training positively affects vasomotor response in young healthy women.

Vasomotor response is related to the capacity of the vessel to maintain vascular tone within a narrow range. Two main control mechanisms are involved: the autonomic control of the sympathetic neural drive (global control) and the endothelial smooth cells capacity to respond to mechanical stress by releasing vasoactive factors (peripheral control). The aim of this study was to evaluate the effects of respiratory muscle training (RMT) on vasomotor response, assessed by flow-mediated dilation (FMD) and heart rate variability, in young healthy females. The hypothesis was that RMT could enhance the balance between sympathetic and parasympathetic neural drive and reduce vessel shear stress. Thus, twenty-four women were randomly assigned to either RMT or SHAM group. Maximal inspiratory mouth pressure and maximum voluntary ventilation were utilized to assess the effectiveness of the RMT program, which consisted of three sessions of isocapnic hyperventilation/ week for eight weeks, (twenty-four training sessions). Heart rate variability assessed autonomic balance, a global factor regulating the vasomotor response. Endothelial function was determined by measuring brachial artery vasodilation normalized by shear rate (%FMD/SR). After RMT, but not SHAM, maximal inspiratory mouth pressure and maximum voluntary ventilation increased significantly (+31% and +16%, respectively). Changes in heart rate variability were negligible in both groups. Only RMT exhibited a significant increase in %FMD/SR (+45%; p<0.05). These data suggest a positive effect of RMT on vasomotor response that may be due to a reduction in arterial shear stress, and not through modulation of sympatho-vagal balance.

Effect of a Respiratory Training Program Using Wind Instruments on Cardiopulmonary Function, Endurance, and Quality of Life of Elderly Women.

BACKGROUND Physical changes due to aging lead to weakening of respiratory muscles and decreased lung functions that result in increasing risk of chronic respiratory disease. A complex respiratory rehabilitation program is needed to prevent respiratory diseases and improve lung functions and quality of life. The purpose of the present study was to examine the effects of respiratory training programs on pulmonary functions, cardiovascular endurance, and quality of life in elderly women. MATERIAL AND METHODS The program was structured with respiration exercise and playing wind musical instruments for 10 weeks (n=13) and 5 weeks (n=16), respectively, for elderly women in 2 different community welfare centers. The program consisted of breathing exercises twice a week, 20 min per session, and 40 min of wind instrumentation. Effects were assessed using forced vital capacity (FVC), forced expiratory volume-one second (FEV1), FEV1/FVC ratio (FEV1%), maximum voluntary ventilation (MVV), 6-minute walk test (6MWT), modified Borg scale (MBS), and life satisfaction scale (LSS). RESULTS The 10-week program group (10WPG) showed significant differences in FVC, MVV, 6MWT, MBS, and LSS before and after interventions (p<.05), and the 5-week program group (5WPG) showed significant differences in FVC and 6MWT. MVV, MBS, and LSS were not significantly different between the 2 groups (p<.05). CONCLUSIONS This study confirms that the long-term respiration training program has positive effects on pulmonary functions, cardiopulmonary endurance, and quality of life. Various respiratory training programs and long-term implementations are needed to prevent respiratory illness and to improve lung functions and quality of life of respiratory patients.

Short-Term Effects of Normocapnic Hyperpnea and Exercise Training in Patients With Chronic Obstructive Pulmonary Disease: A Pilot Study.

OBJECTIVE: The aim of the study was to evaluate the short-term physiologic effects of respiratory muscle training with normocapnic hyperpnea added to standard exercise training on respiratory muscle endurance/strength and exercise tolerance in patients with chronic obstructive pulmonary disease. DESIGN: The study used a randomized controlled trial. Patients referred for rehabilitation were randomly assigned to 20 sessions (twice daily 5 d/wk) of either normocapnic hyperpnea (group 1, n = 12) or sham maneuvers (group 2, n = 10) in addition to individualized cycle training and abdominal, upper, and lower limb muscle exercise. At baseline and end of study, patients underwent evaluation of respiratory muscle endurance, maximum voluntary ventilation, maximal inspiratory, and expiratory pressures, and 6-min walking distance. RESULTS: After training, a significant improvement was found only for group 1 in respiratory muscle endurance time (by 654 [481] secs versus 149 [216] secs for group 2, P = 0.0108) and maximal inspiratory (group 1: from 81.2 [21.9] cmH2O to 107.6 [23.0] cmH2O, P = 0.018 versus group 2: from 75.4 [13.8] cmH2O to 81.3 [18.9] cmH2O, P = 0.139). The difference between groups for 6-min walking distance, maximum voluntary ventilation, and expiratory pressures was not significant. CONCLUSIONS: Short-term normocapnic hyperpnea training added to standard exercise, compared with exercise training alone, improves respiratory muscle endurance and strength but not exercise tolerance in patients with chronic obstructive pulmonary disease.

The Effects of Game-Based Breathing Exercise on Pulmonary Function in Stroke Patients: A Preliminary Study.

BACKGROUND: Reduction of respiratory function along with hemiparesis leads to decreased endurance, dyspnea, and increased sedentary behavior, as well as to an increased risk of stroke. The main purpose of this study was to investigate the preliminary effects of game-based breathing exercise (GBE) on pulmonary function in stroke patients. MATERIAL AND METHODS: Thirty-eight in-patients with stroke (22 men, 16 women) were recruited for the study. Participants were randomly allocated into 2 groups: patients assigned to the GBE group (n=19), and the control group (n=19). The GBE group participated in a GBE program for 25 minutes a day, 3 days a week, during a 5 week period. For the same period, both groups participated in a conventional stroke rehabilitation program. Forced vital capacity (FVC), forced expiratory volume at 1 second (FEV1), FEV1/FVC, and maximum voluntary ventilation (MVV) were measured by a spirometer in pre- and post-testing. RESULTS: The GBE group had significantly improved FVC, FEV1, and MVV values compared with the control group (p<0.05), although there was no significant difference in FEV1/FVC value between groups. Significant short-term effects of the GBE program on pulmonary function in stroke patients were recorded in this study. CONCLUSIONS: These findings gave some indications that it may be feasible to include GBE in rehabilitation interventions with this population.

Respiratory muscle training on pulmonary and swallowing function in patients with Huntington's disease: a pilot randomised controlled trial.

OBJECTIVE: To examine the effects of 4-month of respiratory muscle training on pulmonary and swallowing function, exercise capacity and dyspnoea in manifest patients with Huntington's disease. DESIGN: A pilot randomised controlled trial. SETTING: Home based training program. PARTICIPANTS: Eighteen manifest Huntington's disease patients with a positive genetic test and clinically verified disease expression, were randomly assigned to control group (n=9) and training group (n=9). INTERVENTION: Both groups received home-based inspiratory (5 sets of 5 repetitions) and expiratory (5 sets of 5 repetitions) muscle training 6 times a week for 4 months. The control group used a fixed resistance of 9 centimeters of water, and the training group used a progressively increased resistance from 30% to 75% of each patient's maximum respiratory pressure. MAIN MEASURES: Spirometric indices, maximum inspiratory pressure, maximum expiratory pressure, six minutes walk test, dyspnoea, water-swallowing test and swallow quality of life questionnaire were assessed before, at 2 and 4 months after training. RESULTS: The magnitude of increases in maximum inspiratory (d=2.9) and expiratory pressures (d=1.5), forced vital capacity (d=0.8), forced expiratory volume in 1 second (d=0.9) and peak expiratory flow (d=0.8) was substantially greater for the training group in comparison to the control group. Changes in swallowing function, dyspnoea and exercise capacity were small (d ≤ 0.5) for both groups without substantial differences between groups. CONCLUSIONS: A home-based respiratory muscle training program appeared to be beneficial to improve pulmonary function in manifest Huntington's disease patients but provided small effects on swallowing function, dyspnoea and exercise capacity.

[Autonomic regulation at emotional stress under hypoxic conditions in the elderly with physiological and accelerated aging: effect of hypoxic training].

The effect of hypoxic training on autonomic regulation in psycho-emotional stress conditions in hypoxic conditions in older people with physiological (25 people) and accelerated (28 people) aging respiratory system. It is shown that hypoxic training leads to an increase in vagal activity indicators (HF) and reduced simpatovagal index (LF/HF), have a normalizing effect on the autonomic balance during stress loads in older people with different types of aging respiratory system.

Physiotherapy intervention for preventing the respiratory muscle deterioration in institutionalized older women with functional impairment.

INTRODUCTION: In elderly seniors (>80 years), respiratory function may be compromised when, in addition to the presence of comorbidity and loss of mobility, there is also reduced respiratory muscle (RM) strength. The literature has shown that RM training could be an effective method to improve RM function and prevent clinical deterioration, particularly in population with RM weakness. The main purpose of this paper was to assess the effectiveness of RM training on the respiratory muscle strength and endurance of institutionalized elderly women with functional impairment. METHOD: Fifty-four residents (mean=85 years, SD=6.7) were randomly assigned to either a control (n=27) or training (n=27) group. A supervised training program was developed with Threshold(®)IMT, five times per week for 6-weeks. The main variables of the intervention were: maximum inspiratory pressure (PI(max)), maximum expiratory pressure (PE(max)) and maximal voluntary ventilation (MVV), all of which were measured at weeks 0, 4, 7 and 10. RESULTS: Statistical analysis revealed no significant differences in PI(max) (F(3,114)=1.04, p=0.368, R(2)=0.027), PE(max) (F(3,114)=1.86, p=0.14, R(2)=0.047) and MVV (F(3,114)=1.74, p=0.162, R(2)=0.044) between the two groups after the intervention. However, the workload significantly improved with the training sessions (F(5,100)=72.031, p<0.001, R(2)=0.791). CONCLUSION: In a 6-week interval-based training program, the threshold loading device does not significantly improve parameters related to RM strength and endurance of the study population.

Efecto de la suplementación de vitamina E en el rendimiento de una prueba incremental de consumo máximo de oxígeno en ratas wistar / Effect of vitamin E supplemantation on the performance of an incremental maximal oxigen uptake test in wistar rats

Diversas investigaciones han investigado el efecto de la suplementación de vitamina E en diversos marcadores de estrés oxidativo y en el rendimiento de diversas pruebas de resistencia, pero nunca en una prueba incremental hasta alcanzar el consumo de oxígeno máximo. Este trabajo pretende investigar el efecto de la toma de vitamina E en el rendimiento de una prueba incremental hasta alcanzar el consumo de oxígeno máximo en ratas. Se analizaron 2 grupos de ratas (G1: 190.8±1.83 gr; G2:198.0±0.86 gr), ambos realizaron una prueba incremental máxima en tapiz rodante (5’ a 25 cm/s mas aumentos de 3cm/s cada minuto hasta la extenuación). Dos horas antes de la prueba se administró al G1 un placebo (agua bidestilada) y alG2 una dosis de 1000UI/kg de peso de vitamina E, mediante una cánula endotraqueal. El G2 presentó unos valores deVO2max, VCO2max, VCO2relativo y RQ significativamente superiores (p<0.05) a los del G1. No se observaron diferencias significativas en las variables de VO2 relativo (G1: 87.1±7.61 vsG2: 91.0±3.55 ml/kg/min), tiempo final (G1: 1231.4±297.6 s vs G2: 1268.1±115.5 s) y velocidad final (G1: 76.6±14.91 cm/s vs G2: 78.3±5.89 cm/s). Estos datos muestran que la suplementación con una dosis de 1000 UI/kg peso de vitamina E no aumenta el rendimiento de ratas wistar al realizar una prueba incremental máxima hasta alcanzar el consumo de oxígeno máximo en tapiz rodante (AU)

Several studies have investigated the effect of vitamin E supplementation in various markers of oxidative stress and performance in different endurance exercises, but never in an incremental test to reach the maximum oxygen uptake. This work aims to investigate the effect of vitamin E supplementation on the performance of an incremental test to reach the maximum oxygen uptake in wistar rats. We analyzed two groups of wistar rats (G1: 190.8 g SEM 13.4, G2: 198.0 1.49 g SEM), both performed a maximum incremental test on a treadmill (5 ‘ to 25 cm/ s and increases of 3 cm/s every minute until exhaustion). Two hours before maximum incremental test G1 was administered a placebo (bi distilled water) and G2 was administered a dose of 1000UI/kg weight of vitamin E using an endotracheal tube.VO2max, VCO2max, relative VCO2 and RQ were significantly higher (p <0.05) in G2 when compared to G1. No significant differences were found for relative VO2 (G1: 87.14±7.61 vs G2: 91.00±3.55 ml/kg/min), final time (G1: 1231.40±297.63s vs G2: 1268.10±115.47 s) and final speed (G1: 76.60±14.91cm/s vs G2: 78.30±5.89 cm/s) between the two experimental groups. These data show that supplementation with a dose of1000 IU / kg vitamin E does not increase the performance of Wistar rats in an incremental test to reach maximum oxygen uptake (AU)

Effects of chest physiotherapy on the respiratory function of postoperative gastroplasty patients.

INTRODUCTION: Bariatric surgery has become increasingly more recommended for the treatment of morbidly obese individuals for whom it is possible to identify co-morbidities other than alterations in pulmonary function. The objective of this study was to evaluate the effects of conventional chest physiotherapy (CCP) and of conventional physiotherapy associated with transcutaneous electrical diaphragmatic stimulation (CCP+TEDS) on pulmonary function and respiratory muscle strength in patients who have undergone Roux-en-Y gastric bypass. METHODS: In total, 44 female patients with an average age of 37 +/- 7.3 years and an average body mass index (BMI) of 47.4 +/- 6.5 K/m(2) were selected as candidates for Roux-en-Y gastric bypass laparoscopy. They were evaluated for pulmonary volume and flow using spirometry and maximum respiratory pressure through manovacuometry during the preoperative period and on the fifteenth and thirtieth postoperative days. RESULTS: No differences were detected between CCP and CCP + TEDS, and both factors contributed to the maintenance of pulmonary flow and volume as well as inhalation muscle strength. Exhalation muscle strength was not maintained in the CCP group at fifteen or thirty days postoperative, but it was maintained in patients treated with conventional chest physiotherapy + transcutaneous electric diaphragmatic stimulation. DISCUSSION: These results suggest that both conventional chest physiotherapy and conventional chest physiotherapy + transcutaneous electric diaphragmatic stimulation prevent the reduction of pulmonary function during the Roux-en-Y gastric bypass postoperative period, and that transcutaneous electric diaphragmatic stimulation also contributes to expiratory muscle strength.

Effects of chest physiotherapy on the respiratory function of postoperative gastroplasty patients

INTRODUCTION: Bariatric surgery has become increasingly more recommended for the treatment of morbidly obese individuals for whom it is possible to identify co-morbidities other than alterations in pulmonary function. The objective of this study was to evaluate the effects of conventional chest physiotherapy (CCP) and of conventional physiotherapy associated with transcutaneous electrical diaphragmatic stimulation (CCP+TEDS) on pulmonary function and respiratory muscle strength in patients who have undergone Roux-en-Y gastric bypass. METHODS: In total, 44 female patients with an average age of 37 ± 7.3 years and an average body mass index (BMI) of 47.4 ± 6.5 K/m² were selected as candidates for Roux-en-Y gastric bypass laparoscopy. They were evaluated for pulmonary volume and flow using spirometry and maximum respiratory pressure through manovacuometry during the preoperative period and on the fifteenth and thirtieth postoperative days. RESULTS: No differences were detected between CCP and CCP+TEDS, and both factors contributed to the maintenance of pulmonary flow and volume as well as inhalation muscle strength. Exhalation muscle strength was not maintained in the CCP group at fifteen or thirty days postoperative, but it was maintained in patients treated with conventional chest physiotherapy + transcutaneous electric diaphragmatic stimulation. DISCUSSION: These results suggest that both conventional chest physiotherapy and conventional chest physiotherapy + transcutaneous electric diaphragmatic stimulation prevent the reduction of pulmonary function during the Roux-en-Y gastric bypass postoperative period, and that transcutaneous electric diaphragmatic stimulation also contributes to expiratory muscle strength.

Lung function in subjects exposed to crude oil spill into sea water.

A Greek oil-tanker ran aground, resulting in a huge oil spill along the costal areas of Karachi, Pakistan. The purpose of this study was to assess the lung function and follow up change after one year in subjects exposed to crude oil spill in sea water. It was a cross sectional study with follow up in 20 apparently healthy, non-smoking, male workers, who were exposed to a crude oil spill environment during oil cleaning operation. The exposed group was matched with 31 apparently healthy male control subjects. Pulmonary function test was performed using an electronic Spirometer. Subjects exposed to polluted air have significant reduction in forced vital capacity (FVC), forced expiratory volume in first second (FEV(1)), forced expiratory flow (FEF(25-75%)) and maximum voluntary ventilation (MVV) compared to their matched controls. This impairment was reversible and lung functions parameters were improved when the subjects were withdrawn from the polluted air environment.

Effect of respiratory muscle training on pulmonary function in preoperative preparation of tobacco smokers

PURPOSE: To evaluate the effect of utilization of a specific training program of respiratory muscles on pulmonary function in tobacco smokers. METHODS: Fifty asymptomatic tobacco smokers with age superior to 30 years were studied, at the moments: A0 - initial evaluation followed by protocol of respiratory exercises; A1 - reevaluation after 10 minutes of protocol application; and A2 - final reevaluation after 2 weeks of training utilizing the same protocol 3 times per week. The evaluation was realized through measures of maximum respiratory pressures (PImax and PEmax), respiratory peak flow (IPF and EPF), maximum voluntary ventilation (MVV), forced vital capacity (FVC) and forced expiratory volume at the 1st second (FEV1). RESULTS: There was no improvement from initial to final evaluation in FVC and FEV1. But there were significant increases in the variables IPF, EPF, MVV and PImax at evaluations A1 and A2. The PEmax variable increased only at evaluation A2. CONCLUSION: The application of the protocol of respiratory exercises with and without additional load in tobacco smokers produced immediate improvement in the performance of respiratory muscles, but this gain was more accentuated after 2 weeks of exercise.

OBJETIVO: Avaliar o efeito da utilização de um programa de treinamento específico dos músculos respiratórios sobre a função pulmonar em indivíduos tabagistas. MÉTODOS: Foram estudados 50 indivíduos tabagistas assintomáticos com idade superior a 30 anos, nos seguintes momentos: A0 - avaliação inicial seguida do protocolo de exercícios respiratórios; A1 - reavaliação após 10 minutos da aplicação do protocolo; e A2 -reavaliação final após duas semanas de treinamento utilizando o mesmo protocolo três vezes por semana. A avaliação foi realizada através das medidas de pressões respiratórias máximas (PImax. e PEmax.), picos de fluxo respiratórios (PFI e PFE), ventilação voluntária máxima (VVM), capacidade vital Forçada (CVF) e Volume expiratório forçado no primeiro segundo (VEF1). RESULTADOS: Não houve melhora na CVF e VEF1 da avaliação inicial para a final. Houve aumento significativo das variáveis PFI, PFE, VVM e PImax nas avaliações A1 e A2. A variável PEmax. aumentou somente na avaliação A2. CONCLUSÃO: A aplicação de protocolo de exercícios respiratórios com e sem carga adicional em indivíduos tabagistas produziu melhora imediata na performance dos músculos respiratórios, mas esta melhora foi mais acentuada após duas semanas de exercício.

Effect of respiratory muscle training on pulmonary function in preoperative preparation of tobacco smokers.

PURPOSE: To evaluate the effect of utilization of a specific training program of respiratory muscles on pulmonary function in tobacco smokers. METHODS: Fifty asymptomatic tobacco smokers with age superior to 30 years were studied, at the moments: A0 - initial evaluation followed by protocol of respiratory exercises; A1 - reevaluation after 10 minutes of protocol application; and A2 - final reevaluation after 2 weeks of training utilizing the same protocol 3 times per week. The evaluation was realized through measures of maximum respiratory pressures (PImax and PEmax), respiratory peak flow (IPF and EPF), maximum voluntary ventilation (MVV), forced vital capacity (FVC) and forced expiratory volume at the 1st second (FEV1). RESULTS: There was no improvement from initial to final evaluation in FVC and FEV1. But there were significant increases in the variables IPF, EPF, MVV and PImax at evaluations A1 and A2. The PEmax variable increased only at evaluation A2. CONCLUSION: The application of the protocol of respiratory exercises with and without additional load in tobacco smokers produced immediate improvement in the performance of respiratory muscles, but this gain was more accentuated after 2 weeks of exercise.

Entrenamiento muscular en paciente traqueostomizado: a propósito de un caso / Respiratory muscle training in tracheostomized patient: a case report

Se presenta el caso de una niña de 14 años portadora de Síndrome de Escobar, trastorno congénito caracterizado por alteraciones musculoesqueléticas, entre ellas escoliosis, que determinan una alteración ventilatoria restrictiva, similar a la presentada por pacientes neuromusculares. La Paciente está traqueostomizada con soporte ventilatorio en su domicilio. Se plantea un programa de Rehabilitación Respiratoria con Entrenamiento Físico general y de la musculatura específica inspiratoria. Este entrenamiento específico es realizado con una válvula Threshold IMT® con una carga de un 30 por ciento de la fuerza generada, medida a través de la Presión Inspiratoria Máxima. En un corto período presentó una mejoría significativa de su valor basal en un 42 por ciento. Es interesante destacar la factibilidad de entrenar pacientes con traqueostomía.