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1.
Mymensingh Med J ; 28(4): 925-929, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31599262

RESUMO

Blood pressure in our body is finely regulated through autonomic nervous system and cardiac centers and studies established that parasympathetic dominance exerted by slow deep breathing decreases blood pressure. Reaction time is an estimate of the subject's capacity for inhibiting pre-potent motor responses. Decreased reaction time indicates greater alertness, faster information processing and less distractibility. Nevertheless, there has been conflicting results about the effect of deep slow breathing on reaction time The present research targeted a community based cross sectional observational study (n=80, age=17-70 years) performed in Lalitpur Municipality, Ward number-14, Nepal from May 2019 to June 2019, to observe the immediate effect of slow deep breathing exercise on blood pressure and reaction time by using online visual reaction time test. Volunteers performed the slow breathing exercise (approximately 4seconds inhalation and 6 seconds exhalation) in Sukhasana for 5 minutes. Base-line and post-slow-breathing blood pressure and visual reaction time was recorded and compared. Decrease in systolic and diastolic pressure was recorded in all, but statistically insignificant. Among the whole study population, significant decrease (p<0.001) in reaction time was noted (90.35±13.96 msVs 76.68±9.90 ms). Among male subjects of age-group 17-28 years, and 50-70 years, significant decrease in reaction time was noted (p<0.05) whereas, among the female subjects of all age groups, reaction time decreased significantly (p<0.05). Decrease in reaction time signifies improved central neuronal processing activity. This may be due to greater arousal, faster information processing, and ability to ignore or inhibit extraneous stimuli. Hence, regular practice of slow deep breathing exercise may be beneficial to lower blood pressure and to improve concentration.


Assuntos
Pressão Sanguínea , Exercícios Respiratórios , Estudos Transversais , Feminino , Frequência Cardíaca , Humanos , Masculino , Nepal , Tempo de Reação
2.
Pediatr Phys Ther ; 31(4): 323-330, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31568374

RESUMO

PURPOSE: This study reports the respiratory muscle training effect on strength and endurance in individuals with Duchenne muscular dystrophy. METHODS: Articles published from 1984 to 2017 were reviewed. Six articles met the inclusion criteria that included within-subject control or between-subject control group, participants with a diagnosis of only Duchenne muscular dystrophy, participation in respiratory muscle training intervention, and outcome measures of endurance and strength. Effect sizes were calculated for each study and overall, weighted mean effect sizes for strength and endurance outcome measures. RESULTS: There was a large effect for improving respiratory endurance and a moderate effect for muscle strength. However, these effects were not significant. CONCLUSION: Findings justify further exploration of the potential benefits of respiratory muscle training for individuals with Duchenne muscular dystrophy.


Assuntos
Exercícios Respiratórios/métodos , Força Muscular/fisiologia , Distrofia Muscular de Duchenne/reabilitação , Humanos , Distrofia Muscular de Duchenne/fisiopatologia
3.
Cochrane Database Syst Rev ; 9: CD011711, 2019 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-31487757

RESUMO

BACKGROUND: Neuromuscular diseases (NMDs) are a heterogeneous group of diseases affecting the anterior horn cell of spinal cord, neuromuscular junction, peripheral nerves and muscles. NMDs cause physical disability usually due to progressive loss of strength in limb muscles, and some NMDs also cause respiratory muscle weakness. Respiratory muscle training (RMT) might be expected to improve respiratory muscle weakness; however, the effects of RMT are still uncertain. This systematic review will synthesize the available trial evidence on the effectiveness and safety of RMT in people with NMD, to inform clinical practice. OBJECTIVES: To assess the effects of respiratory muscle training (RMT) for neuromuscular disease (NMD) in adults and children, in comparison to sham training, no training, standard treatment, breathing exercises, or other intensities or types of RMT. SEARCH METHODS: On 19 November 2018, we searched the Cochrane Neuromuscular Specialized Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, and Embase. On 23 December 2018, we searched the US National Institutes for Health Clinical Trials Registry (ClinicalTrials.gov), the World Health Organization International Clinical Trials Registry Platform, and reference lists of the included studies. SELECTION CRITERIA: We included randomized controlled trials (RCTs) and quasi-RCTs, including cross-over trials, of RMT in adults and children with a diagnosis of NMD of any degree of severity, who were living in the community, and who did not need mechanical ventilation. We compared trials of RMT (inspiratory muscle training (IMT) or expiratory muscle training (EMT), or both), with sham training, no training, standard treatment, different intensities of RMT, different types of RMT, or breathing exercises. DATA COLLECTION AND ANALYSIS: We followed standard Cochrane methodological procedures. MAIN RESULTS: We included 11 studies involving 250 randomized participants with NMDs: three trials (N = 88) in people with amyotrophic lateral sclerosis (ALS; motor neuron disease), six trials (N = 112) in Duchenne muscular dystrophy (DMD), one trial (N = 23) in people with Becker muscular dystrophy (BMD) or limb-girdle muscular dystrophy, and one trial (N = 27) in people with myasthenia gravis.Nine of the trials were at high risk of bias in at least one domain and many reported insufficient information for accurate assessment of the risk of bias. Populations, interventions, control interventions, and outcome measures were often different, which largely ruled out meta-analysis. All included studies assessed lung capacity, our primary outcome, but four did not provide data for analysis (1 in people with ALS and three cross-over studies in DMD). None provided long-term data (over a year) and only one trial, in ALS, provided information on adverse events. Unscheduled hospitalisations for chest infection or acute exacerbation of chronic respiratory failure were not reported and physical function and quality of life were reported in one (ALS) trial.Amyotrophic lateral sclerosis (ALS)Three trials compared RMT versus sham training in ALS. Short-term (8 weeks) effects of RMT on lung capacity in ALS showed no clear difference in the change of the per cent predicted forced vital capacity (FVC%) between EMT and sham EMT groups (mean difference (MD) 0.70, 95% confidence interval (CI) -8.48 to 9.88; N = 46; low-certainty evidence). The mean difference (MD) in FVC% after four months' treatment was 10.86% in favour of IMT (95% CI -4.25 to 25.97; 1 trial, N = 24; low-certainty evidence), which is larger than the minimal clinically important difference (MCID, as estimated in people with idiopathic pulmonary fibrosis). There was no clear difference between IMT and sham IMT groups, measured on the Amyotrophic Lateral Sclerosis Functional Rating Scale (ALFRS; range of possible scores 0 = best to 40 = worst) (MD 0.85, 95% CI -2.16 to 3.85; 1 trial, N = 24; low-certainty evidence) or quality of life, measured on the EuroQol-5D (0 = worst to 100 = best) (MD 0.77, 95% CI -17.09 to 18.62; 1 trial, N = 24; low-certainty evidence) over the medium term (4 months). One trial report stated that the IMT protocol had no adverse effect (very low-certainty evidence).Duchenne muscular dystrophy (DMD)Two DMD trials compared RMT versus sham training in young males with DMD. In one study, the mean post-intervention (6-week) total lung capacity (TLC) favoured RMT (MD 0.45 L, 95% CI -0.24 to 1.14; 1 trial, N = 16; low-certainty evidence). In the other trial there was no clear difference in post-intervention (18 days) FVC between RMT and sham RMT (MD 0.16 L, 95% CI -0.31 to 0.63; 1 trial, N = 20; low-certainty evidence). One RCT and three cross-over trials compared a form of RMT with no training in males with DMD; the cross-over trials did not provide suitable data. Post-intervention (6-month) values showed no clear difference between the RMT and no training groups in per cent predicted vital capacity (VC%) (MD 3.50, 95% CI -14.35 to 21.35; 1 trial, N = 30; low-certainty evidence).Becker or limb-girdle muscular dystrophyOne RCT (N = 21) compared 12 weeks of IMT with breathing exercises in people with Becker or limb-girdle muscular dystrophy. The evidence was of very low certainty and conclusions could not be drawn.Myasthenia gravisIn myasthenia gravis, there may be no clear difference between RMT and breathing exercises on measures of lung capacity, in the short term (TLC MD -0.20 L, 95% CI -1.07 to 0.67; 1 trial, N = 27; low-certainty evidence). Effects of RMT on quality of life are uncertain (1 trial; N = 27).Some trials reported effects of RMT on inspiratory and/or expiratory muscle strength; this evidence was also of low or very low certainty. AUTHORS' CONCLUSIONS: RMT may improve lung capacity and respiratory muscle strength in some NMDs. In ALS there may not be any clinically meaningful effect of RMT on physical functioning or quality of life and it is uncertain whether it causes adverse effects. Due to clinical heterogeneity between the trials and the small number of participants included in the analysis, together with the risk of bias, these results must be interpreted very cautiously.


Assuntos
Exercícios Respiratórios/métodos , Doenças Neuromusculares/reabilitação , Adulto , Criança , Expiração/fisiologia , Humanos , Debilidade Muscular , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Capacidade Vital
4.
Arq Bras Cir Dig ; 32(2): e1439, 2019 Aug 26.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31460599

RESUMO

BACKGROUND: Abdominal disorders can alter respiratory function and increase the morbidity and mortality of patients with chronic obstructive pulmonary disease. AIM: To improve the physiotherapeutic and muscular capacity in chronic obstructive pulmonary muscular inspiration in the preoperative preparation in abdominal surgeries. METHOD: Retrospective and documentary study using SINPE © , clinical database software of patients with chronic obstructive pulmonary disease and candidates to abdominal operation. The sample consisted of 100 men aged 55-70 years, all with chronic obstructive pulmonary disease who underwent preoperative physiotherapeutic treatment. They were divided into two groups of 50 individuals (group A and group B). In group A the patients were treated with modern mobility techniques for bronchial clearance and the strengthening of the respiratory muscles was performed with IMT ® Threshold. In group B the treatment performed for bronchial obstruction was with classic maneuvers and for the strengthening of the respiratory muscles for flow incentive was used Respiron ® . RESULTS: Both groups obtained improvement in the values ​​of the PiMáx after the different treatments. Group A obtained greater change in the intervals and a more significant increase of the values of the PiMax in relation to the average pre and post-treatment. However, when analyzing the variance and the standard deviation of the samples, group B presented the best results showing more homogeneity. CONCLUSIONS: The modern and traditional bronchial clearance techniques associated with inspiratory muscle training were equally effective in gaining inspiratory muscle strength with increased Pmax. In this way, the two can be used in the preoperative preparation of patients with chronic obstructive pulmonary disease and referred to abdominal operations.


Assuntos
Exercícios Respiratórios/métodos , Procedimentos Cirúrgicos do Sistema Digestório , Cuidados Pré-Operatórios/métodos , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Músculos Respiratórios/fisiopatologia , Idoso , Humanos , Masculino , Pessoa de Meia-Idade , Doença Pulmonar Obstrutiva Crônica/reabilitação , Testes de Função Respiratória , Estudos Retrospectivos , Software , Espirometria
5.
Int. j. cardiovasc. sci. (Impr.) ; 32(4): 331-342, July-Aug. 2019. tab, graf, ilus
Artigo em Inglês | LILACS | ID: biblio-1012349

RESUMO

Cardiorespiratory (aerobic) fitness is strongly and directly related to major health outcomes, including all-cause mortality. Maximum oxygen uptake (VO2max), directly measured by maximal cardiopulmonary exercise test (CPET), represents the subject's aerobic fitness. However, as CPET is not always available, aerobic fitness estimation tools are necessary. Objectives: a) to propose the CLINIMEX Aerobic Fitness Questionnaire (C-AFQ); b) to validate C-AFQ against measured VO2max; and c) to analyze the influence of some potentially relevant variables on the error of estimate. Methods: We prospectively studied 1,000 healthy and unhealthy subjects (68.6% men) aged from 14 to 96 years that underwent a CPET. The two-step C-AFQ describes physical activities with corresponding values in metabolic equivalents (METs) - ranging from 0.9 to 21 METs. Results: Application of C-AFQ took less than two minutes. Linear regression analysis indicated a very strong association between estimated (C-AFQ) and measured (CPET) maximal METs - r2 = 0.83 (Sy.x = 1.63; p < .001) - with median difference of only 0.2 METs between both values and interquartile range (percentiles 25 and 75) of 2 METs. The difference between estimated and measured METs was not influenced by age, sex, body mass index, clinical condition, ß-blocker use or sitting-rising test scores. Conclusion: C-AFQ is a simple and valid tool for estimating aerobic fitness when CPET is unavailable and it is also useful in planning individual ramp protocols. However, individual error of estimate is quite high, so C-AFQ should not be considered a perfect substitute for CPET's measured VO2max


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Exercícios Respiratórios , Exercício , Estudos de Validação como Assunto , Aptidão Física , Análise Estatística , Estudos Prospectivos , Inquéritos e Questionários , Análise de Variância , Teste de Esforço/métodos , Terapia por Exercício , Hipertensão
6.
Univ. salud ; 21(2): 119-126, mayo-ago. 2019. tab, graf
Artigo em Espanhol | LILACS, COLNAL | ID: biblio-1004849

RESUMO

Resumen Introducción: Los cambios fisiológicos asociados al envejecimiento generan una serie de modificaciones funcionales, destacando una disminución en la capacidad respiratoria. En este sentido, una estrategia alternativa para mejorar tal condición podría ser el entrenamiento de la musculatura inspiratoria (EMI). Objetivo: Analizar el efecto del EMI con válvula umbral, sobre la capacidad funcional en mujeres físicamente activas mayores de 60 años. Materiales y métodos: Se realizó un EMI con válvula umbral durante 4 semanas, sobre un grupo experimental (GE; n:10), contrastado con un grupo control (GC; n:5). Se valoraron las siguientes variables hemodinámicas y antropométricas: peso, talla, índice de masa corporal (IMC), lactato, doble producto y capacidad funcional, analizando los cambios pre y post entrenamiento. Resultados: en el grupo GE disminuye post intervención la concentración de lactato y la escala de percepción del esfuerzo; 3,16±0,51 a 2,5±0,39 y 5,56 ± 1,81 a 4±2, respectivamente. En el mismo grupo se incrementan los valores de presión inspiratoria máxima (Pimáx) post intervención; 42,11±14,57 a 60,44±14,47. El GC no presentó cambios en sus valores. Conclusión: No se evidencian cambios favorables en los metros recorridos post intervención, sin embargo, el EMI mostró una disminución sobre la concentración de lactato post ejercicio, lo que podría identificar un retraso en la aparición de la fatiga.


Abstract Introduction: Physiological changes associated with aging generate a series of functional modifications, mainly a decrease in respiratory capacity. In this regard, an alternative strategy to improve such a condition could be inspiratory muscle training (IMT). Objective: To analyze the effect of IMT with threshold valve on the functional capacity of physically active women who are older than 60 years of age. Materials and methods: IMT with threshold valve was carried out over a period of 4 weeks, comparing data from the experimental group (GE; n:10) to the control group (GC; n:5). The following hemodynamic and anthropometric variables were assessed: weight, height, body mass index (BMI), lactate, double product (DP) and functional capacity. Pre and post training changes were evaluated. Results: The GE group showed a decrease in both post-intervention lactate concentration (from 3.16±0.51 to 2.5±0.39) and effort perception scale (from 5.56 ± 1.81 to 4±2). On the other hand, this group experienced a post-intervention increase in maximal inspiratory pressure (MIP) from 42.11±14.57 to 60.44±14.47. The GC group did not present changes in its values. Conclusion: Although no evidence was found regarding favorable changes in the walked distance post-intervention, IMT induced a reduction in post-exercise lactate concentration, which could indicate a delay of onset of fatigue.


Assuntos
Idoso , Idoso de 80 Anos ou mais , Idoso , Pressões Respiratórias Máximas , Testes de Função Respiratória , Exercícios Respiratórios , Ácido Láctico
7.
Med Sci Monit ; 25: 5159-5169, 2019 Jul 12.
Artigo em Inglês | MEDLINE | ID: mdl-31296834

RESUMO

BACKGROUND Respiratory therapy is an integral part of treatment of cardiac patients. The aim of this study was to evaluate the effect of addition of inspiratory muscle training (IMT) to second-stage cardiac rehabilitation on exercise tolerance and function of lower extremities in patients following myocardial infarction (MI). MATERIAL AND METHODS This study included 90 patients (mean age 65 years) with MI who took part in the second stage of an 8-week cycle of cardiac rehabilitation (CR). They were divided into 3 groups: group I underwent CR and IMT, group II only underwent CR, and group III only underwent IMT. Groups I and II were allocated randomly according sealed opaque envelopes. The third group consisted of patients who could not participate in standard rehabilitation for various reasons. Before and after the 8-week program, participants were assessed for maximal inspiratory and expiratory pressure (PImax and PEmax) values, exercise tolerance, and knee muscle strength. RESULTS In groups I and II, a significant increase in the PImax parameters and exercise tolerance parameters (MET) were observed. Group I had increased PEmax parameters. In group III, the same changes in the parameter values that reflect respiratory muscle function were observed. All of the examined strength parameters of the knee joint muscles demonstrated improvement in all of the investigated groups, but the biggest differences were observed in group I. CONCLUSIONS Use of IMT in the ambulatory rehabilitation program of MI patients resulted in improved rehabilitation efficacy, leading to a significant improvement in physical condition.


Assuntos
Terapia por Exercício/métodos , Tolerância ao Exercício/fisiologia , Infarto do Miocárdio/terapia , Idoso , Idoso de 80 Anos ou mais , Exercícios Respiratórios/métodos , Exercício/fisiologia , Teste de Esforço , Feminino , Humanos , Extremidade Inferior/fisiopatologia , Masculino , Pessoa de Meia-Idade , Força Muscular/fisiologia , Modalidades de Fisioterapia , Músculos Respiratórios/fisiopatologia , Terapia Respiratória/métodos
8.
BMC Pulm Med ; 19(1): 134, 2019 Jul 24.
Artigo em Inglês | MEDLINE | ID: mdl-31340793

RESUMO

BACKGROUND: To investigate the effect of asthma rehabilitation at high altitude (3100 m, HA) compared to low altitude (760 m, LA). METHODS: For this randomized parallel-group trial insufficiently controlled asthmatics (Asthma Control Questionnaire (ACQ) > 0.75) were randomly assigned to 3-week in-hospital rehabilitation comprising education, physical-&breathing-exercises at LA or HA. Co-primary outcomes assessed at 760 m were between group changes in peak expiratory flow (PEF)-variability, and ACQ) from baseline to end-rehabilitation and 3 months thereafter. RESULTS: 50 asthmatics were randomized [median (quartiles) LA: ACQ 2.7(1.7;3.2), PEF-variability 19%(14;33); HA: ACQ 2.0(1.6;3.0), PEF-variability 17%(12;32)]. The LA-group improved PEF-variability by median(95%CI) -7%(- 14 to 0, p = 0.033), ACQ - 1.4(- 2.2 to - 0.9, p < 0.001), and after 3 months by - 3%(- 18 to 2, p = 0.103) and - 0.9(- 1.3 to - 0.3, p = 0.002). The HA-group improved PEF-variability by - 10%(- 21 to - 3, p = 0.004), ACQ - 1.1(- 1.3 to - 0.7, p < 0.001), and after 3 months by - 9%(- 10 to - 3, p = 0.003) and - 0.2(- 0.9 to 0.4, p = 0.177). The additive effect of HA vs. LA directly after the rehabilitation on PEF-variability was - 6%(- 14 to 2), on ACQ 0.3(- 0.4 to 1.1) and after 3 months - 5%(- 14 to 5) respectively 0.4(- 0.4 to 1.1), all p = NS. CONCLUSION: Asthma rehabilitation is highly effective in improving asthma control in terms of PEF-variability and symptoms, both at LA and HA similarly. TRIAL REGISTRATION: Clinicaltrials.gov: NCT02741583, Registered April 18, 2016.


Assuntos
Altitude , Asma/reabilitação , Adulto , Exercícios Respiratórios , Treino Aeróbico , Feminino , Volume Expiratório Forçado , Humanos , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Educação de Pacientes como Assunto , Pico do Fluxo Expiratório , Treinamento de Resistência , Índice de Gravidade de Doença , Inquéritos e Questionários , Suíça
9.
Neuromodulation ; 22(6): 751-757, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31347247

RESUMO

AIMS: To investigate the effects and possible mechanisms of transcutaneous electrical acustimulation (TEA) combined with deep breathing training (DBT) on refractory gastroesophageal reflux disease (rGERD). METHODS: Twenty-one patients with rGERD were recruited and randomly assigned to receive either only esomeprazole (ESO, 20 mg bid) (group A, n = 7), TEA + DBT + ESO (group B, n = 7), or sham-TEA + DBT + ESO (group C, n = 7) in a four-week study. The reflux diagnostic questionnaire (RDQ) score and heart rate variability (HRV) were recorded and evaluated at baseline and at the end of each treatment. Blood samples were collected for the measurement of serum acetylcholine (Ach) and nitric oxide (NO). Esophageal manometry and 24-hour pH monitoring were performed before and after the treatment. RESULTS: After treatment, 1) the participants in group B had significantly lower scores of RDQ and DeMeester and increased lower esophageal sphincter pressure (LESP) than those in group C (all p < 0.05), suggesting the role of TEA; 2) low frequency band (LF)/(LF + HF) ratio in groups B and C was decreased, compared with group A (p = 0.010, p = 0.042, respectively); high frequency band (HF)/(LF + HF) ratio in B and C groups was significantly increased, compared with group A (p = 0.010, p = 0.042, respectively); 3) The serum Ach in groups B and C was significantly higher than group A (p = 0.022, p = 0.046, respectively); the serum NO in groups B and C was significantly lower than group A (p = 0.010, p = 0.027, respectively). CONCLUSIONS: TEA combined with the DBT can effectively improve the reflux symptoms in rGERD patients by increasing LESP and reducing gastroesophageal reflux, which may be mediated via the autonomic and enteric mechanisms.


Assuntos
Vias Autônomas/fisiologia , Exercícios Respiratórios/métodos , Refluxo Gastroesofágico/fisiopatologia , Refluxo Gastroesofágico/terapia , Estimulação Elétrica Nervosa Transcutânea/métodos , Terapia Combinada/métodos , Esfíncter Esofágico Inferior/inervação , Esfíncter Esofágico Inferior/fisiologia , Feminino , Refluxo Gastroesofágico/diagnóstico , Humanos , Masculino , Manometria/métodos , Estudos Prospectivos , Método Simples-Cego , Resultado do Tratamento
10.
J Sports Sci ; 37(22): 2513-2521, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31357915

RESUMO

Exercise-induced arterial hypoxemia (EIAH) has been consistently reported in elite endurance athletes. This study examined the effects of an inspiratory muscle training protocol (IMT) on resting pulmonary function, end-exercise arterial oxygen saturation and performance in hypoxemic rowers. Twenty male and sixteen female well-trained hypoxemic rowers were divided into four groups: IMT-male, control-male, IMT-female and control-female. The IMT groups, additionally to the regular training, performed IMT (30 min/day, 5 times/week, 6 weeks). Before and after training, groups underwent an incremental rowing test, a 2000-m time trial and a 5-min "all-out" race. IMT increased respiratory strength in the IMT-male (135 ± 31 vs. 180 ± 22 cmH2O) and IMT-female (93 ± 19 vs. 142 ± 22 cmH2O) (P < 0.05). The IMT-female group exhibited lower EIAH and improved rowing performance in the 2000-m time trial (487 ± 32 vs. 461 ± 34 sec) and in the 5-min "all-out" test (1,285 ± 28 vs. 1,310 ± 36m) (P < 0.05). IMT protocol improved performance in IMT-male only in the 5-min test (1,651 ± 31 vs. 1,746 ± 37m) (P < 0.05). IMT may be a useful tool for increasing respiratory strength and enhancing performance in hypoxemic rowers, especially for women. Abbreviations: EIAH: Exercise-induced arterial hypoxemia; IMT: inspiratory muscle training protocol; PaO2: partial pressure of arterial oxygen; SaO2: arterial oxyhemoglobin saturation; VO2max: maximal oxygen consumption; [(A-a)DO2]: alveolar-to-arterial oxygen difference; VA/Q: ventilation-perfusion inequality/mismatching; PImax: maximal inspiratory pressure; BMI: body mass index; BSA: body surface area; FVC: vital capacity; FEV1: forced expiratory volume in 1 sec; VCin: vital capacity; MVV12: maximal voluntary ventilation in 12 sec.


Assuntos
Exercícios Respiratórios/métodos , Capacidade Inspiratória/fisiologia , Força Muscular/fisiologia , Oxigênio/sangue , Resistência Física/fisiologia , Músculos Respiratórios/fisiologia , Esportes Aquáticos/fisiologia , Adolescente , Estatura , Índice de Massa Corporal , Teste de Esforço , Feminino , Humanos , Hipóxia/fisiopatologia , Masculino , Consumo de Oxigênio/fisiologia , Fatores Sexuais , Adulto Jovem
11.
J Clin Nurs ; 28(19-20): 3632-3640, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31192478

RESUMO

AIMS AND OBJECTIVES: To examine the effects of the two-month breathing-based walking intervention and its follow-up on anxiety, depression, dyspnoea and quality of life in patients with chronic obstructive pulmonary disease. BACKGROUND: Mind-body-related exercises improve bio-psychological symptoms and quality of life in chronic diseases, but these improvements are not proven for chronic obstructive pulmonary disease. DESIGN: This was a randomised controlled study and applied the Consolidated Standards of Reporting Trials (CONSORT) statement. METHODS: Outpatients diagnosed with chronic obstructive pulmonary disease were recruited from a medical centre in Taiwan and randomly assigned to two groups. The walking group (n = 42) received breathing, meditation and walking for two months, and the control group (n = 42) did not. Data from the outcomes of anxiety, depression, dyspnoea and quality of life were collected at baseline and in Month 1, Month 2 and Month 3. Clinical trial registration was done (ClinicalTrials.gov.: NCT03388489). FINDINGS: The results showed significant changes in anxiety, depression, dyspnoea and quality of life in the walking group across three months, compared to those in the control group and at baseline. CONCLUSION: This breathing-based walking intervention is promising to achieve bio-psychological well-being for patients with chronic obstructive pulmonary disease. RELEVANCE TO CLINICAL PRACTICE: This breathing-based walking, as a mind-body exercise, could serve as an evidence-based nursing care that contributes to improving anxiety, depression, dyspnoea and quality of life in stable chronic obstructive pulmonary disease outpatients. The feasibility and acceptability of the breathing-based walking were met the requirement of the chronic obstructive pulmonary disease outpatients, which could be considered as home-based exercise.


Assuntos
Exercícios Respiratórios/métodos , Terapias Mente-Corpo/enfermagem , Doença Pulmonar Obstrutiva Crônica/psicologia , Qualidade de Vida , Caminhada/psicologia , Idoso , Ansiedade/complicações , Ansiedade/terapia , Depressão/complicações , Depressão/terapia , Dispneia/complicações , Dispneia/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doença Pulmonar Obstrutiva Crônica/complicações , Taiwan
12.
Compr Child Adolesc Nurs ; 42(sup1): 1-8, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31192742

RESUMO

Respiratory disease in children can contribute to damaged alveoli, frailty of respiratory muscles, reduced lung function, impaired gas exchange, and gas retention in the airway. Such condition may lead to disruption of oxygen status. This study aimed to examine the effects of modified pursed lips breathing (PLB) by blowing into a water-filled bottle through a straw and a party whistle on the oxygenation status in children with oxygenation problems. This study used a quasi-experiment method with a pretest-posttest without a control group design approach. The sample consisted of 32 school-aged children and adolescents who were divided into two intervention groups. Group 1 underwent modified PLB by blowing into a water-filled bottle through a straw and Group 2 was provided with modified PLB by blowing a party whistle. The intervention was conducted one time in a day, in a rest time, for 10 min. The results showed that modified PLB by blowing into a water-filled bottle through a straw was more effective in reducing respiratory rate (RR) and improving oxygen saturation (SpO2) than modified PLB by blowing a party whistle. Modified PLB intervention by blowing into a water-filled bottle through a straw improved the oxygenation status of children affected by oxygenation problems. This intervention can be implemented as an independent nursing intervention to improve children's oxygenation status.


Assuntos
Exercícios Respiratórios/normas , Lábio/fisiologia , Oximetria/estatística & dados numéricos , Respiração , Adolescente , Exercícios Respiratórios/métodos , Criança , Avaliação Educacional/métodos , Feminino , Humanos , Masculino , Monitorização Fisiológica/métodos , Oximetria/métodos , Pediatria/métodos
13.
Holist Nurs Pract ; 33(4): 197-203, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31192831

RESUMO

This study tests the hypothesis that yoga breathing (pranayama) improves lung function in healthy volunteers during a 6-week protocol. A randomized controlled pilot study demonstrated an improvement in peak expiratory flow rate and forced expiratory volume. The easy-to-learn approach can be translated to the inpatient and outpatient settings.


Assuntos
Exercícios Respiratórios/normas , Respiração , Testes de Função Respiratória/estatística & dados numéricos , Ioga , Adulto , Exercícios Respiratórios/métodos , Feminino , Voluntários Saudáveis/estatística & dados numéricos , Humanos , Pulmão/fisiologia , Masculino , Projetos Piloto , Testes de Função Respiratória/métodos , South Dakota
14.
Cancer Invest ; 37(4-5): 227-232, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31198066

RESUMO

Purpose: This randomized controlled trial (RCT: NCT02633748) examined effectiveness of an abbreviated mindfulness program on psychosocial symptoms, behaviors, and inflammation. Methods: Cancer survivors (n = 36) underwent a 4-week mindfulness intervention compared to a breathing control. Data included psychosocial questionnaires, anthropometrics, actigraphy, and blood draws. Clinic visits occurred at baseline, post-intervention, and a 3-month post-follow-up. Results: Compared to baseline, the intervention arm displayed reductions in sedentary time and perceived stress and improvements in subjective sleep quality, and daily steps at post-follow-up. Conclusions: An abbreviated mindfulness intervention in feasible in cancer survivors and signs of efficacy warrant further mindfulness studies among this population.


Assuntos
Exercícios Respiratórios/métodos , Sobreviventes de Câncer/psicologia , Atenção Plena/métodos , Neoplasias/reabilitação , Qualidade de Vida , Idoso , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/psicologia , Resultado do Tratamento
15.
J Altern Complement Med ; 25(8): 824-826, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31180234

RESUMO

The purpose of this study is to investigate the effects of alternate nostril breathing (ANB) and foot reflexology (FR) on lower intraocular pressure (IOP) in patients with ocular hypertension (OHTN). This prospective pilot study recruited 11 patients from 2014 to 2016 from Temple opthamology outpatient clinic. Patients had OHTN with ages of 48-78 years. Patients were excluded if they currently performed ANB or FR, were unable to perform the task, had previous eye surgery or laser, were receiving other complementary and alternative medicine for OHTN, or were unable to complete drug washout period. After a 30-day drug washout, patients were randomly assigned to complete either ANB or FR for 5 min. After instruction, patients completed either ANB or FR, and completed the alternate task 2 weeks later. IOP was measured before the task, immediately after the task, and then every 30 min for 2 h. Decrease in IOP compared with baseline IOP was significant for ANB and FR at all time points. Baseline IOP was 25.86 ± 3.19 mmHg for ANB and 25.41 ± 3.54 mmHg for FR (N = 22 eyes). There was only one significant difference between IOP for the right and left eyes for FR at 120 min. Otherwise, there was no difference between eyes for both ANB and FR. There was a significant decrease in IOP at 30 min post task with IOP decrease of 1.98 ± 1.70 mmHg for ANB and 3.59 ± 1.89 mmHg for FR (both p < 0.0001) and at 60 min post task with IOP decrease of 2.39 ± 2.05 mmHg for ANB and 3.86 ± 1.89 mmHg for FR (both p < 0.0001). The decrease in IOP at 90 and 120 min post task was less but remained significant (p < 0.0001). Both FR and ANB had a small but significant IOP lowering effect. These alternative therapies could serve as possible adjunctive treatments for lowering IOP.


Assuntos
Exercícios Respiratórios/métodos , Pressão Intraocular/fisiologia , Manipulações Musculoesqueléticas/métodos , Hipertensão Ocular/terapia , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Estudos Prospectivos
16.
Clin Rehabil ; 33(11): 1757-1766, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31244327

RESUMO

OBJECTIVE: To compare the effects of an integrated programme of physical and electrical therapy to standard rehabilitation to improve physical and functional performance in elderly patients with pneumonia. DESIGN: Randomized clinical trial. The study was registered in the ClinicalTrial.gov website (identifier: NCT02515565). SETTING: University Hospital. SUBJECTS: In total, 185 elderly patients with pneumonia were eligible for the study, of which 95 were finally randomized. INTERVENTIONS: Patients were randomized to a control group which received the standard treatment or to an intervention group which received additionally an integrated programme of physical and electrical therapy. MAIN MEASURES: Demographic and clinical information was acquired. Pulmonary function, length of hospital stay, handgrip strength, independence levels and comorbidities were assessed as descriptive outcomes. The main outcome measure was functional and physical performance, evaluated with the short physical performance battery. Secondary outcome measures were respiratory symptoms including dyspnoea, fatigue and cough. RESULTS: Mean age of patients was 74.92 (11.03) years in the intervention group and 72.53 (9.24) years in the control group. Significant between groups differences (P < 0.05) were found in short physical performance battery chair stand test (2.17 (0.97) vs. 0.58 (0.61)) and total score (5.91 (3.61) vs. 4.15 (3.15)). The intervention group showed better performance than the control group in both cases. Fatigue (32.04 (18.58) vs. 46.22 (8.90)) and cough (18.84 (2.47) vs. 17.40 (3.67)) showed higher improvement in the intervention group, and significant differences were observed between the groups. CONCLUSION: An integrated programme of physical and electrical therapy during hospitalization improves physical and functional performance in patients with pneumonia.


Assuntos
Exercícios Respiratórios , Terapia por Estimulação Elétrica , Pneumonia/terapia , Idoso , Tosse/terapia , Teste de Esforço , Fadiga/terapia , Feminino , Hospitalização , Humanos , Masculino , Desempenho Físico Funcional , Modalidades de Fisioterapia
17.
J Rehabil Med ; 51(8): 616-620, 2019 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-31198974

RESUMO

OBJECTIVE: To investigate the effects of normocapnic hyperpnoea training on pulmonary function and patient-reported outcomes in chronic spinal cord injury. DESIGN: Single-centre randomized controlled trial. PATIENTS: Eighteen patients with spinal cord injury > 24 months post-injury and without regular respiratory muscle training prior to the study were included prospectively. METHODS: Patients were randomly assigned to either normocapnic hyperpnoea or control groups. The normocapnic hyperpnoea group patients performed training 15-20 min per day, 5 times a week for 4 weeks. The patients hyperventilated through partial re-breathing of ventilated air. The control group received no respiratory muscle training. Other rehabilitative programmes were performed identically in both groups. Lung function testing was performed in the sitting position prior to and after the study. Patient-reported outcomes were assessed using the Patient Health Questionnaire-9, St George's Respiratory Questionnaire, Chronic Obstructive Pulmonary Disease Assessment Test and Borg scores. RESULTS: Significant differences were found in the improvement ratio between the normocapnic hyperpnoea and control groups for all investigated parameters, except total lung capacity and diffusing capacity of the lung for carbon monoxide. CONCLUSION: Normocapnic hyperpnoea training may reduce the incidence of respiratory symptoms, improve pulmonary function and quality of life, and reduce depression in patients with chronic spinal cord injury, regardless of their neurological level of injury, even at more than 24 months after injury.


Assuntos
Exercícios Respiratórios/métodos , Treino Aeróbico/métodos , Qualidade de Vida/psicologia , Músculos Respiratórios/fisiopatologia , Traumatismos da Medula Espinal/terapia , Adulto , Doença Crônica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto
18.
Trials ; 20(1): 258, 2019 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-31064379

RESUMO

BACKGROUND: Inspiratory muscle training (IMT) has brought great benefits in terms of improving physical performance in healthy individuals. However, there is no consensus regarding the best training load, as in most cases the maximal inspiratory pressure (MIP) is used, mainly the intensity of 60% of MIP. Therefore, prescribing an IMT protocol that takes into account inspiratory muscle strength and endurance may bring additional benefits to the commonly used protocols, since respiratory muscles differ from other muscles because of their greater muscular resistance. Thus, IMT using critical inspiratory pressure (PThC) can be an alternative, as the calculation of PThC considers these characteristics. Therefore, the aim of this study is to propose a new IMT protocol to determine the best training load for recreational cyclists. METHODS: Thirty recreational cyclists (between 20 and 40 years old) will be randomized into three groups: sham (SG), PThC (CPG) and 60% of MIP, according to age and aerobic functional capacity. All participants will undergo the following evaluations: pulmonary function test (PFT), respiratory muscle strength test (RMS), cardiopulmonary exercise test (CPET), incremental inspiratory muscle endurance test (iIME) (maximal sustained respiratory pressure for 1 min (PThMAX)) and constant load test (CLT) (95%, 100% and 105% of PThMÁX) using a linear load inspiratory resistor (PowerBreathe K5). The PThC will be calculated from the inspiratory muscle endurance time (TLIM) and inspiratory loads of each CLT. The IMT will last 11 weeks (3 times/week and 55 min/session). The session will consist of 5-min warm-up (50% of the training load) and three sets of 15-min breaths (100% of the training load), with a 1-min interval between them. RMS, iIME, CLT and CPET will be performed beforehand, at week 5 and 9 (to adjust the training load) and after training. PFT will be performed before and after training. The data will be analyzed using specific statistical tests (parametric or non-parametric) according to the data distribution and their respective variances. A p value <0.05 will be considered statistically significant. DISCUSSIONS: It is expected that the results of this study will enable the training performed with PThC to be used by health professionals as a new tool to evaluate and prescribe IMT. TRIAL REGISTRATION: ClinicalTrials.gov, NCT02984189 . Registered on 6 December 2016.


Assuntos
Ciclismo , Exercícios Respiratórios/métodos , Aptidão Cardiorrespiratória , Inalação , Contração Muscular , Músculos Respiratórios/fisiologia , Adulto , Método Duplo-Cego , Teste de Esforço , Humanos , Masculino , Força Muscular , Consumo de Oxigênio , Resistência Física , Pressão , Ensaios Clínicos Controlados Aleatórios como Assunto , Testes de Função Respiratória , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
19.
Adv Respir Med ; 87(2): 77-82, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31038717

RESUMO

INTRODUCTION: Physical exercise can improve patient outcomes and reduce hospitalization and mortality rates among subjects with chronic obstructive pulmonary disease. This study aimed to compare the effects of upper limb and breathing exercises on six-minute walking distance among these patients. MATERIAL AND METHODS: This three-group randomized controlled clinical trial was conducted in 2017-2018 in Velayat hospital, Qazvin, Iran. Seventy-five patients were purposively selected from the outpatient lung clinic of the hospital and randomly allocated to either the 25-patient groups of upper limb exercise, breathing exercise, or control. The patients in the first group were performing upper limb exercises thrice weekly for one month in the study setting. Their counterparts in the second group were doing pursed-lip and diaphragmatic breathing exercises four times daily for one month at their homes. However, the patients in the control group received no exercise intervention. Six-minute walk test was performed by each participant both before and after the study intervention. The SPSS for Windows program (v. 23.0) was used to analyze the data via the Chi-square test, the paired-sample t test, and the one-way analysis of variance. RESULTS: Before the intervention, the groups did not significantly differ from each other respecting six-minute walking distance. During the study, walking distance in the control group did not change significantly, while it remarkably increased in both the upper limb exercise and the breathing exercise groups (p < 0.05). After the intervention, walking distance in the upper limb exercise group was significantly greater than the breathing exercise group (p < 0.05) and the control group (p < 0.05); however, the difference between the breathing exercise and the control groups was not statistically significant (p > 0.05). CONCLUSION: Upper limb exercise is more effective than breathing exercise in increasing walking distance among patients with chronic obstructive pulmonary disease. Therefore, upper limb exercise can be used as a safe, simple, and inexpensive rehabilitation technique for these patients.


Assuntos
Exercícios Respiratórios/métodos , Terapia por Exercício/métodos , Resistência Física/fisiologia , Doença Pulmonar Obstrutiva Crônica/reabilitação , Caminhada/fisiologia , Adulto , Exercício/fisiologia , Feminino , Humanos , Irã (Geográfico) , Masculino , Pessoa de Meia-Idade , Teste de Caminhada
20.
Wiad Lek ; 72(4): 613-616, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31055542

RESUMO

OBJECTIVE: Introduction: Heart rate variability is a highly informative non-invasive method of research not only for the functional state of the cardiovascular system and also for the integrative regulatory activity of the autonomic nervous system. The positive effect of diaphragmatic breathing is positive in the mode of biological feedback using portable devices, but there is little evidence of the use of yoga breathing gymnastics in order to influence the heart rate variability. The aim: To compare the possibilities of using courses of breathing gymnastics of yogis and diaphragmatic breathing sessions in the mode of biological feedback using a portable device. PATIENTS AND METHODS: Materials and methods: The study involved 70 practically healthy foreigners, who were divided into 2 groups of 35 people. Participants of the 1st group daily engage in respiratory exercises pranayama for 15 minutes in 1 month. Participants in the 2nd group used the MyCalmBeat portable device. Heart rate variability was registered by using the computer diagnostic complex "CardioLab" ("KhAI-Medika", Ukraine). RESULTS: Results: In both groups there was similar dynamics of heart rate variability indices, but its severity was different. The common integral effect was a significant growth of heart rate variability both according to statistical and spectral indicators - total power increased, as well as high-frequency component. The power of the very-low frequency waves has probably decreased only in the group with the device. In the percentage structure of the cardiac rhythm spectrum, the specific weight of very-low frequency component and the percentage of high-frequency component increased. CONCLUSION: Conclusions: Respiratory gymnastics yoga for 15 minutes daily contributes to the growth of heart rate variability through the suppression of the central link (very-low frequency component) of regulation of cardiac rhythm and increased activity of parasympathetic influences (high-frequency component), as well as the redistribution of regulatory activity of the central nervous system between the central and peripheral links of regulation of the cardiac rhythm in favor of the latter.


Assuntos
Exercícios Respiratórios , Frequência Cardíaca , Ioga , Sistema Nervoso Autônomo , Humanos , Ucrânia
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