Does the external nasal dilator strip help in sports activity? A systematic review and meta-analysis.

BACKGROUND: Numerous studies have shown that the external nasal dilator (END) increases the cross sectional area of the nasal valve, thereby reducing nasal resistance, transnasal inspiratory pressure, stabilizing the lateral nasal vestibule, and preventing its collapse during final inhalation. OBJECTIVES: Our objective was to carry out a systematic review of the literature and meta-analysis on the effects of the END during physical exercise. METHODS: After selecting articles in the PubMed, Cochrane Library and EMBASE databases, 624 studies were identified. However, after applying the inclusion and exclusion criteria, 19 articles were considered eligible for review. RESULTS: Those studies included in the meta-analysis, the maximal oxygen uptake (VO2max.) outcome was assessed in 168 participants in which no statistically significant difference was found, MD (95% CI) = 0.86 [- 0.43, 2.15], p = 0.19, and I2 = 0%. The heart rate (HR) outcome was assessed in 138 participants in which no statistically significant difference was found, MD (95% CI) = 0.02 [- 3.19, 3.22], p = 0.99, and I2 = 0%. The rating of perceived exertion (RPE) outcome was assessed in 92 participants in which no statistically significant difference was found, MD (95% CI) = - 0.12 [- 0.52, 0.28], p = 0.56, and I2 = 27%. CONCLUSIONS: The external nasal dilator strip showed no improvement in VO2max., HR and RPE outcomes in healthy individuals during exercise.

Peak nasal inspiratory flow in children and adolescents with sickle cell disease: a case-control study.

OBJECTIVE: Sickle cell disease is the most frequent of the hereditary hemoglobinopathies and it presents multisystemic effects. A manifestation that is commonly found in sickle cell disease is upper airway obstruction, particularly adenotonsillar hypertrophy. This study aims to evaluate the peak nasal inspiratory flow measurements of children and adolescents with sickle cell disease. METHODS: This is a case-control study on children aged between 8 and 15 years who were diagnosed with sickle cell disease. Peak nasal inspiratory flow measurements were obtained from patients. RESULTS: A total of 279 patients were enrolled in this study, with 93 in the case group and 186 in the control group. The case group had an 82.83% chance of having lower peak nasal inspiratory flow values than the control group. In the case group, 75% of the peak nasal inspiratory flow values were in the lower standards, whereas in the control group, only 25% were in the lower standards. CONCLUSION: This study showed a high prevalence of reduced peak nasal inspiratory flow values in children with sickle cell disease and could certainly be incorporated into the day-to-day clinical evaluation of patients as a screening instrument.

Nasal function and cardio-respiratory capacity of adolescent with external nasal dilator.

BACKGROUND: the external nasal dilator (END) has been employed for the purpose of aiding sporting performance. The objective of this study was to evaluate nasal function and cardio-respiratory capacity in healthy adolescent athletes using the END. METHODS: double-blind, crossover clinical trial in which adolescents were evaluated while using the experimental and placebo END during physical exercise. Values for peak nasal inspiratory flow (PNIF), nasal resistance (NR) and maximal oxygen uptake (VO2max) were obtained in randomized order. Additionally, the rating of perceived exertion (RPE) after the cardio-respiratory test was assessed. RESULTS: for the 71 adolescents evaluated, the use of the experimental END, compared to the placebo, produced a significant improvement in values of PNIF (177.4 ± 20.9 L/min and 172.8 ± 20.2 L/min) (p = 0.020), NR (0.24 ± 0.16 and 0.27 ± 0.16) (p = 0.007), VO2max. (39.5 ± 5.2 mL/kg. min-1 and 37.5 ± 5.2 mL/kg. min-1) (p < 0.001) and RPE (6.0 ± 2.2 and 5.5 ± 2.4) (p < 0.001), respectively. CONCLUSION: the END reduced NR, increased PNIF and improved VO2max. In addition, it improved RPE after the maximal cardio-respiratory test. The use of the END can significantly improve nasal function, increase cardio-respiratory capacity and reduce rating of perceived exertion during a maximal test involving adolescent athletes.

Peak nasal inspiratory flow in children and adolescents with sickle cell disease: a case-control study

SUMMARY OBJECTIVE: Sickle cell disease is the most frequent of the hereditary hemoglobinopathies and it presents multisystemic effects. A manifestation that is commonly found in sickle cell disease is upper airway obstruction, particularly adenotonsillar hypertrophy. This study aims to evaluate the peak nasal inspiratory flow measurements of children and adolescents with sickle cell disease. METHODS: This is a case-control study on children aged between 8 and 15 years who were diagnosed with sickle cell disease. Peak nasal inspiratory flow measurements were obtained from patients. RESULTS: A total of 279 patients were enrolled in this study, with 93 in the case group and 186 in the control group. The case group had an 82.83% chance of having lower peak nasal inspiratory flow values than the control group. In the case group, 75% of the peak nasal inspiratory flow values were in the lower standards, whereas in the control group, only 25% were in the lower standards. CONCLUSION: This study showed a high prevalence of reduced peak nasal inspiratory flow values in children with sickle cell disease and could certainly be incorporated into the day-to-day clinical evaluation of patients as a screening instrument.

Effect of the external nasal dilator on adolescent athleteswith and without allergic rhinitis.

OBJECTIVES: The ability to effectively breathe through the nose is an important component of physical exercise. The goal of this study is to evaluate the effect of the external nasal dilator (END) on healthy adolescent athletes and those with allergic rhinitis. METHODS: Clinical trial, double-blind, crossover, in which we evaluated healthy adolescent athletes with allergic rhinitis, using experimental and placebo ENDs, submitted to a maximum cardio-respiratory test in randomized order. Predicted values for peak nasal inspiratory flow (PNIF%) and nasal resistance (NR) were obtained, and the rating of perceived exertion (RPE) was also assessed after the race test. RESULTS: 65 adolescents participated in the study, 30 of whom had allergic rhinitis. The use of experimental ENDs demonstrated a statistically significant improvement in peak nasal inspiratory flow values (predicted %), nasal resistance, maximal oxygen uptake value (VO2Max.) and rating of perceived exertion, both in the healthy group and the one with allergic rhinitis. CONCLUSION: Results suggested that END reduces nasal resistance, improves maximal oxygen uptake and rating of perceived exertion after a maximum cardio-respiratory test on healthy adolescents and those with allergic rhinitis.

Efeito do treinamento de força com diferentes velocidades de movimento sobre a capacidade funcional e qualidade de vida em idosos: uma revisão sistemática / Effect of resistance training with different movement speeds on functional capacity and quality of life in elderly: a systematic review

Uma das alternativas para manter o idoso ativo a fim de melhorar as capacidades funcionais e a qualidade de vida (QV) é o treinamento de força (TF). Porém, existem variáveis que devem ser consideradas na prescrição do TF como a velocidade de movimento. O objetivo do presente estudo foi realizar uma revisão sistemática para verificar o impacto de programas de TF realizados com diferentes velocidades de movimento na capacidade funcional e qualidade de vida em idosos saudáveis. Após seleção de artigos nas bases de dados Pubmed, Scopus e Web of Science foram encontrados 282 artigos, contudo, após a aplicação dos critérios de inclusão e exclusão foram considerados elegíveis 13 artigos para a revisão. Desses, 10 evidenciaram melhora na funcionalidade do grupo treinamento de força em alta velocidade (TFAV) ou resultado similar comparado ao treinamento tradicional (TT), dois encontraram resultados inalterados para ambos os grupos e um indicou que o grupo TT teve melhoras nos testes funcionais comparado ao TFAV. Quanto à QV, somente dois artigos avaliaram esta variável e foi observado resultado positivo utilizando o TFAV. Assim, foi observado que grande parte dos estudos sugere a realização do TFAV em detrimento do TT visando melhora ou manutenção da funcionalidade e QV. (AU)

One of the alternatives to keep the elderly active in order to improve functional capacities and quality of life (QL) is resistance training (RT). However, there are variables that should be considered in the prescription of RT as the speed of movement. The aim of the present study was to carry out a systematic review to verify the impact of RT programs carried out with different movement speeds on functional capacity and quality of life in healthy elderly people. After selecting articles in the Pubmed, Scopus and Web of Science databases, 282 articles were found, however, after applying the inclusion and exclusion criteria, 13 articles were considered eligible for review. Of these, 10 showed improvement in the functionality of the high-speed resistance training group (HSRT) or similar result compared to traditional training (TT), two found results unchanged for both groups and one indicated that the TT group had improvements in functional tests compared to HSRT. As for QL, only two articles evaluated this variable and a positive result was observed using HSRT. Thus, it was observed that most studies suggest the performance of HSRT at the expense of TT in order to improve or maintain functionality and QL. (AU)

Does the Airmax® internal nasal dilator increase peak nasal inspiratory flow (PNIF) in adolescent athletes?

OBJECTIVES: Nasal dilators are being developed for the purpose of increasing air flow in the nasal valve. The aim of this study is to evaluate the use of the internal nasal dilator (IND) by adolescent athletes. METHODS: A double-blind, crossover clinical trial in which we evaluated 54 adolescents using experimental and placebo INDs, submitted to a cardio-respiratory test in randomized order. The predicted values for the peak nasal inspiratory flow (PNIF) were obtained and the intensity of dyspnea was evaluated using the visual analog scale method after the race. RESULTS: In relation to PNIF (% predicted), when participants used the experimental IND, significantly higher means were found in comparison with the placebo (104.27±24.67L/min and 97.73±25.61L/min, respectively) (p=0.010). There were no significant differences observed in terms of heart rate (HR), pulse oximetry (SpO2) and maximal oxygen uptake (VO2max), before and after the cardio-respiratory test. There was also no significant difference (p>0.05) between the use of experimental and placebo INDs on dyspnea scale measurements after completion of the cardio-respiratory test. CONCLUSION: Results suggested that the Airmax® IND improves nasal patency, as measured by PNIF, in healthy adolescent athletes. There was no statistically significant difference in the values for heart rate and SpO2. There was also no difference between the conditions tested for the mean VO2max. Further studies should be conducted to evaluate the effect of IND in adolescent athletes with chronic diseases, such as asthma and allergic rhinitis, and also using other cardio-respiratory assessment methods.

A realização do sistema supersérie com diferentes segmentos corporais não impacta no volume e percepção subjetiva de esforço / The superset system performed using different limbs does not impact on volume and rating of perceived exertion / El sistema supersérie realizado con diferentes segmentos corporais no impacta en el volumen y percepción subjetiva del esfuerzo

O objetivo do estudo foi comparar os sistemas tradicional (TRAD) e supersérie (SS) quanto ao número de repetições (volume) e percepção subjetiva de esforço (PSE) nos exercícios supino e extensão de joelhos. Doze homens treinados realizaram de forma randomizada (medidas repetidas) os protocolos em sistemas TRAD e SS (4 séries com pausas de 2 minutos, intensidade de 10 repetições máximas). No sistema SS, cada série do exercício banco extensor foi realizada durante a pausa do exercício supino. Não houve diferença significativa no volume (TRAD supino - série 1: 16,1 ± 1,6; série 2: 10,9 ± 2,1; série 3: 7,8 ± 2,3; série 4: 7,0 ± 2,0; TRAD extensão de joelhos ­ série 1: 13,1 ± 2,5; série 2: 11,0 ± 2,0; série 3: 9,1 ± 1,7; série 4: 7,6 ± 1,6; SS supino ­ série 1: 16,3 ± 2,3; série 2: 10,9 ± 1,6; série 3: 7,8 ± 1,9; série 4: 6,1 ± 1,4; SS extensão de joelhos ­ série 1: 13,8 ± 1,8; série 2: 11,2 ± 1,6; série 3: 8,8 ± 1,7; série 4: 7,0 ± 1,7) e na PSE (TRAD supino - mediana série 1: 15,0; mediana série 4: 19,5; TRAD extensão de joelhos - mediana série 1: 17,0; mediana série 4: 19,5; SS supino - mediana série 1: 16,5; mediana série 4: 20,0; SS extensão de joelhos - mediana série 1: 17,5; mediana série 4: 19,5) entre os protocolos. Verificou-se redução do volume e aumento da PSE no decorrer das séries em ambas situações experimentais. Considerando a similaridade dos resultados obtidos entre os sistemas SS e TRAD, a aplicação de SS torna-se uma alternativa eficiente para a redução do tempo de treinamento.

The objective of the study was to compare the number of repetitions (volume) and the rating of perceived exertion (RPE) in the bench press and knee extension exercises when performing Traditional (TRAD) and Superset (SS) training systems. Twelve trained men randomly performed (repeated measurements) the TRAD and SS systems (4 sets and 2-minute rest intervals, intensity of 10 max repetitions). In the SS system, each set of the knee extension was performed during the interval of the bench press. There was no significant difference in volume (TRAD bench press ­ set 1: 16,1 ± 1,6; set 2: 10,9 ± 2,1; set 3: 7,8 ± 2,3; set 4: 7,0 ± 2,0; TRAD knee extension ­ set 1: 13,1 ± 2,5; set 2: 11,0 ± 2,0; set 3: 9,1 ± 1,7; set 4: 7,6 ± 1,6; SS bench press ­ set 1: 16,3 ± 2,3; set 2: 10,9 ± 1,6; set 3: 7,8 ± 1,9; set 4: 6,1 ± 1,4; SS knee extension ­ set 1: 13,8 ± 1,8; set 2: 11,2 ± 1,6; set 3: 8,8 ± 1,7; set 4: 7,0 ± 1,7) and PSE (TRAD bench press median set 1: 15,0; median set 2: 19,5; TRAD knee extension ­ median set 1: 17,0; median set 4: 19,5; SS bench press ­ median set 1:16,5; median set 4: 20,0; SS knee extension ­ median set 1: 17,5; median set 4: 19,5) between the protocols. There was a reduction in volume and increase of PSE during the sets in both experimental situations. Considering the similarity of the results obtained between the SS and TRAD systems, SS application becomes an efficient alternative for decreasing training time.

El objetivo del estudio fue comparar los sistemas Tradicional (TRAD) y Supersérie (SS) en cuanto al número de repeticiones (volumen) y percepción subjetiva de esfuerzo (PSE) en los ejercicios press de banca (PB) y extensión de rodillas (ER). Doce hombres entrenados realizaron de forma aleatorizada (mediciones repetidas) los sistemas TRAD y SS (4 series; pausas de 2 minutos, intensidad de 10 repeticiones máximas). En el sistema SS, cada serie de ER se realizó durante la pausa de PB. No hubo diferencia en el volumen (TRAD press de banca - serie 1: 16,1 ± 1,6; serie 2: 10,9 ± 2,1; serie 3: 7,8 ± 2,3; serie 4: 7,0 ± 2,0; TRAD extensión de rodillas ­ serie 1: 13,1 ± 2,5; serie 2: 11,0 ± 2,0; serie 3: 9,1 ± 1,7; serie 4: 7,6 ± 1,6; SS press de banca ­ serie 1: 16,3 ± 2,3; serie 2: 10,9 ± 1,6; serie 3: 7,8 ± 1,9; serie 4: 6,1 ± 1,4; SS extensión de rodillas ­ serie 1: 13,8 ± 1,8; serie 2: 11,2 ± 1,6; serie 3: 8,8 ± 1,7; serie 4: 7,0 ± 1,7) e na PSE (TRAD press de banca - mediana serie 1: 15,0; mediana serie 4: 19,5; TRAD extensión de rodillas - mediana serie 1: 17,0; mediana serie 4: 19,5; SS press de banca - mediana serie 1: 16,5; mediana serie 4: 20,0; SS extensión de rodillas - mediana serie 1: 17,5; mediana serie 4: 19,5) entre los protocolos. Se verificó reducción del volumen y aumento de la PSE en el curso de las series en ambas situaciones. Considerando la similitud de los resultados obtenidos entre los sistemas SS y TRAD, la aplicación de SS se convierte en una alternativa eficiente para la reducción del tiempo de entrenamiento.

External nasal dilators: definition, background, and current uses.

Our goal was to revise the literature about external nasal dilators (ENDs) as to their definition, history, and current uses. We reviewed journals in the PubMed and MEDLINE databases. The current uses hereby presented and discussed are physical exercise, nasal congestion and sleep, snoring, pregnancy, cancer, and healthy individuals. Numerous studies have shown that ENDs increase the cross-sectional area of the nasal valve, reducing nasal resistance and transnasal inspiratory pressure and stabilizing the lateral nasal vestibule, avoiding its collapse during final inspiration. These effects also facilitate breathing and are beneficial to patients with nasal obstruction. Furthermore, END use is simple, noninvasive, painless, affordable, and bears minimum risk to the user. Most studies have limited sample size and are mainly focused on physical exercise. In conclusion, ENDs seem useful, so further studies involving potential effects on the performance of physical tests and improvements in sleep quality are necessary, especially in children and teenagers.

Evaluation of the effectiveness of the external nasal dilator strip in adolescent athletes: a randomized trial.

OBJECTIVES: Evaluate the cardio-respiratory capacity (VO2max.) and peak nasal inspiratory flow (PNIF) of healthy adolescent athletes with experimental and placebo external nasal dilator strips (ENDS). METHODS: 48 healthy adolescent athletes between the ages of 11 and 15 were evaluated and submitted to a cardio-respiratory 1000 m race in randomized order. The participants had peak nasal inspiratory flow (PNIF) values measured using the In-check-inspiratory flow meter. Dyspnea intensity was evaluated after a 1000 m test race using a labeled visual analog scale for dyspnea. RESULTS: In relation to VO2max., when the participants used the experimental ENDS, significantly higher means were noted than when the placebo was used (53.0 ± 4.2 mL/kg min(-1) and 51.2 ± 5.5 mL/kg min(-1), respectively) (p<0.05). In relation to PNIF, there was a statistically significant difference between the experimental and placebo ENDS result, that being, 123 ± 38 L/min and 116 ± 38 L/min, respectively (p<0.05). The dyspnea perceived by the participants was representatively lesser in the experimental ENDS condition compared to the placebo after the cardio-respiratory test (p<0.05). CONCLUSIONS: The results suggest that the ENDS improve maximal oxygen uptake, nasal patency and respiratory effort in healthy adolescent athletes after submaximal exercise.