Impacts of cold air on the performance of cardiopulmonary function and athletic skills in synchronized swimming / Impactos do ar frio sobre o desempenho da função cardiopulmonar e habilidades atléticas no nado sincronizado / Impacto del aire frío en el rendimiento de la función cardiopulmonar y las habilidades atléticas en la natación sincronizada

ABSTRACT Introduction: Synchronized swimming is a sport that demands high cardiopulmonary capacity from the athletes, physical conditioning, excellent swimming, and aerobic metabolism preparation. Long-term exposure to cold air is a key factor that affects lung function, affecting the athlete's performance in synchronized swimming. This exposure can lead to inflammation of the athletes' airways, although few studies have analyzed the changes in cardiorespiratory conditioning during competition. Objective: This study aims to analyze the effect of synchronized swimming athletes' cardiopulmonary function on competition performance in cold air environments. Methods: This paper selects volunteer swimmers for the research. Ventilation tests are performed to collect data and to analyze the effect of training on cardiorespiratory conditioning during swimming. Results: There were significant differences in small airway function, generally defined as airways with caliber < 2 mm internal diameter, without cartilage, values measured among synchronized swimmers (P<0.05). There were significant differences in forced vital capacity, and one-second forced expiratory rate between synchronized swimmers (P<0.05). Conclusion: Synchronized swimmers may have their small airway function impaired due to the inherent characteristics of the sport. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução: O nado sincronizado é um esporte que exige alta capacidade cardiopulmonar dos atletas, condicionamento físico, excelente natação e preparo do metabolismo aeróbico. A exposição a longo prazo ao ar frio é um fator essencial que afeta a função pulmonar, afetando o desempenho do atleta no nado sincronizado. Essa exposição pode levar à inflamação das vias aéreas dos atletas, apesar de poucos estudos analisarem as alterações do condicionamento cardiorrespiratório durante a competição. Objetivo: O objetivo deste estudo é analisar o efeito da função cardiopulmonar dos atletas de nado sincronizado sobre o desempenho da competição em ambientes com ar frio. Métodos: Este artigo seleciona nadadores voluntários à pesquisa. Testes de ventilação são executados para a coleta dos dados, além de análise do efeito do treinamento sobre o condicionamento cardiorrespiratório durante a natação. Resultados: Houve diferenças significativas na função das vias aéreas de pequeno porte, geralmente definidas como vias aéreas com calibre < 2 mm de diâmetro interno, sem cartilagem, valores medidos entre nadadores sincronizados (P<0,05). Houve diferenças significativas na capacidade vital forçada e taxa expiratória forçada de um segundo entre nadadores sincronizados (P<0,05). Conclusão: Nadadores sincronizados podem ter a função das suas vias aéreas de pequeno porte prejudicadas devido às características inerentes do esporte. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción: La natación sincronizada es un deporte que exige a las atletas una alta capacidad cardiopulmonar, un acondicionamiento físico, un excelente nado y una preparación del metabolismo aeróbico. La exposición prolongada al aire frío es un factor esencial que afecta a la función pulmonar, lo que repercute en el rendimiento del atleta en la natación sincronizada. Esta exposición puede provocar la inflamación de las vías respiratorias de los atletas, aunque son pocos los estudios que analizan los cambios en el acondicionamiento cardiorrespiratorio durante la competición. Objetivo: El objetivo de este estudio es analizar el efecto de la función cardiopulmonar de las atletas de natación sincronizada en el rendimiento de la competición en ambientes de aire frío. Métodos: Este artículo selecciona nadadores voluntarios para la investigación. Se realizan pruebas de ventilación para la recogida de datos, así como el análisis del efecto del entrenamiento en el acondicionamiento cardiorrespiratorio durante la natación. Resultados: Hubo diferencias significativas en la función de las vías respiratorias pequeñas, generalmente definidas como vías respiratorias con calibre < 2 mm de diámetro interno, sin cartílago, valores medidos entre los nadadores sincronizados (P<0,05). Hubo diferencias significativas en la capacidad vital forzada y en la tasa de espiración forzada de un segundo entre las nadadoras sincronizadas (P<0,05). Conclusión: Las nadadoras de natación sincronizada pueden tener la función de las vías respiratorias pequeñas alterada debido a las características inherentes a este deporte. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

Eficácia de um protocolo de laseracupuntura sobre a fadiga e alterações respiratórias pós- covid-19: estudo quase experimental / Effectiveness of a laseracupuncture protocol on post- covid-19 fatigue and lung capacity: a quasi-experimental study / Eficacia de un protocolo de laseracupuntura sobre cambios respiratorios de la fatiga y poscovida-19: estudio casi experimental

Objetivo: Estudo quase experimental aprovado pelo Comitê de Ética em Pesquisas com Seres Humanos ­ COPEP da Universidade Estadual de Maringá, sob Parecer nº. 5.262.784, cujo objetivo foi avaliar a segurança e eficácia da laseracupuntura como uma abordagem terapêutica complementar no tratamento da fadiga e capacidade pulmonar em pacientes pós-COVID. Materiais e método: Nos meses de fevereiro e maço de 2023, no ambulatório de enfermagem da Universidade Estadual do Paraná, Campus de Paranavaí, foram recrutados 23 pacientes da comunidade acadêmica (discentes, docentes e agentes universitários) da própria universidade, com idade mediana de 24 anos (IQR = 22,0, 32,0), com diagnóstico prévio de COVID-19 e que apresentavam sintomas de fadiga e queixa de desconforto respiratório por pelo menos quatro semanas após a recuperação da fase aguda da doença. Dados demográficos, socioeconômicos e de estado de saúde geral e relacionados à COVID-19 foram coletados. Os pacientes foram tratados com duas sessões semanais de laseracupuntura por um período de cinco semanas. Para identificação da presença e intensidade da fadiga, foi aplicada a Escala de Fadiga de Piper Revisada com 23 itens e dividida em três dimensões, no início e final do tratamento e realizados testes de função pulmonar por espirometria para descrição do padrão ventilatório dos voluntários, em todas as sessões. Resultados: Participaram 23 voluntários com idade mediana de 24 anos (IQR, 22-32) e predominantemente do sexo feminino (N= 15 [65%]) e da cor branca (N = 13 [56,4%]). A maioria dos voluntários tinha sobrepeso ou obesidade (N = 16 [79,6%]). Após a fase aguda da COVID-19, os sintomas mais relatados foram ansiedade (65%), queda de cabelo (35%) e dor de cabeça (30%). Todos os participantes apresentaram fadiga intensa pós-COVID (6,36 [IQR = 6,00 ­ 7,73]). Os resultados do estudo mostraram que o tratamento com a laseracupuntura resultou em redução significativa nas pontuações da escala de fadiga quanto à Dimensão comportamental (Diferença média [DM] = -1,65; IC 95%; 0,56-2,75; p < 0,001) Dimensão afetiva (DM = -2,43; IC 95%; 1,33-3,52; p < 0,001) e Dimensão sensorial (DM= -2,85; IC 95%; 2,08-3,63; p < 0,001), além do total geral de fadiga (-2,44; IC 95%; 1,63-3,24; p < 0,001), mas não apresentou qualquer efeito nas medidas de função pulmonar como Capacidade Vital Forçada (DM = -0,87; IC 95%; -4,24, 5,98); p = 0,727), manobra básica avaliada em espirometria e relação entre Volume expiratório forçado em 1 segundo (VEF1) e Capacidade vital forçada (CVF), o VEF1/CVF (DM = -1,00; IC 95%; -10,38-8,39; p = 0,828). Nenhum efeito colateral foi relatado durante o tratamento. Conclusão: O protocolo de laseracupuntura foi seguro e bem tolerado pelos pacientes, sem efeitos colaterais relatados durante o tratamento, sugerindo que a laseracupuntura pode ser uma opção segura para o tratamento da fadiga pós-COVID-19. Apesar da intervenção não ter provocado efeito nos padrões respiratórios dos voluntários, estes verbalizaram melhora da expansibilidade e dor torácica, aumento do fôlego e disposição. Sugere-se novos estudos controlados para melhor compreensão do manejo dos sintomas pós-agudos da COVID-19.

Objective: Quasi-experimental study approved by the Ethics Committee for Research with Human Beings ­ COPEP of the State University of Maringá, Opinion nº. 5,262,784, whose objective was to evaluate the safety and efficacy of laser acupuncture as a complementary therapeutic approach in the treatment of fatigue and lung capacity in post-COVID patients. Materials and method: In February and March 2023, at the nursing clinic of the State University of Paraná, Campus Paranavaí, 23 patients were recruited from the academic community (students, professors and university agents) of the university itself, with a median age of 24 years old (IQR = 22.0, 32.0), with a previous diagnosis of COVID-19 and who had symptoms of fatigue and a complaint of respiratory distress for at least four weeks after recovery from the acute phase of the disease. Demographic, socioeconomic, and general health and COVID-19 related data were collected. The patients were treated with two laseracupuncture sessions per week for a period of five weeks. To identify the presence and intensity of fatigue, the Revised Piper Fatigue Scale was applied, with 23 items and divided into three dimensions, at the beginning and end of treatment, and pulmonary function tests were performed by spirometry to describe the ventilatory pattern of the volunteers, in all sessions. Results: Participants were 23 volunteers with a median age of 24 years (IQR, 22-32) and predominantly female (N = 15 [65%]) and Caucasian (N = 13 [56.4%]). Most volunteers were overweight or obese (N = 16 [79.6%]). After the acute phase of COVID-19, the most reported symptoms were anxiety (65%), hair loss (35%) and headache (30%). All participants experienced severe post-COVID fatigue (6.36 [IQR = 6.00 ­ 7.73]). The results of the study showed that treatment with laser acupuncture resulted in a significant reduction in scores on the fatigue scale for the Behavioral Dimension (Mean difference [MD] = -1.65; CI 95%; 0.56-2.75; p < 0.001) Affective dimension (DM = -2.43; CI 95%; 1.33-3.52; p < 0.001) and Sensory dimension (DM = -2.85; CI 95%; 2.08-3, 63; p <0.001), in addition to the fatigue grand total (-2.44; 95% CI; 1.63-3.24; p < 0.001), but had no effect on measures of lung function such as Forced Vital Capacity (MD = -0.87; 95% CI; -4.24, 5.98); p = 0.727), basic maneuver evaluated in spirometry and ratio between Forced Expiratory Volume in 1 Second (FEV1) and Forced Vital Capacity (FVC), FEV1/FVC (DM = -1.00; CI 95%; -10.38 -8.39; p = 0.828). No side effects were reported during treatment. Conclusion: The laseracupuncture protocol was safe and well tolerated by patients, with no reported side effects during treatment, suggesting that laseracupuncture may be a safe option for treating post-COVID-19 fatigue. Although the intervention had no effect on the breathing patterns of the volunteers, they reported improvement in chest expansion and pain, increased breath and disposition. New controlled studies are suggested to better understand the management of post-acute symptoms of COVID-19.

Objetivo: Estudio casi experimental aprobado por el Comité de Ética en Investigación con Seres Humanos - COPEP de la Universidad Estatal de Maringá, con arreglo a la Opinión No. 5,262,784, cuyo objetivo fue evaluar la seguridad y eficacia de la laseracupuntura como enfoque terapéutico complementario en el tratamiento de la fatiga y la capacidad pulmonar en pacientes post-COVID. Materiales y método: En los meses de febrero y marzo de 2023, en la clínica de enfermería de la Universidad Estatal de Paraná, Campus de Paranavaí, se reclutaron 23 pacientes de la comunidad académica (estudiantes, profesores y agentes universitarios) de la propia universidad, con una edad media de 24 años (IQR = 22,0, 32,0), con diagnóstico COVID y que muestren síntomas de fatiga y una queja de molestias respiratorias durante al menos cuatro semanas después de la recuperación de la fase aguda de la enfermedad. Se han recopilado datos demográficos, socioeconómicos y de salud general relacionados con el programa COVID-19. Los pacientes fueron tratados con dos sesiones de laseracupuntura por semana durante cinco semanas. Para la identificación de la presencia y la intensidad de la fatiga, se revisó la escala de fatiga de los piper con 23 elementos y se dividió en tres dimensiones, al inicio y al final del tratamiento, y se realizaron pruebas de función pulmonar mediante espirometría para describir el patrón de ventilación de los voluntarios, en todas las sesiones. Resultados: participaron 23 voluntarios con una edad media de 24 años (RCI, 22-32) y predominantemente mujeres (N = 15 [65%]) y blancas (N = 13 [56,4%]). La mayoría de los voluntarios presentaron sobrepeso u obesidad (N = 16 [79,6%]). Después de la fase aguda de COVID-19, los síntomas notificados más frecuentemente fueron ansiedad (65%), pérdida de pelo (35%) y dolor de cabeza (30%). Todos los participantes presentaron fatiga grave post-COVID (6,36 [IQR = 6,00 - 7,73]). Los resultados del estudio mostraron que el tratamiento con laseracupuntura dio lugar a una reducción significativa de las puntuaciones de la escala de fatiga para la dimensión conductual (Diferencia media [DM] = -1,65; IC del 95%; IC del 0,56-2,75; p < 0,001) La dimensión afectiva (DM = -2,43; IC del 95%: 1; 33-3,52; p < 0,001) y dimensión sensorial (DM = -2,85; IC del 95% 2,08-3,63; p < 0,001), además de la fatiga general (-2,44; IC del 95%: 1,63-3,24; p < 0,0 01), pero no tuvo efecto sobre las medidas de función pulmonar como capacidad vital forzada (DM = -0,87; IC del 95%; -4,24,5,98); p = 0,727), maniobra basal evaluada en espirometría y relación entre el volumen respiratorio forzado 1 segundo (VEF1) y la capacidad viciosa forzada (CVF), EF1/CVF (DM = -1,00; IC del 95%; -10,38-8,39; p = 0,828). No se notificaron efectos adversos durante el tratamiento. Conclusión: El protocolo de laseracupuntura fue seguro y bien tolerado por los pacientes, sin efectos secundarios notificados durante el tratamiento, lo que sugiere que la laseracupuntura puede ser una opción segura para el tratamiento de la fatiga post-COVID-19. Aunque la intervención no tuvo efecto sobre los patrones respiratorios de los voluntarios, verbalizaron mejoría en la capacidad de expansión y dolor torácico, dificultad respiratoria y disposición. Se sugieren nuevos estudios controlados para entender mejor el manejo de los síntomas post-agudos de COVID-19.

A Study to Assess the Effectiveness of Balloon Therapy on Lung Capacity of Patients with Lower Respiratory Tract Infections in Selected Hospital of Chitrakoot U.P.

As per 2019 report of the National Health Portal of India, 41,996,260 cases and 3,740 deaths from respiratory infections were recorded across India in 2018. The main aim of the study was to assess the effectiveness of balloon therapy on increased level of oxygenation of patients with lower respiratory tract disorders. Quasi experimental design was used for this study. Balloon therapy improves pulmonary functions. Daily practice of blowing up balloon, once a day, 10 times per day for 10 days will steadily increase lung capacity. The data pertaining to lung capacity was collected using self-administered questionnaire. Respiratory assessment viz Vital, Tidal and Lung capacity were measured using balloon therapy. The pre-test mean and SD were 6.83 & 1.30 respectively where as posttest mean & SD were 7.16 & 1.26, with t-test value of 6.12. These reading indicate the effectiveness of Balloon therapy on lung capacity in patients with lower respiratory tract infections. The result of this study guides that regular practice of balloon therapy can improve the lung capacity to a greater extent among patients with lower respiratory tract infection. Off course, large sample size is recommended for generalization.

Delayed chest closure for oversized lung allograft in lung transplantation: a retrospective analysis from turkey

Abstract Introduction: The aim of this study was to evaluate the delayed chest closure (DCC) results in patients who underwent lung transplantation. Methods: Sixty patients were evaluated retrospectively. Only bilateral lung transplantations and DCC for oversized lung allograft (OLA) were included in the study. Six patients who underwent single lung transplantation, four patients who underwent lobar transplantation, two patients who underwent retransplantation, and four patients who underwent DCC due to bleeding risk were excluded from the study. Forty-four patients were divided into groups as primary chest closure (PCC) (n=28) and DCC (n=16). Demographics, donor characteristics, and operative features and outcomes of the patients were compared. Results: The mean age was 44.5 years. There was no significant difference between the demographics of the groups (P>0.05). The donor/recipient predicted total lung capacity ratio was significantly higher in the DCC group than in the PCC group (1.06 vs. 0.96, P=0.008). Extubation time (4.3 vs. 3.1 days, P=0.002) and intensive care unit length of stay (7.6 vs. 5.2 days, P=0.016) were significantly higher in the DCC group than in the PCC group. In the DCC group, postoperative wound infection was significantly higher than in the PCC group (18.6% vs. 0%, P=0.19). Median survival was 14 months in all patients and there was no significant difference in survival between the groups (16 vs. 13 months, P=0.300). Conclusion: DCC is a safe and effective method for the management of OLA in lung transplantation.

Prueba de ejercicio cardiopulmonar en receptores de trasplante cardíaco / Cardiopulmonary Exercise Test in Heart Transplant Recipients

RESUMEN Introducción: La capacidad de ejercicio de los pacientes con insuficiencia cardíaca avanzada mejora después del trasplante cardíaco (TXC). La prueba de ejercicio cardiopulmonar (PECP) es reconocida como el estudio "estándar de oro" para la evaluación de la capacidad de ejercicio aeróbico. El objetivo del estudio fue analizar las características de la PECP realizada en receptores de TXC. Material y métodos: Se realizó un estudio de corte transversal. Se incluyeron pacientes mayores de 18 años receptores de TXC desde el 1 de noviembre de 2013 hasta el 30 de junio de 2019, que hubieran realizado una PECP dentro del primer año posterior al trasplante. Se analizaron variables clínicas y de la PECP. Resultados: Se incluyeron 122 pacientes (edad media 50,1 ± 11,8 años, 77,0% hombres). El consumo de oxígeno (VO2) pico fue de 23,3 ± 5,3 mL/min/kg y el 45,9% alcanzó el umbral anaeróbico. El 68,0% y el 28,7% de la población mostró valores de pulso de oxígeno y de la pendiente de la eficiencia del VO2 (OUES) normales, respectivamente. El 46,7%, 23,0% y 3,3% presentaron una reducción leve, moderada o grave de la capacidad funcional, respectivamente. El valor de OUES fue bajo en el 80,0%, 71,4% y 92,9% de los pacientes con disminución de la capacidad funcional de origen cardiovascular, periférico y mixto, respectivamente. Conclusión: En esta población de receptores de TXC, la proporción de sujetos con capacidad funcional reducida o valores de OUES alterados fue considerable. La evaluación de estos pacientes a través de la PECP podría favorecer la derivación temprana a centros de rehabilitación cardiovascular.

ABSTRACT Background: Exercise capacity of patients with advanced heart failure improves after heart transplantation (HTX). Cardiopulmonary exercise test (CPET) is recognized as the "gold standard" study for the evaluation of aerobic exercise capacity. Objective: The aim of this study was to analyze the characteristics of CPET in HTX recipients. Methods: A cross-sectional study was performed in patients over 18 years of age undergoing HTX from November 1, 2013 to June 30, 2019, and with a CPET within the first year after transplantation. Clinical and CPET variables were analyzed. Results: A total of 122 patients with mean age of 50.1 ± 11.8 years and 77.0% men were included in the study. Peak oxygen consumption (VO2) was 23.3 ± 5.3 mL/min/kg and 45.9% of patients achieved the anaerobic threshold. In 68.0% and 28.7% of cases, the population presented normal oxygen pulse and oxygen uptake efficiency slope (OUES) values, respectively. Mild, moderate, or severe reduced functional capacity was found in 46.7%, 23.0%, and 3.3% of patients, respectively. Oxygen uptake efficiency slope was low in 80.0%, 71.4% and 92.9% of patients with decreased functional capacity of cardiovascular, peripheral, and mixed origin, respectively. Conclusion: In this population of HTX recipients, a considerable proportion of subjects showed reduced functional capacity or abnormal OUES values. The evaluation of these patients through CPET could favor early referral to cardiovascular rehabilitation centers.

Slow Vital Capacity: Differences Between the Expiratory Vital Capacity and the Inspiratory Vital Capacity

ABSTRACT Introduction: The vital capacity (VC) can be determined by means of the expiratory vital capacity (EVC) or the inspiratory vital capacity (IVC). Obtaining the highest VC volume is essential for the correct interpretation of lung function tests. Objectives: To determine the differences between the EVC and the IVC (EVC-IVC) according to the ventilatory pattern; to characterize the FEV1/EVC and FEV1/IVC ratios when an obstruction of the airways is detected; to study the effects of the EVC or IVC on the detec tion of air trapping or lung hyperinflation. Materials and Methods: Cross-sectional study. The sample included 388 individuals divided in 3 groups: healthy, airway obstruc tion, and restrictive lung disease. In order to detect the airway obstruction, we studied the FEV1/EVC and FEV1/IVC ratios. The presence of air trapping or lung hyperinflation was determined by means of a lung volume test. The differences between the EVC and the IVC (EVC-IVC) according to the ventilatory pattern were grouped into classes. Results: In the normal group, there was an EVC-IVC difference of ≥ 200 ml in 34.8% of the individuals; in the airway obstruction group, 28.4%, and in the restrictive lung disease group, 22.4%. The FEV1/EVC ratio detected airway obstruction in 44.8% of the individuals, and the FEV1/IVC ratio in 39.4%. In patients with airway obstruction, the EVC maneuver determined the presence of air trapping in 21.6% of subjects and lung hyperinflation in 9.5%. The IVC maneuver showed 18.2% and 10.8%, respectively. Conclusions: The EVC and IVC should not be used as interchangeable maneuvers, considering the volume differences obtained with each one of them. Their results influenced the interpretation of lung function.

Concurrent validity of the static and dynamic measures of inspiratory muscle strength: comparison between maximal inspiratory pressure and s-index

Abstract Objective: To verify the concurrent validity between the inspiratory muscle strength (IMS) values obtained in static (maximal inspiratory pressure [MIP]) and dynamic (S-Index) assessments. Methods: Healthy individuals were submitted to two periods of evaluation: i) MIP, static maneuver to obtain IMS, determined by the Mueller's maneuver from residual volume (RV) until total lung capacity (TLC); ii) and S-Index, inspiration against open airway starting from RV until TLC. Both measures were performed by the same evaluator and the subjects received the same instructions. Isolated maneuvers with differences < 10% were considered as reproducible measures. Results: Data from 45 subjects (21 males) were analyzed and that showed statistical difference between MIP and S-Index values (133.5 ± 33.3 and 125.6 ± 32.2 in cmH2O, respectively), with P=0.014. Linear regression showed r2=0.54 and S-Index prediction formula = 39.8+(0.75×MIP). Pearson's correlation demonstrated a strong and significant association between the measures with r=0.74. The measurements showed good concordance evidenced by the Bland-Altman test. Conclusion: S-Index and MIP do not present similar values since they are evaluations of different events of the muscular contraction. However, they have a strong correlation and good agreement, which indicate that both are able to evaluate the IMS of healthy individuals.

Correlação entre os níveis de independência, nutrição, provas de forças de músculos ventilatórios e equilíbrio em idosos / Correlation amongdegrees of independence, mutrition, ventilatory muscles streng tests and equilibrium in olde adults

Introdução: O processo de envelhecimento proporciona alterações funcionais, psicossociais e biológicas de caráter progressivo e irreversível, diminuindo a capacidade funcional e pulmonar dos idosos. A fraqueza muscular presente nos idosos pode reduzir o nível de atividades funcionais e do sistema respiratório, favorecendo a inatividade e dependência. Objetivo: Avaliar a correlação entre a capacidade funcional e pulmonar em idosos. Metodologia: Estudo descritivo transversal, no qual foi realizada uma avaliação por meio do Índice de Barthel Modificado, da PI máx, PE máx com a utilização de manuvacuometro, da circunferência da panturrilha (CP) e do teste Timed Up and Go (TUG). A amostra foi de 40 idosos. Resultados: a associação significativa entre achados de força da musculatura inspiratória, CP, teste TUG, Índice de Barthel, PI máx, PE máx e idade, correlaciona a redução da força muscular com menor nível de capacidade funcional em idosos, ainda mais significativa no sexo masculino, com menor tempo para a realização do teste TUG, comparado ao sexo feminino. Conclusão: Houve correlação entre o nível de capacidade funcional e pulmonar de idosos, demonstrando a importância da associação do treinamento da função respiratória associado ao exercício físico.(AU)

Introduction: The aging process provides functional, psychosocial and biological changes of a progressive and irreversible character, reducing the functional and pulmonary capacity of older adults. The muscular weakness present in older persons reduces the level of functional activities and the respiratory system, favoring inactivity and dependence. Objective: Evaluate the correlation between functional and pulmonary capacity in older people. Methodology: A physical therapy evaluation was performed through an evaluation form deve loped by the authors and the Modified Barthel Index. The rating consisted of identification, pulmonary evaluation, calf circumference (CP) and performance the Timed Up and Go test (TUG). The data was collected at a long permanence institution for older adults, located in the interior of Goiás, with a sample of 40 older individuals. Results: The association between inspiratory muscle strength, CP, TUG test, Barthel index, PI max, PE max and age, correlate the reduction of muscle strength with lower level of functional capacity in older adults, even more significant in sex male, with less time to perform the TUG test, compared to the female. Conclusion: Is suggested a correlation between the level of functional and pulmonary capacity of older people, demonstrating the importance of the association of respiratory function training associated to physical exercise.(AU)

Alteraciones respiratorias de la Ataxia Espinocerebelosa Tipo 2: de las bases fisiopatológicas a su impacto en la neurorrehabilitación / Respiratory Alterations in Spinocerebellar Ataxia Type 2: from the Pathophysiological Bases to its Impact on Neurorehabilitation

Los objetivos del presente estudio han sido identificar y analizar publicaciones que han indagado acerca de la funcionalidad del sistema respiratorio en pacientes con Ataxia Espinocerebelosa Tipo 2. Se presentan los datos obtenidos a partir de la búsqueda avanzada en Google Académico y en bases de datos tales como PubMed, Scopus, en los idiomas español e inglés, se tuvieron en cuenta los tipos artículos y resúmenes de eventos científicos de varios países, se acotó en la indagación realizada a las palabras claves o en resumen del artículo que hicieran referencia a: Ataxia Espinocerebelosa Tipo 2, Sistema Respiratorio y Capacidad Vital Pulmonar, en un período o desde 1998 hasta 2015, cuyos resultados permitieron revelar que el sistema respiratorio es el menos sistematizado en la búsqueda realizada, aunque existen evidencias de sus alteraciones en los pocos trabajos revisados respecto al tema; se demostró, además, desde el punto de vista teórico la existencia de un impacto positivo de este en la rehabilitación física. Como conclusión, hay indicios que permiten profundizar en este sistema en pacientes con SCA2, los que permiten la identificación de nuevas líneas de investigación en esta temática.

The aims of the present study were to identify and analyze publications that have inquired the functionality of respiratory system in patients with Spinocerebellar Ataxia type 2. The data obtained from the advanced search in Google Scholar and in databases such as PubMed, Scopus, in Spanish and English languages were presented, taking into account the types articles and summaries of scientific events from various countries, the search was limited to the key words or in the summary of the article that made reference to: Spinocerebellar Ataxia Type 2, Respiratory System and Pulmonary Vital Capacity, in a period or from 1998 to 2015 , whose results revealed that the respiratory system is the least systematized in the search performed, although there are evidences of its alterations in the few researches reviewed on the subject. In conclusion, there are traces that allow deepening this system in patients with SCA2, which admit the identification of new lines of research in this area.

O impacto dos valores previstos nos testes de função pulmonar / The impact of predicted values in pulmonary function tests

A interpretação dos testes de função pulmonar é resultado da comparação de valores obtidos com valores previstos para um determinado indivíduo. Os valores previstos são obtidos através de equações de referência, sendo estas determinadas por dados antropométricos e demográficos dos indivíduos. A presente revisão de literatura pretende identificar quais as equações referência mais utilizadas para os testes de função pulmonar, comparar estudos entre equações com ênfase nas publicações de equações de referência brasileiras.

Lung function test interpretation is based on the comparison between values measured according to the predicted values for each individual. The predicted values come from reference equations, which depend on anthropometric and demographic data of individuals. The present review aims to identify the most commonly used reference equations for pulmonary function tests, interpret comparative studies between equations and emphasizes publications with Brazilian reference equations.

The characteristics and clinical manifestation of 120 subjects with non-specific pattern of pulmonary function tests / 重庆医学

Objective To analyze the characteristics of pulmonary function and the clinical significance of non‐specific pattern (NSP) ,and provide basis for the clinical research .Methods A total of 120 pulmonary function tests of adult patients from January 2013 to June 2014 were selected and divided into NSP group(n=20) and normal lung function group(n=100) according to their lung function behavior .The pulmonary function test results ,clinical diagnosis and radiological manifestations were analyzed .The relevant factors affecting NSP occurred were selected and logistic regression analysis was used to analyze multiple factors .Results The FEVl ,VC ,TLC ,FVC ,MVV and FEVl/FVC in normal group were significantly higher than that of NSP group and the RV/TCL was lower than NSP group ,the difference was statistically significant (P<0 .05) .Patients in NSP group were with obstructive and (or) restrictive clinical manifestations .There were 9 patients were without lung disease .Univariate analysis showed that age , BMI ,smoking history ,smoking ,obstructive diseases ,and restrictive disease in NSP group were significantly higher than that in nor‐mal group ,the difference were statistically significant (P<0 .05) .Multivariate analysis showed that age ,BMI ,history of smoking , obstructive diseases and restrictive disease were independent risk factors for NSP (P<0 .05) .Conclusion Old age ,smoking and o‐besity could increase the incidence rate of NSP .The clinical characteristics include obstructive and restrictive ventilation defects ,and need to be identified positively .

The Prognostic Value of Residual Volume/Total Lung Capacity in Patients with Chronic Obstructive Pulmonary Disease

The prognostic role of resting pulmonary hyperinflation as measured by residual volume (RV)/total lung capacity (TLC) in chronic obstructive pulmonary disease (COPD) remains poorly understood. Therefore, this study aimed to identify the factors related to resting pulmonary hyperinflation in COPD and to determine whether resting pulmonary hyperinflation is a prognostic factor in COPD. In total, 353 patients with COPD in the Korean Obstructive Lung Disease cohort recruited from 16 hospitals were enrolled. Resting pulmonary hyperinflation was defined as RV/TLC > or = 40%. Multivariate logistic regression analysis demonstrated that older age (P = 0.001), lower forced expiratory volume in 1 second (FEV1) (P < 0.001), higher St. George Respiratory Questionnaire (SGRQ) score (P = 0.019), and higher emphysema index (P = 0.010) were associated independently with resting hyperinflation. Multivariate Cox regression model that included age, gender, dyspnea scale, SGRQ, RV/TLC, and 6-min walking distance revealed that an older age (HR = 1.07, P = 0.027), a higher RV/TLC (HR = 1.04, P = 0.025), and a shorter 6-min walking distance (HR = 0.99, P < 0.001) were independent predictors of all-cause mortality. Our data showed that older age, higher emphysema index, higher SGRQ score, and lower FEV1 were associated independently with resting pulmonary hyperinflation in COPD. RV/TLC is an independent risk factor for all-cause mortality in COPD.

Can the single-breath helium dilution method predict lung volumes as measured by whole-body plethysmography? / Pode o metodo de diluicao do helio em respiracao unica estimar os volumes pulmonares medidos pela pletismografia de corpo inteiro?

OBJECTIVE: To compare TLC and RV values obtained by the single-breath helium dilution (SBHD) method with those obtained by whole-body plethysmography (WBP) in patients with normal lung function, patients with obstructive lung disease (OLD), and patients with restrictive lung disease (RLD), varying in severity, and to devise equations to estimate the SBHD results. METHODS: This was a retrospective cross-sectional study involving 169 individuals, of whom 93 and 49 presented with OLD and RLD, respectively, the remaining 27 having normal lung function. All patients underwent spirometry and lung volume measurement by both methods. RESULTS: TLC and RV were higher by WBP than by SBHD. The discrepancy between the methods was more pronounced in the OLD group, correlating with the severity of airflow obstruction. In the OLD group, the correlation coefficient of the comparison between the two methods was 0.57 and 0.56 for TLC and RV, respectively (p < 0.001 for both). We used regression equations, adjusted for the groups studied, in order to predict the WBP values of TLC and RV, using the corresponding SBHD values. It was possible to create regression equations to predict differences in TLC and RV between the two methods only for the OLD group. The TLC and RV equations were, respectively, ∆TLCWBP-SBHD in L = 5.264 − 0.060 × FEV1/FVC (r2 = 0.33; adjusted r2 = 0.32) and ∆RVWBP-SBHD in L = 4.862 − 0.055 × FEV1/FVC (r2 = 0.31; adjusted r2 = 0.30). CONCLUSIONS: The correction of TLC and RV results obtained by SBHD can improve the accuracy of this method for assessing lung volumes in patients with OLD. However, additional studies are needed in order to validate these equations. .

OBJETIVO: Comparar resultados de CPT e VR obtidos pelo método de diluição de hélio em respiração única (DHRU) com aqueles obtidos por pletismografia de corpo inteiro (PCI) em indivíduos com função pulmonar normal, portadores de distúrbio ventilatório obstrutivo (DVO) e portadores de distúrbio ventilatório restritivo (DVR) com diferentes níveis de gravidade e elaborar equações para estimar CPT e VR por DHRU. MÉTODOS: Estudo transversal retrospectivo com 169 indivíduos, dos quais, respectivamente, 93, 49 e 27 apresentavam DVO, DVR e espirometria normal. Todos realizaram espirometria e determinação de volumes pulmonares pelos dois métodos. RESULTADOS: Os valores de CPT e VR foram maiores por PCI que por DHRU. A discrepância entre os métodos foi mais acentuada no grupo com DVO e se relacionou com a gravidade da obstrução ao fluxo aéreo. No grupo com DVO, o coeficiente de correlação da comparação entre os dois métodos foi de 0,57 e 0,56 para CPT e VR, respectivamente (p < 0,001 para ambos). Para predizer os valores de CPT e VR por PCI utilizando os respectivos valores por DHRU foram utilizadas equações de regressão, corrigidas de acordo com os grupos estudados. Somente foi possível criar equações de regressão para predizer as diferenças de CPT e VR entre os dois métodos para pacientes com DVO. Essas equações foram, respectivamente, ∆CPTPCI-DHRU em L = 5,264 − 0,060 × VEF1/CVF (r2 = 0,33; r2 ajustado = 0,32) e ∆VRPCI-DHRU em L = 4,862 − 0,055 × VEF1/CVF (r2 = 0,31; r2 ajustado = 0,30). CONCLUSÕES: A correção de CPT e VR obtidos por DHRU pode melhorar a acurácia desse método para avaliar os volumes pulmonares em pacientes com DVO. Entretanto, estudos adicionais ...

Alterações na capacidade funcional de pacientes após dois anos da cirurgia de revascularização do miocárdio / Changes in functional capacity of patients two years after coronary artery bypass grafting surgery

OBJETIVO: Verificar alterações na capacidade funcional dos pacientes que se submetem à cirurgia de revascularização do miocárdio (CRM) por meio do teste de caminhada de seis minutos (TC6) no seguimento de dois anos. MÉTODOS: Estudo de coorte prospectivo, no qual foram arrolados 215 pacientes submetidos a CRM, 13 não preencheram os critérios de inclusão. Foram 202 pacientes avaliados no pré-operatório, 13 morreram no período da internação e seis no seguimento de dois anos. Quatro pacientes foram considerados perdas de seguimento. Foram acompanhados 179 pacientes no período de 2 anos, classificados em ativos e sedentários, conforme a prática de atividade física no tempo livre e submetidos ao TC6 no préoperatório e 2 anos depois. RESULTADOS: Dos 202 pacientes avaliados no pré-operatório da CRM, 67 por cento eram do sexo masculino, com idade média de 63 (± 9,75) anos. Pré e após 2 anos da CRM, 52 pacientes se mantiveram ativos e as distâncias caminhadas foram 359m (± 164,47) e 439m (± 171,34), respectivamente, P= 0,016. A distância caminhada no pré e pós-operatório, dos 45 pacientes que permaneceram sedentários, foi, respectivamente, 255m (± 172,15) e 376m (± 210,92) P<0,001. Oitenta e dois pacientes transitaram entre estes dois grupos, 71 passaram de sedentários para ativos e caminharam 289m (± 157,15) no pré e 380m (± 125,44) no pós-operatório, P= 0,001; os 11 pacientes que eram ativos e passaram a sedentários caminharam no pré 221m (± 191,91) e, no pós-operatório, 384m (± 63,73) P= 0,007. CONCLUSÃO: A capacidade funcional dos pacientes submetidos à CRM melhorou de forma importante no seguimento de médio prazo.

OBJECTIVE: To check changes in the functional capacity of patients undergoing coronary artery bypass grafting (CABG) by testing six-minute walk test (6MWT) following two years. METHODS: A prospective cohort study where 215 patients were enrolled who underwent CABG, 13 did not meet the criteria for inclusion. 202 patients were evaluated preoperatively, 13 died during hospitalization and 6 in the follow up of two years. Four patients were considered lost follow up. This study followed 179 patients for two years classified into active and sedentary, according to physical activity in leisure time and to the 6MWT preoperatively and 2 years later. RESULTS: One hundred and twenty patients were evaluated in the day before CABGS, being 67 percent male with an average age of 63 (± 9.75) years. Before surgery and 2 years later, 52 were active and the 6MWT distances performed had been 359m (± 164.47) and 439m (± 171.34), respectively; P= 0.016. Forty five patients were classified as sedentary before and 2 years after surgery. The 6MWT distances walked before and after surgery had been 255m (± 172.15) and 376m (± 210.92), respectively; P < 0.001. Eighty two patients transited between these two groups, 71 passed from sedentary to active and had walked before and after surgery 289m (± 157.15) and 380m (± 125.44), respectively; P= 0.001. The 11 patients who were active and passed to the sedentary group walked 221m (± 191.91) and 384m (± 63.73), respectively; P= 0.007. CONCLUSION: The functional capacity of the patients submitted to CABGS had a significant improvement in a medium period of follow-up.

Uma análise entre índices pressóricos, obesidade e capacidade cardiorrespiratória em escolares / Comparison analysis of blood pressure, obesity, and cardio-respiratory fitness in schoolchildren

FUNDAMENTO: Durante a infância e adolescência, o sedentarismo, o excesso de peso e a alimentação inadequada são fatores de risco para doenças crônicas, sobretudo obesidade, hipertensão arterial sistêmica e diabete melito. A intervenção precoce pode prevenir o desenvolvimento dessas complicações. OBJETIVO: Verificar a presença de fatores de risco cardiovasculares (obesidade e hipertensão arterial) e suas possíveis interações com a capacidade cardiorrespiratória. Métodos: Estudo transversal composto de amostra estratificada por conglomerados, de 1.666 escolares, com idades entre 7 e 17 anos, 873 (52,4 por cento) do sexo masculino e 793 (47,6 por cento) do sexo feminino. Avaliaram-se as pressões arteriais sistólica (PAS) e diastólica (PAD), índice de massa corporal (IMC), percentual de gordura ( por centoG) e capacidade cardiorrespiratória. Ainda, PAS e PAD foram correlacionadas com circunferência da cintura (CC), relação cintura-quadril (RCQ), somatório de dobras cutâneas (ΣDC) e capacidade cardiorrespiratória. RESULTADOS: A avaliação do IMC dos escolares evidenciou 26,7 por cento de sobrepeso ou obesidade e 35,9 por cento com o percentual de gordura acima de moderadamente alto. Com relação aos níveis pressóricos, encontraram-se 13,9 por cento e 12,1 por cento de escolares limítrofes e hipertensos, para PAS e PAD, respectivamente. Houve associação entre hipertensão, obesidade e capacidade cardiorrespiratória. Observou-se correlação significativa em relação à PAS e PAD, para todas as variáveis analisadas, apresentando, ainda, uma relação fraca a moderada com as variáveis idade, peso, estatura, IMC e circunferência da cintura. CONCLUSÃO: A presença da hipertensão arterial associada à obesidade e seu reflexo na capacidade cardiorrespiratória reforçam a importância de se propor, já na infância, um estilo de vida mais ativo e saudável.

BACKGROUND: During childhood and adolescence, physical inactivity, excess weight, and poor nutrition are risk factors for chronic diseases, especially obesity, hypertension, and diabetes mellitus. Early intervention can prevent the development of these complications. OBJECTIVE: To determine the presence of cardiovascular risk (obesity and hypertension) in schoolchildren and its potential interactions with cardio-respiratory fitness. METHODS: This was a cross-sectional study conducted in a stratified cluster sample of 1,666 schoolchildren, aged between 7 and 17 years, 873 (52.4 percent) of them male and 793 (47.6 percent) of them female. The following variables were evaluated: systolic blood pressure (SBP), diastolic blood pressure (DBP), body mass index (BMI), body fat percentage (BF percent), and cardio-respiratory fitness. SBP and DBP were correlated with waist circumference (WC), waist-hip ratio (WHR), sum of skin folds (ΣSF), and cardio-respiratory fitness. RESULTS: A BMI assessment of the students showed that 26.7 percent of them were overweight or obese, and 35.9 percent had body fat percentage over moderately high. As to blood pressure, we found that 13.9 percent and 12.1 percent of the students were borderline or hypertensive, for SBP and DBP, respectively. There was an association among hypertension, obesity, and cardio-respiratory fitness. There was a significant correlation of SBP and DBP with all variables, and also a weak to moderate correlation with age, weight, height, BMI, and waist circumference. CONCLUSION: The presence of hypertension associated with obesity and its effects on cardio-respiratory fitness stress the importance of recommending, since childhood, a more active and healthy lifestyle.

Pulmonary function in workers exposed to tobacco dust.

Background : Exposure to vegetable dusts is probable in many industrial and agricultural industries. Aim: The aim of this study was to investigate the relation between exposure to tobacco dusts and lung capacities and airflows. Materials and Methods : Two hundred thirty-one individuals who were exposed to tobacco dusts in a cigarette-manufacturing company were included in the study. One hundred individuals who were working in the same area but in other industries and were not exposed to harmful dusts were also selected as controls. Spirometry with American Thoracic Society (ATS) standards was performed for both groups. Statistical Analysis : Spirometry results were compared between the two groups using SPSS software by 't' test. Results : The mean age of the exposed and unexposed groups was 36 ± 7 and 35 ± 7 years, respectively. Spirometry results showed that lung capacities and airflows in the exposed group were significantly less than those of controls (P< 0.001). Considering relative variation, the highest reduction was seen in peak expiratory flow (PEF), forced expiratory flow (FEF25%) and peak inspiratory flow (PIF). Conclusion : The results of this study show that exposure to tobacco dust would decrease lung capacities and airflows during the years.

Transplante hepático: repercussões na capacidade pulmonar, condição funcional e qualidade de vida / Liver transplantation: effects in pulmonary capacity, functional condition and quality of life

RACIONAL: O transplante hepático é utilizado para o tratamento de doenças hepáticas em estado avançado, quando a sobrevida e a função hepática são aumentadas após o procedimento. OBJETIVO: Avaliar e comparar a função pulmonar, a condição funcional e a qualidade de vida de pacientes candidatos ao transplante hepático e após a realização do procedimento cirúrgico no período de 1, 3, 6, 9 e 12 meses de pós-operatório. MÉTODOS: Trabalho transversal, observacional, com amostra de conveniência, composta por 30 pacientes, divididos em seis grupos (com cinco indivíduos em cada grupo), nos seguintes tempos: pré-transplante, 1, 3, 6, 9 e 12 meses de pós-operatório. Todos os indivíduos foram avaliados em um único momento, quando foram mensurados a capacidade vital forçada, o volume expiratório forçado no primeiro segundo, as pressões inspiratória e expiratória máxima, a distância percorrida no teste de caminhada de 6 minutos e os domínios relacionados à qualidade de vida através do questionário de qualidade de vida auto-aplicativo "Short Form 36". RESULTADOS: Houve melhora em todas as variáveis ao comparar o período pré-transplante com os consecutivos meses de pós-operatório, onde a pressão inspiratória máxima, a distância percorrida e o domínio da capacidade funcional apresentaram mudanças estatisticamente significantes. CONCLUSÃO: O transplante hepático é uma alternativa para o tratamento das doenças hepáticas avançadas e proporciona aos pacientes benefícios nas condições respiratórias e funcionais, contribuindo para melhora da qualidade de vida.

BACKGROUND: The liver transpslantation is used for treatment of end-stage liver disease, where the survival and liver function are markedly improved after transplantation. AIM: To evaluate and compare lung function, functional capacity and quality of life in patients submitted to liver transplantation after 1, 3, 6, 9 and 12 months of procedure. METHODS: Observational study with convenience groups composed by 30 patients, which had been divided in six groups (5 subjects each), in preoperative period and in the period of 1, 3, 6, 9 and 12 months after liver transplantation. All the individuals were evaluated at the same time, verificating the measurement of the forced vital capacity, forced expiratory volume in one second, maximum inspiratory and expiratory pressure, distance and domains related to quality of life. RESULTS: According to the explanation, it was observed improvement in all variables in subsequent groups to the liver transplantation in periods of 1, 3, 6, 9 and 12 months when compared to the preoperative group. The most significant changes occurred during the maximum inspiratory pressures, the distance and physical functioning. CONCLUSIONS: The liver transplantation as an alternative treatment for advanced liver disease, gives the patients benefits in respiratory and physical-functional conditions with improvement of life quality.

Accuracy of Spirometry at Predicting Restrictive Pulmonary Impairment / 결핵

BACKGROUND: Low spirometric forced vital capacity(FVC) in conjunction with a normal or high ratio of the forced expiratory volume at 1 second to the forced vital capacity(FEV1/FVC%) has traditionally been classified as a restrictive abnormality. However, the gold-standard diagnosis of a restrictive pulmonary impairment requires a measurement of the total lung capacity (TLC). This study was performed to determine the predictive value of spirometric measurements of the FVC for diagnosing a restrictivepulmonary abnormality. METHODS: Test results from 1,371 adult patients who undertook both spirometry and lung volume measurements on the same visit from January 1999 to December 2000 were enrolled in this study. The test values for the FVC, the TLC that was below 80% of predicted value, and a FEV1/FVC% that was below 70%, were classified as being abnormal. RESULTS: Of the 1,371 patients, 353 patients had a reduced a FVC. Of these patients, 186 patients had a reduced TLC. Therefore, the positive predictive value was 52.7%. Of the 196 patients with a normal FEV1/FVC% and a reduced FVC, 148(75.5%) patients had a lower TLC. Thirty eight (24.2%) patients out of 157 patients with a low FEV1/FVC% and a low FVC showed a restrictive defect. CONCLUSION: Spirometry is useful to rule out a restrictive pulmonary abnormality, but a restrictive pattern on the spirometry dose not mean there is a true restrictive disease. For the patients with a low FVC, TLC measurements are essential for diagnosing a restrictive pulmonary impairment.