Correlação entre pressão plantar e força muscular respiratória / Correlation between plantar pressure and respiratory muscle strength

Existem evidências de que alterações posturais possam influenciar no funcionamento da caixa torácica. Além disso, para uma respiração adequada, é necessária boa postura e equilíbrio muscular. O objetivo do presente estudo foi verificar se existe correlação entre a pressão plantar e a força muscular respiratória, visto que ambas sofrem interferência das alterações posturais. Foram avaliados 30 funcionários de uma instituição de Ensino Superior do Médio Paraíba, com idade média de 43,43 ± 13,29 anos, subdivididos em 2 grupos: Grupo experimental (I) e Grupo Controle (II). O grupo I foi submetido a 30 sessões de treinamento muscular respiratório; e ao final da intervenção, ambos os grupos foram reavaliados. Os resultados mostraram que algumas pressões plantares sofreram interferência significativa, com p < 0,05 da força muscular respiratória (PImáx e PEmáx), após o protocolo de exercício, confirmando nossa hipótese sobre a possível associação entre a força muscular respiratória e a pressão plantar, pela correlação positiva apresentada por algumas variáveis avaliadas. (AU)

There are evidences that postural alteration may influence the functioning of the thoracic cage. However, proper breathing requires good posture and muscle balance. The present study aim was to verify whether there is correlation between a plantar pressure and respiratory muscle strength, as both suffer interference of the postural alterations. We evaluated 30 employees from an a higher Education Institution with the average age between 43,43 ± 13,29 years subdivided into two groups: Experimental group (I) and Control group (II). Group I underwent 30 sessions of respiratory muscle training and at the end of the intervention both groups were reevaluated. The results showed that some plantar pressures undergo significant interference with p < 0.05 in respiratory muscle strength (PEmáx e PEmáx) after exercise protocol confirming our hypothesis about the possible association between respiratory muscle strength and plantar pressure by the positive correlation presented by some variables evaluated. (AU)

Influencia del polimorfismo inserción / deleción (rs4646994) del gen de la enzima convertidora de angiotensina en la presión inspiratoria y espiratoria máxima de jóvenes chilenos sedentarios / Influence of the polymorphism insertion / deletion (rs4646994) of the angiotensin converting enzyme (ACE) gene on maximum inspiratory and expiratory pressure of Chilean sedentary youth

RESUMEN: La expresión de los genes puede impactar sobre el rendimiento muscular. En este aspecto el polimorfismo del gen de la Enzima Convertidora de Angiotensina (ECA), dependiendo de su inserción (Ins) o deleción (Del) puede potenciar diferentes cualidades musculares. Del mismo modo, si consideramos la ventilación como un proceso vital, sería relevante investigar si existe una influencia de este polimorfismo sobre los músculos que llevan a cabo tan importante función. El objetivo de este trabajo consistió en determinar el rendimiento muscular inspiratorio y espiratorio según alelos y polimorfismos del gen de la ECA. Se sometió a 83 sujetos (18 a 35 años), 46 hombres y 37 mujeres, a evaluaciones de capacidad vital forzada (CVF), presión inspiratoria máxima y presión espiratoria máxima (PIM-PEM). Posterior a esto, la genotipificación fue realizada por polimerase chain reaction (PCR) y electroforesis en gel de agarosa. Las variables fueron sometidas al análisis estadístico correspondiente según su distribución paramétrica, el nivel de significancia establecido fue un p<0,05. La distribución genotípica fue: Ins/Ins: 28 %, Ins/Del: 62 % y Del/Del: 19 %. Las mujeres homocigoto Ins, presentaron mayor PIM y PEM en modelos por genotipos (p=0,043; p=0,0001 respectivamente) y por dominancia (p=0,019; p=0,0008 respectivamente). La distribución genotípica y frecuencia alélica fue similar a la descrita anteriormente en población chilena. Además, las mujeres portadoras del alelo Ins, presentaron mayor PIM y PEM.

SUMMARY: Gene expression can impact muscle performance. In this aspect genetic polymorphism of the Angiotensin Converting Enzyme (ACE), depending on its insertion or deletion can strengthen different muscle qualities. Similarly, if we consider ventilation as a vital process, it would be important to research whether or not, there is an influence of this polymorphism on the muscles that perform such an important function. The aim of this study was to determine the inspiratory and expiratory muscle performance according alleles and polymorphisms of the ACE gene. We subjected 83 individuals (18-35 years), 46 men and 37 women, to forced vital capacity evaluations, maximum inspiratory pressure and expiratory pressure. Genotyping was subsequently performed by polymerase chain reaction (PCR) and agarose gel electrophoresis. The variables were subjected to appropriate statistical analysis by parametric distribution, the significance level was set at p <0.05. The genotype distribution was: Ins/Ins: 28 %, Ins/Del: 62 % and Del/Del: 19 %. Women homozygous Ins, exhibited a higher maximum inspiratory pressure and expiratory pressure in models for genotypes (p = 0.043; p = 0.0001 respectively) and for dominance (p = 0.019; p = 0.0008 respectively). The genotype distribution and allele frequency was similar to that described above, in Chilean population. Furthermore, women carrying the Ins allele had a higher maximum inspiratory pressure and expiratory pressure.

Efectos agudos del ciclismo indoor en la presión inspiratoria máxima (PIMax) y la presión espiratoria máxima (PEMax) de adultos activos / Acute effects of indoor cycling on maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) in active adults

Objetivo: verificar el efecto agudo del ciclismo indoor en el PIM y la PEM. Método: estudio experimental con muestra de 10 sujetos, de sexo masculino, de 20 a 30 años, practicantes de entrenamiento de ciclismo indoor durante al menos ocho semanas, con una frecuencia semanal de dos a tres veces. Las variables PIM y PEM se midieron antes y después del entrenamiento de ciclismo indoor con duración de 40 minutos, a través del método continuo. Resultados: Ambas variables mostraron una reducción significativa en comparación con los valores pre y post entrenamiento. PIM (pre: -117.5 ± 19.61; post: -110 ± 21.08) con p = 0.02, mientras que PEM (pre: 50 ± 00; post: 142.5 ± 4.8) con p = 0.01. Conclusiones: la intervención se realiza de forma continua y gradualmente creciente cuya sobrecarga puede generar adaptaciones crónicas tales como aumento de la PIM y PEM. Sin embargo, es necesario más estudios en la misma línea para verificar las relaciones y correlaciones.

Objective: To verify the acute effects of Indoor Cycling on the MIP and MEP. Method: An experimental study sample of ten male subjects, ranging in age from 20 to 30 years old, and who have practiced indoor cycling training for at least eight weeks, two to three times a week. The MIP and MEP variables were measured before and after the indoor cycling workout, lasting 40 minutes and using the continuous method. Results: Both variables showed a significant reduction when compared to pre and post training values. MIP (pre: -117.5 ± 19.61; post: -110 ± 21.08; p = 0.02) while the MEP (pre: 50 ± 00; post: 142.5 ± 4.8; p = 0.01). Conclusion: A continuous intervention with a gradual overload increase which can generate chronic adaptations such as increased MIP and MEP. However, it is necessary to carry out further studies within the same line to verify the correlation.

Level of Physical Exercise Capacity, Respiratory Muscle Strength and Peak Expiratory Flow Rate in Healthy Adolescents.

Introduction: The maturation of respiratory system in children leads to changes in value of respiratory parameters like peak expiratory flow rate (PEFR), maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP), and 6-minute walk distance (6MWD). Accurate analysis and clinical decisionmaking in disease state require reference values for different ages. The current study was undertaken to study pulmonary function and exercise capacity in children and adolescents. Materials and methods: After obtaining Institutional Ethical approval and parental informed consent, 262 subjects aged 9 to 15 years were recruited for the study. They were divided into two age groups, i.e., preadolescent (9-12 years) and early adolescent (13-15 years). Demographic details including age, sex, height, weight, and body mass index (BMI) were noted. Physical activity rating (PAR) scale was used to denote physical activity levels. Peak expiratory flow rate was measured using standard Mini-bell peak flow meter (PFM). The parameters MIP and MEP was measured using micro respiratory pressure meter, and 6-minute walk test (6MWT) was performed as per American Thoracic Society (ATS) guidelines. Results: A significant difference was noted between the two groups in PEFR, MIP, MEP, and 6MWD (p = 0.00). Age showed a strong positive correlation with PEFR (r = 0.613, p = 0.000), MIP (r = 0.676, p = 0.000), and MEP (r = 0.658, p = 0.00) whereas showed a strong negative correlation with 6MWD (r = -0.605, p = 0.00). Height showed a strong positive correlation with MEP (r = 0.720, p = 0.000) whereas a strong negative correlation with 6MWD (r = -0.42, p = 0.00). Weight showed a weak negative correlation with 6MWD (r = -0.328, p = 0.00). Gender difference was noticeable in 6MWD and PEFR (p = 0.00) but not in MIP (p = 0.45) and MEP (p = 0.44). Almost 22.10% of early adolescents were overweight compared to only 7.7% seen in preadolescent group. Conclusion: PEFR and respiratory muscle strength was higher in early adolescents as compared to pre-adolescents. However, exercise capacity reflected by 6 MWD was found to be lower in early adolescents in comparison to pre-adolescents. These findings could be used while interpreting the outcome measures utilized while treating patients and for goal setting in cardiopulmonary rehabilitation in clinical practice.

Respiratory exercise program for elderly individuals with asthma

INTRODUCTION: Asthma in older adults is frequently underdiagnosed, as reflected by approximately 60 percent of asthma deaths occurring in people older than age 65. OBJECTIVE: The present study evaluates the effects of a respiratory exercise program tailored for elderly individuals with asthma. We are not aware of any other reports examining breathing exercises in this population. METHODS: Fourteen patients concluded the 16-week respiratory exercise program. All the patients were evaluated with regard to lung function, respiratory muscle strength, aerobic capacity, quality of life and clinical presentation. RESULTS: After 16 weeks of this open-trial intervention, significant increases in maximum inspiratory pressure and maximum expiratory pressure (27.6 percent and 20.54 percent, respectively) were demonstrated. Considerable improvement in quality of life was also observed. The clinical evaluations and daily recorded-symptoms diary also indicated significant improvements and fewer respiratory symptoms. A month after the exercises were discontinued, however, detraining was observed. DISCUSSION: In conclusion, a respiratory exercise program increased muscle strength and was associated with a positive effect on patient health and quality of life. Therefore, a respiratory training program could be included in the therapeutic approach in older adults with asthma.

Amyotrophic lateral sclerosis: prospective study on respiratory parameters / Esclerose lateral amiotrófica: estudo prospectivo de parâmetros respiratórios

OBJECTIVE: To verify how efficient respiratory parameters are in the follow-up of subjects with amyotrophic lateral sclerosis (ALS) and to observe possible correlations between respiratory and nutritional functions. METHOD: Sixteen patients with probable or defined ALS were selected and evaluated over eight months using the following respiratory parameters: spirometry, maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP), arterial gasometry and pulse oximetry; and nutritional parameters such as body mass index (BMI) and percentage weight loss. RESULTS: PaCO2 was a significant parameter to follow up disease evolution (p=0.051). There was significant correlation between MIP and MEP (r: 0.83); BMI and MIP (r: 0.70); BMI and MEP (r: 0.72); pulse oximetry and forced vital capacity (r: 0.57). CONCLUSION: PaCO2 was shown to be an efficient and significant parameter in the measurement of respiratory impairment; the correlations among MIP, MEP and BMI indicated that these are significant parameters for periodic clinical evaluation.

OBJETIVO: Verificar a eficácia dos parâmetros respiratórios na evolução de indivíduos com esclerose lateral amiotrófica (ELA) e identificar possíveis correlações entre função respiratória e nutricional. MÉTODO: 16 pacientes com diagnóstico provável ou definido de ELA foram selecionados por critérios definidos e avaliados, durante 8 meses, através de parâmetros respiratórios: espirometria, pressão inspiratória máxima (PIM), pressão expiratória máxima (PEM), gasometria arterial e oximetria de pulso; e parâmetros nutricionais: índice de massa corporal (IMC) e porcentagem de perda de peso. RESULTADOS: PaCO2 foi um parâmetro significativo para acompanhar a evolução da doença (p=0.051). Houve correlação significante entre PIM e PEM (r: 0.83); IMC e PIM (r: 0.70); IMC e PEM (r: 0.72); oximetria de pulso e capacidade vital forçada (r: 0.57). CONCLUSÃO: PaCO2 foi marcador eficaz e significante para medir o comprometimento respiratório; correlações entre PIM, PEM e IMC indicaram ser bons parâmetros nas avaliações clínicas periódicas.

Specially Programmed Respiratory Muscle Training for Singers by Using Respiratory Muscle Training Device (Ultrabreathe (R) )

Respiratory muscle training is one of the major methods for enhancing the vocal function. Singers who must use their voice most frequently are well aware of the importance of respiration. However, most of them do not know precisely how to exercise their abdominal respiration. Using a respiratory training device, singers are expected to gain more efficiency in their vocal enhancement. The aim of the study was to examine the pulmonary function, the maximum inspiratory pressure (MIP) and the maximum expiratory pressure (MEP), and the maximum phonation time (MPT) in five female voice-majors students after undergoing specially programmed respiratory muscle training for 2 months. All the voice-majors had an average of 4.8 years of formal classical voice training. A respiratory muscle training device (Ultrabreathe (R) ), Tangent health Care Inc., England) was used to train the respiratory muscle. None of the pulmonary function test variables had changed after respiratory muscle training. However, the MIP, MEP, and MPT were significantly increased higher after the respiratory muscle training. This suggests that the specially programmed respiratory muscle training can improve the respiratory muscle strength and vocal function without increasing the pulmonary function.

Effect of Functional Electrical Stimulation on Clearance of Broncheal Secretion in Patients with High Spinal Cord Injury

OBJECTIVE: To determine the effects of abdominal functional electrical stimulation(FES) on the ability to clear the broncheal secretion in high spinal cord injury(SCI) patients. METHOD: Eleven cervical SCI male patients were assessed for the pulmonary function using a routine pulmonary function test. Maximal expiratory pressure(MEP) and peak expiratory flow rate(PEFR) measurements were recorded during (1) spontaneous cough attempts and (2) cough attempts with FES applied to the abdominal wall. Each measurement was recorded in supine and sitting positions. The portable FES unit was set at 24 Hz, with a pulse width of 150 microsecond( s), an asymmetrical biphasic waveform and a maximal intensity to 90 mA. RESULTS: All subjects had a decreased vital capacity, peak expiratory flow and increased ratio of forced expiratory volume at one second(FEV1) to the forced vital capacity(FVC) in a routine pulmonary function test. These cervical SCI patients were greatly reduced the MEP and the PEFR when they coughed spontaneously. FES-assisted coughing increased the MEP and PEFR in all patients in a supine and sitting positions with statistical significance(p<0.05). CONCLUSION: By increasing the MEP and PEFR, abdominal FES could enhance the coughs in high SCI patients. Abdominal FES can be a useful physical therapy for the prevention and treatment of pulmonary complications in high SCI patients at the bed side as well as at homes.