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OBJECTIVE@#To evaluate the feasibility and safety of Liuzijue exercise (LE) for the clinical effect in patients after cardiac surgery.@*METHODS@#Totally 120 patients who underwent cardiac surgery and were admitted to the Cardiothoracic Intensive Care Unit of Nanjing Drum Tower Hospital between July and Oclober, 2022 were allocated to the LE group, the conventional respiratory training (CRT) group, and the control group by a random number table at a ratio of 1:1:1; 40 patients in each group. All patients received routine treatment and cardiac rehabilitation. LE group and CRT group respectively performed LE and CRT once a day for 30 min for 7 days. Control group did not receive specialized respiratory training. The forced vital capacity, forced expiratory volume in 1 s, peak inspiratory flow rate, peak expiratory flow rate, maximum inspiratory pressure, maximum expiratory pressure, modified Barthel index (MBI), and Hamilton Rating Scale for Anxiety (HAM-A) were evaluated before, after 3 and 7 days of intervention. In addition, the postoperative length of hospital stay (LOS) and the adverse events that occurred during the intervention period were compared.@*RESULTS@#A total of 107 patients completed the study, 120 patients were included in the analysis. After 3 days of intervention, the pulmonary function, respiratory muscle strength, MBI and HAM-A of all 3 groups improved compared with that before the intervention (P<0.05 or P<0.01). Compared with the control group, pulmonary function and respiratory muscle strength were significantly improved in the CRT and LE groups (P<0.05 or P<0.01). MBI and HAM-A were significantly improved in the LE group compared with the control and CRT groups (P<0.05 or P<0.01). On the 7th day after intervention, the difference was still statistically significant (P<0.01), and was significantly different from that on the 3rd day (P<0.05 or P<0.01). In addition, on the 7th day of intervention, the pulmonary function and respiratory muscle strength in the LE group were significantly improved compared with those in the CRT group (P<0.01). MBI and HAM-A were significantly improved in the CRT group compared with the control group (P<0.01). There were no significant differences in postoperative LOS among the 3 groups (P>0.05). No training-related adverse events occurred during the intervention period.@*CONCLUSIONS@#LE is safe and feasible for improving pulmonary function, respiratory muscle strength, the ability to complete activities of daily living and for relieving anxiety of patients after cardiac surgery (Registration No. ChiCTR2200062964).
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Humanos , Actividades Cotidianas , Ejercicios Respiratorios , Procedimientos Quirúrgicos Cardíacos/efectos adversos , Músculos Respiratorios , Fuerza Muscular/fisiologíaRESUMEN
Purpose: This study aimed to investigate the effects of underwater walking for 6 weeks at 60% of the predicted maximum heart rate on respiratory muscle strength of elderly people as well as its sustained effects on respiratory muscle strength. Methods: The participants were 43 healthy elderly men, who were randomly divided into the continuous group (n=21) and the non-continuous group (n=22). Initially, both groups performed 30 min of underwater walking four times a week for 6 weeks, after which the continuous group continued the same for another 6 weeks, whereas the non-continuous group was prohibited from performing any exercise, except for daily activities. The walking speed during underwater walking was adjusted such that the exercise intensity was 60% of the predicted maximum heart rate, with the water depth up to the fourth intercostal space or higher. Outcome Measures: The maximal inspiratory pressure (PImax), maximal expiratory pressure (PEmax), and vital capacity (VC) were measured before exercise and 6, 8, 10, and 12 weeks after exercise. Results: The PImax and PEmax were significantly higher after 6 weeks of exercise than those before exercise. In the continuation group, PEmax increased significantly at 12 weeks of exercise compared to that at 6 weeks, whereas PImax did not show a significant increase. In the non-continuous group, PEmax decreased significantly from the 10th week onwards as compared to that at 6 weeks and showed a significantly lower value than that of the continuous group. The PImax of the non-continuous group decreased significantly at 12 weeks compared to that at 6 weeks. The VC after the 6-week underwater walking program did not differ from the pre-exercise value, with no significant difference observed between the two groups. Moreover, the VC in both groups showed no significant changes after 12 weeks of underwater walking compared to that after 6 weeks. Conclusions: Because underwater walking involves moving forward while resisting water pressure, it is necessary to activate the expiratory abdominal muscles to stabilize the trunk. Notably, the respiratory muscle strength in the non-continuous group decreased 4-6 weeks after the underwater walking program was terminated.
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It has been reported that using of the spine mat increases chest expansion, inspiratory capacity (IC) and maximum inspiratory mouth pressure (PImax). However, no changes were observed in other respiratory functions and the respiratory muscle strength. The purpose of this study was to clarify the effects of pursed-lip breathing lying on the spine mat to the respiratory function and respiratory muscle strength. Forty-two adult male participants were assigned to two groups; an intervention group (IG group) of 21 participants who performed pursed-lip breathing on top of a spine mat and a control group (CG group) of 21 participants who performed pursed-lip breathing only. The intervention period was 5 days, and the respiratory features evaluated were chest expansion, respiratory function, respiratory muscle strength, and spinal alignment. A significant increase between the Pretest and the Posttest in chest expansion at the circumference of the axilla level, of the xiphoid process level and of the 10th rib level was observed only in IG group. For the respiratory function and the respiratory muscle strength, intervention group showed significant increases in percentage of vital capacity (%VC), tidal volume (TV), PImax, and maximum expiratory mouth pressure (PEmax). In the control group, only the TV indicated a significant increase. Regarding changes before and after the intervention, the intervention group showed significantly higher PImax and PEmax than the control group. No significant difference in spinal alignment was observed between the two groups. These results showed that pursed-lip breathing lying on the spine mat would increase the PImax, PEmax and the chest expansion.
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Objective:To explore the effect of inspiratory muscle training (IMT) on the pulmonary functioning, respiratory muscle strength and endurance of morbidly obesity persons after bariatric surgery.Methods:Thirty-six morbidly obese patients undergoing bariatric surgery were randomly divided into an experimental group and a control group. A 20-minute daily IMT intervention was administered on the 2nd through the 30th day after the operation. The intensities were 40% and 5% of the maximum inspiratory pressure (MIP). Forced vital capacity, forced expiratory volume in 1 second, maximum peak expiratory flow, maximum inspiratory pressure (MIP) and maximum expiratory pressure, as well as endurance were measured before the operation and on the 2nd, 7th, 14th and 30th day afterward.Results:By the 7th day the pulmonary function of the experimental group had recovered to the level before the operation. For the control group that took until the 14th day. On the 30th day after the operation the average MIP and inspiratory muscle endurance of the experimental group had increased significantly compared with before the operation, while the average MIP of the control group had decreased significantly.Conclusions:Inspiratory muscle training can improve inspiratory muscle strength and endurance and accelerate the recovery of lung function of morbidly obese persons after bariatric surgery.
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Objective:To explore any effect of high-intensity inspiratory muscle resistance training on exercise capacity and life quality for persons with bronchiectasis.Methods:Sixty patients with bronchiectasis were randomly divided into an observation group and a control group, each of 30. The observation group received two 30-minute sessions of inspiratory muscle resistance training daily using the PowerBreak inspiratory muscle trainer 3 days/week for 8 weeks. The intensity was 70% of the maximum inspiratory pressure (MIP). The control group underwent the same training with the intensity at 10% of the MIP. The severity of illness, pulmonary function, respiratory muscle strength and endurance, exercise capacity and life quality of the two groups were evaluated before and after the intervention.Results:Compared with before the intervention, the average MIP in the observation group and the average distance they walked in the 6min walk test (6MWT) improved significantly. Their average social factor score on the Leicester cough questionnaire had increased significantly, while their average heart rate and self-perceived exertion during the 6MWT had decreased significantly. There were no significant differences in any of these indicators for the control group.Conclusions:High-intensity inspiratory muscle resistance training can significantly improve the exercise capacity and life quality of patients with bronchiectasis. The treatment is worthy of further research and application in the clinic.
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Objective:To observe any short-term effect of combining respiratory muscle training with feedback respiratory electrical stimulation on the pulmonary function and respiratory muscle strength of stroke survivors.Methods:Sixty stroke survivors were randomly divided into an observation group ( n=30) and a control group ( n=30). Both groups were given conventional rehabilitation 6 days a week for 3 weeks, but the observation group also received respiratory muscle training with feedback electrical stimulation. Before and after the treatment, both groups′ pulmonary functioning and respiratory muscle strength were measured, and also their trunk control, skill in the activities of daily living and fatigue level. The trunk impairment scale (TIS), modified Barthel index (MBI) and fatigue severity scale (FSS) were used. The incidence of stroke-associated pneumonia (SAP) was also compared between the two groups. Results:After the treatment, average forced vital capacity, forced expiratory volume in 1 second, maximum voluntary ventilation, peak expiratory flow, maximum inspiratory pressure, maximum expiratory pressure, as well as the average TIS and MBI scores of both groups had improved significantly, and there was a significant decrease in the average FSS scores. After the intervention, all of the average measurements of the experimental group were significantly better than the control group′s averages except their MBI scores. There was no significant difference in the incidence of SAP.Conclusions:Three weeks of respiratory muscle training combined with electrical stimulation feedback can effectively improve the pulmonary function, respiratory muscle strength and inspiratory muscle endurance of stroke survivors, resulting in better coughing ability, trunk control and reduced fatigue.
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Objective:To explore the effect of respiratory muscle endurance training on the blood pressure, lung function, respiratory muscle strength and motor capacity of persons with hypertension.Methods:Sixty persons with essential hypertension were randomly divided into an experimental group and a control group, each of 30. The experimental group received 8 weeks of inspiratory resistance training with an intensity of 55% of their maximum inspiratory air pressure (MIP) while the control group had an intensity of 10% MIP with the other training conditions the same as those of the experimental group. Both groups practiced 30 times as a set, two sets a day, 4 days a week. Blood pressure, lung function and respiratory muscle strength were measured before and after the intervention, and motor capacity was measured using the 6-minute walk test (6MWT).Results:After the intervention, the average MIP of the experimental group had increased significantly (to 123.6±13.9 from 83.5±9.8cmH 2O). The average 6MWT time of the experimental group had also improved significantly, but there were no significant differences in any of the control group observations. Conclusion:Eight weeks of respiratory muscle endurance training can improve the inspiratory muscle strength and motor capacity of patients with essential hypertension, but it has no effect on blood pressure or lung functioning.
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Abstract Introduction: The lung is considered a target organ in diabetes mellitus as a consequence of alterations secondary to chronic hyperglycemia that compromise respiratory muscle strength. Metabolic surgery for improving diabetes mellitus has beneficial effects on weight loss and glucose metabolism. Objective: The objective of this study was to evaluate the respiratory muscle strength, assessed by MIP and MEP, body mass index (BMI) and fasting glucose profile of patients with type 2 diabetes mellitus before and after metabolic surgery without gastric resection. Method: Seventeen patients with type 2 diabetes mellitus participated in the study. The participants had a mean age of 44.8 ± 11.81 years. Results: The results showed a significant decrease of MEP values in the immediate postoperative period when compared to the preoperative period (p=0.001), while no significant results were obtained for MIP. Regarding BMI and fasting glucose, significant weight loss and a significant reduction in fasting glucose levels were observed in the late postoperative period (p=0.006 and p=0.007, respectively). Conclusion: The MIP and MEP were reestablished and satisfactory results were obtained for BMI and fasting glucose in the late postoperative period. Further studies are needed to monitor patients in the pre- and postoperative period of metabolic surgery, identifying complications and acting on the care and recovery of these patients.
Resumo Introdução: O pulmão é considerado um dos órgãos-alvo do diabetes mellitus, como consequência das alterações secundárias à hiperglicemia crônica, comprometendo a força muscular respiratória. A cirurgia metabólica para a melhora do diabetes mellitus exerce efeitos benéficos na perda de peso e no metabolismo da glicose. Objetivo: O objetivo deste estudo foi avaliar o perfil da força muscular respiratória, avaliada por PImáx e PEmáx, o índice de massa corporal (IMC) e a glicemia em jejum de pacientes com diabetes mellitus tipo 2 antes e após a cirurgia metabólica sem ressecção gástrica. Método: Dezessete pacientes com diabetes mellitus tipo 2 participaram do estudo. Os participantes tinham idade média de 44,8±11,81 anos. Resultados: Os resultados mostraram uma diminuição significativa dos valores da PEmáx no pós-operatório imediato, quando comparado ao pré-operatório (p = 0,001), enquanto não foram obtidos resultados significativos para a PImáx. Em relação ao IMC e à glicemia em jejum, observou-se perda significativa de peso e redução significativa dos níveis de glicemia de jejum no pós-operatório tardio (p = 0,006; p= 0,007, respectivamente). Conclusão: A PImáx e a PEmáx foram restabelecidas e resultados satisfatórios foram obtidos para IMC e glicemia de jejum no pós-operatório tardio. Mais estudos são necessários para monitorar pacientes no pré e pós-operatório de cirurgia metabólica, identificando complicações e atuando no cuidado e recuperação desses pacientes.
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Objective:To evaluate the effect of threshold inspiratory muscle training (TIMT) on respiratory muscle strength and clinical outcomes for machinery ventilates patients. Methods:The Cochrane Library, PubMed, Embase, Web of Science, CBM, Wanfang Database, CNKI and VIP were searched for the randomized controlled trials (RCT) about the effect of TIMT on respiratory muscle strength and clinical outcomes from establishment to July 1st, 2018. Two researchers strictly evaluated literature quality and extracted information, and then a Meta-analysis was carried out. Results:A total of 14 literatures were included with 650 patients, 323 cases in the experimental group and 327 cases in the control group. Compared with the control group, the massive inspiratory pressure (MIP) increased (MD = -6.65, 95%CI -8.27~-5.03, P < 0.001), the respiratory muscle strength increased (MD = -5.04, 95%CI -7.68~-2.04, P = 0.0002), the weaning time reduced (MD = -1.01, 95%CI -1.65~-0.37, P = 0.002), the mechanical ventilation time shortened (MD= -2.24, 95%CI -4.33~-0.15, P = 0.04), as well as the intensive care unit (ICU) length of stay (MD= -3.41, 95%CI -6.06~-0.76, P= 0.01). There was no significant difference in maximum expiratory pressure (MEP) (MD= 1.22, 95%CI -6.55~9.00, P = 0.76), the rate of reintubation/tracheotomy (RR = 0.99, 95%CI 0.56~1.73, P = 0.96) and mortality (RR= 1.05, 95%CI 0.53~2.06, P = 0.89) between two groups. Conclusion:TIMP could improve MIP and respiratory muscle strength of patients with mechanical ventilation, shorten the weaning time, the mechanical ventilation time and the ICU length of stay, and then reduce the incidence of weaning failure.
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Background: Athletes are trained for specific games and for specific muscle groups. In all the games respiratory muscles with proper strength are needed so as to provide better outcome. But as the peripheral muscles are trained the Respiratory muscles are not trained specifically in any of the athlete. The less trained Respiratory muscles can directly affect the output of the Athlete by activating Metaboreflex. This reflex is activated when the Respiratory muscles gets fatigued; in which the blood is pulled towards the fatigued Respiratory muscles; due to which the peripheral muscle gets less blood and oxygen to work longer; which results in reduced output. So as to improve overall output, along with specific muscles, the Respiratory muscles should also be trained. Aim: This study was designed to evaluate the effect of Inspiratory Muscle Trainer on Running Performance and Respiratory Muscle strength in Athletes. Materials and methods: An Interventional study was conducted on Athletes studying in a Physical Education college Gujarat. The subjects were selected according to inclusion criteria. The Pre-training outcome of PImax (Inspiratory Mouth Pressure); PEmax (Expiratory Mouth Pressure) and time taken for 30m sprint was taken. And then subjects were divided into two groups’ one training and other control. Group A: Training for Respiratory muscles by Inspiratory Muscle Training Device along with other regular physical activity. Group B: Not getting any additional training for Respiratory muscle other than regular physical activity. The training was given at 50% PImax for 15 min a day for 6 weeks. At the end of 6 weeks postdata of PImax PEmax and speed were collected. Agnihotri DS, Bhise AR, Patel SM. Effect of Inspiratory Muscle Trainer on Running Performance and Respiratory Muscle Strength in Athletes. IAIM, 2016; 3(8): 159-163. Page 160 Results: Data analysis was done using SPSS20 version. In Experimental group Inspiratory Mouth Pressure, Expiratory Mouth Pressure improved significantly (p<0.05) also time taken for completion of 30msprint reduced significantly. (p<0.05) Conclusion: The Inspiratory Muscle Trainer can be used to improve Inspiratory Mouth Pressure, Expiratory Mouth Pressure and Running Performance in Athletes.
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INTRODUCTION: Reference values and equations show strong variability and regional differences, despite a well-established role of the assessment of respiratory muscle strength (RMS) in children, with the objective to follow up on diseases that affect the function of respiratory muscles and enable adequate growth and development. OBJECTIVE: To describe reference values and prediction equations of maximal respiratory pressures for Brazilian children METHODS: Literature review was conducted using databases LILACS, MEDLINE and Science Direct, and descriptors established by DeCS of the Virtual Health Library: reference values, child, respiratory muscle strength, predictive equations and their respective synonyms in English RESULTS: Six clinical trials were carried out, which determined reference values for children in various Brazilian regions. There was a relationship among RMS values and other factors, such as age, height and body mass. However, there was a significant difference among the data in the Brazilian states and divergence among the predicted values CONCLUSION: There is a consensus on the relationship among RMS, anthropometric factors and regional influences. The articles studied reported diverging predicted values and reference equations
INTRODUÇÃO: Apesar da reconhecida importância da análise das pressões respiratórias máximas (PRM) em pediatria, tanto no seguimento de enfermidades que afetam a função dos músculos respiratórios, quanto da adequação do crescimento e desenvolvimento infantil, existe ampla variabilidade e regionalização quantos aos valores e equações de referência OBJETIVO: Descrever os valores de referência e equações preditivas das pressões respiratórias máximas para crianças brasileiras MÉTODO: Revisão de literatura realizada nas bases de dados LILACS, MEDLINE e Science Direct, utilizando os descritores estabelecidos pelo DeCS da Biblioteca Virtual em Saúde: valores de referência, criança, força muscular respiratória, equações preditivas, e seus sinônimos em inglês RESULTADOS: Encontrou-se seis ensaios clínicos, com valores de referência para a população pediátrica, realizados em diferentes regiões brasileiras. Observou-se relação entre os valores das PRM e fatores como idade, estatura e massa corporal. Porém, houve relevante diferença entre os dados nos estados brasileiros e divergência entre os valores preditos CONCLUSÕES: Há consenso ao relacionar as pressões respiratórias máximas e fatores antropométricos, bem como uma influência regional. Os valores preditos e as equações de referência foram divergentes entre os trabalhos encontrados PALAVRAS-CHAVE: valores de referência, criança, força muscular respiratória, equações preditivas
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Humanos , Masculino , Femenino , Niño , Crecimiento y Desarrollo , Fuerza Muscular , Valores de Referencia , Mecánica Respiratoria , Músculos Respiratorios , Antropometría , Ensayos Clínicos Controlados como Asunto , Factores de RiesgoRESUMEN
Introduction Individuals with Down syndrome may have decreased respiratory muscle strength due to hypotonia, a common characteristic in this population. Objective To analyze the effects of a hippotherapy program on respiratory muscle strength in individuals with Down syndrome. Materials and methods The study included 41 subjects, 20 of which were in the hippotherapy practicing group (PG) and 21 of which were in the non-practicing group (NPG). Study subjects were of both sexes, aged 7-13 years, and all diagnosed with Down syndrome. A manovacuometer was used to measure respiratory muscle strength, following the protocol proposed by Black and Hyatt (23). Statistical analysis was performed by means of descriptive distribution. After verifying normality and homoscedasticity of the variables, the Mann-Whitney test was used to determine differences between the means of the two groups (PG and NPG), and the Spearman’s rank correlation coefficient test was used to view possible relationships with age and time practicing hippotherapy. Significance was set at p < 0.05. Results and discussion Individuals who practiced hippotherapy showed improvements in both inspiratory and expiratory respiratory muscle strength, although no significant difference was demonstrated. Conclusion This study demonstrates that hippotherapy benefits respiratory muscle strength in individuals with Down syndrome, and that the youngest subjects had the best results. .
Introdução Os indivíduos portadores de síndrome de Down (SD) podem apresentar uma redução da força muscular respiratória, principalmente em função da hipotonia, característica comum nessa população. Objetivo Analisar o efeito de um programa de equoterapia sobre a força muscular respiratória em indivíduos com SD. Materiais e métodos Participaram do estudo 41 indivíduos, sendo 20 pertencentes ao grupo praticantes (GP) e 21 ao grupo não praticante (GNP), de ambos os sexos, com idades compreendidas entre 7 e 13 anos, todos diagnosticadas com síndrome de Down (SD). Utilizou-se a manovacuometria para aferição da força muscular respiratória, seguindo o protocolo proposto por Black e Hyatt (23). A análise estatística deu-se a partir de uma distribuição descritiva. Após verificado a normalidade e homocedasticidade das variáveis utilizou-se o teste de Mann Whitney para verificar as diferenças entre as médias dos grupos (GNP e GP), como a utilização do teste de correlação de Spearman para visualizar possíveis relações com a idade e o tempo de prática de equoterapia. Adotou uma significância de p < 0,05. Resultados e discussão Os indivíduos que realizavam a equoterapia apresentaram melhoras em relação à força muscular respiratória, tanto inspiratória (MIP) quando expiratória (MEP), embora não apresentando diferença significativa em relação ao grupo não praticante. Conclusão Este estudo demonstra que o programa de equoterapia apresenta benefícios na força muscular respiratória em indivíduos com SD e que principalmente os mais jovens obtiveram melhores resultados. .
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Objective To investigate the sniff nasal inspiratory pressure (SNIP) of Chinese boys. Methods 299 healthy boys aged 5-12 years were measured with SNIP. Their height, weight, and age were recorded. Results The SNIP averaged (76.9 ± 22.6) cmH2O, and was (59.1±14.2) cmH2O, (76.9±19.5) cmH2O, (85.3±23.5) cmH2O and (83.0±22.6) cmH2O in the boys of 5-6 years old, 7-8 years old, 9-10 years old and 11-12 years old, respectively. It was significantly different among boys of 5-6 years old, 7-8 years old and 9-10 years old (P<0.05), but no significant difference between 9-10 years old and 11-12 years old (P=0.55). Regression analysis indicated significant relations of SNIP with age, height, weight and Body Mass Index (P<0.01). Conclusion The SNIP of Chinese healthy boys are different from abroad. It is necessary to establish the Chinese children SNIP reference range.
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@#Objective To investigate the sniff nasal inspiratory pressure (SNIP) of Chinese boys. Methods 299 healthy boys aged 5-12 years were measured with SNIP. Their height, weight, and age were recorded. Results The SNIP averaged (76.9±22.6) cmH2O, and was (59.1±14.2) cmH2O, (76.9±19.5) cmH2O, (85.3±23.5) cmH2O and (83.0±22.6) cmH2O in the boys of 5-6 years old, 7-8 years old, 9-10 years old and 11-12 years old, respectively. It was significantly different among boys of 5-6 years old, 7-8 years old and 9-10 years old (P<0.05), but no significant difference between 9-10 years old and 11-12 years old (P=0.55). Regression analysis indicated significant relations of SNIP with age, height, weight and Body Mass Index (P<0.01). Conclusion The SNIP of Chinese healthy boys are different from abroad. It is necessary to establish the Chinese children SNIP reference range.
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Measurement of respiratory muscle strength is useful in order to detect respiratory muscle weakness and to quantify its severity. Apropos of a patient with bilateral diaphragmatic paralysis, we review the clinical manifestations and methods for assessing the strength of the respiratory muscles. In patients with severe respiratory muscle weakness, vital capacity and total lung capacity are reduced but are a non-specific and relatively insensitive measure. Conventionally, inspiratory and expiratory muscle strength has been assessed by maximal inspiratory and expiratory mouth pressures sustained for one second (PIMax and PEMax). The sniffmanoeuvre is natural and probably easier to perform. Sniff pressures are more reproducible and useful measure of diaphragmatic strength. However, the PIMax-PEMax and sniff manoeuvres are volition dependent, and submaximal efforts are most likely to occur in patients who are ill or breathless. Non-volitional tests include measurements of twitch esophageal, gastric and transdiaphragmatic pressure during bilateral electrical and magnetic phrenic nerve stimulation. Electrical phrenic nerve stimulation is technically difficult and is also uncomfortable and painful. Magnetic phrenic nerve stimulation is less painful and transdiaphragmatic pressure is reproducible in normal subjects. Systematic clinical evaluation and additional laboratory tests allow the diagnosis in most patients with respiratory muscle weakness.
La evaluación de la fuerza de los músculos respiratorios permite diagnosticar y cuantificar la gravedad de la debilidad muscular en diferentes enfermedades. A propósito de un paciente con parálisis diafragmática bilateral, hemos revisado el cuadro clínico y los procedimientos diagnósticos para evaluar la fuerza de los músculos respiratorios. En los pacientes con debilidad muscular respiratoria severa, disminuye la capacidad vital y la capacidad pulmonar total, pero es una medida inespecífica y relativamente insensible. Tradicionalmente, la fuerza muscular respiratoria es evaluada midiendo la presión inspiratoria y espiratoria máximas en la boca sostenidas durante un segundo (PIMax y PEMax). La medición de la presión inspiratoria máxima en la nariz (SNIP) es una maniobra natural, más simple de medir y más reproducible, siendo útil en la evaluación de la fuerza diafragmática. Sin embargo, estas técnicas no invasivas son operador dependiente, por lo tanto, esfuerzos submáximos es más probable que ocurran en pacientes graves o con disnea. Las mediciones de las presiones esofágica, gástrica y transdiafragmática mediante estimulación eléctrica o magnética del nervio frénico no son dependientes de la voluntad y son más confiables. Sin embargo, la estimulación eléctrica del nervio frénico es técnicamente difícil y puede ser incómoda y dolorosa. La estimulación magnética del nervio frénico es menos dolorosa y la medición de la presión transdiafragmática es reproducible en sujetos normales. La evaluación clínica sistemática y los exámenes de laboratorio complementarios permiten establecer el diagnóstico en la mayoría de los pacientes con debilidad de los músculos respiratorios.
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Humanos , Masculino , Anciano , Parálisis Respiratoria/diagnóstico , Músculos Respiratorios/fisiología , Fuerza Muscular/fisiología , Insuficiencia Respiratoria/patología , Técnicas de Laboratorio Clínico/métodosRESUMEN
@#Objective To investigate the sniff nasal inspiratory pressure (SNIP) of Chinese boys. Methods 299 healthy boys aged 5-12 years were measured with SNIP. Their height, weight, and age were recorded. Results The SNIP averaged (76.9±22.6) cmH2O, and was (59.1±14.2) cmH2O, (76.9±19.5) cmH2O, (85.3±23.5) cmH2O and (83.0±22.6) cmH2O in the boys of 5-6 years old, 7-8 years old, 9-10 years old and 11-12 years old, respectively. It was significantly different among boys of 5-6 years old, 7-8 years old and 9-10 years old (P<0.05), but no significant difference between 9-10 years old and 11-12 years old (P=0.55). Regression analysis indicated significant relations of SNIP with age, height, weight and Body Mass Index (P<0.01). Conclusion The SNIP of Chinese healthy boys are different from abroad. It is necessary to establish the Chinese children SNIP reference range.
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BACKGROUND: The cardiovascular system is noticeably affected by respiration. However, whether different inspiratory resistive loading intensities can influence autonomic heart rate (HR) modulation remains unclear. OBJECTIVE: The objective was to investigate HR modulation at three different inspiratory resistive loading intensities in healthy elderly men. METHOD: This was a prospective, randomized, double-blind study that evaluated 25 healthy elderly men. Cardiac autonomic modulation was assessed using heart rate variability (HRV) indices. All of the volunteers underwent maximal inspiratory pressure (MIP) measurements according to standardized pulmonary function measurements. Three randomly-applied inspiratory resistive loading (30, 60 and 80% of MIP) intensities were then applied using an inspiratory resistance device (POWERbreathe, Southam, UK), during which the volunteers were asked to inhale for 2 seconds and exhale for 3 seconds and complete 12 breaths per minute. Each effort level was performed for 4 minutes, and HR and the distance between 2 subsequent R waves of electrocardiogram (R-R intervals) were collected at rest and at each intensity for further HRV analysis. RESULTS : The parasympathetic HRV (rMSSD, SD1 and HF) indices demonstrated lower values at 80% (rMSSD: 19±2 ms, SD1: 13±2 ms and HF: 228±61 ms2) than at 30% MIP (rMSSD: 25±3 ms, SD1: 18±2 ms and HF: 447±95 ms2; p<0.05). CONCLUSIONS: Lower inspiratory resistive loading intensities promoted a marked and positive improvement of parasympathetic sinus node modulation. .
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Anciano , Humanos , Masculino , Frecuencia Cardíaca/fisiología , Inhalación/fisiología , Método Doble Ciego , Estudios Prospectivos , Pruebas de Función RespiratoriaRESUMEN
INTRODUÇÃO: O envelhecimento é um processo fisiológico que traz consigo várias alterações nos sistemas corporais, inclusive a diminuição de força da musculatura respiratória. OBJETIVO: Avaliar PImáx (pressão inspiratória máxima), PEmáx (pressão expiratória máxima) e pico de fluxo expiratório de idosos institucionalizados antes e após a aplicação de técnicas manuais expansivas e incentivador respiratório orientado a fluxo (Respiron®) e comparar os resultados obtidos. MATERIAIS E MÉTODOS: Estudo longitudinal, caso controle realizado em uma instituição da cidade de Curitiba (PR), com 16 indivíduos (70 a 80 anos) do sexo masculino. Os sujeitos foram selecionados e submetidos à avaliação da força da musculatura respiratória por meio do manovacuômetro da marca Indumed® e fluxo expiratório através do peak flow da marca Mini Wright®. Após a avaliação, a amostra foi dividida aleatoriamente em grupos: grupo 1 (G1, n = 7) - idosos submetidos ao uso incentivador inspiratório (Respiron®) e técnicas expansivas (exercícios diafragmáticos e compressão/descompressão); grupo 2 (G2, n = 7) - técnicas manuais expansivas; grupo 3 (G3, n = 7), incentivador inspiratório; grupo 4 (G4, n = 7) - grupo controle. RESULTADOS: Ocorreu melhora para todas as variáveis pré e pós-tratamento para os grupos experimentais, porém o destaque é dado para o grupo II. CONCLUSÃO: Este estudo apresentou resultados satisfatórios com a aplicação de técnicas de expansão pulmonar e Respiron® na força da musculatura respiratória e pico de fluxo expiratório de idosos institucionalizados.
INTRODUCTION: Aging is a physiological process that brings with it several changes in the body system, including the decrease in respiratory muscle strength. OBJECTIVE: To evaluate MIP (maximal inspiration pressure), MEP (maximal expiratory pressure) and expiratory flow peak of institutionalized elderly before and after application of manual techniques and expansive flow-oriented incentive spirometry (Respiron®), and compare the results obtained. MATERIALS AND METHODS: A longitudinal study, case control study in an institution in Curitiba (PR), with 16 male individuals (70-80 years old). The subjects were selected and evaluated for their respiratory muscle strength through the manometer Indumed® and expiratory peak flow through the flow of Mini Wright® brand. The treatment program was conducted for 15 minutes, interspersed with one minute rest every four minutes of technique, three times a week for six consecutive weeks. After evaluation, the sample was randomly divided into groups: group 1 (G1, n = 7) - elderly submitted to the use the encouraged inspiratory (Respiron®) and to expansive techniques (diaphragmatic breathing exercises and compression/decompression); group 2 (G2, n = 7) - manual expansive techniques; group 3 (G3, n = 7) - inspiratory incentive; group 4 (G4, n = 7) - control group. RESULTS: There was an improvement for all variables before and after treatment for the experimental groups, but the emphasis is given to group II. CONCLUSION: This study showed satisfactory results with the application of techniques for lung expansion and Respiron® in respiratory muscle strength and expiratory flow peak of institutionalized elderly.
Asunto(s)
Humanos , Anciano , Hogares para Ancianos , Institucionalización , Fuerza Muscular , Respiración , Mecánica Respiratoria , Frecuencia Respiratoria , Especialidad de FisioterapiaRESUMEN
INTRODUÇÃO: A asma é uma desordem inflamatória crônica que, em casos graves, altera o fluxo aéreo, mesmo no período intercrise. OBJETIVO: Verificar, em crianças asmáticas, a influência das posturas sentada ereta e sentada inclinada para frente sobre o efeito da nebulização medicamentosa, avaliando as forças inspiratória e expiratória máximas (PI máx e PE máx) e o pico de fluxo expiratório (PFE). MÉTODO: 57 crianças, na faixa etária de 6 a 12 anos, foram distribuídas em três grupos: Grupo I, com crianças na postura sentada ereta e sentada inclinada para frente; Grupo II, com crianças na postura sentada ereta antes e após a nebulização; e Grupo III, com crianças na postura sentada inclinada para frente antes e após a nebulização. As crianças foram avaliadas três vezes nas medidas analisadas. Para comparação, foi utilizado o teste t de student (pareado) RESULTADOS: A PI máx, a PE máx e o PFE foram maiores na posição sentada inclinada para frente, com p = 0,003, p = 0,006 e p = 0,000, respectivamente. Após a nebulização, o Grupo II apresentou aumentos de 44,16% na PI máx, 36,02% no PEF e 34,88% na PE máx. Após a nebulização, o Grupo III apresentou elevação de 69,46% na PI máx, 60,87% na PE máx e 52,05% no PFE. Comparados os grupos II e III, os ganhos são maiores no Grupo III, com (p < 0,05) para as medidas do PFE e da PE máx. CONCLUSÃO: A postura sentada inclinada para frente oferece maior vantagem mecânica para a musculatura expiratória, favorecendo a redução da obstrução, por evidenciar aumentos na PE máx e no PFE.
INTRODUCTION: Asthma is a chronic inflammatory disorder which in severe cases changes the air flow, even in the period between episodes. OBJECTIVE: To evaluate, in asthmatic children under the effect of nebulized drug, the influence of upright sitting and leaning forward sitting postures, by assessing the intensity of the inspiratory and expiratory pressures (MIP and MEP) and peak expiratory flow (PEF). METHODS: 57 children aged 6-12 years were divided in three groups: In Group I, both postures, upright sitting and leaning forward sitting, were assessed without using nebulized drug; in Group II, only the upright sitting posture was assessed before and after nebulization; in Group III, only the leaning forward sitting posture was assessed before and after nebulization. The measures were repeated by assessing these children three times in a single session. A student t-test (pared) was used for comparisons. RESULTS: MIP, MEP and PEF were higher in the leaning forward position indicating respective p values of p = 0.003, p = 0.006 and p = 0.000. After nebulization, the Group II demonstrated an increase of 44.16% in MIP, 36.02% in PEF and 34.88% in MEP. After nebulization, the Group III showed a gain of 69.46% in MIP, 60.87 in MEP and 52.05% in PEF. The difference between groups II and III were significant (p < 0.05) for levels of PEF and MEP, indicating that the Group III showed better performance during these tests. CONCLUSION: It can be suggested that the leaning forward sitting posture provided an increased mechanical advantage for expiratory muscles, favoring the airflow during expiration and reducing the obstruction as evidenced by MEP and PEF increase.