Effects of 12-week inspiratory muscle training with low resistance in patients with multiple sclerosis: A non-randomised, double-blind, controlled trial.

BACKGROUND: Patients with multiple sclerosis (MS) have respiratory limitations like fatigue or muscle weakness. The aim of the study was to evaluate the effectiveness of a low-intensity protocol with inspiratory muscle training (IMT) to improve respiratory strength, spirometric parameters and dyspnea in patients with MS. METHODS: This study was a controlled, non-randomised, double-blind trial on 67 patients with MS distributed in 2 groups, intervention group (IG) (n = 36) and respiratory exercise group (REG) (n = 31). Over 12 weeks, 5 days/week, 15 min/day all subjects followed a respiratory training program. IG trained with IMT with low resistance (20% maximum inspiratory pressure (MIP) during the first two weeks, 30% MIP after the second week). REG followed a program involving nasal breathing and maximum exhalation. Main outcome measured was inspiratory strength (MIP); secondary outcomes were maximum expiratory pressure (MEP), spirometry, dyspnea and health-related quality of life. RESULTS: After respiratory training, the intervention group improved MIP, MEP, MVV, peak expiratory flow (PEF), tidal volume (TV) and dyspnea, 51%, 36%, 21%,11%, 51% and 19% respectively (p < .001, p < .001, p < .001, p < .05, p < .05, p < .05). The control group improved MIP, MEP, MVV and PEF, 24%, 27%, 28% and 12% respectively (p < .001, p < .001, p < .001, p < .05). Improvements achieved on MIP and dyspnea were significantly higher in IG patients (p=.002, p=.046, respectively). CONCLUSION: 12-week inspiratory muscle training with low resistance was more effective than conventional respiratory exercises to improve respiratory strength, spirometric parameters and dyspnea in patients with multiple sclerosis.

Efectos del ejercicio físico moderado sobre la cognición en adultos mayores de 60 años / The effects of moderate physical exercise on cognition in adults over 60 years of age

Introducción. La evidencia clínica a lo largo de estos años indica que los individuos ancianos muestran con mayor frecuencia diversos cambios cognitivos. Estos cambios asociados a la edad se refieren sobre todo a las funciones mnésicas y a la rapidez de pensamiento y razonamiento. Numerosos estudios han demostrado que la actividad física puede establecerse como un mecanismo importante para la protección de las funciones cognitivas. Objetivo. Contrastar la hipótesis de que el ejercicio físico es capaz de producir cambios en las funciones cognitivas de adultos mayores sanos sin deterioro cognitivo, mejorando su calidad de vida. Sujetos y métodos. La población de estudio fue tomada de los participantes en el programa de revitalización geriátrica de la Universidad de Salamanca. La muestra estaba formada en un principio por un total de 44 sujetos de ambos sexos, con una edad media de 74,93 años. Para la valoración neuropsicológica de los sujetos se incluyó una serie de pruebas neuropsicológicas validadas: examen cognitivo minimental, test de retención visual de Benton, aprendizaje audioverbal de Rey, test de Stroop y test del trazo. Resultados. Los resultados indican que una mayor actividad física se relaciona con un mejor rendimiento en las funciones cognitivas de los sujetos incluidos en este estudio, tras la aplicación del programa de revitalización geriátrica. Conclusiones. El programa de revitalización geriátrica puede ser una herramienta útil de cara a la mejoría sobre la cognición en adultos mayores de 60 años, logrando un mejor bienestar en su calidad de vida

Introduction. Clinical evidence gathered in recent years indicates that elderly individuals more frequently display cognitive changes. These age-related changes refer, above all, to memory functions and to the speed of thinking and reasoning. A number of studies have shown that physical activity can be used as an important mechanism for protecting the cognitive functions. Aim. To test the hypothesis that physical exercise is able to bring about changes in the cognitive functions of healthy elderly adults without cognitive impairment, thereby improving their quality of life. Subjects and methods. The study population included participants in the University of Salamanca geriatric revitalization programme. The sample initially consisted of a total of 44 subjects of both sexes, with a mean age of 74.93 years. The neuropsychological evaluation of the subjects included a series of validated neuropsychological tests: Mini-Mental State Examination, Benton Visual Retention Test, Rey Auditory Verbal Learning Test, Stroop Test and Trail Making Test. Results. The results show that more physical activity is related to better performance in the cognitive functions of the subjects included in this study, after applying the geriatric revitalisation programme. Conclusions. The geriatric revitalisation programme can be a valuable tool for improving cognition in adults over 60 years of age, resulting in enhanced well-being in their quality of life

Clinical benefits of home-based pulmonary rehabilitation in patients with chronic obstructive pulmonary disease.

PURPOSE: To evaluate the benefits of home-based pulmonary rehabilitation (PR) in patients with severe and very severe chronic obstructive pulmonary disease (COPD). METHODS: Randomized clinical trial involving 58 patients. Pulmonary function, quality of life evaluated by the Saint George Respiratory Questionnaire, breathlessness evaluated by the London Chest Activity of Daily Living Scale, and exercise tolerance evaluated by 6-minute walk distance were assessed at baseline and at 12 weeks. The program consisted of 2 weekly visits by a physiotherapist in the first 2 weeks, followed by visits twice a month, as well as weekly telephone calls. Training included breathing and stretching exercises and strength exercises (upper and lower limbs), along with endurance training, including walking, stair climbing, cycling, and treadmill walking, depending on available patient resources. RESULTS: The treatment group (TG; n = 23) and control group (CG; n = 18) completed the study. Following the intervention, no statistically significant differences were found in pulmonary function in the TG and CG. The TG exhibited statistically significant differences in the activity domain (P = .008), impact domain (P < .001), and total scores of the Saint George Respiratory Questionnaire (P < .001). In addition, the TG demonstrated statistically significant differences in all domains of the London Chest Activity of Daily Living Scale and no differences were observed in the CG after 12 weeks. There was a statistically significant difference in the 6-Minute Walk Distance in the TG after rehabilitation (P = .008). CONCLUSIONS: This study offers evidence that home-based PR promotes benefits in the quality of life, breathlessness in activities of daily living, and exercise capacity in patients with severe and very severe COPD. Home-based PR must be considered as part of the treatment for patients who live far from hospitals even in severe COPD.

Immediate effects of adding a sciatic nerve slider technique on lumbar and lower quadrant mobility in soccer players: a pilot study.

OBJECTIVE: The objective of this study was to assess the immediate effect of a sciatic nerve slider technique added to sustained hamstring stretching on lumbar and lower quadrant flexibility. DESIGN: This was a randomized controlled pilot study. SUBJECTS: Eight (8) healthy male soccer players (21 +/- 3 years) were randomly assigned to 2 groups. INTERVENTIONS: Group A received 5 minutes of bilateral sustained hamstring stretching. Group B additionally received 60 seconds of a sciatic nerve slider technique for each leg. OUTCOMES: Pre- and postintervention outcomes taken by an assessor blinded to the treatment allocation of the participants included metric distance on finger-to-floor, sit and reach, and the modified Schöber tests and goniometric range of each hip for the straight-leg raise and each knee for seated slump test. Baseline between-group differences were examined with an independent t test and a two-way repeated-measures analysis of variance with p < 0.05 and p < 0.025 analyzed effects of the interventions. RESULTS: There were no significant between-group baseline differences (p > 0.2). There was a significant effect for time on all outcomes (p < 0.01) other than the sit and reach test (p = 0.8). A significant interaction between group . time with greater improvements in group B was found for the modified Schöber test (F = 5.5; p < 0.05), left straight-leg raise (F = 6.1; p < 0.05) and slump test in either leg (left F = 28.7; p = 0.002; right F = 4.9; p < 0.05). CONCLUSIONS: Adding a sciatic nerve slider technique to sustained hamstring stretching led to greater immediate increases in both lumbar and lower quadrant flexibility in young healthy soccer players as measured by four of the seven outcomes used. Study limitations and suggestions for future studies are discussed.