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Zhang YS, Zhang K, Huang L, Wei JX, Bi ZT, Xiao JH, Huang J, Luo CS, Li YD, Zhang JM. The effects of respiratory muscle training on respiratory function and functional capacity in patients with early stroke: a meta-analysis. Eur Rev Aging Phys Act 2024; 21:4. [PMID: 38383309 PMCID: PMC10882726 DOI: 10.1186/s11556-024-00338-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 02/10/2024] [Indexed: 02/23/2024] Open
Abstract
BACKGROUND Respiratory muscle training is a continuous and standardized training of respiratory muscles, but the evidence of the effects on early stroke patients is not clear. This meta-analysis aimed to investigate the effects of respiratory muscle training on respiratory function and functional capacity in patients with early stroke. METHODS PubMed, Embase, PEDro, ScienceDirect, AMED, CINAHL, and China National Knowledge Infrastructure databases were searched from inception to December 8, 2023 for articles about studies that 1) stroke patients with age ≥ 18 years old. Early stroke < 3 months at the time of diagnosis, 2) respiratory muscle training, including inspiratory and expiratory muscle training, 3) the following measurements are the outcomes: respiratory muscle strength, respiratory muscle endurance, pulmonary function testing, dyspnea fatigue score, and functional capacity, 4) randomized controlled trials. Studies that met the inclusion criteria were extracted data and appraised the methodological quality and risk of bias using the Physiotherapy Evidence Database scale and the Cochrane Risk of Bias tool by two independent reviewers. RevMan 5.4 with a random effect model was used for data synthesis and analysis. Mean differences (MD) or standard mean differences (SMD), and 95% confidence interval were calculated (95%CI). RESULTS Nine studies met inclusion criteria, recruiting 526 participants (mean age 61.6 years). Respiratory muscle training produced a statistically significant effect on improving maximal inspiratory pressure (MD = 10.93, 95%CI: 8.51-13.36), maximal expiratory pressure (MD = 9.01, 95%CI: 5.34-12.69), forced vital capacity (MD = 0.82, 95%CI: 0.54-1.10), peak expiratory flow (MD = 1.28, 95%CI: 0.94-1.63), forced expiratory volume in 1 s (MD = 1.36, 95%CI: 1.13-1.59), functional capacity (SMD = 0.51, 95%CI: 0.05-0.98) in patients with early stroke. Subgroup analysis showed that inspiratory muscle training combined with expiratory muscle training was beneficial to the recovery of maximal inspiratory pressure (MD = 9.78, 95%CI: 5.96-13.60), maximal expiratory pressure (MD = 11.62, 95%CI: 3.80-19.43), forced vital capacity (MD = 0.87, 95%CI: 0.47-1.27), peak expiratory flow (MD = 1.51, 95%CI: 1.22-1.80), forced expiratory volume in 1 s (MD = 0.76, 95%CI: 0.41-1.11), functional capacity (SMD = 0.61, 95%CI: 0.08-1.13), while inspiratory muscle training could improve maximal inspiratory pressure (MD = 11.60, 95%CI: 8.15-15.05), maximal expiratory pressure (MD = 7.06, 95%CI: 3.50-10.62), forced vital capacity (MD = 0.71, 95%CI: 0.21-1.21), peak expiratory flow (MD = 0.84, 95%CI: 0.37-1.31), forced expiratory volume in 1 s (MD = 0.40, 95%CI: 0.08-0.72). CONCLUSIONS This study provides good-quality evidence that respiratory muscle training is effective in improving respiratory muscle strength, pulmonary function, and functional capacity for patients with early stroke. Inspiratory muscle training combined with expiratory muscle training seems to promote functional recovery in patients with early stroke more than inspiratory muscle training alone. TRIAL REGISTRATION Prospero registration number: CRD42021291918.
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Affiliation(s)
- Yun-Shan Zhang
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, China.
| | - Kai Zhang
- Department of Rehabilitation Medicine, Sir Run Run Shaw Hospital of Zhejiang University, Hangzhou, 310016, China
| | - Lang Huang
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, China
| | - Jing-Xue Wei
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, China
| | - Zi-Ting Bi
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, China
| | - Jing-Hua Xiao
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, China
| | - Jian Huang
- Cardiopulmonary Rehabilitation Center, Jiangbin Hospital of Guangxi Zhuang Autonomous Region, Nanning, 530000, China
| | - Chao-Song Luo
- Cardiopulmonary Rehabilitation Center, Jiangbin Hospital of Guangxi Zhuang Autonomous Region, Nanning, 530000, China
| | - Ying-Dong Li
- Department of Rehabilitation Medicine, The Guangxi Zhuang Autonomous Region Workers' Hospital, Nanning, 530000, China
| | - Jia-Mei Zhang
- Department of Rehabilitation Medicine, Guangxi International Zhuang Medicine Hospital, NanningNanning, 530000, China
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Held S, Rappelt L, Donath L. Acute and Chronic Performance Enhancement in Rowing: A Network Meta-analytical Approach on the Effects of Nutrition and Training. Sports Med 2023; 53:1137-1159. [PMID: 37097415 DOI: 10.1007/s40279-023-01827-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2023] [Indexed: 04/26/2023]
Abstract
INTRODUCTION This systematic review and network meta-analysis assessed via direct and indirect comparison the occurrence and magnitude of effects following different nutritional supplementation strategies and exercise interventions on acute and chronic rowing performance and its surrogates. METHODS PubMed, Web of Science, PsycNET and SPORTDiscus searches were conducted until March 2022 to identify studies that met the following inclusion criteria: (a) controlled trials, (b) rowing performance and its surrogate parameters as outcomes, and (c) peer-reviewed and published in English. Frequentist network meta-analytical approaches were calculated based on standardized mean differences (SMD) using random effects models. RESULTS 71 studies with 1229 healthy rowers (aged 21.5 ± 3.0 years) were included and two main networks (acute and chronic) with each two subnetworks for nutrition and exercise have been created. Both networks revealed low heterogeneity and non-significant inconsistency (I2 ≤ 35.0% and Q statistics: p ≥ 0.12). Based on P-score rankings, while caffeine (P-score 84%; SMD 0.43) revealed relevantly favorable effects in terms of acute rowing performance enhancement, whilst prior weight reduction (P-score 10%; SMD - 0.48) and extensive preload (P-score 18%; SMD - 0.34) impaired acute rowing performance. Chronic blood flow restriction training (P-score 96%; SMD 1.26) and the combination of β-hydroxy-β-methylbutyrate and creatine (P-score 91%; SMD 1.04) induced remarkably large positive effects, while chronic spirulina (P-score 7%; SMD - 1.05) and black currant (P-score 9%; SMD - 0.88) supplementation revealed impairment effects. CONCLUSION Homogeneous and consistent findings from numerous studies indicate that the choice of nutritional supplementation strategy and exercise training regimen are vital for acute and chronic performance enhancement in rowing.
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Affiliation(s)
- Steffen Held
- Department of Intervention Research in Exercise Training, Institute of Exercise Training and Sport Informatics, German Sport University, Cologne, Germany.
- Department of Sport and Management, IST University of Applied Sciences, Duesseldorf, Germany.
| | - Ludwig Rappelt
- Department of Intervention Research in Exercise Training, Institute of Exercise Training and Sport Informatics, German Sport University, Cologne, Germany
- Department of Movement and Training Science, University of Wuppertal, Wuppertal, Germany
| | - Lars Donath
- Department of Intervention Research in Exercise Training, Institute of Exercise Training and Sport Informatics, German Sport University, Cologne, Germany
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Gonçalves TR, Soares PPDS. Positive Pressure Ventilation Improves Exercise Performance and Attenuates the Fall of Postexercise Inspiratory Muscular Strength in Rower Athletes. J Strength Cond Res 2021; 35:253-259. [PMID: 29309387 DOI: 10.1519/jsc.0000000000002420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
ABSTRACT Gonçalves, TR and Soares, PP. Positive pressure ventilation improves exercise performance and attenuates the fall of postexercise inspiratory muscular strength in rower athletes. J Strength Cond Res 35(1): 253-259, 2021-Positive pressure ventilation (PPV) can increase exercise performance in cyclists, but its effects are unclear in other exercise modes, especially those using large muscle mass. The aim of this study was to compare the exercise performance and postexercise inspiratory muscles' strength with and without PPV (NO-PPV) during rowing. Nine male rowers (19 ± 1 year) participated in 3 experimental days (M1, M2, and M3) separated by 1 week. In M1, rowers performed a 2,000-m test (2k) on a rowing ergometer to obtain average power (W2k). In M2 and M3, the rowers performed 4 minutes' workouts at 55, 65, 75, and 85% W2k, respectively, separated by 1 minute of recovery, with PPV and NO-PPV application in randomized order. Blood lactate (La) was measured during intervals. After submaximal exercises, with 10 minutes of "cool down," the rowers performed a maximal performance test of 4 minutes (4-minute all-out rowing). Traveled distance was computed and correlated with maximal inspiratory pressure (MIP) changes from pretest to posttest (∆). Positive pressure ventilation application increased the traveled distance in relation to NO-PPV exercise (1,210.7 ± 45.5 vs. 1,199.8 ± 43.4 m, p ≤ 0.05). The ∆MIP (cmH2O) was lower in PPV as compared to NO-PPV exercise (-19.1 ± 10.2 vs. -26.3 ± 7.9 cmH2O, p ≤ 0.05). The [La] showed no significant difference between PPV and NO-PPV exercises (p > 0.05). Therefore, the PPV during whole-body rowing exercise improved the exercise performance and attenuated the inspiratory postexercise fatigue. These findings suggest that inspiratory muscles' strength plays a role during high-intensity exercise with large muscle mass.
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Affiliation(s)
- Thiago R Gonçalves
- Department of Physiology and Pharmacology, Laboratory of Experimental and Applied Exercise Physiology, Fluminense Federal University, Niterói, Brazil
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Effectiveness of Respiratory Muscle Training for Pulmonary Function and Walking Ability in Patients with Stroke: A Systematic Review with Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17155356. [PMID: 32722338 PMCID: PMC7432552 DOI: 10.3390/ijerph17155356] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 07/15/2020] [Accepted: 07/22/2020] [Indexed: 01/01/2023]
Abstract
Background: Neurological dysfunction due to stroke affects not only the extremities and trunk muscles but also the respiratory muscles. Aim: to synthesise the evidence available about the effectiveness of respiratory muscle training (RMT) to improve respiratory function parameters and functional capacity in poststroke patients. Methods: a systematic electronic search was performed in the MEDLINE, EMBASE, SPORTDiscus, PEDro and Web of Science databases, from inception to May 2020. Study selection and data extraction: randomised controlled trials (RCTs) that examined the effects of RMT versus non-RMT or sham RMT in poststroke patients. We extracted data about respiratory function, respiratory muscle strength and functional capacity (walking ability, dyspnea, balance, activities of daily life), characteristics of studies and features of RMT interventions (a type of RMT exercise, frequency, intensity and duration). Two reviewers performed study selection and data extraction independently. Results: nineteen RCTs met the study criteria. RMT improved the first second forced expiratory volume (FEV1), forced vital capacity (FVC), peak expiratory flow (PEF), maximal expiratory pressure (MEP), maximal inspiratory pressure (MIP) and walking ability (6 min walking test), but not Barthel index, Berg balance scale, and dyspnea. Conclusions: RMT interventions are effective to improve respiratory function and walking ability in poststroke patients.
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Crisp KD, Case LE, Kravitz RM, Kishnani PS, Jones HN. Training, detraining, and retraining: Two 12-week respiratory muscle training regimens in a child with infantile-onset Pompe disease. J Pediatr Rehabil Med 2020; 13:71-80. [PMID: 32176666 DOI: 10.3233/prm-190601] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Respiratory muscle weakness is a primary cause of morbidity and mortality in patients with Pompe disease. We previously described the effects of our 12-week respiratory muscle training (RMT) regimen in 8 adults with late-onset Pompe disease [1] and 2 children with infantile-onset Pompe disease [2]. CASE REPORT Here we describe repeat enrollment by one of the pediatric participants who completed a second 12-week RMT regimen after 7 months of detraining. We investigated the effects of two 12-week RMT regimens (RMT #1, RMT #2) using a single-participant A-B-A experimental design. Primary outcome measures were maximum inspiratory pressure (MIP) and maximum expiratory pressure (MEP). Effect sizes for changes in MIP and MEP were determined using Cohen's d statistic. Exploratory outcomes targeted motor function. RELEVANCE From pretest to posttest, RMT #2 was associated with a 25% increase in MIP and a 22% increase in MEP, corresponding with very large effect sizes (d= 2.92 and d= 2.65, respectively). Following two 12-week RMT regimens over 16 months, MIP increased by 69% and MEP increased by 97%, corresponding with very large effect sizes (d= 3.57 and d= 5.10, respectively). MIP and MEP were largely stable over 7 months of detraining between regimens. Magnitude of change was greater for RMT #1 relative to RMT #2.
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Affiliation(s)
- Kelly D Crisp
- Department of Head and Neck Surgery and Communication Sciences, Duke University, Durham, NC, USA
| | - Laura E Case
- Physical Therapy Division, Duke University, Durham, NC, USA
| | - Richard M Kravitz
- Division of Pediatric Pulmonary and Sleep Medicine, Duke University, Durham, NC, USA
| | - Priya S Kishnani
- Department of Pediatrics, Division of Medical Genetics, Duke University, Durham, NC, USA
| | - Harrison N Jones
- Department of Head and Neck Surgery and Communication Sciences, Duke University, Durham, NC, USA
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Effects of Inspiratory Muscle Training With Progressive Loading on Respiratory Muscle Function and Sports Performance in High-Performance Wheelchair Basketball Athletes: A Randomized Clinical Trial. Int J Sports Physiol Perform 2019; 15:238-242. [PMID: 31172823 DOI: 10.1123/ijspp.2018-0979] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Revised: 04/07/2019] [Accepted: 05/08/2019] [Indexed: 11/18/2022]
Abstract
PURPOSE To evaluate the effects of inspiratory muscle training associated with interval training on respiratory muscle strength and fatigue and aerobic physical performance (PP) in high-performance wheelchair basketball athletes. METHODS Blinded, randomized clinical trial with 17 male wheelchair basketball players, randomized into control group (CG; n = 8) and training group (TG; n = 9). Respiratory muscle strength was evaluated by measuring maximal inspiratory and expiratory pressures (MIP and MEP), aerobic PP by the Yo-Yo test for wheelchair, and recovery of inspiratory muscle fatigue was assessed at 1, 5, 10, and 15 minutes after exercise test. TG performed inspiratory muscle training protocol with incremental loading for 12 weeks with 50%, 60%, and 70% of MIP, while CG performed with load 15% of MIP. RESULTS After training period, CG presented a significant increase in MIP and MEP (P ≤ .05), with no change in aerobic PP (P ≥ .05). TG showed a significant increase for all variables (≤.05). MIP showed a large effect size for CG (1.00) and TG (1.35), while MEP showed a moderate effect for CG (0.61) and TG (0.73); distance covered had a moderate effect size for TG (0.70). For recovery of inspiratory muscle strength, CG did not present differences, while TG recovered in 10 minutes (≤.05), representing 87% of the pretest value. Positive and significant correlation between MIP and distance (.54; P ≤ .05) was observed. CONCLUSION Inspiratory muscle training protocol with progressive loading was more effective for increasing aerobic PP and maximal inspiratory strength recovery.
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Karsten M, Ribeiro GS, Esquivel MS, Matte DL. The effects of inspiratory muscle training with linear workload devices on the sports performance and cardiopulmonary function of athletes: A systematic review and meta-analysis. Phys Ther Sport 2018; 34:92-104. [DOI: 10.1016/j.ptsp.2018.09.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 08/31/2018] [Accepted: 09/10/2018] [Indexed: 01/09/2023]
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Klusiewicz A, Starczewski M, Sadowska D, Ładyga M. Effect of high- and low-resistance inspiratory muscle training on physiological response to exercise in cross-country skiers. J Sports Med Phys Fitness 2018; 59:1156-1161. [PMID: 30411602 DOI: 10.23736/s0022-4707.18.09120-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The aim of the study was to evaluate the effect of different kinds of respiratory muscle training (RMT) on work capacity and selected spirometric indices in trained male cross-country skiers. METHODS The study involved 13 competitively trained, elite Polish male cross-country skiers. The subjects were randomly divided into two groups who completed 7 weeks of RMT: one with gradually increasing resistance (power RMT) and the other with constant resistance (endurance RMT). Both groups' training programs consisted of 30 inspiratory maneuvers performed twice a day, 6 days a week. The first week of RMT started with a low resistance (29 cmH2O). In the following weeks, resistance in the power RMT group was gradually increased, while in the endurance RMT group, inspiratory resistance was maintained at a constant level of 53 cm H2O (36±8% PImax). Maximal inspiratory pressure (PImax), peak inspiratory flow rate (PIF), and stress test indices were measured before and after RMT. The stress test was conducted on a ski ergometer, with a gradual increase in intensity in all-out effort. RESULTS A significant increase in PImax, PIF, and exercise work capacity (test time, work output, and peak power) was noted in both groups. No significant changes were observed in the VO2max or the selected respiratory variables. CONCLUSIONS During a short training period (up to 7 weeks), the use of gradual and constant inspiratory resistance during RMT improves exercise and spirometric parameters in a similar way. RMT did not have a considerable impact on breathing efficiency in maximal effort.
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Affiliation(s)
- Andrzej Klusiewicz
- Department of Physiology, Institute of Sport, National Research Institute in Warsaw, Warsaw, Poland -
| | - Michał Starczewski
- Department of Physiology, Institute of Sport, National Research Institute in Warsaw, Warsaw, Poland
| | - Dorota Sadowska
- Department of Physiology, Institute of Sport, National Research Institute in Warsaw, Warsaw, Poland
| | - Maria Ładyga
- Department of Physiology, Institute of Sport, National Research Institute in Warsaw, Warsaw, Poland
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Taşkin H, Telli Atalay O, Yuncu G, Taşpinar B, Yalman A, Şenol H. Postoperative respiratory muscle training in addition to chest physiotherapy after pulmonary resection: A randomized controlled study. Physiother Theory Pract 2018; 36:378-385. [DOI: 10.1080/09593985.2018.1488189] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Harun Taşkin
- School of Physical Therapy and Rehabilitation, Pamukkale University, Denizli, Turkey
| | - Orçin Telli Atalay
- School of Physical Therapy and Rehabilitation, Pamukkale University, Denizli, Turkey
| | - Gökhan Yuncu
- Department of Chest Surgery, Kent Hospital, İzmir, Turkey
| | - Betül Taşpinar
- Department of Physical Therapy and Rehabilitation, Dumlupınar University, School of Health Sciences, Kütahya, Turkey
| | - Ali Yalman
- School of Physical Therapy and Rehabilitation, Pamukkale University, Denizli, Turkey
| | - Hande Şenol
- Faculty of Medicine, Department of Biostatistics, Pamukkale University, Denizli, Turkey
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Nunes Júnior ADO, Donzeli MA, Shimano SGN, Oliveira NMLD, Ruas G, Bertoncello D. EFFECTS OF HIGH-INTENSITY INSPIRATORY MUSCLE TRAINING IN RUGBY PLAYERS. REV BRAS MED ESPORTE 2018. [DOI: 10.1590/1517-869220182403166216] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Introduction: Rugby is a sport characterized by high and low intensity motor action. Therefore, the respiratory muscles need adequate work to maintain sustained effective breathing. Objective: To analyze the effects of high-intensity inspiratory muscle training (IMT) in amateur rugby players from the city of Uberaba, Minas Gerais, Brazil. Methods: This is a clinical study in which 20 amateur players underwent a pulmonary function test, respiratory muscle strength and physical capacity assessment. The participants were divided into two groups: 10 volunteers in the IMT group (G1) and 10 in the control group (G2). All the assessments were carried out before and after 12 weeks of IMT. Results: No significant changes were observed in the pulmonary function test. However, maximal voluntary ventilation, maximal inspiratory pressure, maximal expiratory pressure and distance increased significantly after IMT. Conclusion: IMT had beneficial effects on amateur rugby players. Level of evidence I; Therapeutic studies - Investigation of treatment results.
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Affiliation(s)
| | | | | | | | | | - Dernival Bertoncello
- Universidade Federal do Triângulo Mineiro, Brazil; Universidade Federal de São Carlos, Brazil
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Jones HN, Crisp KD, Robey RR, Case LE, Kravitz RM, Kishnani PS. Respiratory muscle training (RMT) in late-onset Pompe disease (LOPD): Effects of training and detraining. Mol Genet Metab 2016; 117:120-8. [PMID: 26381077 DOI: 10.1016/j.ymgme.2015.09.003] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Revised: 09/01/2015] [Accepted: 09/01/2015] [Indexed: 01/08/2023]
Abstract
BACKGROUND Determine the effects of a 12-week respiratory muscle training (RMT) program in late-onset Pompe disease (LOPD). METHODS We investigated the effects of 12-weeks of RMT followed by 3-months detraining using a single-subject A-B-A experimental design replicated across 8 adults with LOPD. To assess maximal volitional respiratory strength, our primary outcomes were maximum inspiratory pressure (MIP) and maximum expiratory pressure (MEP). Effect sizes for changes in MIP and MEP were determined using Cohen's d statistic. Exploratory outcomes targeted motor function, and peak cough flow (PCF) was measured in the last 5 subjects. RESULTS From pretest to posttest, all 8 subjects exhibited increases in MIP, and 7 of 8 showed increases in MEP. Effect size data reveal the magnitude of increases in MIP to be large in 4 (d≥1.0) and very large in 4 (d≥2.0), and effect sizes for increases in MEP were large in 1 (d≥1.0) and very large in 6 (d≥2.0). Across participants, pretest to posttest MIP and MEP increased by a mean of 19.6% (sd=9.9) and 16.1% (sd=17.3), respectively. Respiratory strength increases, particularly for the inspiratory muscles, were generally durable to 3-months detraining. CONCLUSIONS These data suggest our 12-week RMT program results in large to very large increases in inspiratory and expiratory muscle strength in adults with LOPD. Additionally, increases in respiratory strength appeared to be relatively durable following 3-months detraining. Although additional research is needed, RMT appears to offer promise as an adjunctive treatment for respiratory weakness in LOPD.
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Affiliation(s)
- Harrison N Jones
- Department of Surgery, Division of Head and Neck Surgery & Communication Sciences, Duke University, Durham, NC, USA.
| | - Kelly D Crisp
- Department of Speech Pathology & Audiology, Duke University, Durham, NC, USA.
| | - Randall R Robey
- Communication Disorders, University of Virginia, Charlottesville, VA, USA.
| | - Laura E Case
- Physical Therapy Division, Duke University, Durham, NC, USA.
| | - Richard M Kravitz
- Division of Pediatric Pulmonary and Sleep Medicine, Duke University, Durham, NC, USA.
| | - Priya S Kishnani
- Department of Pediatrics, Division of Medical Genetics, Duke University, Durham, NC, USA.
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Sales ATDN, Fregonezi GADF, Ramsook AH, Guenette JA, Lima INDF, Reid WD. Respiratory muscle endurance after training in athletes and non-athletes: A systematic review and meta-analysis. Phys Ther Sport 2015; 17:76-86. [PMID: 26626464 DOI: 10.1016/j.ptsp.2015.08.001] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Revised: 07/03/2015] [Accepted: 08/07/2015] [Indexed: 11/13/2022]
Abstract
The objectives of this systematic review was to evaluate the effects of respiratory muscle training (RMT) on respiratory muscle endurance (RME) and to determine the RME test that demonstrates the most consistent changes after RMT. Electronic searches were conducted in EMBASE, MEDLINE, COCHRANE CENTRAL, CINHAL and SPORTDiscus. The PEDro scale was used for quality assessment and meta-analysis were performed to compare effect sizes of different RME tests. Twenty studies met the inclusion criteria. Isocapnic hyperpnea training was performed in 40% of the studies. Meta-analysis showed that RMT improves RME in athletes (P = 0.0007) and non-athletes (P = 0.001). Subgroup analysis showed differences among tests; maximal sustainable ventilatory capacity (MSVC) and maximal sustainable threshold loading tests demonstrated significant improvement after RMT (P = 0.007; P = 0.003 respectively) compared to the maximal voluntary ventilation (MVV) (P = 0.11) in athletes whereas significant improvement after RMT was only shown by MSVC in non-athletes. The effect size of MSVC was greater compared to MVV in studies that performed both tests. The meta-analysis results provide evidence that RMT improves RME in athletes and non-athletes and MSVC test that examine endurance over several minutes are more sensitive to improvement after RMT.
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Affiliation(s)
- Ana Tereza do N Sales
- Department of Physical Therapy, University Federal of the Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil.
| | - Guilherme A de F Fregonezi
- Department of Physical Therapy, University Federal of the Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Andrew H Ramsook
- Centre for Heart Lung Innovation, University of British Columbia and St. Paul's Hospital, Vancouver, British Columbia, Canada
| | - Jordan A Guenette
- Centre for Heart Lung Innovation, University of British Columbia and St. Paul's Hospital, Vancouver, British Columbia, Canada
| | - Illia Nadinne D F Lima
- Department of Physical Therapy, University Federal of the Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - W Darlene Reid
- Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
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Bell GJ, Game A, Jones R, Webster T, Forbes SC, Syrotuik D. Inspiratory and expiratory respiratory muscle training as an adjunct to concurrent strength and endurance training provides no additional 2000 m performance benefits to rowers. Res Sports Med 2014; 21:264-79. [PMID: 23777381 DOI: 10.1080/15438627.2013.792090] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The purpose of this study was to examine respiratory muscle training (RMT) combined with 9 weeks of resistance and endurance training on rowing performance and cardiopulmonary responses. Twenty-seven rowers (mean ± SD: age = 27 ± 9 years; height = 176.9 ± 10.8 cm; and body mass = 76.1 ± 12.6 kg) were randomly assigned to an inspiratory only (n = 13) or expiratory only (n = 14) training group. Both RMT programs were 3 sets of 10 reps, 6 d/wk in addition to an identical 3 d/wk resistance and 3 d/wk endurance training program. Both groups showed similar improvements in 2000 m rowing performance, cardiorespiratory fitness, strength, and maximum inspiratory (PImax) and expiratory (PEmax) pressures (p < .05). It was concluded that there were no additional benefits of 9 weeks of inspiratory or expiratory RMT on simulated 2000 m rowing performance or cardiopulmonary responses when combined with resistance and endurance training in rowers.
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Affiliation(s)
- Gordon J Bell
- Faculty of Physical Education and Recreation, University of Alberta, Edmonton, Alberta, Canada.
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An exploratory study of respiratory muscle endurance training in high lesion level paraplegic handbike athletes. Clin J Sport Med 2014; 24:69-75. [PMID: 24326928 DOI: 10.1097/jsm.0000000000000003] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To investigate the impact of respiratory muscle endurance training (RMET) on lung function and exercise performance in athletes with high lesion level paraplegia. DESIGN This was a case-control intervention study. SETTING Sport and exercise science laboratories and bike path. PARTICIPANTS Twelve competitive handbike athletes with high lesion level paraplegia matched by lesion and fitness level in training (T) group (7) and control (C) group (5). INTERVENTIONS The T group performed 20 RMET training sessions over a 4-week period using a SpiroTiger. Each session lasted for 30 minutes. The C group did not perform any RMET. MAIN OUTCOME MEASURES Resting lung function, respiratory muscle endurance, and exercise performance (arm cranking maximal incremental test and simulated handbike time trial). RESULTS Resting lung function was not different between groups and did not change with the intervention. After RMET, the respiratory muscle endurance was significantly increased by 27% in the T group but did not alter in the C group. Final minute ventilation was increased from 89 ± 20 L/min to 112 ± 20 L/min after RMET in the T group and the sensation of dyspnea decreased (P < 0.05). Peak oxygen consumption, peak mechanical power output, and handbike time trial performance were not different between groups and did not change with the RMET intervention. CONCLUSIONS A short-term RMET intervention in handbike athletes with high lesion level paraplegia improved respiratory muscle endurance but had little impact on overall exercise performance.
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Sandnes A, Andersen T, Hilland M, Ellingsen TA, Halvorsen T, Heimdal JH, Røksund OD. Laryngeal Movements During Inspiratory Muscle Training in Healthy Subjects. J Voice 2013; 27:448-53. [DOI: 10.1016/j.jvoice.2013.02.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2013] [Accepted: 02/26/2013] [Indexed: 11/16/2022]
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Mans CM, Reeve JC, Gasparini CA, Elkins MR. Postoperative outcomes following preoperative inspiratory muscle training in patients undergoing open cardiothoracic or upper abdominal surgery: protocol for a systematic review. Syst Rev 2012; 1:63. [PMID: 23249730 PMCID: PMC3541345 DOI: 10.1186/2046-4053-1-63] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2012] [Accepted: 11/26/2012] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND In patients undergoing open cardiothoracic and upper abdominal surgery, postoperative pulmonary complications remain an important cause of postoperative morbidity and mortality, impacting upon hospital length of stay and health care resources. Adequate preoperative respiratory muscle strength may help protect against the development of postoperative pulmonary complications and therefore preoperative inspiratory muscle training has been suggested to be of potential value in improving postoperative outcomes. METHODS/DESIGN A systematic search of electronic databases will be undertaken to identify randomized trials of preoperative inspiratory muscle training in patients undergoing elective open cardiothoracic and upper abdominal surgery. From these trials, we will extract available data for a list of predefined outcomes, including postoperative pulmonary complications, hospital length of stay and respiratory muscle strength. We will meta-analyze comparable results where possible, and report a summary of the available pool of evidence. DISCUSSION This review will provide the most comprehensive answer available to the question of whether preoperative inspiratory muscle training is clinically useful in improving postoperative outcomes in patients undergoing cardiothoracic and upper abdominal surgery. It will help inform clinicians working in the surgical arena of the likely effectiveness of instituting preoperative inspiratory muscle training programs to improve postoperative outcomes.
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Affiliation(s)
- Christina M Mans
- Physiotherapy Department, Waikato Hospital, Waikato District Health Board, Hamilton, New Zealand
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