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de Souza HCM, Pessoa MF, Clemente RDS, da Silva AV, Cardoso PRG, Fernandes J, Dornelas de Andrade A. Effects of 12 weeks of inspiratory muscle training and whole body vibration on the inflammatory profile, BDNF and muscular system in pre-frail elderly women: A randomized controlled trial. Arch Gerontol Geriatr 2024; 123:105421. [PMID: 38593699 DOI: 10.1016/j.archger.2024.105421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 02/12/2024] [Accepted: 03/20/2024] [Indexed: 04/11/2024]
Abstract
AIM to investigate the effects of the whole body vibration (WBV) and inspiratory muscle training (IMT) on the inflammatory profile and in muscle mass and strength in pre-frail older women. METHODS this study was a randomized double-blind trial. Forty two older women aged 60-80 years were randomly allocated to IMT + WBV (G1), IMTsham + WBV (G2) or Sham groups (G3). During 12 weeks G1 received both trainings, whereas G2 received WBV alone and G3 received IMT with a low fixed load and were positioned at the vibratory platform without therapeutic effect. Participants were evaluated before and after the intervention for the following outcomes: Brain-derived neurotrophic factor (BDNF) and inflammatory biomarkers (IB), respiratory (RT) and quadriceps thickness (QT) and diaphragmatic mobility (DM) using muscle ultrasound, body composition (BC) using a bioelectrical impedance scale and inspiratory muscle strength (IMS). RESULTS after the training, G1 (114.93 ± 21.29) improved IMS (p<0.005) compared with G2 (91.29 ± 23.10) and G3 (85.21 ± 27.02). There was also a significant improve on time of the DM (p<0.001) and RT (p=0.006) for G1 (8.59 ± 3.55 and 11.11 ± 12.66) compared with G2 (1.05 ± 3.09 and 1.10 ± 10.60) and G3 (0.40 ± 2.29 and -1.85 ± 7.45). BDNF, IB, QT and BC were similar between groups. CONCLUSIONS IMT associated with WBV is effective to improve in increasing IMS, RT and DM in pre-frail older women. However, these interventions do not modify BDNF, IB, QT or BC in this population.
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Affiliation(s)
- Helga Cecília Muniz de Souza
- Postgraduate Program of Biology Applied to Health, Federal University of Pernambuco, Recife, Pernambuco, Brazil; Hospital das Clínicas de Pernambuco - Empresa Brasileira de Serviços Hospitalares (HCPE-EBSERH), Federal University of Pernambuco, Recife, Brazil; Laboratory of Cardiopulmonary Physiotherapy, Department of Physiotherapy, Federal University of Pernambuco, Recife, Brazil.
| | - Maíra Florentino Pessoa
- Postgraduate Program of Biology Applied to Health, Federal University of Pernambuco, Recife, Pernambuco, Brazil; Laboratory of Cardiopulmonary Physiotherapy, Department of Physiotherapy, Federal University of Pernambuco, Recife, Brazil
| | - Rafaela Dos Santos Clemente
- Laboratory of Cardiopulmonary Physiotherapy, Department of Physiotherapy, Federal University of Pernambuco, Recife, Brazil
| | - Alanna Vasconcelos da Silva
- Laboratory of Cardiopulmonary Physiotherapy, Department of Physiotherapy, Federal University of Pernambuco, Recife, Brazil
| | | | - Juliana Fernandes
- Laboratory of Physiotherapy and Collective Health, Department of Physiotherapy, Federal University of Pernambuco, Recife, Brazil
| | - Arméle Dornelas de Andrade
- Postgraduate Program of Biology Applied to Health, Federal University of Pernambuco, Recife, Pernambuco, Brazil; Laboratory of Cardiopulmonary Physiotherapy, Department of Physiotherapy, Federal University of Pernambuco, Recife, Brazil.
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Yildiz A, Demir R, Mustafaoglu R, Erkut U, Kesiktas FN. Structured different exercise protocols improve lung function, respiratory muscle strength, and thickness in stroke patients. A randomized controlled trial. Top Stroke Rehabil 2024:1-13. [PMID: 38780025 DOI: 10.1080/10749357.2024.2356413] [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: 10/04/2023] [Accepted: 04/23/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND The effect of core stabilization exercises (CSE) alone, or in combination with neuromuscular electrical stimulation (NMES) and Kinesio taping (KT) on lung function, respiratory muscle strength, and thickness in patients with stroke is not fully known. ObjectivesTo compare the efficacy of NMES and KT applied with CSE on lung functions, respiratory muscle strength, and thickness in stroke. OBJECTIVE The effect of core stabilization exercises (CSE) alone, or in combination with neuromuscular electrical stimulation (NMES) and Kinesio taping (KT) on lung function, respiratory muscle strength, and thickness in patients with stroke is not fully known. The aim of this study was to compare the efficacy of NMES and KT applied with CSE on lung functions, respiratory muscle strength, and thickness in stroke. METHODS A total of 45 stroke patients were randomly assigned to the core stabilization exercises (CSE) group, CSE+KT group or CSE+NMES group, respectively. All groups received the training protocol for 30-45 minutes, 3 days a week, for 6 weeks. Lung functions were measured using portable spirometry. Respiratory muscle strength was assessed using an analog manometer to measure maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP). Peak cough flow (PCF) was measured with a peak flow meter. Respiratory muscles thickness were determined using ultrasonography. RESULTS Except for FVC (%pred%) (F = 4.432, p = 0.018, ηp = 0.174), FEV1(%pred%) (F = 3.725, p = 0.032, ηp = 0.151), and MEP (F = 3.861, p = 0.029, ηp = 0.155), the overall group by time interaction for rmANOVA showed that there was no statistically significant difference between groups (p > 0.05). After post hoc analysis, it was determined that there was no statistically significant difference between the groups in terms of FVC (%pred%), FEV1(%pred%) and MEP (p > 0.025). CONCLUSIONS The addition of NMES or KT to core stabilization exercises did not appear to provide additional benefit in improving lung function, respiratory muscle strength, and thickness in stroke patients.
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Affiliation(s)
- Abdurrahim Yildiz
- Department of Physiotherapy and Rehabilitation, Sakarya University of Applied Sciences, Sakarya, Türkiye
| | - Rengin Demir
- Department of Cardiology, Cardiology Institute, Istanbul University-Cerrahpasa, Istanbul, Türkiye
| | - Rustem Mustafaoglu
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul University-Cerrahpasa, Istanbul, Türkiye
| | - Umit Erkut
- Department of Physiotherapy and Rehabilitation, Rumeli University, Istanbul, Türkiye
| | - Fatma Nur Kesiktas
- Istanbul Physical Medicine and Rehabilitation Training and Research Hospital, University of Health Sciences, Istanbul, Türkiye
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Sanchez-Ruiz R, de la Plaza San Frutos M, Sosa-Reina MD, Sanz-Esteban I, García-Arrabé M, Estrada-Barranco C. Associations between respiratory function, balance, postural control, and fatigue in persons with multiple sclerosis: an observational study. Front Public Health 2024; 12:1332417. [PMID: 38572010 PMCID: PMC10987765 DOI: 10.3389/fpubh.2024.1332417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 03/08/2024] [Indexed: 04/05/2024] Open
Abstract
Introduction Fatigue, postural control impairments, and reduced respiratory capacities are common symptoms in persons diagnosed with Multiple Sclerosis (MS). However, there is a paucity of evidence establishing correlations among these factors. The aim of this study is to analyze respiratory function in persons with MS compared to the control group as well as to analyze the relationship between fatigue, respiratory function and postural control in persons with MS. Materials and methods A total of 17 persons with MS and 17 healthy individuals were enrolled for this cross-sectional study. The evaluated parameters included fatigue assessed using the Visual Analog Scale-fatigue (VAS-F) and the Borg Dyspnea Scale, postural control assessed through the Mini Balance Evaluation System Test (Mini-BESTest), Berg Balance Scale (BBS), Timed Up and Go (TUG) test, and Trunk Impairment Scale (TIS); and respiratory capacities measured by Maximum Inspiratory Pressure (MIP), Maximum Expiratory Pressure (MEP), Forced Vital Capacity (FVC), Forced Expiratory Volume in the first second (FEV1), FEV1/FVC ratio, Diaphragmatic excursion and diaphragmatic thickness. Results A very high correlation was observed between the Borg Dyspnoea Scale and the BBS (r = -0.768), TUG (0.867), and Mini-BESTest (r = -0.775). The VAS-F exhibited an almost perfect correlation solely with the TUG (0.927). However, none of the variables related to fatigue exhibited any correlation with the respiratory variables under study. Balance-related variables such as BBS and Mini-BESTest demonstrated a very high and high correlation. Respectively, with respiratory function variables MEP (r = 0.783; r = 0.686), FVC (r = 0.709; r = 0.596), FEV1 (r = 0.615; r = 0.518). BBS exhibited a high correlation with diaphragmatic excursion (r = 0.591). Statistically significant differences were noted between the persons with MS group and the control group in all respiratory and ultrasound parameters except for diaphragmatic thickness. Conclusion The findings suggest that decreased postural control and balance are associated with both respiratory capacity impairments and the presence of fatigue in persons with MS. However, it is important to note that the alterations in respiratory capacities and fatigue are not mutually related, as indicated by the data obtained in this study. Discrepancies were identified in abdominal wall thickness, diaphragmatic excursion, and respiratory capacities between persons with MS and their healthy counterparts.
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Affiliation(s)
| | | | | | | | - Maria García-Arrabé
- Faculty of Physical Activity and Sport Sciences, European University of Madrid, Madrid, Spain
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Skoura A, Billis E, Papanikolaou DT, Xergia S, Tsarbou C, Tsekoura M, Kortianou E, Maroulis I. Diastasis Recti Abdominis Rehabilitation in the Postpartum Period: A Scoping Review of Current Clinical Practice. Int Urogynecol J 2024; 35:491-520. [PMID: 38340172 PMCID: PMC11023973 DOI: 10.1007/s00192-024-05727-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 12/29/2023] [Indexed: 02/12/2024]
Abstract
INTRODUCTION AND HYPOTHESIS Despite exercise being the standard approach to diastasis recti abdominis (DRA) rehabilitation, there is no consensus on the most effective exercise routine and adjunct modalities for reducing DRA and improving functional parameters. The present study is aimed at investigating evidence for DRA rehabilitation in postpartum women, as well as knowledge gaps and areas for future research. METHODS For this scoping review a systematic search was conducted in MEDLINE, AMED, CINAHL, Embase, ScienceDirect, Scopus, and PEDro up to November 2022. Selection criteria included studies investigating exercise therapy interventions both with and without adjunct modalities for postpartum DRA. Sample characteristics, diagnostic criteria, program design, and outcome measures were recorded. Critical appraisal of clinical trials was performed using PEDro classification. RESULTS Twenty-eight studies were included: 14 clinical trials, 3 case series, and 11 observational studies. DRA exercises that focused on deep and superficial muscles, pelvic floor muscles, respiratory maneuvers, functional exercises, or alternative interventions (yoga, suspension training, hypopressive exercise) and adjunct modalities showed promising results in reducing the inter-recti distance and related dysfunction. However, there was great variability in diagnostic criteria and methods, DRA severity, time post-birth, and exercise program design. CONCLUSIONS Reviewed studies provide valuable insights into exercise therapy, but it is important to recognize their limitations, as variability in diagnostic criteria, sample characteristics, and exercise program design hinder the generalizability of the findings. Further high-quality research is needed to strengthen the evidence in this area and provide reliable recommendations for clinical practice.
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Affiliation(s)
- Anastasia Skoura
- Laboratory of Clinical Physiotherapy and Research, Department of Physiotherapy, School of Health Rehabilitation Sciences, University of Patras, Building B, Central Campus 26504 Rio, Patras, Achaia, Greece.
| | - Evdokia Billis
- Laboratory of Clinical Physiotherapy and Research, Department of Physiotherapy, School of Health Rehabilitation Sciences, University of Patras, Building B, Central Campus 26504 Rio, Patras, Achaia, Greece
| | - Dimitra Tania Papanikolaou
- Laboratory of Clinical Physiotherapy and Research, Department of Physiotherapy, School of Health Rehabilitation Sciences, University of Patras, Building B, Central Campus 26504 Rio, Patras, Achaia, Greece
| | - Sofia Xergia
- Laboratory of Clinical Physiotherapy and Research, Department of Physiotherapy, School of Health Rehabilitation Sciences, University of Patras, Building B, Central Campus 26504 Rio, Patras, Achaia, Greece
| | - Charis Tsarbou
- Laboratory of Clinical Physiotherapy and Research, Department of Physiotherapy, School of Health Rehabilitation Sciences, University of Patras, Building B, Central Campus 26504 Rio, Patras, Achaia, Greece
| | - Maria Tsekoura
- Laboratory of Clinical Physiotherapy and Research, Department of Physiotherapy, School of Health Rehabilitation Sciences, University of Patras, Building B, Central Campus 26504 Rio, Patras, Achaia, Greece
| | - Eleni Kortianou
- Department of Physiotherapy, School of Health Sciences, University of Thessaly, Lamia, Greece
| | - Ioannis Maroulis
- Faculty of Medicine, School of Health Sciences, University of Patras, Rio, Patras, Greece
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Liu H, Wiedman CM, Lovelace-Chandler V, Gong S, Salem Y. Deep Diaphragmatic Breathing-Anatomical and Biomechanical Consideration. J Holist Nurs 2024; 42:90-103. [PMID: 36734111 DOI: 10.1177/08980101221149866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Background: Deep diaphragmatic breathing (DDB) involves slow and fully contraction of the diaphragm with expansion of the belly during inhalation, and slow and fully contraction of the abdominal muscles with reduction of the belly during exhalation. It is the key component of the holistic mind-body exercises commonly used for patients with multimorbidity. Purpose: The purpose of this study was to re-visit and address the fundamental anatomical and biomechanical consideration of the DDB with the relevant literature. Method: Peer-reviewed publications from last the 15 years were retrieved, reviewed, and analyzed. Findings: In this article, we described the updated morphological and anatomical characteristics of the diaphragm. Then, we elucidated in a biomechanical approach how and why the DDB can work on the gastrointestinal, cardiopulmonary, and nervous systems as well as on regulating the intra-abdominopelvic pressure and mind-body interaction to coordinate the diaphragm-pelvic floor-abdominal complex for a variety of physical and physiological activities. Conclusion: Understanding of this updated DDB knowledge may help holistic healthcare professionals including holistic nurses provide better patient education and care management during the DDB or DDB-based mind-body intervention time.
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Affiliation(s)
- Howe Liu
- Physical Therapy Program, Allen College, Waterloo, IA, USA
| | | | | | - Suzhen Gong
- Office of Research, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Yasser Salem
- Physical Therapy Program, Hofstra University, Hempstead, NY, USA
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Jiroumaru T, Hyodo Y, Mori K, Hattori T, Wachi M, Shichiri N, Fujikawa T. Relationship between respiratory muscle strength and dynamic balance in older persons requiring care or support: Focusing on the maximal single step length test and maximal double step length test as dynamic balance indices. Gait Posture 2024; 109:64-69. [PMID: 38281431 DOI: 10.1016/j.gaitpost.2023.12.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 12/10/2023] [Accepted: 12/28/2023] [Indexed: 01/30/2024]
Abstract
BACKGROUND Falls are a major health problem. The relationship between dynamic balance related to falls and respiratory muscle strength related to sarcopenia and frailty is poorly understood. RESEARCH QUESTION How do dynamic balance measures, such as maximal single step length test (MSL) and maximal double step length test (MDST), and respiratory muscle strength measures, such as maximal inspiratory (PImax) and maximal expiratory (PEmax), related to the requirement for long-term care or support in older people who live in the community? METHODS This was a cross-sectional study of 39 older people (17 men, 22 women) aged ≥ 65 years community-dwelling who were certified as requiring long-term care or support under the Japanese system. The participants' PImax, PEmax, MSL, and MDST results were recorded. The measurement data were evaluated using Pearson's correlation coefficients and multiple regression analysis. RESULTS MDST showed a positive correlation with PImax (r = 0.430, p = 0.006) but no correlation with PEmax. MSL showed no correlation with PImax or PEmax. A positive correlation was found between MDST and MSL (r = 0.851, p < 0.001), and multiple regression analysis with MDST as the dependent variable and PImax and MST as independent variables showed significant differences for MSL (p < 0.001) and PImax (p = 0.027). SIGNIFICANCE In older people requiring long-term care or support, MDST had a greater association with inspiratory muscle strength compared with MSL. These results suggest the importance of inspiratory muscle strength training and MDST assessment in the prevention of falls in older people requiring long-term care or support.
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Affiliation(s)
- Takumi Jiroumaru
- Department of Physical Therapy, School of Health Sciences, Bukkyo University, 7 Nishinokyohigashitoganocho, Kyoto Nakagyo-ku, Kyoto 604-8418, Japan.
| | - Yutaro Hyodo
- Kanazawa Orthopaedic and Sports Medicine Clinic, Ritto, Shiga, Japan
| | - Kenji Mori
- Kanazawa Orthopaedic and Sports Medicine Clinic, Ritto, Shiga, Japan
| | - Tomoka Hattori
- Kanazawa Orthopaedic and Sports Medicine Clinic, Ritto, Shiga, Japan
| | - Michio Wachi
- Bukkyo University, Kyoto Nakagyo-ku, Kyoto, Japan
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Liang WM, Ji YX, Xiao J, Truskauskaitė I, Hendrixson A, Bai ZM, Ruksenas O. Respiratory patterns and physical fitness in healthy adults: a cross-sectional study. BMC Public Health 2024; 24:228. [PMID: 38243241 PMCID: PMC10797802 DOI: 10.1186/s12889-024-17687-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 01/05/2024] [Indexed: 01/21/2024] Open
Abstract
BACKGROUND The altered respiratory patterns have a significant impact on our health. However, the links between respiration patterns during spontaneous breathing and physical fitness remain unknown. Therefore, we sought to examine how the respiratory pattern during spontaneous breathing interacts with physical fitness. METHODS A total of 610 participants (aged 20-59 years) were enrolled; 163 men (age = 41 ± 11) and 401 women (age = 42 ± 9) were included for analysis. The parameters of the respiration pattern were respiration rate (RR) and inhalation/exhalation (I/E) ratio. The physical fitness components were body size, visuomotor reaction time, balance, flexibility, hand grip strength, back extension strength, vertical jump height, number of push-ups, number of sit-ups, and the maximum rate of oxygen consumption. The data were analyzed separately for two gender groups. Participants within each gender group were further divided into two age categories (young: 20-39 years, middle-aged: 40-59 years) for the analysis, and both correlational and comparative tests were used to solidify the results. RESULTS Neither RRs nor the I/E ratios were substantially correlated with physical fitness in women. In addition, the I/E ratios showed no significant correlation with physical fitness in young men, while the results from correlational and comparative tests were inconsistent in middle-aged men. Consistently, men with lower RRs exhibited significantly shorter visuomotor reaction times in two age groups, and demonstrated significantly higher vertical jump heights in the middle-aged group. CONCLUSIONS In women, respiratory patterns were not correlated with physical fitness. The relationship between middle-aged men's I/E ratios and their physical fitness warrants further investigation. Men with lower RRs may have better visual-motor coordination and/or sustained attention, while middle-aged men with lower RRs may also have greater leg explosive power and neuromuscular coordination, which should be considered for physical assessment and health improvement.
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Affiliation(s)
- Wen-Ming Liang
- Department of Physiotherapy and Rehabilitation, Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences, Beijing, China
- Life Sciences Center, Vilnius University, Vilnius, Lithuania
| | - Yu-Xuan Ji
- Department of Physiotherapy and Rehabilitation, Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences, Beijing, China
| | - Jing Xiao
- Department of Physiotherapy and Rehabilitation, Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences, Beijing, China.
| | | | | | - Zhen-Min Bai
- Department of Sports Rehabilitation, School of Sports Medicine and Rehabilitation, Beijing Sport University, Beijing, China
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Özkal Ö, Demircioğlu A, Topuz S. Clarifying the relationships between trunk muscle endurance, respiratory muscle strength and static/dynamic postural control in Latin dancers. Sports Biomech 2024:1-14. [PMID: 38193516 DOI: 10.1080/14763141.2024.2301984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 12/30/2023] [Indexed: 01/10/2024]
Abstract
Sufficient study has not been performed to clarify the role of trunk/respiratory muscles strength/endurance in providing postural control in dancers. The purpose of this study was to identify predictors affecting static/dynamic postural control in Latin dancers and to compare these measurements with non-dancers. The study included 38 (26F; 12 M) Latin dancers and 33 (21F; 11 M) non-dancers. Static/dynamic postural control, trunk muscle endurance, respiratory muscle strength/pulmonary functions, flexibility, and reaction tests were assessed with a force platform system, the McGill battery, spirometer, sit-and-reach test and Nelson-reaction-tests, respectively. Trunk muscle endurance times, respiratory muscle strength, FEV1/FVC, gender, hours of training per week and dancing experience were significant predictors of static/dynamic postural control in dancers (p < 0.05). All the trunk muscle endurance times, reaction tests results, and maximal inspiratory pressure were higher in the dancers compared to the non-dancers (p < 0.05). The limits of stability for forward and backward directions were higher, and anteroposterior sway in normal stability with eyes open was lower in the dancers compared to the non-dancers (p < 0.05). Trunk muscles endurance, respiratory muscle strength, dancing experience, and hours of training per week were positively associated with static/dynamic postural control. These predictors should be taken into consideration to improve postural control in dancers.
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Affiliation(s)
- Özden Özkal
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Bursa Uludağ University, Bursa, Turkey
| | - Arzu Demircioğlu
- Department of Physical Therapy and Rehabilitation, Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Semra Topuz
- Department of Physical Therapy and Rehabilitation, Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
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Terada M, Kosik KB, Gribble PA. Association of Diaphragm Contractility and Postural Control in a Chronic Ankle Instability Population: A Preliminary Study. Sports Health 2024; 16:19-25. [PMID: 36691689 PMCID: PMC10732118 DOI: 10.1177/19417381221147304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Altered reorganization of the sensorimotor system after an initial lateral ankle sprain may lead to a chronic neuromuscular maladaptation in multiple body locations. Specifically, decreased diaphragm contractility has been observed in patients with chronic ankle instability (CAI). The diaphragm has an essential role in postural control. Decreased diaphragm contractility could associate with diminished postural control commonly observed in patients with CAI. However, no study has determined if diaphragm contractility contributes to postural control in a CAI population. HYPOTHESIS Decreased diaphragm contractility would be negatively associated with static postural control in patients with CAI. STUDY DESIGN Cross-sectional study design. LEVEL OF EVIDENCE Level 4. METHODS A total of 15 participants with CAI participated voluntarily. An ultrasonography assessment was performed to quantify the right and left hemidiaphragm thickness at the end of resting inspiration and expiration in supine while breathing quietly. The degree of diaphragm contractility was calculated from the diaphragm thickness. Participants performed 3 eyes-open trials of a 20-second single-leg balance task on the involved limb. Static postural control measures included the center of pressure velocity (COPV) and mean of time-to-boundary (TTB) minima in the anteroposterior (AP) and mediolateral directions. RESULTS Moderate correlations of the right hemidiaphragm contractility were observed with COPV (ρ = -0.54) and TTB mean minima (ρ = 0.56) (P < 0.05) in the AP direction. The left hemidiaphragm contractility was moderately correlated with COPV (ρ = -0.56) and TTB mean minima (ρ = 0.60) (P < 0.05) in the AP direction. CONCLUSION Lower diaphragm contractility may be associated with diminished static postural control in the AP direction in patients with CAI. CLINICAL RELEVANCE This study highlights diaphragm contractility could be a potential connection with diminished static postural control in patients with CAI. Our data raise new avenues for future exploration including potential beneficial effects of implementation of diaphragm breathing exercises and techniques for restoring static postural control in patients with CAI.
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Affiliation(s)
- Masafumi Terada
- College of Sport and Health Science, Ritsumeikan University, Kusatsu, Shiga, Japan
| | - Kyle B. Kosik
- The Department of Athletic Training and Clinical Nutrition, University of Kentucky, Lexington, Kentucky
| | - Phillip A. Gribble
- The Department of Athletic Training and Clinical Nutrition, University of Kentucky, Lexington, Kentucky
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Jiroumaru T, Hyodo Y, Wachi M, Shichiri N, Ochi J, Fujikawa T. Relationship between walking speed, respiratory muscle strength, and dynamic balance in community-dwelling older people who required long-term care or support and used a daycare center. PeerJ 2023; 11:e16630. [PMID: 38144200 PMCID: PMC10749086 DOI: 10.7717/peerj.16630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 11/16/2023] [Indexed: 12/26/2023] Open
Abstract
Background Focusing on the relationship between frail older people and gait speed is vital to minimize the need for long-term care or increased support. The relationship between gait speed, respiratory muscle strength, and dynamic balance, is not well understood in older people requiring long-term care or support. Therefore, this study aimed to provide new insights into the relationship between gait speed, respiratory muscle strength, and dynamic balance in community-dwelling older people who required long-term care or support and used a daycare center. Methods This was a cross-sectional study of 49 community-dwelling older people (21 men, 28 women) aged ≥65 years who were certified as requiring long-term care or support under the Japanese system. The participants' maximal inspiratory pressure (PImax), maximal expiratory pressure (PEmax), walking speed (maximal and normal walking speed), and maximal double-step length test (MDST) results were recorded. The measurement data were evaluated using Pearson's correlation coefficient and multiple regression analysis. Results Pearson's correlation coefficient revealed correlations between PImax and the following: maximal walking speed (r = 0.606, p < 0.001), normal walking speed (r = 0.487, p < 0.001), and MDST (r = 0.435, p = 0.002). Correlations were also observed between PEmax and the following: maximal walking speed (r = 0.522, p < 0.001), normal walking speed (r = 0.467, p < 0.001), and MDST (r = 0.314, p = 0.028). Moreover, a correlation was found between MDST and both maximal walking speed and (r = 0.684, p < 0.001) and normal walking speed (r = 0.649, p < 0.001). The effect size was 0.379. Multiple regression analysis using a forced entry method with maximal walking speed as the dependent variable showed that maximal walking speed was significantly associated with MDST (p < 0.001) and PEmax (p = 0.036), with an effect size of 0.272. The model's adjusted coefficient of determination was 0.593 (p < 0.001). Multiple regression analysis using a forced entry method with normal walking speed as the dependent variable showed that normal walking speed was significantly associated with MDST (p < 0.001) and PEmax (p = 0.021), with an effect size of 0.272. The model's adjusted coefficient of determination was 0.497 (p < 0.001). Multiple regression analysis using a forced entry method with MDST as the dependent variable showed that MDST was significantly associated with PImax (p < 0.025), with an effect size of 0.243. The model's adjusted coefficient of determination was 0.148 (p = 0.017). Conclusions Respiratory muscle strength and dynamic balance were related to walking speed in older people requiring long-term care or support.
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Affiliation(s)
- Takumi Jiroumaru
- Department of Physical Therapy, School of Health Sciences, Bukkyo University, Kyoto Nakagyo-ku, Kyoto, Japan
| | - Yutaro Hyodo
- Department of Rehabilitation, Kanazawa Orthopaedic and Sports Medicine Clinic, Ritto, Shiga, Japan
| | - Michio Wachi
- Department of Physical Therapy, School of Health Sciences, Bukkyo University, Kyoto Nakagyo-ku, Kyoto, Japan
| | - Nobuko Shichiri
- Department of Occupational Therapy, School of Health Sciences, Bukkyo University, Kyoto Nakagyo-ku, Kyoto, Japan
| | - Junko Ochi
- Department of Physical Therapy, School of Health Sciences, Bukkyo University, Kyoto Nakagyo-ku, Kyoto, Japan
| | - Takamitsu Fujikawa
- Department of Physical Therapy, School of Health Sciences, Bukkyo University, Kyoto Nakagyo-ku, Kyoto, Japan
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11
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Naz I, Turgut B, Gunay Ucurum S, Komurcuoglu B, Ozer Kaya D. Investigation of factors associated with static and dynamic balance in early-stage lung cancer survivors. J Cancer Surviv 2023:10.1007/s11764-023-01492-0. [PMID: 37964048 DOI: 10.1007/s11764-023-01492-0] [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: 06/19/2023] [Accepted: 10/25/2023] [Indexed: 11/16/2023]
Abstract
PURPOSE Balance impairment and falls are common among patients after cancer treatment. This study aimed to compare static and dynamic balance functions in lung cancer survivors (LCS) and healthy controls and to investigate the factors related to balance in LCS. METHODS Cross-sectional data were collected from lung cancer patients whose treatment had been completed within the previous 3 months (n = 60) and age and gender-matched healthy controls (n = 60). Clinical characteristics and history of falls were recorded. Pulmonary function tests and measurements of respiratory muscle strength were performed. Dynamic and static balance, fear of falling, knee-extension strength, physical activity level, dyspnea, comorbidity, and quality of life (QoL) were assessed using the Time Up and Go Test, Single Leg Standing Test, the Fall Efficacy Scale-International, hand-held dynamometer, the International Physical Activity Questionnaire, the Modified Medical Research Dyspnea Scale, the Charlson Comorbidity Index, and the European Organization for Research and Treatment of Cancer QoL Scale. RESULTS LCS reported a higher fall rate and exhibited lower dynamic balance compared to controls (p < 0.05). The number of chemotherapy cycles, number of falls in the past year, fear of falling, perceived dyspnea, forced expiratory volume in 1 s (%), maximal inspiratory pressure (%), knee-extension strength, physical activity score, and QoL score related to physical function were correlated with balance function in LCS (p < 0.05). CONCLUSION LCS had a higher risk of falls and lower dynamic balance function which might be related to various clinical and physical parameters. IMPLICATIONS FOR CANCER SURVIVORS Identifying factors related to balance should be considered within the scope of fall prevention approaches for these patients.
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Affiliation(s)
- Ilknur Naz
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Izmir Katip Celebi University, Balatçık Mahallesi Havaalanı Şosesi No:33/2 Balatçık, 35620, İzmir, Turkey.
| | - Büsra Turgut
- Department of Physiotherapy and Rehabilitation, Institute of Health Sciences, Izmir Katip Celebi University, Balatçık Mahallesi Havaalanı Şosesi No:33/2 Balatçık, 35620, İzmir, Turkey
| | - Sevtap Gunay Ucurum
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Izmir Katip Celebi University, Balatçık Mahallesi Havaalanı Şosesi No:33/2 Balatçık, 35620, İzmir, Turkey
| | - Berna Komurcuoglu
- Dr. Suat Seren Chest Disease and Surgery Training and Research Hospital, University of Health Sciences, Yenisehir Mah. Gaziler Cad. No:331 Konak, 35170, Izmir, Turkey
| | - Derya Ozer Kaya
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Izmir Katip Celebi University, Balatçık Mahallesi Havaalanı Şosesi No:33/2 Balatçık, 35620, İzmir, Turkey
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12
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Daros Dos Santos T, Pasqualoto AS, Cardoso DM, Da Cruz IBM, Moresco RN, Ferreira da Silveira A, Martins de Albuquerque I. Effects of multimodal exercise program on postural balance in patients with chronic obstructive pulmonary disease: study protocol for a randomized controlled trial. Trials 2023; 24:532. [PMID: 37580800 PMCID: PMC10426202 DOI: 10.1186/s13063-023-07558-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 07/31/2023] [Indexed: 08/16/2023] Open
Abstract
BACKGROUND Evidence has shown that patients with chronic obstructive pulmonary disease present significant deficits in the control of postural balance when compared to healthy subjects. In view of this, it is pertinent to investigate the effects of different therapeutic strategies used alone or in association with pulmonary rehabilitation with the potential to improve postural balance and other outcomes with clinical significance in patients with chronic obstructive pulmonary disease. This study will investigate the effects of an 8-week (short-term) multimodal exercise program [inspiratory muscle training (IMT) plus neuromuscular electrical stimulation (NMES)] on postural balance in patients with chronic obstructive pulmonary disease enrolled in a pulmonary rehabilitation program compared to individualized addition of IMT or NMES to pulmonary rehabilitation or standard pulmonary rehabilitation. METHODS This is a randomized, single-blind, 4-parallel-group trial. Forty patients with chronic obstructive pulmonary disease will be included prospectively to this study during a pulmonary rehabilitation program. Patients will be randomly assigned to one of four groups: multimodal exercise program (IMT + NMES + pulmonary rehabilitation group) or (IMT + pulmonary rehabilitation group) or (NMES + pulmonary rehabilitation group) or standard pulmonary rehabilitation group. Patients will receive two sessions per week for 8 weeks. The primary outcome will be static postural balance and secondary outcomes will include as follows: static and dynamic postural balance, fear of falling, muscle strength and endurance (peripheral and respiratory), functional capacity, health-related quality of life, muscle architecture (quadriceps femoris and diaphragm), and laboratory biomarkers. DISCUSSION This randomized clinical trial will investigate the effects of adding of short-term multimodal exercise program, in addition to pulmonary rehabilitation program, in postural balance in patients with chronic obstructive pulmonary disease enrolled in a pulmonary rehabilitation. Furthermore, this randomized control trial will enable important directions regarding the effectiveness of short-term intervention as part of the need to expand the focus of pulmonary rehabilitation to include balance management in chronic obstructive pulmonary disease patients which will be generated. TRIAL REGISTRATION ClinicalTrials.gov NCT04387318. Registered on May 13, 2020.
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Affiliation(s)
- Tamires Daros Dos Santos
- Programa de Pós-Graduação em Distúrbios da Comunicação Humana, Universidade Federal de Santa Maria (UFSM), Avenida Roraima, 1000, Santa Maria, 97105-900, Brazil
| | - Adriane Schmidt Pasqualoto
- Programa de Pós-Graduação em Distúrbios da Comunicação Humana, Universidade Federal de Santa Maria (UFSM), Avenida Roraima, 1000, Santa Maria, 97105-900, Brazil
| | - Dannuey Machado Cardoso
- Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, 90010-150, Brazil
- Centro de Ensino Superior Dom Alberto, Santa Cruz do Sul, Brazil
| | - Ivana Beatrice Mânica Da Cruz
- Programa de Pós-Graduação em Farmacologia e Programa de Pós-Graduação em Gerontologia, Universidade Federal de Santa Maria (UFSM), Avenida Roraima, 1000, Santa Maria, 97105-900, Brazil
| | - Rafael Noal Moresco
- Programa de Pós-Graduação em Ciências Farmacêuticas, Universidade Federal de Santa Maria (UFSM), Avenida Roraima, 1000, Santa Maria, 97105-900, Brazil
| | - Aron Ferreira da Silveira
- Programa de Pós-Graduação em Distúrbios da Comunicação Humana, Universidade Federal de Santa Maria (UFSM), Avenida Roraima, 1000, Santa Maria, 97105-900, Brazil
| | - Isabella Martins de Albuquerque
- Programa de Pós-Graduação em Ciências do Movimento e Reabilitação, Universidade Federal de Santa Maria (UFSM), Avenida Roraima, 1000, Santa Maria, 97105-9000, Brazil.
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13
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Yesantharao LV, Vohra V, Cheng M, Simonsick EM, Agrawal Y, du Lac S, Rowan NR. Olfactory Dysfunction and Balance Dysfunction are Associated with Increased Falls in Older Adults. Laryngoscope 2023; 133:1964-1969. [PMID: 37159236 DOI: 10.1002/lary.30733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 03/19/2023] [Accepted: 04/08/2023] [Indexed: 05/10/2023]
Abstract
OBJECTIVE This study aims to characterize the association between impairments in olfaction and balance, both of which are mediated in part by the cerebellum, and how this relates to prospective incidence of falls in a cohort of aging adults. METHODS The Health ABC study was queried to identify 296 participants with data on both olfaction (measured using the 12-item Brief Smell Identification Test) and balance-related function (measured using the Romberg test). The relationship between olfaction and balance was investigated using multivariable logistic regression. Predictors of performance on a standing balance assessment and predictors of falls were studied. RESULTS Of 296 participants, 52.7% had isolated olfactory dysfunction, 7.4% had isolated balance dysfunction, and 5.7% had dual dysfunction. Severe olfactory dysfunction was associated with increased odds of balance dysfunction when compared to those without olfactory dysfunction, even when adjusting for age, gender, race, education, BMI, smoking, diabetes, depression, and dementia (OR = 4.1, 95% CI [1.5, 13.7], p = 0.011). Dual sensory dysfunction was associated with worse performance on a standing balance assessment (β = -22.8, 95% CI [-35.6, -10.1], p = 0.0005) and increased falls (β = 1.5, 95% CI [1.0, 2.3], p = 0.037). CONCLUSION This study highlights a unique relationship between olfaction and balance, and how dual dysfunction is associated with increased falls. With substantial implications of falls on morbidity and mortality in older adults, this novel relationship between olfaction and balance emphasizes a potentially shared mechanism between olfactory dysfunction and increased fall risk in older adults; however, further study is required to explore the novel relationship of olfaction with balance and future falls. LEVEL OF EVIDENCE 3 Laryngoscope, 133:1964-1969, 2023.
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Affiliation(s)
- Lekha V Yesantharao
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Varun Vohra
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Michael Cheng
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Eleanor M Simonsick
- Intramural Research Program, National Institute on Aging, Baltimore, Maryland, USA
| | - Yuri Agrawal
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Sascha du Lac
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Nicholas R Rowan
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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14
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Dzięcioł-Anikiej Z, Dakowicz A, Dzięcioł J, Kopko S, Moskal-Jasińska D, Gawlikowska-Sroka A, Kuryliszyn-Moskal A, Kostro AM. Balance Disorders in People with History of COVID-19 in Light of Posturographic Tests. J Clin Med 2023; 12:4461. [PMID: 37445496 DOI: 10.3390/jcm12134461] [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: 05/10/2023] [Revised: 06/28/2023] [Accepted: 07/01/2023] [Indexed: 07/15/2023] Open
Abstract
Coronavirus disease-19 (COVID-19), resulting from infection with the SARS-CoV-2 virus, causes not only flu-like symptoms, such as fever, aches, or a dry cough, but also affects the sensory system, leading to a loss of smell and taste or to neurological deficits in the shape of balance disorders and dizziness. PURPOSE OF THE STUDY Our research aimed to assess the prevalence of balance disorders in patients who had suffered COVID-19. MATERIAL AND METHODS The study group consisted of 73 subjects with a history of SARS-CoV-2 infection. The control group consisted of 50 healthy people with similar demographics. A balance analysis was performed on a tensometric platform, using the Romberg test. RESULTS Statistically significant differences between the results of the study group and the control group were obtained in the evaluation of the length of body sways and the area of gravity center, both with open and closed eyes, and in the case of maximum body sways with open eyes. CONCLUSIONS Patients who have suffered COVID-19 may suffer from balance disorders detectable by posturographic tests.
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Affiliation(s)
- Zofia Dzięcioł-Anikiej
- Department of Rehabilitation, Faculty of Health Sciences, Medical University of Białystok, Skłodowskiej-Curie 7A Street, 15-096 Białystok, Poland
| | - Agnieszka Dakowicz
- Department of Rehabilitation, Faculty of Health Sciences, Medical University of Białystok, Skłodowskiej-Curie 7A Street, 15-096 Białystok, Poland
| | - Janusz Dzięcioł
- Department of Human Anatomy, Faculty of Medicine, Medical University of Bialystok, Mickiewicza 2A Street, 15-230 Białystok, Poland
| | - Szymon Kopko
- Department of Human Anatomy, Faculty of Medicine, Medical University of Bialystok, Mickiewicza 2A Street, 15-230 Białystok, Poland
| | - Diana Moskal-Jasińska
- Department of Clinical Phonoaudiology and Speech Therapy, Faculty of Health Sciences, Medical University of Białystok, Skłodowskiej-Curie 7A Street, 15-096 Białystok, Poland
| | - Aleksandra Gawlikowska-Sroka
- Department of Human Anatomy, Pomeranian Medical University in Szczecin, Rybacka 1 Street, 70-204 Szczecin, Poland
| | - Anna Kuryliszyn-Moskal
- Department of Rehabilitation, Faculty of Health Sciences, Medical University of Białystok, Skłodowskiej-Curie 7A Street, 15-096 Białystok, Poland
| | - Amanda Maria Kostro
- Department of Rehabilitation, Faculty of Health Sciences, Medical University of Białystok, Skłodowskiej-Curie 7A Street, 15-096 Białystok, Poland
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15
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Bai ZM, Sun YT, Liang WM, Truskauskaitė I, Yan ME, Li CR, Xiao J, Aihemaiti M, Yuan L, Rukšėnas O. Respiratory Movements at Different Ages. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1024. [PMID: 37374227 DOI: 10.3390/medicina59061024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 05/19/2023] [Accepted: 05/22/2023] [Indexed: 06/29/2023]
Abstract
Background and Objectives: The current study aimed to better understand the changes in respiration that occur with aging in men and women to provide accurate recommendations for breathing exercises to improve health. Materials and Methods: A total of 610 healthy subjects, aged 20 to 59, participated in the study. They performed quiet breathing while wearing two respiration belts (Vernier, Beaverton, OR, USA) at the height of the navel and at the xiphoid process to record abdominal motion (AM) and thoracic motion (TM), respectively. Vital capacity, representing maximal inhalation movement, was measured using a spirometer (Xindonghuateng, Beijing, China). After exclusion, 565 subjects (164 men, aged 41 ± 11; 401 women, aged 42 ± 9) were included for statistical analysis using the Kruskal-Wallis U test and stepwise multiple linear regression. Results: Abdominal motion and its contribution to spontaneous breathing were significantly larger for older men, while the contribution of thoracic motion was smaller for older men. There was no significant difference in thoracic motion between the younger and older men. The differences in women's respiratory movements among various ages were mild and negligible. The contribution of thoracic motion to spontaneous breathing in women was larger than in men for those of older ages (40-59 years), but not for those of younger ages (20-39 years). Additionally, men's and women's vital capacities were less in those of older ages, and the men's were larger than the women's. Conclusions: The findings indicate that men's abdominal contribution to spontaneous breathing increased from 20 to 59 years of age due to increased abdominal motion. Women's respiratory movements did not change much with aging. The maximal inhalation movement became smaller with aging for men and women. Healthcare professionals should focus on improving thoracic mobility when addressing health concerns about aging.
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Affiliation(s)
- Zhen-Min Bai
- School of Sports Medicine and Rehabilitation, Beijing Sport University, Beijing 100084, China
| | - Yi-Ting Sun
- School of Sports Medicine and Rehabilitation, Beijing Sport University, Beijing 100084, China
| | - Wen-Ming Liang
- Life Sciences Center, Vilnius University, LT-01513 Vilnius, Lithuania
| | - Inga Truskauskaitė
- Institute of Psychology, Vilnius University, LT-01513 Vilnius, Lithuania
| | - Miao-E Yan
- Department of Traditional Chinese Medicine, Maternal and Children's Healthcare Hospital of Beijing Dongcheng District, Beijing 100007, China
| | - Chun-Ri Li
- College of Acupuncture and Moxibustion, Liaoning University of Traditional Chinese Medicine, Shenyang 110847, China
- Faculty of Health, Slovak Medical University, 974 05 Banská Bystrica, Slovakia
| | - Jing Xiao
- Department of Physiotherapy and Rehabilitation, Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences, Beijing 100091, China
| | - Maiwulamu Aihemaiti
- School of Sports Medicine and Rehabilitation, Beijing Sport University, Beijing 100084, China
| | - Lei Yuan
- Department of Cardiology, Peking University Third Hospital, NHC Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides, Beijing 100191, China
| | - Osvaldas Rukšėnas
- Life Sciences Center, Vilnius University, LT-01513 Vilnius, Lithuania
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16
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Azevedo IG, da Câmara SMA, Maciel ACC, Vieira ER, Espinoza CFL, Pichún SMM, Viana EDSR, Sousa SLDO. Relationship between inspiratory muscle strength and balance in women: A cross-sectional study. PLoS One 2023; 18:e0280465. [PMID: 36791078 PMCID: PMC9931101 DOI: 10.1371/journal.pone.0280465] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 12/31/2022] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND There is scarce evidence on changes at the functional level associated with the respiratory area in women. This study aims to analyse the relationship between inspiratory muscle strength and balance in women. MATERIAL AND METHODS In this cross-sectional observational study, the sample consisted of groups according to the results obtained in the balance test. Inspiratory muscle weakness was defined as maximum inspiratory pressure (MIP) ≤ 80% of the predictive value. MIP was carried out using through a mouthpiece, with an electronic manometer. Logistic regression model was used to examine if MIP predicts balance. RESULTS 159 women participated in the study. Approximately 20% of them achieved balance ≤ 2 seconds and 18% presented MIP≤80%. MIP was associated with the time achieved in the one-leg support test. Subjects with MIP ≤ 80% of the predictive value show 3 times more risk of having a lower performance in the balance test (OR = 3.26). CONCLUSIONS Inspiratory muscle weakness is associated with deficient balance in this sample. It shows the need for multidimensional assessment and rehabilitation strategies for patients identified as having MIP weakness and/or balance disorders.
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Affiliation(s)
- Ingrid Guerra Azevedo
- Departamento de Procesos Terapéuticos, Universidad Católica de Temuco UCT, La Araucanía, Temuco, Chile,Departamento de Fisioterapia, Federal University of Rio Grande do Norte UFRN, Natal, Rio Grande do Norte (RN), Brazil,* E-mail:
| | - Saionara M. A. da Câmara
- Departamento de Fisioterapia, Federal University of Rio Grande do Norte UFRN, Natal, Rio Grande do Norte (RN), Brazil
| | - Alvaro C. C. Maciel
- Departamento de Fisioterapia, Federal University of Rio Grande do Norte UFRN, Natal, Rio Grande do Norte (RN), Brazil
| | - Edgar R. Vieira
- Department of Physical Therapy, Florida International University, Miami, Florida, United States of America
| | - Camila F. L. Espinoza
- Departamento de Procesos Terapéuticos, Universidad Católica de Temuco UCT, La Araucanía, Temuco, Chile
| | - Sebastián M. M. Pichún
- Departamento de Procesos Terapéuticos, Universidad Católica de Temuco UCT, La Araucanía, Temuco, Chile
| | - Elizabel de S. R. Viana
- Departamento de Fisioterapia, Federal University of Rio Grande do Norte UFRN, Natal, Rio Grande do Norte (RN), Brazil
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17
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Wahyuni LK. Multisystem compensations and consequences in spastic quadriplegic cerebral palsy children. Front Neurol 2023; 13:1076316. [PMID: 36698899 PMCID: PMC9868261 DOI: 10.3389/fneur.2022.1076316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 12/20/2022] [Indexed: 01/11/2023] Open
Abstract
Spastic quadriplegic cerebral palsy (CP) is a permanent neuromuscular disorder causing limitation on all four limbs following a lesion on the developing brain. Most children with spastic quadriplegic CP are identified to be Gross Motor Function Classification System (GMFCS) level V, thus they have more comorbidities compared to other types at lower levels. Spastic quadriplegic CP is characterized by weak and inactive postural muscles of the neck and trunk, hence, they will undergo a total body extension as a compensatory mechanism leading to an atypical movement pattern, that give rise to multisystem consequences that reduce their quality of life. The relationship between atypical movement patterns, compensatory strategies, and multisystem consequences have not yet been explored. In fact, these multisystem consequences aggravate their condition and make movement much more atypical, forming a vicious cycle. This review aimed to provide a summary and highlight the mechanism of atypical movement pattern, multisystem compensations, and consequences in spastic quadriplegic CP children. It is true that central nervous system (CNS) lesion in CP is non-progressive, however the multisystem consequences may impair overall function over time. An understanding of how compensatory strategy and multisystem consequences in spastic quadriplegic CP offers the opportunity to intervene as early as possible to improve their quality of life.
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Affiliation(s)
- Luh Karunia Wahyuni
- Physical Medicine and Rehabilitation Department, Dr. Cipto Mangunkusumo Hospital - Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
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18
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Palermo AE, Nash MS, Kirk-Sanchez NJ, Cahalin LP. Adherence to and impact of home-based high-intensity IMT in people with spinal cord injury: a pilot study. Spinal Cord Ser Cases 2022; 8:85. [PMID: 36309488 PMCID: PMC9617741 DOI: 10.1038/s41394-022-00551-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 10/10/2022] [Accepted: 10/12/2022] [Indexed: 11/29/2022] Open
Abstract
Study design The pilot study was completed in 5 phases (Control and 4 phases of IMT) incorporating assessments at Baseline 1 (BL1), BL2, Follow-up 1 (F1), F2, F3, and F4. Objective To assess the adherence and impact of a daily high-intensity (80% of max) inspiratory muscle training (IMT) home program with once weekly supervision for people with spinal cord injury (SCI). Setting Assessments: research institution or zoom. IMT: participant’s home. Methods Participants completed daily IMT in IMT Phase 1 and 2, once weekly in IMT Phase 3, self-selected frequency in IMT Phase 4. All phases had one weekly supervised session except IMT Phase 4. Primary outcomes included adherence and a difficulty score [DS (0- not difficult to 10- the most difficult)]. Secondary outcomes included respiratory function and seated balance. Results Data from 10 people with chronic SCI (>1 year) (Cervical level of injury: 6, AIS: A-B, injury duration: 10.9 years 95% CI [3.9, 18.1]) were used in the analysis. Participants completed 69% of their training days in IMT Phase 1 and 65% overall reporting an average DS of 7.4 ± 1.4. Only one participant completed training during IMT Phase 4. One participant’s training load was reduced due to suspected overtraining. Maximal inspiratory pressure (MIP), sustained MIP (SMIP), and total power (TP), improved significantly (p < 0.05) from BL2 to F1. Conclusion Our data suggest that people with SCI can perform high-intensity IMT at home to improve inspiratory performance. It is strongly recommended that participants be intermittently monitored for adherence and safety. ClinicalTrials.gov Registration number: NCT04210063.
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Affiliation(s)
- Anne E Palermo
- Neuroscience Research Australia, Sydney, NSW, Australia. .,University of New South Wales, Sydney, NSW, Australia.
| | - Mark S Nash
- University of Miami Miller School of Medicine, Department of Physical Therapy and The Miami Project to Cure Paralysis, Miami, FL, USA
| | - Neva J Kirk-Sanchez
- University of Miami Miller School of Medicine, Department of Physical Therapy, Miami, FL, USA
| | - Lawrence P Cahalin
- University of Miami Miller School of Medicine, Department of Physical Therapy, Miami, FL, USA
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19
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Sicilia-Gomez C, Fernández-Carnero S, Martin-Perez A, Cuenca-Zaldívar N, Naranjo-Cinto F, Pecos-Martín D, Cervera-Cano M, Nunez-Nagy S. Abdominal and Pelvic Floor Activity Related to Respiratory Diaphragmatic Activity in Subjects with and without Non-Specific Low Back Pain. Diagnostics (Basel) 2022; 12:diagnostics12102530. [PMID: 36292219 PMCID: PMC9600311 DOI: 10.3390/diagnostics12102530] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 10/10/2022] [Accepted: 10/10/2022] [Indexed: 11/28/2022] Open
Abstract
One of the advances in physiotherapy in recent years is the exploration and treatment by ultrasound imaging. This technique makes it possible to study the relationship between the musculature of the anterolateral wall of the abdomino-pelvic cavity, the pelvic floor muscles and the diaphragm muscle, among others, and thus understand their implication in non-specific low back pain (LBP) in pathological subjects regarding healthy subjects. Objective: To evaluate by RUSI (rehabilitative ultrasound imaging) the muscular thickness at rest of the abdominal wall, the excursion of the pelvic floor and the respiratory diaphragm, as well as to study their activity. Methodology: Two groups of 46 subjects each were established. The variables studied were: non-specific low back pain, thickness and excursion after tidal and forced breathing, pelvic floor (PF) excursion in a contraction and thickness of the external oblique (EO), internal oblique (IO) and transverse (TA) at rest. Design: Cross-sectional observational study. Results: Good-to-excellent reliability for measurements of diaphragm thickness at both tidal volume (TV) (inspiration: 0.763, expiration: 0.788) and expiration at forced volume (FV) (0.763), and good reliability for inspiration at FV (0.631). A correlation was found between the EO muscle and PF musculature with respect to diaphragmatic thickness at TV, inspiration and expiration, and inspiration at FV, in addition to finding significant differences in all these variables in subjects with LBP. Conclusion: Subjects with LBP have less thickness at rest in the OE muscle, less excursion of the pelvic diaphragm, less diaphragmatic thickness at TV, in inspiration and expiration, and in inspiration to FV.
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Affiliation(s)
- Cristina Sicilia-Gomez
- Universidad de Alcalá, Facultad de Medicina y Ciencias de la Salud, Departamento de Enfermería y Fisioterapia, Grupo de Investigación en Fisioterapia y Dolor, 28801 Alcalá de Henares, Spain
| | - Samuel Fernández-Carnero
- Universidad de Alcalá, Facultad de Medicina y Ciencias de la Salud, Departamento de Enfermería y Fisioterapia, Grupo de Investigación en Fisioterapia y Dolor, 28801 Alcalá de Henares, Spain
- Correspondence: ; Tel.: +34-620-895-315
| | - Alicia Martin-Perez
- Universidad de Alcalá, Facultad de Medicina y Ciencias de la Salud, Departamento de Enfermería y Fisioterapia, Grupo de Investigación en Fisioterapia y Dolor, 28801 Alcalá de Henares, Spain
| | - Nicolas Cuenca-Zaldívar
- Universidad de Alcalá, Facultad de Medicina y Ciencias de la Salud, Departamento de Enfermería y Fisioterapia, Grupo de Investigación en Fisioterapia y Dolor, 28801 Alcalá de Henares, Spain
- Research Group in Nursing and Health Care, Puerta de Hierro Health Research Institute-Segovia de Arana (IDIPHISA), 28222 Madrid, Spain
| | - Fermin Naranjo-Cinto
- Universidad de Alcalá, Facultad de Medicina y Ciencias de la Salud, Departamento de Enfermería y Fisioterapia, Grupo de Investigación en Fisioterapia y Dolor, 28801 Alcalá de Henares, Spain
| | - Daniel Pecos-Martín
- Universidad de Alcalá, Facultad de Medicina y Ciencias de la Salud, Departamento de Enfermería y Fisioterapia, Grupo de Investigación en Fisioterapia y Dolor, 28801 Alcalá de Henares, Spain
| | - Maria Cervera-Cano
- Universidad de Alcalá, Facultad de Medicina y Ciencias de la Salud, Departamento de Enfermería y Fisioterapia, Grupo de Investigación en Fisioterapia y Dolor, 28801 Alcalá de Henares, Spain
| | - Susana Nunez-Nagy
- Universidad de Alcalá, Facultad de Medicina y Ciencias de la Salud, Departamento de Enfermería y Fisioterapia, Grupo de Investigación en Fisioterapia y Dolor, 28801 Alcalá de Henares, Spain
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Liang WM, Bai ZM, Aihemaiti M, Yuan L, Hong ZM, Xiao J, Ren FF, Rukšėnas O. Women's Respiratory Movements during Spontaneous Breathing and Physical Fitness: A Cross-Sectional, Correlational Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12007. [PMID: 36231308 PMCID: PMC9566329 DOI: 10.3390/ijerph191912007] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 09/15/2022] [Accepted: 09/20/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Abdominal/diaphragmatic breathing exercises are popular worldwide and have been proven to be beneficial for physical performance. Is abdominal motion (AM) during spontaneous breathing correlated with physical fitness? The present study aimed to answer this question. METHODS 434 women (aged 20-59) were enrolled and participated in respiration tests using two respiration belts (one was tied at the height of the xiphoid and another at the navel) to detect AM and thoracic motion (TM). They also performed physical fitness tests to measure body size, muscular strength, muscular power, muscular endurance, balance, flexibility, reaction time, and cardiorespiratory endurance. RESULTS All the correlation coefficients between respiratory movements (AM, TM, AM + TM, AM/(AM + TM)) and physical fitness outcomes were less than 0.4/-0.4. Only AM and muscular power (countermovement jump height) had a weak correlation, with a correlation coefficient close to 0.4 in the 20-29-year age group (rs = 0.398, p = 0.011, n = 40). CONCLUSIONS Women's respiratory movements during spontaneous breathing were not correlated with physical fitness. Future studies may focus on the relationship between AM and countermovement jump height in young women with a larger sample size and using ultrasound to directly test the excursion of the diaphragm.
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Affiliation(s)
- Wen-Ming Liang
- Life Sciences Center, Vilnius University, LT-10257 Vilnius, Lithuania
- Department of Physiotherapy and Rehabilitation, Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences, Beijing 100091, China
| | - Zhen-Min Bai
- School of Sports Medicine and Rehabilitation, Beijing Sport University, Beijing 100084, China
| | - Maiwulamu Aihemaiti
- School of Sports Medicine and Rehabilitation, Beijing Sport University, Beijing 100084, China
| | - Lei Yuan
- School of Sports Medicine and Rehabilitation, Beijing Sport University, Beijing 100084, China
| | - Zhi-Min Hong
- School of Science, Inner Mongolia University of Technology, Hohhot 010051, China
| | - Jing Xiao
- Department of Physiotherapy and Rehabilitation, Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences, Beijing 100091, China
| | - Fei-Fei Ren
- Department of Physical Education, Beijing Language and Culture University, Beijing 100083, China
| | - Osvaldas Rukšėnas
- Life Sciences Center, Vilnius University, LT-10257 Vilnius, Lithuania
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21
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Mętel S, Kostrzon M, Adamiak J. Dynamic Balance and Chest Mobility of Older Adults after Speleotherapy Combined with Pulmonary Rehabilitation, Endurance and Strength Training-A Prospective Study in Chronic Respiratory Diseases. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191811760. [PMID: 36142033 PMCID: PMC9517220 DOI: 10.3390/ijerph191811760] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 09/15/2022] [Accepted: 09/16/2022] [Indexed: 05/29/2023]
Abstract
BACKGROUNDS As people age, they are more likely to experience balance disturbances. Pulmonary rehabilitation is recognized as a core component in the management of older adults with chronic respiratory diseases. The aim of the study was to assess the dynamic balance and chest mobility of older adults participating in speleotherapy combined with pulmonary rehabilitation, endurance and strength training. METHODS The study group consisted of 51 older adults with chronic respiratory disorders who participated in a 3-week pulmonary rehabilitation programme in underground salt chambers in the 'Wieliczka' Salt Mine Health Resort. These individuals underwent the Four Square Step Test (FSST) and circumferential chest mobility measurement before and after the outpatient rehabilitation programme conducted 135 m underground. RESULTS Before rehabilitation in the underground salt chambers, half of the results (50%, 22 patients) were below the norm in the assessment of chest mobility between maximal inhale and exhale. The average time needed to perform FSST decreased significantly (p ≤ 0.05) from 10.2 ± 1.9 s before the stay to 9.1 ± 1.7 s after the stay and the average increase in chest mobility increased significantly (p ≤ 0.05) from 4.5 ± 5.5 cm to 5.4 ± 2.8 cm. CONCLUSIONS Speleotherapy combined with pulmonary rehabilitation, endurance and strength training increased the dynamic balance and chest mobility of older adults with chronic respiratory diseases, as measured by the FSST and circumferential chest expansion assessment.
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Affiliation(s)
- Sylwia Mętel
- Institute of Applied Sciences, University of Physical Education in Krakow, 31-571 Krakow, Poland
| | - Magdalena Kostrzon
- ‘Wieliczka’ Salt Mine Health Resort in Wieliczka, 32-020 Wieliczka, Poland
| | - Justyna Adamiak
- Institute of Applied Sciences, University of Physical Education in Krakow, 31-571 Krakow, Poland
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22
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Palermo AE, Kirk-Sanchez NJ, Garcia KL, Nash MS, Cahalin LP. Inspiratory Muscle Performance Is Related to Seated Balance Function in People With Spinal Cord Injury: An Observational Study. Arch Phys Med Rehabil 2022; 103:1303-1310. [PMID: 34922931 DOI: 10.1016/j.apmr.2021.11.006] [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: 08/27/2021] [Revised: 11/14/2021] [Accepted: 11/16/2021] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To examine the relationship between inspiratory muscle performance (IMP) and functional sitting balance (FSB) in persons with chronic spinal cord injury (SCI). We hypothesized that a moderate correlation would be found between IMP and FSB and that individuals with better balance would have better IMP. DESIGN The SCI-specific modification of the Function in Sitting Test (FIST-SCI) measured FSB. The IMP measures included (1) maximal inspiratory pressure (MIP), (2) sustained MIP (SMIP), and (3) inspiratory duration. Upper extremity motor score (UEMS) and level of injury (LOI) were taken from International Standards for Neurological Classification of Spinal Cord Injury examinations. Spearman correlational analyses assessed relationships among these factors in the sample (N=37). Mann-Whitney U tests explored differences between 2 comparison group pairs (tetraplegia group [TG] vs paraplegia group [PG]; independent transfer group [ITG] vs assisted transfer group [ATG]). Regression analysis examined variables predictive of FSB in the TG. SETTING Research facility. PARTICIPANTS Volunteers with tetraplegia (n=21, American Spinal Injury Association Impairment Scale (AIS) A=8, B=7, C=6) and paraplegia (n=16, AIS A=9, B=4, C=3) (N=37). INTERVENTION Not applicable. MAIN OUTCOME MEASURES IMP, LOI, UEMS, FIST-SCI. RESULTS UEMS, MIP, SMIP, and LOI had moderate to high correlations with FIST-SCI scores (ρ=0.720 (P<.001), 0.480 (P=.003), 0.467 (P=.004), 0.527 (P=.001), respectively). UEMS, MIP, and FIST-SCI scores were higher in the PG and ITG than the TG and ATG, respectively (PG vs. TG P values=<.001, .008, .002, respectively, and ITG vs. ATG P values=<.001, .032, <.001, respectively). Further, SMIP and UEMS predicted FIST-SCI balance scores in the TG, accounting for 55% of total variance (P<.001) (FIST-SCI=11.88+0.03 [SMIP]+0.425 [UEMS]). CONCLUSIONS The relationship between IMP and balance appears preserved after SCI. FSB was predicted, in part, via UEMS and SMIP in the TG. Future research should focus on the effect of SCI-based breathing interventions on FSB.
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Affiliation(s)
- Anne E Palermo
- Department of Physical Therapy, University of Miami Miller School of Medicine, Miami, Florida; Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, Florida.
| | - Neva J Kirk-Sanchez
- Department of Physical Therapy, University of Miami Miller School of Medicine, Miami, Florida
| | - Kelsey L Garcia
- Department of Physical Therapy, University of Miami Miller School of Medicine, Miami, Florida; Department of Rehabilitation, Jackson Health Systems, Miami, Florida
| | - Mark S Nash
- Department of Physical Therapy, University of Miami Miller School of Medicine, Miami, Florida; Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, Florida
| | - Lawrence P Cahalin
- Department of Physical Therapy, University of Miami Miller School of Medicine, Miami, Florida
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Yu B, Xie Q, Xu J, Chen L, Zhang J, Yin H, Jia J, Qiu Y, Xu W. Impairments and Compensations of Static Balance and Plantar Load Distribution in Patients With Chronic Stroke: An Observational Study. J Manipulative Physiol Ther 2022; 44:734-742. [PMID: 35752501 DOI: 10.1016/j.jmpt.2022.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 02/18/2022] [Accepted: 03/08/2022] [Indexed: 11/18/2022]
Abstract
OBJECTIVES The purpose of this study was to explore impairment and compensation characteristics of static balance and plantar load distribution in patients with chronic stroke. METHODS We recruited 68 patients who had chronic stroke who could stand independently (stroke group) and 30 healthy individuals (control group) with the Zebris FDM platform. Static balance parameters, including center of pressure (COP) ellipse sway area, COP path length, and angle-θ between y and major axis, were compared between 2 groups under standard standing posture. In the stroke group, balance parameters were re-tested under their preferring standing posture. Plantar load distribution was also assessed. Another 8 patients with chronic stroke who could not stand independently and had to rely on a crutch were enrolled to analyze the characteristics of balance compensation. RESULTS In the stroke group, the ellipse sway area, COP path length, and angle-θ were significantly larger than those of the control group. Sixty-one (89.7%) patients preferred standing with the affected foot outward-forward supporting, and their preferring standing balance was better than that of standard standing. All patients who could not stand independently tended to compensate for balance with a crutch supporting laterally and also preferred standing with a typical posture- the affected foot was outward-forward. CONCLUSIONS In patients post stroke, static balance is impaired mainly at the lateral direction, and patients commonly locate the crutch laterally for compensation of lateral balance. Patients preferred standing with the affected foot outward-forward supporting, and their preferring standing balance was better than that of standard standing, which challenged the necessity of training standing symmetrically.
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Affiliation(s)
- Baofu Yu
- Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, China; The Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Qian Xie
- Department of Radiology, Jing'an District Center Hospital, Fudan University, Shanghai, China
| | - Jing Xu
- Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, China; Department of Hand and Upper Extremity Surgery, Jing'an District Center Hospital, Fudan University, Shanghai, China; Shanghai Clinical Medical Center for Limb Function Reconstruction, Shanghai, China
| | - Liwen Chen
- Department of Hand and Upper Extremity Surgery, Jing'an District Center Hospital, Fudan University, Shanghai, China; Shanghai Clinical Medical Center for Limb Function Reconstruction, Shanghai, China
| | - Jionghao Zhang
- Shanghai Clinical Medical Center for Limb Function Reconstruction, Shanghai, China; Department of Orthopaedic Surgery, Jing'an District Center Hospital, Fudan University, Shanghai, China
| | - Huawei Yin
- Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, China; Department of Hand and Upper Extremity Surgery, Jing'an District Center Hospital, Fudan University, Shanghai, China; Shanghai Clinical Medical Center for Limb Function Reconstruction, Shanghai, China
| | - Jie Jia
- Shanghai Clinical Medical Center for Limb Function Reconstruction, Shanghai, China; Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Yanqun Qiu
- Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, China; Department of Hand and Upper Extremity Surgery, Jing'an District Center Hospital, Fudan University, Shanghai, China; Shanghai Clinical Medical Center for Limb Function Reconstruction, Shanghai, China; National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China; Research Unit of Synergistic Reconstruction of Upper and Lower Limbs After Brain Injury, Chinese Academy of Medical Sciences, Shanghai, China.
| | - Wendong Xu
- Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, China; Shanghai Clinical Medical Center for Limb Function Reconstruction, Shanghai, China; Shanghai Clinical Medical Center for Limb Function Reconstruction, Shanghai, China; Research Unit of Synergistic Reconstruction of Upper and Lower Limbs After Brain Injury, Chinese Academy of Medical Sciences, Shanghai, China; Research Unit of Synergistic Reconstruction of Upper and Lower Limbs After Brain Injury, Chinese Academy of Medical Sciences, Shanghai, China
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24
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Pistol Shooting Performance Correlates with Respiratory Muscle Strength and Pulmonary Function in Police Cadets. SUSTAINABILITY 2022. [DOI: 10.3390/su14127515] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Breathing patterns play a crucial role in shooting performance; however, little is known about the respiratory muscle strength and pulmonary capacities that control these patterns. The present study aimed to examine the relationship between shooting performance, respiratory muscle strength, and pulmonary function and to determine differences in respiratory capacities according to the shooting performance categories in police cadets. One hundred sixty-seven police cadets were recruited to assess respiratory muscle strength, pulmonary function, and shooting performance in a well-controlled environment. Measurements included maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), slow vital capacity (SVC), maximal voluntary ventilation (MVV), and pistol shooting scores. The shooting score had a moderate positive correlation with MIP (ρ = 0.33) and MEP (ρ = 0.45). FVC (ρ = 0.25), FEV1 (ρ = 0.26), SVC (ρ = 0.26) (p < 0.001) and MVV (ρ = 0.21) (p < 0.05) were slightly correlated with shooting score. There were differences between shooting performance categories in MIP, MEP, FVC, FEV1, SVC, and MVV (p < 0.001, p < 0.05). The results imply that both strong respiratory muscles and optimal pulmonary function may be one of the necessary prerequisites for superior shooting performance in police.
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25
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Fan ZQ, Liu DW. Impairment characteristics of static balance and plantar load distribution of patients undergoing tibial cortex transverse distraction for diabetic foot ulcers. J Orthop Surg Res 2022; 17:171. [PMID: 35303911 PMCID: PMC8932111 DOI: 10.1186/s13018-022-03042-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 03/02/2022] [Indexed: 11/16/2022] Open
Abstract
Objective Tibial cortex transverse distraction (TCTD) has been recently reported for the treatment of diabetic foot ulcers. Herein, we explored the characteristics of the impairments in static balance and plantar load distribution in patients. Methods We performed a retrospective study of 21 patients with diabetic foot ulcers who underwent TCTD, who were regularly followed up for > 1 year after surgery, and 20 healthy individuals (control group). A pressure platform was used to assess the standing balance functions of the lower extremities and the plantar load distribution. Results One patient underwent amputation because of severe infection. In patient group, center of pressure (COP) ellipse sway area, COP path length and angle θ were all larger, compared with those of control group (250.15 ± 98.36 mm2 vs. 135.67 ± 53.21 mm2, 145.15 ± 67.43 mm vs. 78.47 ± 34.15 mm, 39.75 ± 17.61° vs. 22.17 ± 14.15°), with statistically significant differences (P < 0.01). The average plantar load and backfoot load of the unaffected side was significantly larger than that of the affected side (58.4 ± 5.5% vs. 41.6 ± 5.5%, 45.3 ± 6.4% vs. 36.5 ± 5.6%), but they were similar for the two feet of members of the control group. Conclusions Although TCTD may represent an appropriate method for the treatment of diabetic foot ulcers, postoperative impairments in static balance and plantar load distribution remain in the long term. These potential long-term problems should be taken into account in further rehabilitation planning. Type of study/level of evidence: Therapeutic III.
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Affiliation(s)
- Zhi-Qiang Fan
- Department of Orthopaedic Surgery, Jiangxi Provincial People's Hospital Affiliated To Nanchang University, 152 Ai Guo Road, Nanchang, 330006, Jiangxi, People's Republic of China. .,Institute of Burn, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
| | - De-Wu Liu
- Institute of Burn, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
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Zhang Y, Wang C, Yang J, Qiao L, Xu Y, Yu L, Wang J, Ni W, Wang Y, Yao Y, Yong Z, Ding S. Comparing the Effects of Short-Term Liuzijue Exercise and Core Stability Training on Balance Function in Patients Recovering From Stroke: A Pilot Randomized Controlled Trial. Front Neurol 2022; 13:748754. [PMID: 35242094 PMCID: PMC8886894 DOI: 10.3389/fneur.2022.748754] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Accepted: 01/10/2022] [Indexed: 11/13/2022] Open
Abstract
AimsLiuzijue Qigong (LQG) exercise is a traditional Chinese exercise method in which breathing and pronunciation are combined with movement guidance. Breathing is closely related to balance, and LQG, as a special breathing exercise, can be applied to balance dysfunction after stroke. The purpose of this study was to observe the clinical effects of short-term LQG exercise on balance function in patients recovering from stroke.MethodsStroke patients were randomly divided into an Intervention Group (IG) (n = 80) and a Control Group (CG) (n = 80). The IG received conventional rehabilitation training plus LQG and the CG received conventional rehabilitation training plus Core Stability Training (CST). All patients received treatment once a day, 5 times a week for 2 weeks. The primary outcome was Berg Balance Scale (BBS). Secondary outcome measures were static standing and sitting balance with eyes open and closed, Fugl-Meyer Assessment (FMA), Maximum Phonation Time (MPT), Modified Barthel Index (MBI) and diaphragm thickness and mobility during quiet breath (QB) and deep breath (DB).ResultsCompared with the CG, the IG showed significant improvement in the BBS (10.55 ± 3.78 vs. 9.06 ± 4.50, P = 0.039), MPT (5.41 ± 4.70 vs. 5.89 ± 5.24, P = 0.001), MBI (12.88 ± 6.45 vs. 10.00 ± 4.84, P = 0.003), diaphragmatic mobility during QB (0.54 ± 0.73 vs. 0.33 ± 0.40, P = 0.01) and diaphragmatic mobility during DB (0.99 ± 1.32 vs. 0.52 ± 0.77, P = 0.003), Cop trajectory in the standing position with eyes open (−108.34 ± 108.60 vs. −89.00 ± 140.11, P = 0.034) and Cop area in the standing positions with eyes open (−143.79 ± 431.55 vs. −93.29 ± 223.15, P = 0.015), Cop trajectory in the seating position with eyes open (−19.95 ± 23.35 vs. −12.83 ± 26.64, P = 0.001) and Cop area in the seating position with eyes open (−15.83 ± 9.61 vs. −11.29 ± 9.17, P = 0.002).ConclusionsThe short-term LQG combined with conventional rehabilitation training significantly improved the balance functions of stroke patients. It also improved static standing and sitting balance with the eyes open, diaphragm functions, maximum phonation time and the quality of daily life for stroke patients.Clinical Trial Registrationhttp://www.chictr.org.cn/edit.aspx?pid=25313&htm=4, Identifier: ChiCTR1800014864.
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Affiliation(s)
- Ying Zhang
- Department of Rehabilitation, Shanghai Xuhui Central Hospital, Zhongshan-Xuhui Hospital, Fudan University, Shanghai, China
| | - Chen Wang
- Department of Rehabilitation, Shanghai Xuhui Central Hospital, Zhongshan-Xuhui Hospital, Fudan University, Shanghai, China
| | - JianZhong Yang
- Department of Rehabilitation, Shanghai Xuhui Central Hospital, Zhongshan-Xuhui Hospital, Fudan University, Shanghai, China
| | - Lei Qiao
- Department of Rehabilitation, Shanghai Xuhui Central Hospital, Zhongshan-Xuhui Hospital, Fudan University, Shanghai, China
| | - Ying Xu
- Department of Rehabilitation, Shanghai Xuhui Central Hospital, Zhongshan-Xuhui Hospital, Fudan University, Shanghai, China
| | - Long Yu
- Department of Rehabilitation, Shanghai Xuhui Central Hospital, Zhongshan-Xuhui Hospital, Fudan University, Shanghai, China
| | - Jie Wang
- Department of Rehabilitation, Shanghai Xuhui Central Hospital, Zhongshan-Xuhui Hospital, Fudan University, Shanghai, China
| | - Weidong Ni
- Department of Rehabilitation, Shanghai Xuhui Central Hospital, Zhongshan-Xuhui Hospital, Fudan University, Shanghai, China
| | - Yan Wang
- Department of Rehabilitation, Shanghai Xuhui Central Hospital, Zhongshan-Xuhui Hospital, Fudan University, Shanghai, China
| | - Yue Yao
- Department of Rehabilitation, Shanghai Xuhui Central Hospital, Zhongshan-Xuhui Hospital, Fudan University, Shanghai, China
| | - ZhiJie Yong
- Department of Rehabilitation, Shanghai Xuhui Central Hospital, Zhongshan-Xuhui Hospital, Fudan University, Shanghai, China
| | - ShanShan Ding
- Department of Rehabilitation, Shanghai Xuhui Central Hospital, Zhongshan-Xuhui Hospital, Fudan University, Shanghai, China
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Yu X, Jiang HY, Zhang CX, Jin ZH, Gao L, Wang RD, Fang JP, Su Y, Xi JN, Fang BY. The Role of the Diaphragm in Postural Stability and Visceral Function in Parkinson's Disease. Front Aging Neurosci 2022; 13:785020. [PMID: 35002681 PMCID: PMC8733584 DOI: 10.3389/fnagi.2021.785020] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 11/29/2021] [Indexed: 11/25/2022] Open
Abstract
Background: In normal subjects, the diaphragm plays a key functional role in postural stability, articulation, respiration, defecation, and urination. Objectives: The aim of this study was to investigate the role of the diaphragm in postural stability and visceral function in patients with Parkinson’s disease (PD) and to compare the diaphragm function by gender, Hoehn and Yahr (H&Y) staging, and motor subtypes. Methods: In total, 79 patients were enrolled in this cross-sectional study. The severity of the disease was assessed by the Movement Disorder Society-Unified Parkinson’s Disease Rating Scale III and by H&Y staging. Postural stability was quantitatively recorded, and respiratory function was evaluated by spirometry. Several scales were used to evaluate visceral function in patients with PD. In addition, diaphragm ultrasound was used to measure the excursion, contraction velocity, and thickness of the diaphragm during quiet breathing, deep breathing, and the sniff test. Significant features were selected by the least absolute shrinkage and selection operator (LASSO) regression and fitted in the multivariate linear regression and Pearson’s correlation analysis. Results: Diaphragm thickness and excursion during quiet breathing were significantly different between men and women and between H&Y stage 1–2 and stage 2.5–3, whereas the diaphragm function was not influenced by motor subtypes. It was shown that the diaphragmatic function was significantly correlated with postural stability, voice function, respiratory function, constipation, and urological function to varying degrees in patients with PD. Conclusion: The diaphragmatic function is associated with dysfunction in PD although it remains unclear as to whether the observed changes in the diaphragm are primary or secondary.
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Affiliation(s)
- Xin Yu
- Beijing Rehabilitation Medical College, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Hong-Ying Jiang
- Department of Respiratory Rehabilitation Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Chen-Xi Zhang
- Department of Respiratory Rehabilitation Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Zhao-Hui Jin
- Parkinson Medical Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Lei Gao
- Parkinson Medical Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Rui-Dan Wang
- Parkinson Medical Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Jin-Ping Fang
- Parkinson Medical Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Yuan Su
- Parkinson Medical Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Jia-Ning Xi
- Department of Respiratory Rehabilitation Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Bo-Yan Fang
- Parkinson Medical Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
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Tough D, Dunning J, Robinson J, Dixon J, Ferguson J, Paul I, Harrison SL. Investigating balance, gait, and physical function in people who have undergone thoracic surgery for a diagnosis of lung cancer: A mixed-methods study. Chron Respir Dis 2021; 18:14799731211052299. [PMID: 34715760 PMCID: PMC8558594 DOI: 10.1177/14799731211052299] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Objectives Symptoms associated with lung cancer and thoracic surgery might increase fall risk. We aimed to investigate: 1) balance, gait and functional status in people post-thoracic surgery compared to healthy controls; 2) perceptions of balance, gait and functional status. Methods Recruitment targeted older adults (≥50 years) who had undergone thoracic surgery for a diagnosis of lung cancer in the previous 3 months, and healthy age-matched controls. Dynamic and static balance, gait velocity, knee-extension strength and physical activity levels were assessed using the BESTest, Kistler force plate, GAITRite system, Biodex System 3 and CHAMPS questionnaire, respectively. Two-part semi-structured interviews were conducted post-surgery. Results Individuals post-surgery (n = 15) had worse dynamic balance and gait, and lower levels of moderate/vigorous physical activity (MVPA) (all p<0.05) versus healthy controls (n = 15). Strength did not differ between groups (p > 0.05). No associations between BESTest and strength or physical activity existed post-surgery (p > 0.05). Three themes were identified: 1) Symptoms affect daily activities; 2) Functional assessments alter perceptions of balance ability and 3) Open to supervised rehabilitation. Conclusion Balance, gait and MVPA are impaired post-thoracic surgery, yet balance was not viewed to be important in enabling activities of daily living. However, supervised rehabilitation was considered acceptable.
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Affiliation(s)
- Daniel Tough
- School of Health and Life Sciences, 5462Teesside University, Middlesbrough, UK
| | - Joel Dunning
- Department of Cardiothoracic Surgery, 156705James Cook University Hospital, Middlesbrough, UK
| | - Jonathan Robinson
- School of Health and Life Sciences, 5462Teesside University, Middlesbrough, UK
| | - John Dixon
- School of Health and Life Sciences, 5462Teesside University, Middlesbrough, UK
| | - Jonathan Ferguson
- Department of Cardiothoracic Surgery, 156705James Cook University Hospital, Middlesbrough, UK
| | - Ian Paul
- Department of Cardiothoracic Surgery, 156705James Cook University Hospital, Middlesbrough, UK
| | - Samantha L Harrison
- School of Health and Life Sciences, 5462Teesside University, Middlesbrough, UK
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Vicente-Campos D, Sanchez-Jorge S, Terrón-Manrique P, Guisard M, Collin M, Castaño B, Rodríguez-Sanz D, Becerro-de-Bengoa-Vallejo R, Chicharro JL, Calvo-Lobo C. The Main Role of Diaphragm Muscle as a Mechanism of Hypopressive Abdominal Gymnastics to Improve Non-Specific Chronic Low Back Pain: A Randomized Controlled Trial. J Clin Med 2021; 10:jcm10214983. [PMID: 34768502 PMCID: PMC8584898 DOI: 10.3390/jcm10214983] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 10/19/2021] [Accepted: 10/26/2021] [Indexed: 12/27/2022] Open
Abstract
Background: Chronic low back pain (LBP) has been stated as one of the main health concerns in the XXI century due to its high incidence. Objective: The objective of this study was to determine the effects of an 8-week program of hypopressive abdominal gymnastics (HAG) on inspiratory muscle strength, diaphragm thickness, disability and pain in patients suffering from non-specific chronic LBP. Methods: A total of 40 patients with chronic LBP were randomly divided into two groups. The experimental group carried out an 8-week supervised program of HAG (two sessions/week), whereas the control group did not receive any treatment. Outcomes were measured before and after the intervention, comprising diaphragm thickness during relaxed respiratory activity, maximal inspiratory pressure (PImax), pain intensity (NRS), pressure pain threshold and responses to four questionnaires: Physical Activity Questionnaire (PAQ), Roland–Morris Disability Questionnaire (RMQ), Central Sensitization Inventory (CSI) and Tampa Scale of Kinesiophobia-11 Items (TSK-11). Results: Statistically significant differences (p < 0.05) were observed for greater thickness of the left and right hemi-diaphragms at inspiration, as well as higher PImax and decreased NRS, CSI and RMQ scores in the intervention group. After treatment, the increases in the thickness of the left and right hemi-diaphragms at inspiration and PImax, as well as the decrease in the NRS and RMQ scores, were only predicted by the proposed intervention (R2 = 0.118–0.552). Conclusions: An 8-week HAG intervention seemed to show beneficial effects and predicted an increase in diaphragm thickness and strength during inspiration, as well as a reduction in pain intensity, central sensitization and disability, in patients suffering from chronic non-specific LBP with respect to non-intervention.
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Affiliation(s)
- Davinia Vicente-Campos
- Faculty of Health Sciences, Universidad Francisco de Vitoria, Pozuelo de Alarcón, 28223 Madrid, Spain; (D.V.-C.); (S.S.-J.); (P.T.-M.); (M.G.); (M.C.); (B.C.)
| | - Sandra Sanchez-Jorge
- Faculty of Health Sciences, Universidad Francisco de Vitoria, Pozuelo de Alarcón, 28223 Madrid, Spain; (D.V.-C.); (S.S.-J.); (P.T.-M.); (M.G.); (M.C.); (B.C.)
| | - Pablo Terrón-Manrique
- Faculty of Health Sciences, Universidad Francisco de Vitoria, Pozuelo de Alarcón, 28223 Madrid, Spain; (D.V.-C.); (S.S.-J.); (P.T.-M.); (M.G.); (M.C.); (B.C.)
| | - Marion Guisard
- Faculty of Health Sciences, Universidad Francisco de Vitoria, Pozuelo de Alarcón, 28223 Madrid, Spain; (D.V.-C.); (S.S.-J.); (P.T.-M.); (M.G.); (M.C.); (B.C.)
| | - Marion Collin
- Faculty of Health Sciences, Universidad Francisco de Vitoria, Pozuelo de Alarcón, 28223 Madrid, Spain; (D.V.-C.); (S.S.-J.); (P.T.-M.); (M.G.); (M.C.); (B.C.)
| | - Borja Castaño
- Faculty of Health Sciences, Universidad Francisco de Vitoria, Pozuelo de Alarcón, 28223 Madrid, Spain; (D.V.-C.); (S.S.-J.); (P.T.-M.); (M.G.); (M.C.); (B.C.)
| | - David Rodríguez-Sanz
- Faculty of Nursing, Physiotherapy and Podiatry, Universidad Complutense de Madrid, 28040 Madrid, Spain; (D.R.-S.); (R.B.-d.-B.-V.); (C.C.-L.)
| | - Ricardo Becerro-de-Bengoa-Vallejo
- Faculty of Nursing, Physiotherapy and Podiatry, Universidad Complutense de Madrid, 28040 Madrid, Spain; (D.R.-S.); (R.B.-d.-B.-V.); (C.C.-L.)
| | - José López Chicharro
- Grupo FEBIO, Universidad Complutense de Madrid, 28040 Madrid, Spain
- Correspondence:
| | - César Calvo-Lobo
- Faculty of Nursing, Physiotherapy and Podiatry, Universidad Complutense de Madrid, 28040 Madrid, Spain; (D.R.-S.); (R.B.-d.-B.-V.); (C.C.-L.)
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Association Between Inspiratory Muscle Function and Balance Ability in Older People: A Pooled Data Analysis Before and After Inspiratory Muscle Training. J Aging Phys Act 2021; 30:421-433. [PMID: 34530401 DOI: 10.1123/japa.2020-0507] [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: 03/20/2021] [Revised: 05/10/2021] [Accepted: 07/06/2021] [Indexed: 11/18/2022]
Abstract
Inspiratory muscle training (IMT) improved balance ability and respiratory muscle function in healthy older adults. The current study is a retrospective analysis to explore the relationship between inspiratory muscle function, balance ability, and adaptation to IMT. All participants (total = 129; IMT = 60; age range = 65-85 years) performed inspiratory and balance assessments, including the mini-balance evaluation system test, maximal inspiratory pressure, and peak inspiratory flow tests. Baseline inspiratory muscle function was positively related to balance ability (p < .05), and IMT-induced improvements in inspiratory function (23.3% in maximal inspiratory pressure, 8.0% in peak inspiratory flow rate, 14.9% in maximal peak inspiratory power) were related to improvements in balance (10.6% in mini-balance evaluation system test), with the greatest improvements (17.0%) observed in the oldest participants (76-85 years old, p < .05). In conclusion, with or without IMT, positive associations between inspiratory function and balance ability exist, with greater improvements in inspiratory muscle function related to greater improvements in balance ability.
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Bordoni B, Escher AR. Functional evaluation of the diaphragm with a noninvasive test. J Osteopath Med 2021; 121:835-842. [PMID: 34523291 DOI: 10.1515/jom-2021-0101] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 05/25/2021] [Indexed: 12/11/2022]
Abstract
Cardiac surgery with median sternotomy causes iatrogenic damage to the function of the diaphragm muscle that is both temporary and permanent. Myocardial infarction itself causes diaphragmatic genetic alterations, which lead the muscle to nonphysiological adaptation. The respiratory muscle area plays several roles in maintaining both physical and mental health, as well as in maximizing recovery after a cardiac event. The evaluation of the diaphragm is a fundamental step in the therapeutic process, including the use of instruments such as ultrasound, magnetic resonance imaging (MRI), and computed axial tomography (CT). This article reviews the neurophysiological relationships of the diaphragm muscle and the symptoms of diaphragmatic contractile dysfunction. The authors discuss a scientific basis for the use of a new noninstrumental diaphragmatic test in the hope of stimulating research.
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Affiliation(s)
- Bruno Bordoni
- Foundation Don Carlo Gnocchi IRCCS, Department of Cardiology, Institute of Hospitalization and Care with Scientific, Milan, Italy
| | - Allan R Escher
- Anesthesiology/Pain Medicine, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
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Jiroumaru T, Wachi M, Noguchi S, Ikeya M, Hattori T, Fujitani R, Suzuki M, Tanida S, Shichiri N, Fujikawa T. Is the diaphragm thickness related to gait speed in patients with hemiplegia caused by cerebrovascular accident? J Phys Ther Sci 2021; 33:450-454. [PMID: 34177107 PMCID: PMC8219597 DOI: 10.1589/jpts.33.450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 03/10/2021] [Indexed: 11/24/2022] Open
Abstract
[Purpose] We aimed to determine the relationship between gait speed and diaphragm thickness in community-residing patients with hemiplegia caused by cerebrovascular accidents. [Participants and Methods] We recruited 11 elderly participants (six male and five female, mean age 71.1 ± 13.6 years) from an outpatient rehabilitation unit. The inclusion criteria were as follows: patients with hemiplegia caused by cerebrovascular accidents, those able to walk without assistance, and those able to understand our instructions. We measured the diaphragm thickness on both the paretic and non-paretic sides in each participant during maximum exhalation and inhalation during three laboured breaths by ultrasonography with a 7.5-MHz linear scanner. The liner scanner was placed on the eighth or ninth rib between the anterior and middle axillary lines. And their gait speed was measured during a 10 m walk. [Results] There was a strong positive correlation between gait speed and the ratio of diaphragm thickness between the paretic and the non-paretic sides during maximal inspiration. The other measured parameters did not show significant correlation with gait speed. [Conclusion] The symmetrical thickness of the diaphragm is a key factor in increasing gait speed in patients with hemiplegia. These findings may contribute to the development of trunk muscle strength-training programs that improve trunk function and gait speed in patients with hemiplegia.
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Affiliation(s)
- Takumi Jiroumaru
- Department of Physical Therapy, Biwako Professional University of Rehabilitation: 967 Kitasaka-cho, Higashiomi, Shiga 527-0145, Japan
| | - Michio Wachi
- Department of Physical Therapy, Biwako Professional University of Rehabilitation: 967 Kitasaka-cho, Higashiomi, Shiga 527-0145, Japan
| | - Shinichi Noguchi
- Department of Physical Therapy, Biwako Professional University of Rehabilitation: 967 Kitasaka-cho, Higashiomi, Shiga 527-0145, Japan
| | - Masae Ikeya
- Department of Physical Therapy, Biwako Professional University of Rehabilitation: 967 Kitasaka-cho, Higashiomi, Shiga 527-0145, Japan
| | | | - Ryo Fujitani
- Department of Physical Therapy, Biwako Professional University of Rehabilitation: 967 Kitasaka-cho, Higashiomi, Shiga 527-0145, Japan
| | - Mika Suzuki
- Department of Physical Therapy, Biwako Professional University of Rehabilitation: 967 Kitasaka-cho, Higashiomi, Shiga 527-0145, Japan
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Relationship between Respiratory Muscle Function and Postural Stability in Male Soccer Players: A Case-Control Study. Healthcare (Basel) 2021; 9:healthcare9060644. [PMID: 34072426 PMCID: PMC8228465 DOI: 10.3390/healthcare9060644] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Revised: 05/21/2021] [Accepted: 05/27/2021] [Indexed: 11/30/2022] Open
Abstract
The important role of postural stability in exercise performance has been determined by several authors. Despite this, few studies have analyzed the relationship between respiratory muscles’ strength and postural stability in athletes. For this reason, the aim of this study was to investigate the relationship between postural stability and respiratory muscles’ function in male soccer players. A case-control study was conducted over twenty-eight healthy men (18 soccer players; 10 non-athletes). Inspiratory muscle strength (MIP) and respiratory resistance (MVV) were obtained through a digital spirometer. Stability variables were obtained in standing position on a stabilometric platform and in open and closed eyes conditions. The area and length of the center of pressures and displacements in the X and Y range were analyzed. Pearson’s coefficient was used to measure the linear correlation between MIP, MVV and stabilometric variables. In the soccer players’ group, MIP and MIP % predictive were inversely correlated with length (r = −0.535 and r = −0.585; p < 0.05) and X range (r = −0.527 and r = −0.560; p < 0.05), whereas MVV was directly correlated with length (r = 0.606; p < 0.01) and Y range (r = 0.558; p < 0.05). Our results show that the greater the inspiratory muscle strength, the less displacement of the pressure center, while at higher respiratory rates there is greater displacement.
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Sliwka A, Pilinski R, Rosa W, Nowobilski R. The influence of the trunk muscle activation on occlusion pressure and respiratory muscle strength in healthy participants: Randomized controlled trial. Respir Physiol Neurobiol 2021; 290:103682. [PMID: 33979696 DOI: 10.1016/j.resp.2021.103682] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 04/12/2021] [Accepted: 05/05/2021] [Indexed: 02/06/2023]
Abstract
OBJECTIVES The purpose of the study was to check if the trunk muscle activation done in accordance with rules of the Bobath concept affects the occlusion pressure and respiratory muscle efficacy in forced breathing manoeuvres in healthy participants. DESIGN Randomized controlled trial. Between-subjects design. PARTICIPANTS Seventy-four healthy volunteers, aged 20-26 years, were recruited from medical students, randomly assigned to the experimental or control groups. INTERVENTION The intervention in the experimental group was individual physiotherapy based on the Bobath concept. It was provided by qualified physiotherapist and lasted about 60 min. The Bobath concept is an inclusive, individualized therapeutic approach to optimize movement recovery, informed by contemporary movement and neuro-sciences. The control group participated in a 45-minute lecture on the importance of the stability of trunk muscle and the diaphragm position that is adequate for its respiratory work. The described interventions, in both groups, were performed once, between the initial and final measurement of the respiratory drive. OUTCOME MEASURES The subjects underwent two assessments of the following variables: occlusion pressure (P0.1) and the respiratory muscle strength: maximal inspiratory pressure (PImax), maximal expiratory pressure (PEmax), maximal occlusion pressure (P0.1max) with the use of MasterScope Spirometer. In experimental group, the physiotherapy assessment was carried out before intervention. RESULTS As a result of the applied intervention, P0.1 in the experimental group increased (p = 0.001; 82.45 vs 103.73), which was not observed in the control group (p = 0.629; 88.95 vs 85.83). The intervention did not change the results of all other outcomes including P0.1 max; PImax and PEmax. CONCLUSION The activation of trunk muscles such as transversus abdominis, multifidius and muscles of the pelvic floor was found to improve the effectiveness of diaphragmatic work during tidal breathing as measured with P0.1 values. Established abdominal pressure, which stabilizes the trunk and prevents chest mobility, might be the reason why forced measurements (PImax, PEmax, P.01 max) remain unchanged.
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Affiliation(s)
- Agnieszka Sliwka
- Faculty of Health Sciences, Jagiellonian University Medical College, Kraków, Poland.
| | - Rafał Pilinski
- Faculty of Health Sciences, Jagiellonian University Medical College, Kraków, Poland.
| | - Wioleta Rosa
- PhD Programme, Faculty of Health Sciences, Jagiellonian University Medical College, Kraków, Poland.
| | - Roman Nowobilski
- Faculty of Health Sciences, Jagiellonian University Medical College, Kraków, Poland.
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The Use of Frequency Analysis as a Complementary and Explanatory Element for Time Domain Analysis in Measurements of the Ability to Maintain Balance. J Hum Kinet 2021; 76:117-129. [PMID: 33603929 PMCID: PMC7877278 DOI: 10.2478/hukin-2021-0004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Assessment of human balance is one of the most common diagnostic tests, both in medical applications and during sports training. Many new methods of measuring are introduced in these studies; however, the analysis of results is still carried out mainly based on the values determined in the time domain - the average COP speed or the ellipse field of the prediction. The aim of the current work is to present the possibilities for the practical application of frequency analyses in assessment of the ability to maintain body balance as a method supplementing standard analyses. As part of the study, measurements of the ability to maintain balance in sensory conflict conditions introduced in the form of an oscillating, three-dimensional, virtual scenery were carried out. 27 healthy volunteers (13 women and 14 men) took part in the study. The three-dimensional scenery, presented by means of the Oculus system, oscillated in the sagittal plane with frequencies equal to 0.7 Hz and 1.4 Hz. The frequency value during the measurement was constant or changed in the middle of the test. Measurements were conducted on the FDM Zebris platform. The results were analyzed using developed coefficients determined on the basis of the Short-time Fourier transform (STFT). The use of frequency-domain analyses confirmed that in the COP movement, one can observe a cyclical component corresponding to following the scenery, as well as the appearance of other cyclical components whose observation is important in terms of assessing the ability to maintain balance. It has been shown that the changes in the average COP speed that occur during the measurement can result from changes related to the movement of following the scenery as well as additional body movements indicating a greater or lesser loss of balance. It has been shown that there are differences in the COP movement provoked by the movement of the surrounding scenery, which depend on the parameters of the introduced disturbances - something that can only be observed in results obtained in the frequency domain. The conducted research shows that in measurements involving the ability to maintain one's balance conducted in sensory conflict conditions, standard time-domain analyses should be supplemented with other types of data analysis, e.g. frequency domain analyses.
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Stroke Severity and Maximum Inspiratory Pressure are Independently Associated with Functional Mobility in Individuals After Stroke. J Stroke Cerebrovasc Dis 2020; 29:105375. [PMID: 33039768 DOI: 10.1016/j.jstrokecerebrovasdis.2020.105375] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 09/12/2020] [Accepted: 09/27/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Clinical changes after stroke can contribute to reduced mobility and negatively affect the survival of these individuals. The objective of this study was to verify factors associated with functional mobility in stroke individuals. METHODS Crosssectional study carried out with stroke individuals in an outpatient clinic. Demographic and clinical data were collected and the following measures were applied: National Institute of Health Stroke Scale (NIHSS), modified Barthel Index, Trunk Impairment Scale, Functional Reach Test, Timed Up and Go Test, and the International Physical Activity Questionnaire. Respiratory muscle strength was assessed by measuring the maximum inspiratory pressure (MIP) and the maximum expiratory pressure (MEP).Variables with p < .05 in univariate logistic regression analysis were included in the multivariate logistic regression model, using the backward stepwise method. RESULTS 53 individuals were enrolled with a mean age of 55 years (±13.43). 51% were male and the median NIHSS score was 2.25 (0-13). The final multivariate model included NIHSS (OR = 1.872; 95% CI 1.167-3.006; p = 0.009), physical therapy treatment (OR = 15.467; 95% CI 1.838-130.178; p = 0.012) and MIP (OR = 1.078; 95% CI 1.024-1.135; p = 0.004). CONCLUSION Stroke severity and inspiratory muscle strength were factros associated with functional mobility in individuals after stroke, regardless stroke time.
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Yoon HS, Cha YJ, You J(SH. Effects of dynamic core-postural chain stabilization on diaphragm movement, abdominal muscle thickness, and postural control in patients with subacute stroke: A randomized control trial. NeuroRehabilitation 2020; 46:381-389. [DOI: 10.3233/nre-192983] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Hyun Sik Yoon
- Department of Rehabilitation Medicine, Chungnam National University Hospital, Daejeon, Republic of Korea
- Department of Physical Therapy, Movement Healing Laboratory, The Graduate School, Yonsei University, Wonju, Republic of Korea
| | - Young Joo Cha
- Department of Physical Therapy, Movement Healing Laboratory, The Graduate School, Yonsei University, Wonju, Republic of Korea
| | - Joshua (Sung) Hyun You
- Department of Physical Therapy, Movement Healing Laboratory, The Graduate School, Yonsei University, Wonju, Republic of Korea
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Abstract
The diaphragm muscle is the most important contractile district used for breathing. Like other muscles in the human body, it is subject to ageing and sarcopenia. Sarcopenia can be classified as primary (or age-related) when there are no local or systemic pathologies that cause a functional and morphological detriment of skeletal musculature. Secondary sarcopenia occurs when there is a cause or more pathological causes (illness, malnutrition, immobility) related or unrelated to ageing. In the elderly population, transdiaphragmatic pressure (Pdi) decreases by 20-41%, with a decline in the overall strength of 30% (the strength of the expiratory muscles also decreases). The article discusses the adaptation of the diaphragm muscle to ageing and some other ailments and co-morbidities, such as back pain, emotional alterations, motor incoordination, and cognitive disorders, which are related to breathing.
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Affiliation(s)
- Bruno Bordoni
- Physical Medicine and Rehabilitation, Foundation Don Carlo Gnocchi, Milan, ITA
| | - Bruno Morabito
- Physical Medicine and Rehabilitation, School of Osteopathic Centre for Research and Studies, Milan, ITA
| | - Marta Simonelli
- Integrative/Complimentary Medicine, French-Italian School of Osteopathy, Pisa, ITA
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Özkal Ö, Kara M, Topuz S, Kaymak B, Bakı A, Özçakar L. Assessment of core and lower limb muscles for static/dynamic balance in the older people: An ultrasonographic study. Age Ageing 2019; 48:881-887. [PMID: 31268513 DOI: 10.1093/ageing/afz079] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Revised: 04/15/2019] [Accepted: 06/06/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND sufficient research has not been conducted to determine the role of core and lower limb muscles in providing balance in older people. OBJECTIVE to investigate the relationships between the thickness of core/lower limb muscles and static/dynamic balance in older people. METHODS the study included a total of 68 older people (≥ 65 years) and 68 gender-matched young subjects, aged 20-40 years. Balance, knee proprioception sense, regional and total muscle measurements and grip strength were assessed using a force platform system, isokinetic dynamometer, ultrasound imaging, bioelectrical impedance analysis and Jamar dynamometer, respectively. RESULTS all the static (postural sway) parameters were higher and all the dynamic (limits of stability) parameters were lower in the older adults compared to the young adults (all P<0.05). The diaphragm was thicker and all the other muscles (except for multifidus and tibialis anterior) were thinner in the older group (all P<0.05). A higher error of knee proprioception sense was determined at 45 and 70 degrees in the older subjects (both P<0.001). According to the multivariate analyses, significant predictors for balance were age, gender, height, and rectus femoris, vastus intermedius and diaphragm muscle thicknesses in the older group, and age, gender, height, grip strength, and rectus abdominis, internal oblique, longissimus, tibialis anterior and soleus muscle thicknesses in the young group (all P<0.05). CONCLUSIONS the thickness of core/lower limb muscles are important determinants of balance in both older and young adults. These findings could provide a strong rationale for strengthening specific (abdominal and quadriceps) muscles to prevent falls and regional sarcopenia, and to improve posture/balance in the older population. CLINICAL TRIAL REGISTRATION NUMBER NCT03791047. ETHICS COMMITTEE APPROVAL Hacettepe University Non-interventional Clinical Research Ethics Board. Decision number:GO 18/506-39.
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Affiliation(s)
- Özden Özkal
- Hacettepe University Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Samanpazari, Ankara, Turkey
| | - Murat Kara
- Hacettepe University Medical School, Department of Physical and Rehabilitation Medicine, Ankara, Turkey
| | - Semra Topuz
- Hacettepe University Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Samanpazari, Ankara, Turkey
| | - Bayram Kaymak
- Hacettepe University Medical School, Department of Physical and Rehabilitation Medicine, Ankara, Turkey
| | - Aysun Bakı
- Hacettepe University Medical School, Department of Physical and Rehabilitation Medicine, Ankara, Turkey
| | - Levent Özçakar
- Hacettepe University Medical School, Department of Physical and Rehabilitation Medicine, Ankara, Turkey
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