Effects of combined training with breathing resistance and sustained physical exertion to improve endurance capacity and respiratory muscle function in healthy young adults

The influence of low resistance respiratory muscle training on pulmonary function and high intensity exercise performance

Background/objectives

Respiratory muscle training (RMT) was recognized as an effective means to improve respiratory muscle (RM) strength and enhance exercise performance. The purpose of this study was to examine the effect of low-intensity RMT on RM strength, pulmonary function, and performance.

Methods

Fourteen healthy active adults were assigned randomly to either a training or placebo group. The training group completed six weeks of RMT, which consisted of a first week, 1 set of 15 min/d, 5 d/wk at 10-25% of maximal inspiratory pressure (PImax), and the remaining 5 weeks, 2 sets of 15 min/d, 5 d/wk, at 30% PImax. The placebo group followed the same protocol but with almost no additional ventilatory resistance. Measurement of RM strength and endurance, spirometry, and endurance exercise performance were obtained before and after the RMT program.

Results

In the training group, PImax (+14%) and maximal expiratory pressure (PEmax, +27%), forced vital capacity (FVC, +3.6%), maximal oxygen uptake (VO2max, +11%), and time to exhaustion (Tlim90%, +25%) increased significantly from baseline values (P < 0.05). No significant changes were observed in the placebo group. Also, no significant interaction in maximum voluntary ventilation (MVV12), minute ventilation (VE), and respiratory rate (RR) were detected.

Conclusions

These data suggest that low-intensity RMT is an effective tool to improve RM strength, pulmonary elastic properties and endurance exercise performance.

Physically Meaningful Surrogate Data for COPD

The rapidly increasing prevalence of debilitating breathing disorders, such as chronic obstructive pulmonary disease (COPD), calls for a meaningful integration of artificial intelligence (AI) into respiratory healthcare. Deep learning techniques are "data hungry" whilst patient-based data is invariably expensive and time consuming to record. To this end, we introduce a novel COPD-simulator, a physical apparatus with an easy to replicate design which enables rapid and effective generation of a wide range of COPD-like data from healthy subjects, for enhanced training of deep learning frameworks. To ensure the faithfulness of our domain-aware COPD surrogates, the generated waveforms are examined through both flow waveforms and photoplethysmography (PPG) waveforms (as a proxy for intrathoracic pressure) in terms of duty cycle, sample entropy, FEV1/FVC ratios and flow-volume loops. The proposed simulator operates on healthy subjects and is able to generate FEV1/FVC obstruction ratios ranging from greater than 0.8 to less than 0.2, mirroring values that can observed in the full spectrum of real-world COPD. As a final stage of verification, a simple convolutional neural network is trained on surrogate data alone, and is used to accurately detect COPD in real-world patients. When training solely on surrogate data, and testing on real-world data, a comparison of true positive rate against false positive rate yields an area under the curve of 0.75, compared with 0.63 when training solely on real-world data.

Eight Weeks of High-Intensity Interval Training Using Elevation Mask May Improve Cardiorespiratory Fitness, Pulmonary Functions, and Hematological Variables in University Athletes

BACKGROUND

In the last two decades, high-altitude training (HAT) and elevation training masks (ETMs) have been widely used among athletes to enhance physical performance. However, few studies have examined the effect of wearing ETMs on physiological and hematological parameters in different sports.

AIMS

The present study aimed to investigate the impact of ETM use in athletes on several hematological and physiological indicators among cyclists, runners, and swimmers.

METHODS

The impact of wearing an ETM on lung function (LF), aerobic capacity (AC), and hematological levels in male university-level athletes (cyclists, runners, and swimmers) was investigated using an experimental approach. The participants (N = 44) were divided into (i) an experimental group wearing ETMs (n = 22; aged 21.24 ± 0.14 years old) and (ii) a control group not wearing ETMs (n = 22; aged 21.35 ± 0.19 years old). Both groups underwent 8 weeks of high-intensity cycle ergometer interval training. Pre- and post-training tests included the above-mentioned physiological and hematological parameters.

RESULTS

Except for FEV₁, FEV₁/FVC, VT1, and MHR in the control group and FEV₁/FVC and HRM in the experimental group, all variables were significantly improved after the 8-week cycle ergometer HIIT program. Significant benefits in favor of the experimental group were noted in terms of changes in FVC, FEV₁, VO₂max, VT1, PO to VT, VT2, and PO to VT2.

CONCLUSIONS

The eight-week ETM-assisted HIIT program improved cardiorespiratory fitness and hematological variables in all participants. Future research would be useful to further investigate the physiological changes resulting from ETM-assisted HIIT programs.

Effects of surgical and FFP2 masks on cardiopulmonary exercise capacity in patients with heart failure

Aims

Surgical and FFP2 masks are recommended to reduce transmission of SARS-CoV-2. The cardiopulmonary effects of facemasks in patients with chronic heart failure are unknown. This prospective, cross-over study quantified the effects of wearing no mask (nm), surgical mask (sm), and FFP2 mask (ffpm) in patients with stable heart failure.

Methods

12 patients with clinically stable chronic heart failure (HF) (age 63.8±12 years, left ventricular ejection fraction (LVEF) 43.8±11%, NTProBNP 573±567 pg/ml) underwent spiroergometry with and without masks in a randomized sequence. Comfort/discomfort was assessed using a standardized questionnaire.

Results

Maximum power was reduced with both types of masks (nm: 108.3 W vs. sm: 101.2 W vs. ffpm: 95.6 W, p<0.01). Maximum respiratory oxygen uptake (1499ml/min vs. 1481 ml/min vs. 1300 ml/min, p = 0.95 and <0.01), peak ventilation (62.1 l/min vs. 56.4 l/min vs. 50.3 l/min, p = 0.15 and p<0.05) and O2-pulse (11.6 ml/beat vs. 11.8 ml/beat vs. 10.6 ml/beat, p = 0.87 and p<0.01) were significantly changed with ffpm but not sm. Discomfort was moderately but significantly increased (nm: 1.6 vs. sm: 3.4 vs. ffpm: 4.4, p<0.05).

Conclusion

Both surgical and FFP masks reduce exercise capacity in heart failure patients, while FFP2 masks reduce oxygen uptake and peak ventilation. This reduction in cardiopulmonary performance should be considered in heart failure patients whose daily life activities are often just as challenging as exercise is for healthy adults.

Effect of Chest Resistance and Expansion Exercises on Respiratory Muscle Strength, Lung Function, and Thoracic Excursion in Children with a Post-Operative Congenital Diaphragmatic Hernia

BACKGROUND

Congenital diaphragmatic hernia (CDH) is a life-threatening condition with long-term complications including respiratory tract infections, respiratory muscle weakness, and abnormal lung functions. This study was designed to ascertain the effects of chest resistance and chest expansion exercises on respiratory muscle strength, lung function, and chest mobility in children with post-operative CDH.

METHODS

This randomized controlled clinical study was conducted in the outpatient physiotherapy clinic at Prince Sattam bin Abdulaziz University. Thirty-two children with CDH aged 10-14 years between May 2020 and February 2021 were randomly allocated to the study group (n = 16) and the control group (n = 16). The control group underwent a usual chest physiotherapy program; however, the study group underwent a 12-week chest resistance exercise combined with chest expansion exercise in addition to usual chest physiotherapy, with three sessions per week. Respiratory muscle strength, lung function, and thoracic excursion were assessed pre- and post-treatment.

RESULTS

Using the 2 × 2 repeated ANOVA, significant time × group interactions were detected in favor of the study group, FVC (F = 4.82, 95% CI = -15.6 to -0.97, p = 0.005, and η² = 0.16), FEV1 (F = 4.54, 95% CI = -11.99 to -2.8, p ˂ 0.001, and η² = 0.14), PImax (F = 5.12, 95% CI = -15.71 to -5.3, p ˂ 0.001, and η² = 0.15), and thoracic excursion (F = 4.41, 95% CI = -2.04 to -0.16, p = 0.036, and η² = 0.17).

CONCLUSIONS

Concurrent chest resistance and expansion exercises may improve respiratory muscle strength, lung function, and thoracic excursion in children with post-operative CDH. The study findings suggest that concurrent chest and chest expansion exercises be part of an appropriate pulmonary rehabilitation program in children with a history of CDH.

Handball Training and Competition With Facemasks in Galicia: The FISICOVID-DXTGALEGO Protocols Experience

Objective

COVID-19 caused a complete stop in non-professional sports. The use of face masks for team sports is not a widely used measure in non-professional sports. The study aimed to evaluate the perception about using the mask and the adaptation difficulties related to training and competition in team sports following the FISICOVID-DXTGALEGO protocol.

Methods

Seven hundred eighty-seven handball players from the Galician Handball Federation were followed during their return to participation after months of confinement through an electronic questionnaire of perception and experience on the use of a mask.

Results

There is an excellent adaptation to the mask in training and competition with medium and high correlations. The 86,41% of players reported an adaptation to the mask in 3 weeks with a three times a week training frequency. The negative opinion on the mask was drastically reduced (-66.86%) after use. The 80,44% of players considered the use of a mask as an essential measure to resume competitions.

Conclusions

It is very feasible to adapt to training and compete with a mask (hygienic or surgical) in a short period. The use of a mask following these protocols changed previous opinions on the disadvantages of the mask during training and competition.

Effects of Acute High-Intensity Exercise With the Elevation Training Mask or Hypoxicator on Pulmonary Function, Metabolism, and Hormones

ABSTRACT

Ott, T, Joyce, MC, and Hillman, AR. Effects of acute high-intensity exercise with the elevation training mask or hypoxicator on pulmonary function, metabolism, and hormones. J Strength Cond Res 35(9): 2486-2491, 2021-The elevation training mask (ETM) 2.0 is an increasingly popular hands-free respiratory muscle training modality proposing to mimic altitude; however, the degree to which this occurs has been questioned. The purpose of this study was to investigate the efficacy of this modality in comparison with using a hypoxicator (HYP) during acute aerobic exercise. Eight regularly active subjects (age: 25 ± 8 years; height: 166 ± 12 cm; body mass 64 ± 10 kg; and V̇o2max: 46 ± 6 ml·kg-1·min-1) completed 3 trials, each including resting metabolic rate measurement, pulmonary function tests, and 13 sprint intervals at 90% V̇o2max using either the HYP, ETM, or control. There was no significant difference in metabolism or heart rate between conditions. Fraction of expired air in the first second was greater after exercise (p = 0.02), while oxygen saturation was lower during exercise with the HYP (p < 0.001). Human growth hormone increased with exercise, but no differences were found between conditions; however, a trend was observed for higher growth hormone after exercise in HYP vs. ETM (p = 0.08). Elevation training mask does not seem to change acute pulmonary function, metabolism, heart rate, or oxygen saturation, indicating it likely does not create a hypoxic environment or mimic altitude.

Assessment of respiratory effort with EMG extracted from ECG recordings during prolonged breath holds: Insights into obstructive apnea and extreme physiology

Breath holding divers display extraordinary voluntary control over involuntary reactions during apneic episodes. After an initial easy phase to the breath hold, this voluntary control is applied against the increasing involuntary effort to inspire. We quantified an electromyographic (EMG) signal associated with respiratory movements derived from broad bandpass ECG recordings taken from experienced breath holding divers during prolonged dry breath holds. We sought to define their relationship to involuntary respiratory movements and compare these signals with what is known to occur in obstructive sleep apnea (OSA) and epileptic seizures. ECG and inductance plethysmography records from 14 competitive apneists (1 female) were analyzed. ECG records were analyzed for intervals and the EMG signal was extracted from a re‐filtered version of the original broad bandpass signal and ultimately enveloped with a Hilbert transform. EMG burst magnitude, quantified as an area measure, increased over the course of the struggle phase, correlated with inductance plethysmography measures, and corresponded to significant variance in heart rate variability. We conclude that an EMG signal extracted from the ECG can complement plethysmography during breath holds and may help quantify involuntary effort, as reported previously for obstructive sleep apnea. Further, given the resemblance between cardiac and respiratory features of the breath hold struggle phase to obstructive apnea that can occur during sleep or in association with epileptic seizure activity, the struggle phase may be a useful simulation of obstructive apnea for controlled experimentation that can help clarify aspects of acute and chronic apnea‐associated physiology.

Impact of two different pulmonary rehabilitation methods in children with down syndrome

PURPOSE

To investigate and compare the effect of proprioceptive neuromuscular facilitation of respiratory muscles with that of inspiratory muscle training as a preventive measure on respiratory muscle strength, chest expansion, spirometry, and functional capacity in children with Down syndrome.

METHODS

Forty-five Down syndrome participants with an age ranged from 10 to 13 years were enrolled. There were distributed into three groups. The study group A (n = 15) underwent proprioceptive neuromuscular facilitation of respiratory muscles while study group B (n = 15) underwent inspiratory muscle training. Third group C (n = 15) was a control group. The three groups received aerobic exercises using the bicycle ergometer for 20 min, 5 times/week for 12 successive weeks. The treatment program for both study groups was conducted for 20-30 min, 5 times/week for 12 successive weeks. Measurements of respiratory muscle strength (MIP, MEP), chest expansion, spirometry test (VC, FEV1, PEFR, MVV) and 6 min walk test were measured pre and post treatment.

RESULTS

The post treatment mean values of all investigated variables were significantly increased in both study groups with higher effect to group underwent proprioceptive neuromuscular facilitation of respiratory muscles.

CONCLUSION

Both proprioceptive neuromuscular facilitation of respiratory muscles and inspiratory muscle training are effective in children with Down syndrome on improving respiratory muscle strength, chest expansion, spirometry and functional capacity with superior effect of proprioceptive neuromuscular facilitation.

Influence of a Six-Week Swimming Training with Added Respiratory Dead Space on Respiratory Muscle Strength and Pulmonary Function in Recreational Swimmers

The avoidance of respiratory muscle fatigue and its repercussions may play an important role in swimmers' health and physical performance. Thus, the aim of this study was to investigate whether a six-week moderate-intensity swimming intervention with added respiratory dead space (ARDS) resulted in any differences in respiratory muscle variables and pulmonary function in recreational swimmers. A sample of 22 individuals (recreational swimmers) were divided into an experimental (E) and a control (C) group, observed for maximal oxygen uptake (VO2max). The intervention involved 50 min of front crawl swimming performed at 60% VO2max twice weekly for six weeks. Added respiratory dead space was induced via tube breathing (1000 mL) in group E during each intervention session. Respiratory muscle strength variables and pulmonary and respiratory variables were measured before and after the intervention. The training did not increase the inspiratory or expiratory muscle strength or improve spirometric parameters in any group. Only in group E, maximal tidal volume increased by 6.3% (p = 0.01). The ARDS volume of 1000 mL with the diameter of 2.5 cm applied in moderate-intensity swimming training constituted too weak a stimulus to develop respiratory muscles and lung function measured in the spirometry test.

Yoga in Burn: Role of pranayama breathing exercise on pulmonary function, respiratory muscle activity and exercise tolerance in full-thickness circumferential burns of the chest

BACKGROUND

Circumferential burn of chest (CBC) is a significant type of burn and considers as a major cause of restrictive lung disease (RLD). Patient who has CBC with RLD leads to respiratory symptoms such as breathing difficulty, airway obstruction, reduced exercise capacity and altered pulmonary functions. However, studies examining the role of pranayama breathing exercise on pulmonary function, respiratory muscle activity and exercise tolerance in full thickness circumferential burn of chest are lacking.

OBJECTIVE

To find the short term effects of pranayama breathing exercise on pulmonary function, respiratory muscle activity and exercise tolerance in full thickness circumferential burns of chest.

METHODS

Through simple random sampling method thirty subjects (N = 30) with RLD following CBC were allocated to pranayama breathing exercise group (PBE-G; n = 15) and conventional breathing exercise group (CBE-G; n = 15). They received pranayama breathing exercise and conventional breathing exercise for 4 weeks respectively. All the subjects received chest mobility exercise as common treatment. Primary (Numeric Pain Rating Scale - NPRS, forced expiratory volume (FEV1), forced vital capacity (FVC) and maximum voluntary ventilation (MVV) and secondary (Electromyogram of sternocleidomastoid, scalene, external intercostal and diaphragm muscle, 6 min walk test & Global Rating of Change - GRC) outcome measures were measured at baseline, after four weeks and after three months follow up.

RESULTS

Baseline demographic and clinical variables show homogenous distribution between the groups (p > 0.05). Four weeks following different breathing exercises, PBE-G group shows more significant changes in pain intensity, pulmonary function, respiratory muscle activity, exercise tolerance and global rating of change than CBE-G group (p ≤ 0.05) at four weeks and three months follow up.

CONCLUSION

Both groups showed improvement over time. However, differences between the groups were noticed small. Still physiotherapy management, which included pranayama breathing exercises with chest mobilization program, had an effective strategy in the treatment of restrictive lung disease following circumferential burn of chest.

Effects of breathing exercises on lung capacity and muscle activities of elderly smokers

[Purpose] Elderly smokers have a reduced chest diameter due to weakening of the respiratory muscles, and this results in decreased ventilation, leading to a vicious circle. Therefore, the present study investigated the effects of an intervention program to enhance the pulmonary function and muscle activity of elderly smokers. [Subjects and Methods] Participants were randomly assigned to one of two experimental groups or a control (CG) group. The experimental groups performed exercises three times per week for six weeks, whereas the CG performed no exercises. One of the experimental groups performed a Feedback Breathing Exercise (FBE) for 15 minutes, and the other repeated three sets of Balloon-Blowing Exercises (BBE) with sufficient rest of more than one minute between sets. [Results] In the experimental groups, FVC, FEV1/FVC, PEF and muscle activity of the rectus abdominis significantly improved after four weeks, but no significant differences were observed in FEV1 or VC after six weeks. [Conclusion] The results show that FBE and BBE improved the pulmonary functions of elderly smokers, demonstrating the potential benefits of the development of various training methods using balloons, and group programs, including recreational factors, for increasing respiratory muscles strength.

Effect of Wearing the Elevation Training Mask on Aerobic Capacity, Lung Function, and Hematological Variables

Altitude training and respiratory muscle training (RMT) have been reported to improve performance in elite and well-trained athletes. Several devices (altitude and RMT) have been developed to help athletes gain the competitive edge. The Elevation Training Mask 2.0 (ETM) purportedly simulates altitude training and has been suggested to increase aerobic capacity (VO2max), endurance performance, and lung function. Twenty-four moderately trained subjects completed 6 weeks of high-intensity cycle ergometer training. Subjects were randomized into a mask (n = 12) or control (n = 12) group. Pre and post-training tests included VO2max, pulmonary function, maximal inspiration pressure, hemoglobin and hematocrit. No significant differences were found in pulmonary function or hematological variables between or within groups. There was a significant improvement in VO2max and PPO in both the control (13.5% and 9.9%) and mask (16.5% and 13.6%) groups. There was no difference in the magnitude of improvement between groups. Only the mask group had significant improvements in ventilatory threshold (VT) (13.9%), power output (PO) at VT (19.3%), respiratory compensation threshold (RCT) (10.2%), and PO at RCT (16.4%) from pre to post-testing. The trends for improvements in VT and PO at VT between groups were similar to improvements in RCT and PO at RCT, but did not reach statistical significance (VT p = 0.06, PO at VT p = 0.170). Wearing the ETM while participating in a 6-week high-intensity cycle ergometer training program does not appear to act as a simulator of altitude, but more like a respiratory muscle training device. Wearing the ETM may improve specific markers of endurance performance beyond the improvements seen with interval training alone. Key pointsWearing the ETM during a 6-week high-intensity cycle ergometer training program may improve performance variables, such as VO2max, PPO, VT, PO at VT, RCT and PO at RCT.Wearing the ETM did not improve lung function, inspiratory muscle strength, or stimulate changes in hemoglobin or hematocrit levels.The ETM does not simulate altitude, but works more like an respiratory training device.

The effect of exercise training with an additional inspiratory load on inspiratory muscle fatigue and time-trial performance

The purpose was to determine the effect of moderate-intensity exercise training (ET) on inspiratory muscle fatigue (IMF) and if an additional inspiratory load during ET (ET+IL) would further improve inspiratory muscle strength, IMF, and time-trial performance. 15 subjects were randomly divided to ET (n=8) and ET+IL groups (n=7). All subjects completed six weeks of exercise training three days/week at ∼70%V̇O2peak for 30min. The ET+IL group breathed through an inspiratory muscle trainer (15% PImax) during exercise. 5-mile, and 30-min time-trials were performed pre-training, weeks three and six. Inspiratory muscle strength increased (p<0.05) for both groups to a similar (p>0.05) extent. ET and ET+IL groups improved (p<0.05) 5-mile time-trial performance (∼10% and ∼18%) and the ET+IL group was significantly faster than ET at week 6. ET and ET+IL groups experienced less (p<0.05) IMF compared to pre-training following the 5-mile time-trial. In conclusion, these data suggest ET leads to less IMF, ET+IL improves inspiratory muscle strength and IMF, but not different than ET alone.

Relative variances of the cadence frequency of cycling under two differential saddle heights

[Purpose] Bicycle saddle height is a critical factor for cycling performance and injury prevention. The present study compared the variance in cadence frequency after exercise fatigue between saddle heights with 25° and 35° knee flexion. [Methods] Two saddle heights, which were determined by setting the pedal at the bottom dead point with 35° and 25° knee flexion, were used for testing. The relative variances of the cadence frequency were calculated at the end of a 5-minute warm-up period and 5 minutes after inducing exercise fatigue. Comparison of the absolute values of the cadence frequency under the two saddle heights revealed a difference in pedaling efficiency. [Results] Five minutes after inducing exercise fatigue, the relative variances of the cadence frequency for the saddle height with 35° knee flexion was higher than that for the saddle height with 25° knee flexion. [Conclusion] The current finding demonstrated that a saddle height with 25° knee flexion is more appropriate for cyclists than a saddle height with 35° knee flexion.

The effects of breathing exercise types on respiratory muscle activity and body function in patients with mild chronic obstructive pulmonary disease

[Purpose] Fragmentary studies on characteristics of respiratory muscles are being done to increase respiratory capacity by classifying exercises into voluntary respiratory exercise which relieves symptoms and prevents COPD and exercise using breathing exercise equipment. But this study found changes on respiratory pattern through changes on the activity pattern of agonist and synergist respiratory muscles and studied what effect they can have on body function improvement. [Subjects and Methods] Fifteen subjects in experimental group I that respiratory exercise of diaphragm and 15 subjects in experimental group II that feedback respiratory exercise were randomly selected among COPD patients to find the effective intervention method for COPD patients. And intervention program was conducted for 5 weeks, three times a week, once a day and 30 minutes a session. They were measured with BODE index using respiratory muscle activity, pulmonary function, the six-minute walking test, dyspnea criteria and BMI Then the results obtained were compared and analyzed. [Results] There was a significant difference in sternocleidomastoid muscle and scalene muscle and in 6-minute walk and BODE index for body function. Thus the group performing feedback respiratory had more effective results for mild COPD patients. [Conclusion] Therefore, the improvement was significant regarding the activity of respiratory muscles synergists when breathing before doing breathing exercise. Although, it is valuable to reduce too much mobilization of respiratory muscles synergists through the proper intervention it is necessary to study body function regarding improvement of respiratory function for patients with COPD.

Effect of complete decongestive therapy and a home program for patients with post mastectomy lymphedema

[Purpose] Post mastectomy lymphedema is common among breast cancer survivors. It leads to physical discomfort and functional impairment. Rehabilitation forms the mainstay of treatment and is multidisciplinary. [Subjects and Methods] Sixty post mastectomy patients were allocated randomly and assigned to either a conventional treatment group (n=30) or a complete decongestive therapy (CDT) group (n=30). The conventional treatment group received manual lymphatic drainage, wore a low elastic compression garment, received glenohumeral mobilization, and performed deep breathing exercises, and the complete decongestive therapy group received CDT from a trained physiotherapist and a daily home program along with the conventional treatment, 5 days a week for 6 weeks. [Results] Arm circumference measurements were taken at five levels: the wrist, mid forearm, elbow, mid-upper arm, and axilla. The upper extremity function was evaluated using the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, and pain was assessed using the visual analogue scale. Measurements were taken at baseline, and at 4th and 6th weeks after the start of intervention. Within and between group comparisons showed significant improvements in the CDT group. [Conclusion] Complete decongestive therapy and a home program assists breast cancer related lymphedema survivors in regaining their lost functions. It also helps to improve their independence in daily activities, reduce their need for caregivers, and thereby improving their quality of life. Therefore, the results of this study showed that the CDT with a home program is an effective treatment for reducing post mastectomy lymphedema.

Effects of chest resistance exercise and chest expansion exercise on stroke patients' respiratory function and trunk control ability

[Purpose] The purpose of this study was to examine the efficiency of chest resistance and chest expansion exercises for improving respiratory function and trunk control ability in patients with stroke. [Subjects] Forty patients with stroke were randomly allocated into a chest resistance exercise group (CREG, n = 20) and a chest expansion exercise group (CEEG, n = 20). [Methods] CREG patients underwent chest resistance exercises, and diaphragmatic resistance exercises by way of the proprioceptive neuromuscular facilitation. CEEG patients underwent respiratory exercises with chest expansion in various positions. Both groups received 30 minutes of training per day, five times per week, for eight weeks. [Results] Both the CERG and CEEG groups showed significant changes in FVC, FEV1, and TIS after the intervention. TIS was significantly increased in the CREG compared to the CEEG after the intervention. [Conclusion] Both chest resistance and chest expansion exercises were effective for improving respiratory function and trunk control ability in stroke patients; however, chest resistance exercise is more efficient for increasing trunk control ability.

The effects of chest expansion resistance exercise on chest expansion and maximal respiratory pressure in elderly with inspiratory muscle weakness

[Purpose] The aim of this study was to examine the effect of chest expansion resistance exercises (CERE) on chest expansion, maximal inspiratory pressure (MIP), and maximal expiratory pressure (MEP) in elderly people with inspiratory muscle weakness. [Subjects] Thirty elderly people with inspiratory muscle weakness (MIP < 80% of the predicted value) were randomly and equally assigned to a chest expansion resistance exercise (CERE) group, core conditioning exercise (CCE) group, and control group. [Methods] The intervention was applied to the CERE group and CCE group five times per week, 30 minutes each time, for six weeks. A tapeline was used to measure upper and lower chest expansion. MIP and MEP before and after the intervention were measured and compared. [Results] There was significant improvement in upper and lower chest expansion and MIP after the intervention in both the CERE group and the CCE group, whereas the control group did not show any significant difference. MEP did not significantly change in any of the three groups after the intervention. [Conclusion] The CERE group underwent greater changes than the CCE group, which proves that the CERE is more effective for improving elderly people's chest expansion capacity and MIP in elderly people. Therefore, application of the CERE by therapists is recommended if the environment and conditions are appropriate for enhancement of chest expansion capacity and MIP in elderly people.