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Manzak Dursun AS, Ozyilmaz S, Ucgun H, Elmadag NM. The effect of Pilates-based exercise applied with hybrid telerehabilitation method in children with adolescent idiopathic scoliosis: A randomized clinical trial. Eur J Pediatr 2024; 183:759-767. [PMID: 37993666 DOI: 10.1007/s00431-023-05340-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 11/10/2023] [Accepted: 11/15/2023] [Indexed: 11/24/2023]
Abstract
This study aimed to investigate the effect of Pilates-based exercise training applied with hybrid telerehabilitation on Cobb angle, respiratory function, respiratory muscle strength, and functional capacity in patients with adolescent idiopathic scoliosis (AIS). This is an evaluator-blinded, randomized, controlled trial. For the study, 32 patients were randomly allocated into two groups: a hybrid telerehabilitation group (training group), provided with modified Pilates-based exercises with synchronous sessions; and a home-based group (control group), doing the same exercises in their home. The Pilates-based exercise program consists of stretching and strengthening exercises combined with postural corrections and breathing exercises modified according to the curve type and localization of the patients, done every day of the week for 12 weeks. Analyses were made based on the comparison between the angle of trunk rotation, Cobb angle, spirometry, maximal inspiratory (MIP) and expiratory pressures (MEP), and incremental shuttle walk tests done at the beginning and end of the study. The training group showed statistically significant improvements in Cobb angle, PEF%, MIP, and MEP values compared with the control group (p < 0.05). CONCLUSION Pilates-based exercises applied with the hybrid telerehabilitation method can improve Cobb angle and respiratory muscle strength in patients with AIS. The hybrid telerehabilitation method can be used as an alternative to home-based programs, especially in locations and times where there may be limited access to supervised training. Also, the nature of the disease that requires long-term follow-up is another factor where hybrid telerehabilitation may be an advantage. TRIAL REGISTRATION ClinicalTrials.gov ID: NCT05761236. WHAT IS KNOWN • Exercise training is one of the main approaches to treating scoliosis. WHAT IS NEW • Application of exercises via telerehabilitation method may contribute more to the improvement of scoliosis-related parameters than home-based programs. • Telerehabilitation may be a preferable alternative exercise method in scoliosis, considering the advantages of accessibility and long-term follow-up.
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Affiliation(s)
- Ayse Sena Manzak Dursun
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Bezmialem Vakif University, 34050, Istanbul, Turkey
- Department of Cardiopulmonary Physiotherapy and Rehabilitation, Institute of Health Sciences, Bezmialem Vakif University, Istanbul, Turkey
| | - Semiramis Ozyilmaz
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Bezmialem Vakif University, 34050, Istanbul, Turkey.
| | - Hikmet Ucgun
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul Atlas University, Istanbul, Turkey
| | - Nuh Mehmet Elmadag
- Department of Orthopedics and Traumatology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
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Arbabzadeh T, Masoumi Shahrbabak M, Pooransari P, Khatuni M, Mirzamoradi M, Saleh Gargari S, Naeiji Z, Rahmati N, Omidi S, Ebrahimi Meimand F. Remdesivir in pregnant women with moderate to severe coronavirus disease 2019 (COVID-19): a retrospective cohort study. Clin Exp Med 2023; 23:3709-3717. [PMID: 37277553 PMCID: PMC10241383 DOI: 10.1007/s10238-023-01095-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 05/16/2023] [Indexed: 06/07/2023]
Abstract
Data on the efficacy of remdesivir in Coronavirus Disease 2019 (COVID-19) are limited in pregnant patients since they have been excluded from clinical trials. We aimed to investigate some clinical outcomes following remdesivir administration in pregnancy. This was a retrospective cohort study conducted on pregnant women with moderate to severe COVID-19. The enrolled patients were divided into two groups with and without remdesivir treatment. The primary outcomes of this study were the length of hospital and intensive care unit stay; respiratory parameters of hospital day 7 including respiratory rate, oxygen saturation, and mode of oxygen support; discharge until days 7 and 14, and need for home oxygen therapy. Secondary outcomes included some maternal and neonatal consequences. Eighty-one pregnant women (57 in the remdesivir group and 24 in the non-remdesivir group) were included. The two study groups were comparable according to the baseline demographic and clinical characteristics. Of the respiratory outcomes, remdesivir was significantly associated with a reduced length of hospital stay (p = 0.021) and also with a lower level of oxygen requirement in patients on low-flow oxygen [odds ratio (OR) 3.669]. Among the maternal consequences, no patients in the remdesivir group developed preeclampsia but three patients (12.5%) experienced this complication in the non-remdesivir group (p = 0.024). Furthermore, in patients with moderate COVID-19, the percentage of emergency termination was significantly lower in remdesivir group (OR 2.46). Our results demonstrated some probable benefits of remdesivir in respiratory and also maternal outcomes. Further investigations with a larger sample size should confirm these results.
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Affiliation(s)
- Taraneh Arbabzadeh
- Department of Gynecology and Obstetrics, Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Masoumi Shahrbabak
- Department of Gynecology and Obstetrics, Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Parichehr Pooransari
- Department of Gynecology and Obstetrics, Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahdi Khatuni
- Department of Pulmonology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Masoumeh Mirzamoradi
- Department of Gynecology and Obstetrics, Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Soraya Saleh Gargari
- Department of Gynecology and Obstetrics, Mahdiyeh Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Naeiji
- Department of Gynecology and Obstetrics, Mahdiyeh Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nayereh Rahmati
- Department of Gynecology and Obstetrics, Mahdiyeh Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Samaneh Omidi
- Department of Gynecology and Obstetrics, Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Faridadin Ebrahimi Meimand
- Department of Surgery, Minimally Invasive Surgery Research Center, Rasool-e Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
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Cassano G, Nattino G, Belotti M, Cortellaro F, Cosentini R, Ghilardi GI, Paganuzzi M, Paglia S, Rossi C, Solbiati M, Bertolini G, Brambilla AM. Prognostic value of respiratory parameters for COVID-19 patients in the emergency department: results from the EC-COVID study. Intern Emerg Med 2023; 18:2075-2082. [PMID: 37338715 DOI: 10.1007/s11739-023-03324-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 05/23/2023] [Indexed: 06/21/2023]
Abstract
While several studies have evaluated the prognostic weight of respiratory parameters in patients with COVID-19, few have focused on patients' clinical conditions at the first emergency department (ED) assessment. We analyzed a large cohort of ED patients recruited within the EC-COVID study over the year 2020, and assessed the association between key bedside respiratory parameters measured in room air (pO2, pCO2, pH, and respiratory rate [RR]) and hospital mortality, after adjusting for key confounding factors. Analyses were based on a multivariable logistic Generalized Additive Model (GAM). After excluding patients who did not perform a blood gas analysis (BGA) test in room air or with incomplete BGA results, a total of 2458 patients were considered in the analyses. Most patients were hospitalized on ED discharge (72.0%); hospital mortality was 14.3%. Strong, negative associations with hospital mortality emerged for pO2, pCO2 and pH (p-values: < 0.001, < 0.001 and 0.014), while a significant, positive association was observed for RR (p-value < 0.001). Associations were quantified with nonlinear functions, learned from the data. No cross-parameter interaction was significant (all p-values were larger than 0.10), suggesting a progressive, independent effect on the outcome as the value of each parameter departed from normality. Our results collide with the hypothesized existence of patterns of breathing parameters with specific prognostic weight in the early stages of the disease.
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Affiliation(s)
- Giulio Cassano
- Emergency Medicine Unit, Luigi Sacco Hospital, ASST FBF Sacco, Milan, Italy
| | - Giovanni Nattino
- Laboratory of Clinical Epidemiology, Department of Public Health, Istituto Di Ricerche Farmacologiche Mario Negri IRCCS Villa Camozzi, Via G.B. Camozzi 3, 24020, Ranica (BG), Italy
| | - Mauro Belotti
- Emergency Medicine Unit, Luigi Sacco Hospital, ASST FBF Sacco, Milan, Italy
| | | | | | - Giulia Irene Ghilardi
- Laboratory of Clinical Epidemiology, Department of Public Health, Istituto Di Ricerche Farmacologiche Mario Negri IRCCS Villa Camozzi, Via G.B. Camozzi 3, 24020, Ranica (BG), Italy
| | - Marco Paganuzzi
- Laboratory of Clinical Epidemiology, Department of Public Health, Istituto Di Ricerche Farmacologiche Mario Negri IRCCS Villa Camozzi, Via G.B. Camozzi 3, 24020, Ranica (BG), Italy
| | | | - Carlotta Rossi
- Laboratory of Clinical Epidemiology, Department of Public Health, Istituto Di Ricerche Farmacologiche Mario Negri IRCCS Villa Camozzi, Via G.B. Camozzi 3, 24020, Ranica (BG), Italy.
| | - Monica Solbiati
- Pronto Soccorso e Medicina d'Urgenza, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan (MI), Italy
- Università Degli Studi Di Milano, Milan (MI), Italy
| | - Guido Bertolini
- Laboratory of Clinical Epidemiology, Department of Public Health, Istituto Di Ricerche Farmacologiche Mario Negri IRCCS Villa Camozzi, Via G.B. Camozzi 3, 24020, Ranica (BG), Italy
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Filippini DFL, Di Gennaro E, van Amstel RBE, Beenen LFM, Grasso S, Pisani L, Bos LDJ, Smit MR. Latent class analysis of imaging and clinical respiratory parameters from patients with COVID-19-related ARDS identifies recruitment subphenotypes. Crit Care 2022; 26:363. [PMID: 36434629 PMCID: PMC9700924 DOI: 10.1186/s13054-022-04251-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 11/21/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Patients with COVID-19-related acute respiratory distress syndrome (ARDS) require respiratory support with invasive mechanical ventilation and show varying responses to recruitment manoeuvres. In patients with ARDS not related to COVID-19, two pulmonary subphenotypes that differed in recruitability were identified using latent class analysis (LCA) of imaging and clinical respiratory parameters. We aimed to evaluate if similar subphenotypes are present in patients with COVID-19-related ARDS. METHODS This is the retrospective analysis of mechanically ventilated patients with COVID-19-related ARDS who underwent CT scans at positive end-expiratory pressure of 10 cmH2O and after a recruitment manoeuvre at 20 cmH2O. LCA was applied to quantitative CT-derived parameters, clinical respiratory parameters, blood gas analysis and routine laboratory values before recruitment to identify subphenotypes. RESULTS 99 patients were included. Using 12 variables, a two-class LCA model was identified as best fitting. Subphenotype 2 (recruitable) was characterized by a lower PaO2/FiO2, lower normally aerated lung volume and lower compliance as opposed to a higher non-aerated lung mass and higher mechanical power when compared to subphenotype 1 (non-recruitable). Patients with subphenotype 2 had more decrease in non-aerated lung mass in response to a standardized recruitment manoeuvre (p = 0.024) and were mechanically ventilated longer until successful extubation (adjusted SHR 0.46, 95% CI 0.23-0.91, p = 0.026), while no difference in survival was found (p = 0.814). CONCLUSIONS A recruitable and non-recruitable subphenotype were identified in patients with COVID-19-related ARDS. These findings are in line with previous studies in non-COVID-19-related ARDS and suggest that a combination of imaging and clinical respiratory parameters could facilitate the identification of recruitable lungs before the manoeuvre.
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Affiliation(s)
- Daan F. L. Filippini
- grid.7177.60000000084992262Department of Intensive Care Medicine, Amsterdam UMC, University of Amsterdam, 1105AZ Amsterdam, The Netherlands
| | - Elisa Di Gennaro
- grid.7177.60000000084992262Department of Intensive Care Medicine, Amsterdam UMC, University of Amsterdam, 1105AZ Amsterdam, The Netherlands ,grid.7644.10000 0001 0120 3326Faculty of Medicine, University of Bari, Bari, Italy
| | - Rombout B. E. van Amstel
- grid.7177.60000000084992262Department of Intensive Care Medicine, Amsterdam UMC, University of Amsterdam, 1105AZ Amsterdam, The Netherlands
| | - Ludo F. M. Beenen
- grid.7177.60000000084992262Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Salvatore Grasso
- grid.7644.10000 0001 0120 3326Department of Emergency and Organ Transplantation, University of Bari Aldo Moro, Bari, Italy
| | - Luigi Pisani
- grid.501272.30000 0004 5936 4917Critical Care Africa Asia Network, Mahidol Oxford Research Unit, Bangkok, Thailand ,Department of Anesthesia and Intensive Care, Miulli Regional Hospital, Acquiviva Delle Fonti, Bari, Italy
| | - Lieuwe D. J. Bos
- grid.7177.60000000084992262Department of Intensive Care Medicine, Amsterdam UMC, University of Amsterdam, 1105AZ Amsterdam, The Netherlands ,grid.7177.60000000084992262Department of Pulmonology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands ,grid.7177.60000000084992262Laboratory of Experimental Intensive Care and Anesthesiology (L.E.I.C.A.), University of Amsterdam, Amsterdam, The Netherlands
| | - Marry R. Smit
- grid.7177.60000000084992262Department of Intensive Care Medicine, Amsterdam UMC, University of Amsterdam, 1105AZ Amsterdam, The Netherlands
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Guvenc-Bayram G, Yalcin M. The involvement of the central cholinergic system in the hyperventilation effect of centrally injected nesfatin-1 in rats. Neuropeptides 2021; 90:102186. [PMID: 34425506 DOI: 10.1016/j.npep.2021.102186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 08/11/2021] [Accepted: 08/15/2021] [Indexed: 11/17/2022]
Abstract
We recently demonstrated that peripheral and central administration of nesfatin-1 in fasting and satiety states generate hyperventilation activity by increasing tidal volume (TV), respiratory rate (RR), and respiratory minute ventilation (RVM). The present study aimed to investigate the mediation of central cholinergic receptors effective in respiratory control in the hyperventilation activity of nesfatin-1. Besides this, we intended to determine possible changes in blood gases due to hyperventilation activity caused by nesfatin-1 and investigate the mediation of central cholinergic receptors in these changes. Intracerebroventricular (ICV) administration of nesfatin-1 revealed a hyperventilation response with an increase in TV, RR, RMV, and pO2 and a decrease in pCO2 in saturated Sprague Dawley rats. ICV pretreatment with the muscarinic receptor antagonist atropine partially blocked the RR, RMV, pO2, and pCO2 responses produced by nesfatin-1 while completely blocking the TV response. However, central pretreatment with nicotinic receptor antagonist mecamylamine blocked the respiratory and blood gas responses induced by nesfatin-1. The study's conclusion demonstrated that nesfatin-1 had active hyperventilation effects resulting in an increase in pO2 and a decrease in pCO2. The critical finding of the study was that activation of central cholinergic receptors was involved in nesfatin-1-evoked hyperventilation and blood gas responses.
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Affiliation(s)
- Gokcen Guvenc-Bayram
- Department of Physiology, Faculty of Veterinary Medicine, Uludag University, Bursa 16059, Turkey; Department of Physiology, Faculty of Veterinary Medicine, Dokuz Eylul University, Kiraz, Izmir 35890, Turkey
| | - Murat Yalcin
- Department of Physiology, Faculty of Veterinary Medicine, Uludag University, Bursa 16059, Turkey.
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Gunusen I, Akdemir A, Sargın A, Karaman S. The effects of CO 2 pneumoperitoneum at different temperature and humidity on hemodynamic and respiratory parameters and postoperative pain in gynecological laparoscopic surgery: A prospective randomized controlled study. Asian J Surg 2021; 45:154-161. [PMID: 33888367 DOI: 10.1016/j.asjsur.2021.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 04/06/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND It is recommended to heat and humidity CO2 in laparoscopic surgery to prevent postoperative pain and hypothermia but information about its effects on hemodynamic and respiratory parameters is limited. We aimed to investigate the effects of standard and heated-humidified CO2 on hemodynamic and respiratory parameters, body temperature and pain in healthy patients. METHODS One hundred patients who underwent total laparoscopic hysterectomy for benign pathology were divided into two groups: Group CD (cold-dry) patients were administered standard CO2, while Group HH (heated-humidified) patients were administered 95% humidified insufflation at 37 °C. Hemodynamic and respiratory parameters, body temperature, pain score and blood count parameters were recorded. RESULTS A total of 96 patients were included in the study, taken from the 100 patients. Group HH (n:47) had only higher systolic blood pressure at 75, mean blood pressure at 50 and 55 and a lower heart rate between 15 and 45 min (p:0.049, 0.037, 0.013 respectively). Pain score, morphine consumption, end-tidal CO2 and arterial blood gas values were not different between the groups, with only body temperature from 40 min and minimum value being significantly higher (at a difference of 0.86-1.04 °C) in Group HH. Postoperative leukocyte, neutrophil and NLR (neutrophil-leukocyte ratio) were found to be higher in this group (p < 0.05). CONCLUSION It has been found that both standard and heated-humidified CO2do not constitute a problem in terms of hemodynamic and respiratory parameters in healthy patients. The heated-humidified CO2group had only a higher core body temperature and inflammatory response. TRIAL REGISTRATION NCT04508387.
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Affiliation(s)
- Ilkben Gunusen
- Department of Anesthesiology and Reanimation, Ege University Faculty of Medicine, Izmir, Turkey.
| | - Ali Akdemir
- Department of Obstetrics and Gynecology, Ege University Faculty of Medicine, Izmir, Turkey.
| | - Asuman Sargın
- Department of Anesthesiology and Reanimation, Ege University Faculty of Medicine, Izmir, Turkey.
| | - Semra Karaman
- Department of Anesthesiology and Reanimation, Ege University Faculty of Medicine, Izmir, Turkey.
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Nallanthighal VS, Mostaani Z, Härmä A, Strik H, Magimai-Doss M. Deep learning architectures for estimating breathing signal and respiratory parameters from speech recordings. Neural Netw 2021; 141:211-224. [PMID: 33915446 DOI: 10.1016/j.neunet.2021.03.029] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 01/29/2021] [Accepted: 03/18/2021] [Indexed: 01/16/2023]
Abstract
Respiration is an essential and primary mechanism for speech production. We first inhale and then produce speech while exhaling. When we run out of breath, we stop speaking and inhale. Though this process is involuntary, speech production involves a systematic outflow of air during exhalation characterized by linguistic content and prosodic factors of the utterance. Thus speech and respiration are closely related, and modeling this relationship makes sensing respiratory dynamics directly from the speech plausible, however is not well explored. In this article, we conduct a comprehensive study to explore techniques for sensing breathing signal and breathing parameters from speech using deep learning architectures and address the challenges involved in establishing the practical purpose of this technology. Estimating the breathing pattern from the speech would give us information about the respiratory parameters, thus enabling us to understand the respiratory health using one's speech.
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Affiliation(s)
- Venkata Srikanth Nallanthighal
- Philips Research, Eindhoven, The Netherlands; Centre for Language Studies (CLS), Radboud University Nijmegen, The Netherlands.
| | - Zohreh Mostaani
- Idiap Research Institute, Martigny, Switzerland; Ecole polytechnique fédérale de Lausanne, Lausanne, Switzerland
| | - Aki Härmä
- Philips Research, Eindhoven, The Netherlands
| | - Helmer Strik
- Centre for Language Studies (CLS), Radboud University Nijmegen, The Netherlands
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Guvenc-Bayram G, Altinbas B, Erkan LG, Yalcin M. Modulation of arachidonic acid-evoked cardiorespiratory effects by the central lipoxygenase pathway. Respir Physiol Neurobiol 2020; 278:103441. [PMID: 32339697 DOI: 10.1016/j.resp.2020.103441] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 04/01/2020] [Accepted: 04/05/2020] [Indexed: 11/21/2022]
Abstract
We previously reported that intracerebroventricularly (ICV) injected arachidonic acid (AA) could produce pressor and bradycardic responses on the cardiovascular system and hyperventilation effect on the respiratory system by activating cyclooxygenase (COX). We also demonstrated that centrally injected AA-induced cardiovascular and respiratory responses were mediated by COX-metabolites, such as thromboxane A2 (TXA2), prostaglandin (PG) D, PGE, and PGF2α. Brain tissue is also able to express the lipoxygenase (LOX) enzyme and LOX-induced AA-metabolites. The current study was designed to investigate the possible mediation of the central LOX pathway in AA-induced cardiorespiratory effects in anesthetized rats. Central pretreatment with different doses of a non-selective LOX inhibitor, nordihydroguaiaretic acid (NDGA) (500 and 1000 μg; ICV) partially blocked the AA (0.5 μmol; ICV)-evoked pressor and bradycardic cardiovascular responses in male anesthetized Sprague Dawley rats. Pretreatment with different doses of NDGA (500 and 1000 μg; ICV) also reduced AA-induced hyperventilation responses, with an increase in tidal volume, respiratory rate and minute ventilation, in the rats. Moreover, AA-induced increasing pO2 and decreasing pCO2 responses were diminished by central NDGA pretreatment. In summary, our findings show that the central LOX pathway might mediate, at least in part, centrally administered AA-evoked cardiorespiratory and blood gases responses.
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Bhatti U, Laghari ZA, Syed BM. Effect of Body Mass Index on respiratory parameters: A cross-sectional analytical Study. Pak J Med Sci 2019; 35:1724-1729. [PMID: 31777523 PMCID: PMC6861468 DOI: 10.12669/pjms.35.6.746] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 07/23/2019] [Accepted: 08/07/2019] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To assess association of Body mass index (BMI) on respiratory parameters by performing spirometry in apparently healthy adults living in the district Jamshoro and Hyderabad, Sindh, Pakistan. METHODS A cross sectional study was conducted at Department of Physiology, Liaquat University of Medical and Health Sciences Jamshoro, Pakistan from January to September 2015. A total of 180 underweight, normal, overweight and obese participants, aged between 18 to 40 years were included in the study. BMI was calculated by measuring weight and height by BMI scale (RGZ-160) in standing position. Pulmonary parameters were determined by spirometry on Power lab (AD instruments). Pulmonary parameters were compared between subjects in different categories of BMI. RESULTS Mean age of participants was 21.83±5.88 years and the mean BMI was 25.10±6.55 kg/m2. The study results revealed that except for FVC, which was not statistically significant (p=0.45) all other respiratory parameters were significantly different (p≤0.05) in all BMI categories. Mean FEV1/FVC ratio (93.1 vs. 90.3, 86.4 and 86.6 respectively) was highest among underweight as compared to overweight, obese and normal weight individuals. The mean VT was 1.22 vs. 0.90, 1.01 and 0.84 respectively, IRV was 1.04 vs. 1.18, 1.23 and 1.20 respectively, IC was 2.26 vs. 2.08, 2.25 and 2.05 respectively, VC was 2.63 vs. 2.42, 2.54 and 2.54 respectively, TLC was 2.98 vs. 3.03 vs. 3.18 and 3.17 respectively among underweight, overweight, obese and normal weight participants. CONCLUSION We found a significant association between body mass index and pulmonary function parameters. Obesity causes detrimental effects on respiratory system.
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Affiliation(s)
- Urooj Bhatti
- Dr. Urooj Bhatti, Lecturer, Department of Physiology, Liaquat University of Medical and Health Sciences (LUMHS), Jamshoro, Sindh, Pakistan
| | - Zulfiqar Ali Laghari
- Prof. Dr. Zulfiqar Ali Laghari, PhD. Professor of Physiology, University of Sindh, Jamshoro, Pakistan. Lecturer, Department of Physiology, Liaquat University of Medical and Health Sciences (LUMHS), Jamshoro, Sindh, Pakistan
| | - Binafsha Manzoor Syed
- Dr. Binafsha Manzoor Syed, MBBS, PhD. Director ORIC Medical Research Centre, Liaquat University of Medical and Health Sciences (LUMHS), Jamshoro, Sindh, Pakistan
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Shu QH, Fu ZX. Effect of different doses of dexmedetomidine on hemodynamic and respiratory parameters in elderly patients undergoing endoscopic retrograde cholangiopancreatography. Shijie Huaren Xiaohua Zazhi 2018; 26:215-220. [DOI: 10.11569/wcjd.v26.i3.215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM To investigate the effect of different doses of dexmedetomidine on hemodynamic and respiratory parameters in elderly patients undergoing endoscopic retrograde cholangiopancreatography (ERCP).
METHODS From August 2015 to July 2017, 104 elderly patients who underwent ERCP at our hospital were randomly divided into a control group (n = 26), a low-dose group (n = 26), a middle-dose group (n = 26), and a high-dose group (n = 26). The control group was given fentanyl, and the low-, middle-, and high-dose groups were intravenously injected with dexmedetomidine at 0.4, 0.7, and 1 μg/kg, respectively. Propofol dosage, operative time, time to recovery, hemodynamic and respiratory parameters [respiratory rate (RR), heart rate (HR), diastolic blood pressure (DBP), and systolic blood pressure (SBP)] at different time points [preoperative (T0), fentanyl or dexmedetomidine infusion completion (T1), duodenal endoscopy into the esophagus (T2)], serum cortisol (Cor) level, and incidence of adverse reactions in the four groups were recorded.
RESULTS There was a significant difference in the dosage of propofol among the four groups (P < 0.05). There was no significant difference in operative time or time to recovery among the four groups. In the middle-dose group, the dosage of propofol was less than those of the other groups (P < 0.05). There was no significant difference in DBP, SBP, HR, or RR at T0 among the four groups, but there was a significant difference among the four groups in DBP, SBP, HR, and RR at T1 and T2 (P < 0.05); the amplitude of each index in the middle-dose group was significantly lower than that of the other groups (P < 0.05). There was no significant difference in the levels of serum Cor among the four groups at T0, but there was a significant difference in serum Cor levels among the four groups at T1 and T2 (P < 0.05). The increase of serum Cor in the middle-dose group was significantly smaller than that of the other groups (P < 0.05). There was a significant difference in the incidence of adverse reactions among the four groups (P < 0.05), and the incidence of adverse reactions in the control group was higher than that of the other three groups (P < 0.05).
CONCLUSION Anesthesia with a moderate dose of dexmedetomidine in ERCP can reduce the dosage of propofol, has no impact on operative time and time to recovery, and can avoid the influence on hemodynamics and respiratory conditions in elderly patients, with little stress response, few adverse reactions, and high safety.
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Affiliation(s)
- Qing-Hua Shu
- Department of Anesthesiology, Anji People's Hospital, Ji'an 313300, Zhejiang Province, China
| | - Zhao-Xia Fu
- Department of Orthopedics, Anji People's Hospital, Ji'an 313300, Zhejiang Province, China
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11
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Awotidebe TO, Awopeju OF, Bisiriyu LA, Ativie RN, Oke KI, Adedoyin RA, Olusola OD, Erhabor GE. Relationships between respiratory parameters, exercise capacity and psychosocial factors in people with chronic obstructive pulmonary disease. Ann Phys Rehabil Med 2017; 60:387-392. [PMID: 28797622 DOI: 10.1016/j.rehab.2017.06.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Revised: 06/22/2017] [Accepted: 06/23/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) affects respiratory functioning and psychosocial factors. However, little is known about perceived ability of people with COPD to engage in a regular exercise program. This study assessed respiratory parameters, exercise capacity, psychosocial factors and their relations in people with COPD. METHODS This cross-sectional study involved patients with COPD recruited from a Nigerian university teaching hospital. Respiratory parameters including forced expiratory volume in 1sec (FEV1) and forced vital capacity (FVC) were assessed by using a spirometer and FEV1/FVC ratio was calculated. Participants were sitting upright in a comfortable chair and wearing a nose clip for measurements. The procedure was performed in accordance with the American Thoracic Society criteria. Exercise capacity was assessed by the 6-min walk test (6MWT). Gait speed was assessed by the distance covered in 6min. Perceived exercise self-efficacy (PESE) and rating of perceived exertion (RPE) were assessed by exercise self-efficacy and Borg scales, respectively. Data were analysed using descriptive and inferential statistics. Alpha level was set at P<0.05. RESULTS The mean age of the 125 participants was 62.0±7.1years (60% male). The mean values for FEV1, FVC and FEV1/FVC were 1.8±0.6L, 2.4±0.5L and 58.0±8.8%, respectively, and the mean 6MWT and PESE values were 291.1±41.6m 63.1±11.2%. Exercise capacity was correlated with mean values for the respiratory parameters FEV1 (r=0.29; P=0.035), FVC (r=0.32; P=0.045) and FEV1/FVC ratio (r=0.37; P=0.007), and both exercise capacity and PESE were correlated with gait speed (r=0.96, P=0.001 and r=0.57; P=0.042) and RPE (r=0.42, P=0.050 and r=-0.44; P=0.032), but PESE was not correlated with respiratory parameter values (P>0.05). CONCLUSION Participants with COPD demonstrated reduced respiratory parameter values and low exercise capacity but moderate PESE. We found significant correlations between exercise capacity and respiratory parameter values, but PESE was correlated with only gait speed and RPE. The study has implications for respiratory health promotion and exercise adherence.
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Affiliation(s)
- T O Awotidebe
- Department of Medical Rehabilitation, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria.
| | - O F Awopeju
- Chest Unit, Obafemi Awolowo University Teaching Hospitals Complex, P.M.B. 5538, Ile-Ife, Nigeria; Department of Medicine, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - L A Bisiriyu
- Department of Demography and Social Statistics, Faculty of Social Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - R N Ativie
- Department of Medical Rehabilitation, Faculty of Health Sciences and Technology, University of Nigeria, Enugu Campus, Enugu State, Nigeria
| | - K I Oke
- Department of Physiotherapy, School of Medical Sciences, University of Benin, Benin City, Edo State, Nigeria
| | - R A Adedoyin
- Department of Medical Rehabilitation, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - O D Olusola
- Department of Medical Rehabilitation, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - G E Erhabor
- Chest Unit, Obafemi Awolowo University Teaching Hospitals Complex, P.M.B. 5538, Ile-Ife, Nigeria; Department of Medicine, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
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12
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Lai CJ, Liu CM, Wu CY, Tsai FF, Tseng PH, Fan SZ. I-Gel is a suitable alternative to endotracheal tubes in the laparoscopic pneumoperitoneum and trendelenburg position. BMC Anesthesiol 2017; 17:3. [PMID: 28125979 PMCID: PMC5267400 DOI: 10.1186/s12871-016-0291-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Accepted: 12/06/2016] [Indexed: 11/18/2022] Open
Abstract
Background The use of supraglottic airway devices (SADs) in surgeries with laparoscopic pneumoperitoneum and Trendelenburg (LPT) positioning is controversial due to concerns about insufficient pulmonary ventilation and aspiration. In this prospective, randomized-controlled trial, we evaluated whether the i-gel, a new second generation SAD, provides an effective alternative to an endotracheal tube (ETT) by comparing respiratory parameters and perioperative respiratory complications in non-obese patients. Methods In a randomized controlled trial, forty anesthetized patients with ASA I-II were divided into equally sized i-gel and ETT groups. We evaluated the respiratory parameters in the supine and LPT position in comparison between the two groups. The leak fraction was our primary outcome, which was defined as the leak volume divided by the inspired tidal volume. The leak volume was the difference between the inspired and expired tidal volumes. We also monitored pulmonary aspiration and respiratory complications during the perioperative period. Results In the LPT position, there were no differences in the leak fraction (median [IQR]) between the i-gel and ETT groups (6.20[3.49] vs 6.38[3.71] %, P = 0.883). In the i-gel group, notably less leakage was observed in the LPT position than in the supine position (median [IQR]: 7.01[3.73] %). This phenomenon was not observed in the ETT group. The rate of postoperative sore throat was also significantly lower in the i-gel group than in the ETT group (3/17 vs 9/11). No vomitus nor any signs associated with aspiration were noted in our patients after extubation in the follow-up prior to discharge. Conclusions The i-gel provides a suitable alternative to an ETT for surgeries with LPT positioning in non-obese patients. Trial registration Registered at Clinicaltrials.gov NCT02462915, registered on 1 June 2015. Electronic supplementary material The online version of this article (doi:10.1186/s12871-016-0291-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Chih-Jun Lai
- Department of Anesthesiology, National Taiwan University Hospital Hsin-Chu Branch, NO. 25, Lane 442, Sec.1, Jingguo Rd., Hsinchu City, 30059, Taiwan (R.O.C.)
| | - Chih-Min Liu
- Department of Anesthesiology, National Taiwan University Hospital, No. 7, Zhung Shan S. Rd., Zhongzheng Dist., Taipei City, 10002, Taiwan (R.O.C.)
| | - Chun-Yu Wu
- Department of Anesthesiology, National Taiwan University Hospital, No. 7, Zhung Shan S. Rd., Zhongzheng Dist., Taipei City, 10002, Taiwan (R.O.C.)
| | - Feng-Fang Tsai
- Department of Anesthesiology, National Taiwan University Hospital, No. 7, Zhung Shan S. Rd., Zhongzheng Dist., Taipei City, 10002, Taiwan (R.O.C.)
| | - Ping-Huei Tseng
- Department of Internal Medicine, National Taiwan University Hospital, No. 7, Zhung Shan S. Rd., Zhongzheng Dist., Taipei City, 10002, Taiwan (R.O.C.)
| | - Shou-Zen Fan
- Department of Anesthesiology, National Taiwan University Hospital, No. 7, Zhung Shan S. Rd., Zhongzheng Dist., Taipei City, 10002, Taiwan (R.O.C.).
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13
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El Ibrahimi M, Laabouri M. Pilot Study of a New Adjustable Thermoplastic Mandibular Advancement Device for the Management of Obstructive Sleep Apnoea-Hypopnoea Syndrome: A Brief Research Letter. Open Respir Med J 2016; 10:46-50. [PMID: 27499821 PMCID: PMC4951758 DOI: 10.2174/1874306401610010046] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Revised: 05/06/2016] [Accepted: 05/10/2016] [Indexed: 01/12/2023] Open
Abstract
Background: Prefabricated adjustable thermoplastic mandibular advancement devices (PAT-MADs) are a practical short-term treatment for obstructive sleep apnoea-hypopnoea syndrome (OSAHS) in patients who have failed or refused continuous positive airway pressure (CPAP) therapy. Objective: To assess the effectiveness of a new professionally-fitted PAT-MAD in patients with OSAHS in Morocco. Method: Twenty-four adults with mild, moderate or severe OSAHS were fitted with the PAT-MAD (BluePro®; BlueSom, France). Respiratory parameters (apnoea-hypopnoea index (AHI), oxygen desaturation index (ODI)) and daytime sleepiness using the Epworth Sleepiness scale (ESS) were assessed before and after treatment. Adverse events were recorded. Results: Mean treatment duration was 106.3 ± 73.4 days. Mean AHI score decreased from 21.4 ± 7.4 to 9.3 ± 4.1 after treatment (p<0.0001) (mean reduction of 57.0 ± 12.3%). Mean ESS and ODI also decreased at EOS (from 10.4 ± 2.8 to 7.3 ± 2.3, mean reduction 30.3 ± 12.2%, p=0.0001; and 7.0 ± 6.9 to 4.7 ± 4.0, mean reduction 30.5 ± 25.0%, p=0.2, respectively). Treatment was considered to have been successful in 22 patients (91.7%) who had mild OSAHS or an AHI score of ≤5 at the end of the study. The device was well-tolerated. Conclusion: This new PAT-MAD appears to be effective at reducing respiratory parameters and improving daytime alertness in patients with OSAHS. Long term studies in a larger number of patients are warranted to assess the long-term efficacy, retention and side-effects of this device.
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Affiliation(s)
- Mohammed El Ibrahimi
- Centre des Maladies Respiratoires, 5 Bis, Rue Ibnou Babek, Quartier Racine, Maarif-Casablanca, Morocco
| | - Mounir Laabouri
- Home Air Maroc, 196 Av Mers Sultan, 20120 Casablanca, Morocco
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14
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Tong PSY, Kale AS, Ng K, Loke AP, Choolani MA, Lim CL, Chan YH, Chong YS, Tambyah PA, Yong EL. Respiratory consequences of N95-type Mask usage in pregnant healthcare workers-a controlled clinical study. Antimicrob Resist Infect Control 2015; 4:48. [PMID: 26579222 PMCID: PMC4647822 DOI: 10.1186/s13756-015-0086-z] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Accepted: 10/22/2015] [Indexed: 01/06/2023] Open
Abstract
Background Outbreaks of emerging infectious diseases have led to guidelines recommending the routine use of N95 respirators for healthcare workers, many of whom are women of childbearing age. The respiratory effects of prolonged respirator use on pregnant women are unclear although there has been no definite evidence of harm from past use. Methods We conducted a two-phase controlled clinical study on healthy pregnant women between 27 to 32 weeks gestation. In phase I, energy expenditure corresponding to the workload of routine nursing tasks was determined. In phase II, pulmonary function of 20 subjects was measured whilst at rest and exercising to the predetermined workload while breathing ambient air first, then breathing through N95-mask materials. Results Exercising at 3 MET while breathing through N95-mask materials reduced mean tidal volume (TV) by 23.0 % (95 % CI −33.5 % to −10.5 %, p < 0.001) and lowered minute ventilation (VE) by 25.8 % (95 % CI −34.2 % to −15.8 %, p < 0.001), with no significant change in breathing frequency compared to breathing ambient air. Volumes of oxygen consumption (VO2) and carbon dioxide expired (VCO2) were also significantly reduced; VO2 by 13.8 % (95 % CI −24.2 % to −3 %, p = 0.013) and VCO2 by 17.7 %, (95 % CI −28.1 % to −8.6 %, p = 0.001). Although no changes in the inspired oxygen and carbon dioxide concentrations were demonstrated, breathing through N95-mask materials during low intensity work (3 MET) reduced expired oxygen concentration by 3.2 % (95 % CI: −4.1 % to −2.2 %, p < 0.001), and increased expired carbon dioxide by 8.9 % (95 % CI: 6.9 % to 13.1 %; p <0.001) suggesting an increase in metabolism. There were however no changes in the maternal and fetal heart rates, finger-tip capillary lactate levels and oxygen saturation and rating of perceived exertion at the work intensity investigated. Conclusions Breathing through N95 mask materials have been shown to impede gaseous exchange and impose an additional workload on the metabolic system of pregnant healthcare workers, and this needs to be taken into consideration in guidelines for respirator use. The benefits of using N95 mask to prevent serious emerging infectious diseases should be weighed against potential respiratory consequences associated with extended N95 respirator usage. Trial Registration The study was registered at clinicaltrials.gov, identifier NCT00265926.
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Affiliation(s)
- Pearl Shuang Ye Tong
- Department of Obstetrics and Gynecology, National University Hospital, 11 Mandalay Road, Singapore, 308232 Singapore
| | - Anita Sugam Kale
- Department of Obstetrics and Gynecology, National University Hospital, 11 Mandalay Road, Singapore, 308232 Singapore
| | - Kailyn Ng
- Department of Obstetrics and Gynecology, National University Hospital, 11 Mandalay Road, Singapore, 308232 Singapore
| | - Amelia Peiwen Loke
- Department of Obstetrics and Gynecology, National University Hospital, 11 Mandalay Road, Singapore, 308232 Singapore
| | - Mahesh Arjandas Choolani
- Department of Obstetrics and Gynecology, National University Hospital, 11 Mandalay Road, Singapore, 308232 Singapore
| | - Chin Leong Lim
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, 11 Mandalay Road, Singapore, 308232 Singapore
| | - Yiong Huak Chan
- Biostatistics Unit, National University of Singapore, Singapore, Republic of Singapore
| | - Yap Seng Chong
- Department of Obstetrics and Gynecology, National University Hospital, 11 Mandalay Road, Singapore, 308232 Singapore
| | - Paul Anantharajah Tambyah
- Medicine, National University of Singapore, 1E Kent Ridge Road, Level 12, Singapore, 119228 Singapore
| | - Eu-Leong Yong
- Medicine, National University of Singapore, 1E Kent Ridge Road, Level 12, Singapore, 119228 Singapore
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15
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Cavaggioni L, Ongaro L, Zannin E, Iaia FM, Alberti G. Effects of different core exercises on respiratory parameters and abdominal strength. J Phys Ther Sci 2015; 27:3249-53. [PMID: 26644685 PMCID: PMC4668176 DOI: 10.1589/jpts.27.3249] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Accepted: 07/23/2015] [Indexed: 12/16/2022] Open
Abstract
[Purpose] This study determined the effects a new modality of core stabilization exercises based on diaphragmatic breathing on pulmonary function, abdominal fitness, and movement efficiency. [Subjects] Thirty-two physically active, healthy males were randomly assigned to an experimental group (n = 16) and a control group (n = 16). [Methods] The experimental group combined diaphragmatic breathing exercises with global stretching postures, and the control group performed common abdominal exercises (e.g., crunch, plank, sit-up), both for 15 minutes twice weekly for 6 weeks. Pulmonary function (measured by forced vital capacity, forced expiratory volume in 1 second, and peak expiratory flow) and abdominal fitness (measured with the American College of Sports Medicine curl-up [cadence] test and the Functional Movement Screen(TM)) were evaluated before and after the intervention. [Results] Significant changes in curl-up (cadence) test scores, Functional Movement Screen scores, and all pulmonary parameters were recorded in the experimental group at the posttraining assessment, whereas in the control group, no significant differences over baseline were observed in any parameters. [Conclusion] Compared with traditional abdominal exercises, core stabilization exercises based on breathing and global stretching postures are more effective in improving pulmonary function and abdominal fitness.
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Affiliation(s)
- Luca Cavaggioni
- Department of Biomedical Sciences for Health, Università
degli Studi di Milano, Italy
| | - Lucio Ongaro
- Department of Biomedical Sciences for Health, Università
degli Studi di Milano, Italy
| | - Emanuela Zannin
- TBM Lab, Dipartimento di Bioingegneria, Politecnico di
Milano, Italy
| | - F. Marcello Iaia
- Department of Biomedical Sciences for Health, Università
degli Studi di Milano, Italy
| | - Giampietro Alberti
- Department of Biomedical Sciences for Health, Università
degli Studi di Milano, Italy
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