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Breaking Barriers in Respiratory Conditions: From Clinical Pathophysiology to Treatment Across the Spectrum of Severity

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Dr. Antenor Rodrigues

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1. École de Réadaptation, Faculté de Médecine, Université Laval, Québec, QC, Canada
2. Centre de Recherche, Institut Universitaire De Cardiologie Et De Pneumologie de Québec (IUCPQ), Québec, QC, Canada
Interests: pulmonary rehabilitation; skeletal muscle; exercise physiology; exercise intolerance; physical activity; respiratory conditions

Special Issue Information

Dear Colleagues,

Respiratory conditions—including chronic obstructive pulmonary disease (COPD), asthma, interstitial lung diseases, and pulmonary hypertension—remain among the leading causes of morbidity and mortality worldwide. Advances in the understanding of their complex pathophysiology have paved the way for more precise diagnostics and targeted therapies, improving outcomes across a wide range of patient populations.

This Special Issue, “Breaking Barriers in Respiratory Conditions: From Clinical Pathophysiology to Treatment Across the Spectrum of Severity,” aims to showcase recent clinical and translational research addressing mechanisms such as airway inflammation, remodeling, and immune dysregulation, as well as novel therapeutic strategies. These include, but are not limited to, exercise-based and physical activity interventions.

We welcome original research articles, clinical trials, and comprehensive reviews that reflect the evolving landscape of respiratory condition management, from outpatient care to intensive care settings.

Dr. Antenor Rodrigues
Guest Editor

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Research

17 pages, 736 KB

Open AccessArticle

The Mediating Role of Adiposity in the Association Between Respiratory Muscle Strength and Exercise Energy Expenditure in Adult Women: A Cross-Sectional Study

by Monira I. Aldhahi, Daad Alhumaid, Dalia Binshaye, Fatimah Almohsen, Rand Alotaibi and Leen Bahathiq

J. Clin. Med. 2026, 15(7), 2629; https://doi.org/10.3390/jcm15072629 - 30 Mar 2026

Viewed by 491

Abstract

Background and Objectives: Obesity affects over 1.9 billion adults globally, with a disproportionately higher prevalence in Saudi Arabia among women. While excessive adiposity is known to impair respiratory mechanics and lung function, its relationship with respiratory muscle strength and exercise energy expenditure remains inadequately elucidated. This study examined differences in respiratory muscle strength, metabolic equivalents (METs) of physical activity, and energy expenditure during exercise between adults with normal and high body fat percentage (BF%) and explored the statistical role of body fat as a potential mediator in the cross-sectional association between respiratory muscle strength and energy expenditure. Methods: In this cross-sectional study, 126 Saudi women aged 18–45 years (mean age: 21.7 ± 4.2 years) were stratified into normal (n = 63) and high (n = 63) BF% groups. Body composition was assessed via bioelectrical impedance analysis, and respiratory muscle strength (MIP and MEP) was measured using a MicroRPM device. Peak oxygen consumption (VO_2peak) and energy expenditure were obtained through the Bruce Submaximal Treadmill Protocol, and physical activity was self-reported via the IPAQ. Hierarchical regression and structural equation modeling were used to examine variable associations and explore statistical mediation patterns. Results: Participants with high body fat demonstrated significantly low MIP (−26%) and MEP (−31%), low VO_2peak (−13%), and approximately 26% high energy expenditure during exercise compared to the normal-BF group (all p < 0.001), despite comparable self-reported physical activity levels. Body fat percentage was the most strongly associated with energy expenditure (β = 0.078, R² = 0.329), with maximal inspiratory pressure contributing an additional 7.3% of explained variance in hierarchical regression (total R² = 0.414). Mediation analyses revealed that body fat percentage was statistically consistent with a partial mediation model in the relationship between MIP and energy expenditure (indirect association = −0.016, p = 0.033), accounting for 27% of the total association, and between MEP and energy expenditure (indirect association = −0.013, p = 0.035), accounting for 38% of the total association. Conclusions: High BF% is independently associated with low respiratory muscle strength and high exercise metabolic cost. Body fat is statistically associated with (and consistent with a mediating role in) an inverse relationship between respiratory muscle strength and energy expenditure. Alternative directional relationships and shared underlying factors may explain these observations. Full article

(This article belongs to the Special Issue Breaking Barriers in Respiratory Conditions: From Clinical Pathophysiology to Treatment Across the Spectrum of Severity)

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Breaking Barriers in Respiratory Conditions: From Clinical Pathophysiology to Treatment Across the Spectrum of Severity

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