Search Results (78)

Objective: To investigate the effect of an 8-week inspiratory muscle training (IMT) intervention on respiratory muscle strength and cardiovascular autonomic regulation in obese young men. Methods: The study included 36 obese young men who met the inclusion and exclusion criteria. Participants were randomly divided into two groups: the IG (inspiratory muscle training group, n = 17), which underwent high-intensity IMT intervention for 8 weeks, 5 times a week, and the CG (control group, n = 18), which was not given any additional intervention. Assessed parameters included maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP), systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR), as well as heart rate variability metrics such as the standard deviation of normal-to-normal intervals (SDNN), root mean square of successive differences (RMSSD), standard deviation of successive differences (SDSD), low-frequency power component (LF), high-frequency power component (HF), and LF/HF ratio. These measurements were taken both at baseline and following the completion of the 8-week intervention period. Results: After 8 weeks of IMT, the MIP and MEP of the IG increased by 31.8% and 26.5%, respectively (p < 0.01). In addition, SBP, DBP, and HR decreased by 2.2%, 3.2%, and 2.1%, respectively (p < 0.01). In the HRV time domain, SDNN and RMSSD increased by 54.1% and 33.5%, respectively (p < 0.01), and there was no significant improvement in SDSD (p > 0.05); in the HRV frequency domain, LF decreased by 40.5%, HF increased by 59.4% (p < 0.01), and the LF/HF ratio decreased by 58.2% (p < 0.05). Conclusion: An 8-week 80%MIP IMT intervention significantly improves respiratory muscle strength and cardiovascular autonomic regulation in obese young men, suggesting that IMT is a promising non-pharmacological strategy for mitigating obesity-related cardiovascular risk. Full article

Objective: The objective of this study was to analyze respiratory muscle function in children and adolescents with cystic fibrosis (CF) treated with Elexacaftor/Tezacaftor/Ivacaftor (ETI) compared to healthy individuals, based on the hypothesis that CFTR modulators may improve respiratory muscle strength. Methods: A descriptive, observational, cross-sectional study was conducted with patients with CF treated with ETI aged 6–18 years. Lung function, maximal expiratory and inspiratory pressures (MIP and MEP), diet quality (KIDMED), and physical activity levels (PAQ) were assessed. The student’s t-test or the Mann–Whitney U-test was used to compare differences between groups. The effect size was calculated with Cohen’s d. Significance level was set as a p-value < 0.05. Results: A total of 48 children and adolescents (60.4% male) were analyzed in this study (24 healthy and 24 with CF). The participants with CF had mild pulmonary involvement. No significant differences were found in respiratory muscle strength between groups (MEP_max p = 0.440, MIP_max p = 0.206). Patients with CF showed lower KIDMED (p = 0.022) and PAQ (p = 0.010) scores. However, the MIP and MEP values observed in CF participants were higher than those reported in previous studies conducted before the introduction of ETI modulators. Conclusions: Children and adolescents with CF treated with ETI showed respiratory muscle strength comparable to that of healthy controls. Despite differences in lifestyle factors, these findings may reflect a positive impact of CFTR modulators on respiratory muscle function, although further longitudinal and controlled studies are needed. Full article

Background: Sarcopenia is characterized by low muscle mass and strength, as well as impaired physical performance. Older adults with sarcopenia experience decreased cardiorespiratory fitness. Physical exercise is recommended for the prevention and treatment of sarcopenia. Virtual reality (VR) exercise was introduced to improve physical activity. However, the effect of VR on cardiorespiratory function in older adults with sarcopenia has not been fully explored. This study aimed to explore the effects of home-based VR aerobic exercise combined with resistive exercise on cardiorespiratory performance in community-dwelling older adults with sarcopenia. Subjects and Methods: In a randomized controlled trial, 53 older adults with sarcopenia were divided into a home-based VR (n = 26) and a control group (CG; n = 27). The VR program combined aerobic and resistance exercises, performed three times per week for 12 weeks, while the CG received knowledge regarding the benefit of exercise and continued with their regular daily activities. All participants were required to undergo respiratory muscle strength and functional capacity tests before and after the 12-week intervention. Two-way mixed repeated ANOVA was conducted to compare within and between groups in cardiorespiratory performance. Results: The home-based VR exercise group showed significant improvement in pre-post (i.e., maximal inspiratory pressure (12.96 ± 1.49 cmH₂O), maximal expiratory pressure (13.73 ± 1.72 cmH₂O), functional capacity (28.32 ± 3.48 m), and between-group (maximal expiratory pressure (F (1,51) = 10.446, p = 0.002, np² = 0.170). In contrast, the CG displayed a reduction in maximal expiratory pressure (−3.93 ± 1.69 cmH₂O, p = 0.024) and functional capacity (−10.39 ± 3.42 m, p = 0.004) after the 12-week program. Conclusions: The home-based VR program provides older adults with sarcopenia an alternative exercise modality that can improve their cardiovascular performance. Full article

Background: High-intensity intermittent training (HIIT) has been proven to improve cardio-metabolic and respiratory health outcomes. In addition, 20-hydroxyecdysone from plant extracts has been studied for its anabolic effects. However, studies examining these two interventions in individuals who are obese or overweight are limited. This study, thus, examined the effects of HIIT combined with Asparagus officinalis (A. officinalis) extract supplementation on cardiovascular and pulmonary function parameters in obese and overweight individuals. Methods: Seventy-two obese and overweight participants were randomized into four groups (n = 18 each): the control (CON) group; HIIT group (HIIT for 3 days/week); AOE (A. officinalis extract) group (supplementation with 20E at 1.71 mg/kg/day); and HIIT + AOE group. Pre- and 12-week post-intervention measures included heart rate (HR), HR variability, endothelial function, blood pressure (BP), BP variability, pulmonary function and volume, respiratory muscle strength, chest expansion, and body composition. Results: The HIIT + AOE group showed better HR variability with higher high-frequency power and a lower low-frequency/high-frequency ratio (both p = 0.038) compared to the CON group. The peak blood flow increased in both the HIIT (p = 0.03) and HIIT + AOE (p = 0.028) groups, but only the HIIT group had a shorter vascular recovery time (p = 0.048). The maximum expiratory pressure was increased in both the HIIT and HIIT + AOE groups compared to the CON group (p = 0.029 and p = 0.041). The ratio of forced expiratory volume in one second to forced vital capacity, the percent-predicted FEV₁/FVC, and chest wall expansion were higher in the HIIT + AOE group than in the CON group (p = 0.047, p = 0.038, and p = 0.001). The waist-to-hip ratio was lower in the HIIT + AOE group than in the CON group (p = 0.043). There were no significant differences in HR, BP, BP variability, or pulmonary volume parameters among groups. Conclusions: The combination of HIIT with A. officinalis extract supplementation markedly improves HR variability. Moreover, it also greatly improves expiratory muscle strength, chest wall expansion, pulmonary function, and body composition parameters in obese and overweight individuals. Full article

Aim: This study aimed to evaluate the effects of inspiratory muscle training on inspiratory muscle strength and cardiorespiratory performance in patients undergoing open heart surgery. Method: This study was conducted as a randomized controlled trial with two groups. Fifty-eight patients who underwent open heart surgery were randomly assigned to either the intervention group or the control group 29 in the control group and 29 in the intervention group. Patients in the intervention group participated in a physical therapy program combined with inspiratory muscle training using the Thammasat University (TU) Breath Trainer. Patients in the control group received only the standard physical therapy program. The maximum inspiratory pressure, maximum expiratory pressure and 6 min walk test distance were assessed both before surgery and prior to hospital discharge. Results: The intervention group had a significant increase in maximum inspiratory pressure (p < 0.001), maximum expiratory pressure (p < 0.001) and 6 min walk test distance (p = 0.013). The control group had a significant decrease in maximum inspiratory pressure (p < 0.001), maximum expiratory pressure (p = 0.002) and 6 min walk test distance (p < 0.001). Conclusions: Inspiratory muscle training can be performed using maximum pressure resistors, such as the TU-Breath Trainer device. This training has been shown to effectively improve inspiratory muscle strength and cardiorespiratory performance in patients undergoing open heart surgery, as well as reduce pulmonary complications and shorten the length of hospital stay. Full article

Background/Objectives: The aim of this review was to evaluate the effectiveness of respiratory muscle strength training in patients with Parkinson’s disease (PD). Methods: A systematic review and meta-analysis of randomised controlled trials (RCTs) was performed on PubMed, Web of Science, and Scopus databases. We included RCTs that evaluated the effectiveness of respiratory muscle training in patients with PD versus no intervention, sham treatment, or a different type of intervention. Quality assessment and risk of bias were assessed using the Downs and Black scale and the ROB2 tool. Results: Finally, 10 studies were included. The methodological quality of the studies was “good” in most of the studies, with results ranging from 21 to 25. In terms of risk of bias, six of them indicated low risk and four of them showed unclear risk of bias. Data were pooled and a meta-analysis of maximum expiratory pressure (MEP), maximum inspiratory pressure (MIP), and voluntary peak expiratory flow rate (PEFR) was performed. Meta-analysis indicated a significant overall effect of respiratory muscle strength training on MEP (MD = 17.08; 95% CI = 2.32, 31.84; p = 0.02) and on voluntary PEFR (MD = 1.50; 95% CI = 0.51, 2.48; p = 0.003). However, results in the meta-analysis showed a non-significant overall effect of respiratory muscle strength training on MIP (MD = 1.69; 95% CI = −11.91, 16.29; p = 0.82). Conclusions: The synthesis of evidence presented in this systematic review and meta-analysis underscores the potential of respiratory muscle strength training as an effective means of increasing MEP and PEFR in patients with PD. Full article

Background and Objectives: This study aimed to evaluate the predictive value of ultrasonographic abdominal muscle thickness and thickening ratios for expiratory muscle strength in SCI patients. Materials and Methods: A case-controlled, cross-sectional study was conducted with 36 SCI patients and 30 age- and sex-matched healthy controls. Ultrasonographic measurements of the rectus abdominis (RA), external oblique (EO), internal oblique (IO), and transversus abdominis (TrA) were performed at rest and during forced expiration. Maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) were measured to assess respiratory muscle strength. Correlation and regression analyses were performed to determine the relationship between ultrasonography (USG) parameters and expiratory muscle function. Results: SCI patients exhibited significantly lower MIP (76.27 ± 29 cmH₂O vs. 91.63 ± 17.3 cmH₂O, p = 0.007) and MEP (64.52 ± 21.55 cmH₂O vs. 119.1 ± 26.48 cmH₂O, p < 0.001) compared to healthy individuals. Ultrasonographic measurements revealed a significant reduction in forced thickness and thickening ratios of EO, IO, and TrA muscles in SCI patients (p < 0.001). MEP was positively correlated with EO forced thickness (r = 0.333, p = 0.047), IO forced thickness (r = 0.501, p = 0.002), and TrA forced thickness (r = 0.530, p = 0.001). Multiple linear regression analysis identified TrA forced thickness as the strongest predictor of MEP (β = 0.49, p = 0.001). Conclusions: Ultrasonographic measurements of abdominal muscle thickness and thickening ratios provide valuable insights into expiratory muscle dysfunction in SCI patients. TrA forced thickness demonstrated the strongest association with MEP, suggesting its potential as a novel, non-invasive biomarker for expiratory muscle weakness. These results support the use of USG as a practical clinical tool for guiding respiratory assessment and rehabilitation strategies in patients with spinal cord injury. Full article

Objectives: The aim of this study was to evaluate the effectiveness of respiratory muscle training in runners in relation to gender and trainers (PowerBreathe and Threshold). Methods: This study comprised 32 athletes training in middle-distance running at a high sports level. The subjects were divided into groups depending on the applied breathing training (IMT): group IMT on the PowerBreath, group IMT on the Threshold, and the control group labeled sham-IMT. The following tests were performed on each athlete: spirometry, maximal inspiratory pressure, expiratory pressure, and physical performance. Results: A significant increase in the levels of the parameters VO₂/kg, PEF, PI_max, and PE_max, as well as a decrease in lactic acid levels and an increase in lactate threshold in both sexes, were observed as a result of the training on the PowerBreathe device. There were no significant differences in the levels of the parameters VO₂/kg, PEF, PI_max, lactic acid, and lactate threshold in either sex after Threshold training. A significant increase in PE_max was found in the Threshold device training group. Conclusions: Most of the assessed parameters of physical fitness and lung ventilation function, along with the respiratory muscle strength of women and men running middle distances, increased significantly after the use of IMT on PowerBreathe, and these results were maintained in the third stud, in contrast to the use of IMT on Threshold, with which there was no significant improvement. Full article

Objective: This study investigated the dose–response relationship of inspiratory muscle training (IMT) on respiratory muscle strength, lactic acid accumulation and exercise tolerance in amateur runners. Methods: Thirty male amateur runners were randomly assigned to three groups: a high-intensity IMT (HIMT) group, a low-intensity IMT (LIMT) group, and a control group. In addition to their regular training regimen, the high-intensity and low-intensity IMT groups underwent a supervised IMT protocol for a duration of 8 weeks. The primary outcome measures included maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), time to exhaustion (TTE), blood lactate (BLa), rate of perceived exertion (RPE), and rate of perceived breathlessness (RPB). Secondary outcomes encompassed VO2 max, forced vital capacity (FVC), forced expiratory volume in one second (FEV₁), and the FEV₁/FVC ratio. Results: After 8 weeks of IMT, the MIP of HIMT and LIMT were significantly improved (p < 0.01), and the MEP of both groups also increased (p < 0.01). There were no significant changes in FVC and FEV₁ (p > 0.05), but only FEV₁/FVC in HIMT was significantly improved (p < 0.01). Exercise testing showed a significant increase in TTE in both the HIMT and low LIMT groups (p < 0.01). Post-exercise RPE scores were lower in both the HIMT group (p < 0.01) and LIMT group (p < 0.05), and both HIMT and LIMT groups’ post-exercise RPB scores were also reduced in both (p < 0.05). In addition, blood lactate accumulation was significantly lower in both HIMT (p < 0.01) and LIMT (p < 0.05). There were no significant changes in VO2 max (p > 0.05) and HR peak (p > 0.05). Conclusion: IMT for 8 weeks can improve respiratory muscle strength, prolong exercise time, improve blood lactate accumulation, subjective fatigue, and dyspnea during exercise. Among them, high-intensity IMT can better improve exercise tolerance. Full article

Introduction: We sought to evaluate the effects of a 12-week pulmonary rehabilitation (PR) program on lung function, mechanics, as well as pulmonary and systemic inflammation in a cohort of 33 individuals with moderate to severe post-COVID-19. Material and Methods: The pulmonary rehabilitation (PR) program employed a combination of aerobic and resistance exercises. Thirty minutes of treadmill training at 75% of the maximum heart rate, combined with 30 min resistance training consisting of 75% of one maximum repetition, three times a week throughout 12 weeks. Results: PR improved the lung function, FVC (p < 0.02), FEV1 (p < 0.02), FEV1/FVC (p < 0.01), MEF25% (p < 0.006), MEF50% (p < 0.03), and MEF75% (p < 0.02). PR also positively influenced lung mechanics, reducing respiratory impedance (Z5Hz, p < 0.03), respiratory reactance (X5Hz, p < 0.01), resistance of the entire respiratory system (R5Hz, p < 0.03), central airway resistance (RCentral, p < 0.03), and peripheral airway resistance (RPeripheral, p < 0.02). Moreover, muscle strength gains were evident, with significant improvements observed in hand grip strength for both the right (p < 0.02) and left (p < 0.01) hands, as well as maximal inspiratory (p < 0.02) and expiratory (p < 0.03) pressures. Additionally, PR exhibited anti-inflammatory effects by reducing the pro-inflammatory cytokines IL-1β (p < 0.0001) and IL-6 (p < 0.0001) and increasing the anti-inflammatory IL-1RA (p < 0.0004) and IL-10 (p < 0.003) and anti-viral IFN-γ (p < 0.0002) and IFN-β (p < 0.008) cytokines in breath condensate and serum samples. Conclusions: Collectively, these findings highlight the effectiveness of PR in ameliorating COVID-19 sequel across respiratory system, skeletal muscle, and immune responses. This highlights its promising potential as a therapeutic intervention for individuals recovering from COVID-19. Full article

Objectives: The aim of this study was to evaluate the effect of brace use application and the Schroth intervention on lung ventilation and respiratory muscle strength in patients treated long-term with a Chaneau brace and the Schroth method. Methods: A total of 26 post-menarche females aged 15.7 ± 1.5 years, with a Cobb angle of 18–48° and a diagnosis of AIS in inpatient rehabilitation were examined. All participants received brace treatment for a minimum of 3 months with a dosage of 20–22 h/day. This study protocol was performed three times: 1—brace intervention—first day of the present study; 2—without the brace—second day of the present study; and 3—Schroth intervention on the same day. Results: During the period of brace use, girls treated with a long-term therapy showed significantly reduced values for VC, FVC, and FEV₁ and significantly higher values for inspiratory muscle strength PI_max compared to values obtained in studies without the brace and after single exercises. Expiratory muscle strength did not differ significantly. Conclusions: The majority showed restrictive lung ventilation disorders and decreased respiratory muscle strength in relation to norms. There was a significant correlation of PI_max with the duration of wearing the brace and the duration of therapy. Full article

Background: This study aimed to analyze the impact of seated, 45° inclined, and supine positions on respiratory muscle strength (Maximal Inspiratory Pressure—MIP, Maximal Expiratory Pressure—MEP, Sniff Nasal Inspiratory Pressure—SNIP and Sniff Nasal Expiratory Pressure—SNEP) and the electrical activity of respiratory muscles in healthy adults. Ten healthy subjects were evaluated. Methods: Personal, anthropometric data (weight, height, BMI) and lung function (spirometry) were collected, followed by random assessments of inspiratory (MIP, SNIP) and expiratory (MEP, SNEP) muscle strength. Respiratory muscle strength maneuvers and surface electromyographic (sEMG) activity were assessed in sitting, 45° inclined, and supine positions. Results: present that MIP was statistically higher in the sitting position compared to the supine position (p < 0.05) and the 45° supine position (p < 0.05), with SNIP: p < 0.05 and SNEP: p < 0.05 as well. Intercostal muscle activity was higher during MIP, MEP, and SNEP maneuvers in the sitting position (p < 0.05). Additionally, rectus abdominis muscle activity was higher in this position during MIP and SNEP maneuvers. Conclusions: The results suggest there are significant differences in inspiratory pressures between positions, with the difference in activity muscle pattern. In conclusion, body position affected maximal respiratory pressures and influences EMG activation of specific respiratory muscles during MIP. Full article

Background/Objectives: The primary life-threatening complication in spinal–bulbar muscular atrophy (SBMA) is ventilatory failure. The present study analyzes the longitudinal patterns of respiratory function tests over a follow-up of 11 years. Methods: We collected data from 9 genetically confirmed SBMA patients. Spirometric measurements [maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP), and forced vital capacity (FVC)], serum biochemical indices and SBMA functional rating scale (SBMAFRS) were collected every 6 months for 11 years. An average time curve was utilized to assess the changes in both pulmonary tests and serum biochemical indices of the patients. One-way repeated-measures ANOVA was applied to assess statistical differences. The Spearman’s rank correlation coefficient was utilized to evaluate the correlations between the respiratory function tests and serum biochemical and clinical indices. Results: A progressive decrease was observed in the respiratory function tests; the slope of the linear regression was significantly non-zero (p < 0.0001) for all three time curves. A major decrease was observed for MEP (52%) and MIP (42%), while this was minor for FVC (25%). SBMAFRS score correlated with FVC (r = 0.27), MIP (r = 0.53) and MEP (r = 0.51). MIP and MEP correlated with creatine phosphokinase (r = 0.3, r = 0.25, respectively) and MIP with creatinine levels (r = 0.31). Conclusions: This longitudinal study shows a progressive decline of spirometric data throughout life in SBMA patients. The decline appears to be related to clinical deterioration and muscle denervation. Spirometric measures relative to maximal strength of the respiratory muscles (MIP and MEP) may have a better predictive value for pulmonary and muscular decline than FVC. Full article

This study explores the association of respiratory muscle strength with aerobic endurance kinetics among athletes, with a specific focus on maximal oxygen consumption (VO₂max). Previous research has elucidated the complex interactions between respiratory and skeletal muscles during exercise, highlighting the critical role of efficient respiration in maximizing athletic performance. The interplay between active skeletal muscles and respiratory muscles, especially the influence of respiratory muscle fatigue on exercise capacity, is well-documented. High-intensity exercise has been shown to activate the respiratory muscle metaboreflex, which can restrict blood flow to working muscles, thereby impacting the energy required for respiration. A total of 41 athletes, drawn from the disciplines of biathlon, judo, and cross-country, participated in this study. Respiratory function tests (RFTs) were administered to assess various respiratory parameters, including changes in chest circumference. Additionally, maximal oxygen consumption (VO₂max) and heart rate were measured during a treadmill test. To explore the associations between VO2max and ventilatory parameters—namely, ventilation (VE), oxygen consumption (VO₂), carbon dioxide production (VCO₂)—as well as respiratory metrics, linear regression analysis was employed. Based on the standardized regression coefficients (β), it was found that maximum expiratory pressure (MEP) (mean ± SD: 130.95 ± 42.82) and inspiratory diaphragmatic circumference values were significantly associated with VE, VO₂, and VCO₂. Conversely, the other predictor variables did not exhibit a significant effect on VE (mean ± SD: 134.80 ± 36.69), VO₂ (mean ± SD: 3877.52 ± 868.47 mL), and VCO₂ (mean ± SD: 4301.27 ± 1001.07 mL). Similarly, measurements of chest circumference (mean ± SD: 91.40 ± 10.72 cm), MEP, and diaphragmatic circumference during inspiration (mean ± SD: 95.20 ± 10.21 cm) were significantly associated with VO₂max (mean ± SD: 58.52 ± 10.74 mL/kg/min), while the remaining predictor variables did not demonstrate a significant effect on VO₂max. Additionally, a multiple linear regression analysis was conducted to examine the combined effects of respiratory muscle strength and ventilatory factors on VO₂max. The model, which included interaction terms, explained 89.9% of the variance in VO₂max (R² = 0.899, adjusted R² = 0.859). Significant interactions were found between MIP and VE (B = −0.084, p = 0.006), as well as MEP and VE (B = 0.072, p = 0.012). These findings suggest that respiratory muscle strength plays a more substantial role in determining VO₂max in individuals with higher ventilatory efficiency, highlighting the importance of both respiratory strength and breathing efficiency in aerobic performance. Our findings underscore the importance of considering respiratory muscle strength in assessing and enhancing athletes’ aerobic performance. Integrating objective measurements such as maximal inspiratory and expiratory pressure assessments into routine performance evaluations allows coaches and sports scientists to monitor changes in respiratory function over time and adjust training protocols accordingly. Full article

Background: Pompe disease is a rare metabolic myopathy caused by the lack or deficiency of the lysosomal acid alpha-glucosidase, resulting in skeletal muscle weakness and cardiomyopathy. The disease varies by onset age and genetic mutations and is categorized into infantile-onset and late-onset Pompe disease. Respiratory muscle weakness may persist regardless enzyme replacement therapy. This systemic review and meta-analysis aim to assess the effect of respiratory muscle training (RMT) on respiratory muscle strength, functional endurance, and pulmonary function in patient with Pompe disease. Methods: PubMed, EMBASE, and Cochrane databases were searched up until Aug 2024. Studies examining the therapeutic effects of RMT in patients with Pompe disease were included. Outcome measures included the change in maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), six-minute walking test (6MWT), pulmonary function before after RMT, quality of life and adverse events. Results: The meta-analysis consisted of 5 single-arm studies, including 31 patients in total. Regarding inspiratory muscle strength, RMT has significantly improving MIP (8.71 cmH₂O; 95% CI, 6.23–11.19, p < 0.001) and MEP (12.15 cmH₂O; 95% CI, 10.55–13.74, p < 0.001) in both types of Pompe disease. However, no significant change regarding 6MWT. No serious adverse events were reported. Conclusions: Our meta-analysis revealed that RMT may increase inspiratory muscle and expiratory muscle strength, but may not have an effect on 6MWT in patients with Pompe disease. RMT has potential to be integrated into the cardioplulmonary rehabilitation for patients with Pompe disease. Further large randomized controlled trials are needed to verify the efficacy and safety of RMT in patients with Pompe disease. Full article