Immediate effects of osteopathic manipulative therapy on thoracoabdominal mobility, respiratory muscle strength and pulmonary function in healthy men: Preliminary crossover trial

The Pilates method can be an effective tool for the physical therapist during rehabilitation, because it has varied benefits and few contraindications. Although widely practiced by the population, the literature is scarce about the benefits related to the respiratory system. The purpose of this study was to evaluate the influence of the Pilates method on lung function, thoracoabdominal mobility, respiratory muscle strength and anthropometric characteristics in healthy women. This is a non-randomized placebo-controlled clinical trial with 21 volunteers, who were allocated for convenience in two groups: Pilates with 11 female volunteers, aged 33.18±8.08 years, subjected to the Pilates method twice a week for three months; and Control with 10 female volunteers, aged 31.70±7.39 years that remained three months without regular physical exercises. All of them were submitted to the anthropometric evaluation, physical activity Baecke questionnaire, spirometry lung function, thoracoabdominal mobility by cirtometry and respiratory muscle strength by measures of the maximum respiratory pressure obtained by means of a manovacuometer. All volunteers were evaluated prior to insertion in the groups and revaluated after three months. In the Pilates group, there was significant increase in recreational physical activity, total of the physical activity questionnaire, mobility in the three levels (axillary, xiphoid and abdominal) of the respiratory, inspiratory and expiratory muscle strength, and significant reduction in waist circumference (WC) (p;0.05). As to the lung function, significant differences were not detected (p>;0.05) in the groups and between them. It is concluded that, after the practice of the Pilates method, there was improvement in leisure physical activity, thoracoabdominal mobility, respiratory muscle strength and waist circumference reduction, however, in comparison with the control group, the Pilates method did not show relevant changes in pulmonary function, thoracoabdominal mobility, respiratory muscle strength and anthropometric characteristics in healthy women that did not perform physical activities.

Fibromyalgia syndrome (FMS) is associated with a variety of symptoms, such as fatigue and dyspnea, which may be related to changes in the respiratory system. The objective of this work was to evaluate pulmonary function, respiratory muscle strength, and thoracoabdominal mobility in women with FMS and its association with clinical manifestations. The study included 23 women with FMS and 23 healthy women (control group). Pulmonary function, respiratory muscle strength, and thoracoabdominal mobility were assessed in all participants. Clinical manifestations such as number of active tender points, pain, fatigue, well-being, and general pressure pain threshold and pressure pain threshold in regions involved in respiratory function were also assessed. For data analysis, the Mann-Whitney test and Spearman correlation coefficient were used. The FMS group showed lower values of maximum voluntary ventilation (P = .030), maximal inspiratory pressure (P = .003), and cirtometry at the axillary and xiphoid levels (P < .001 and P < .001, respectively) as well as higher cirtometry at the abdominal level (P = .005) compared with the control group. However, there was no significant difference between groups for maximum expiratory pressure. In predicted percentage, maximal inspiratory pressure showed significant positive correlation with axillary cirtometry (r = 0.41, P = .049) and negative correlation with the number of active tender points (r = -0.44, P = .031) and fatigue (r = -0.41, P = .049). Subjects with FMS had lower respiratory muscle endurance, inspiratory muscle strength, and thoracic mobility than healthy subjects. In addition, inspiratory muscle strength was associated with the number of active tender points, fatigue, and axillary mobility.

BackgroundAlthough vitamin D is well known for its function in calcium homeostasis and bone mineralization, several studies have shown positive effects on muscle strength and physical function. In addition, vitamin D has been associated with pulmonary function and the incidence of airway infections. As vitamin D deficiency is highly prevalent in chronic obstructive pulmonary disease (COPD) patients, supplementation might have a beneficial effect in these patients.ObjectiveTo assess the effect of vitamin D supplementation on respiratory muscle strength and physical performance in vitamin D-deficient COPD patients. Secondary outcomes are pulmonary function, handgrip strength, exacerbation rate, and quality of life.MethodsWe performed a randomized, double-blind, placebo-controlled pilot trial. Participants were randomly allocated to receive 1,200 IU vitamin D3 per day (n=24) or placebo (n=26) during 6 months. Study visits were conducted at baseline, and at 3 and 6 months after randomization. During the visits, blood was collected, respiratory muscle strength was measured (maximum inspiratory and expiratory pressure), physical performance and 6-minute walking tests were performed, and handgrip strength and pulmonary function were assessed. In addition, participants kept a diary card in which they registered respiratory symptoms.ResultsAt baseline, the mean (standard deviation [SD]) serum 25-hydroxyvitamin D (25(OH)D) concentration (nmol/L) was 42.3 (15.2) in the vitamin D group and 40.6 (17.0) in the placebo group. Participants with vitamin D supplementation had a larger increase in serum 25(OH)D compared to the placebo group after 6 months (mean difference (SD): +52.8 (29.8) vs +12.3 (25.1), P<0.001). Primary outcomes, respiratory muscle strength and physical performance, did not differ between the groups after 6 months. In addition, no differences were found in the 6-minute walking test results, handgrip strength, pulmonary function, exacerbation rate, or quality of life.ConclusionVitamin D supplementation did not affect (respiratory) muscle strength or physical performance in this pilot trial in vitamin D-deficient COPD patients.

PurposeRecently, reports in the mass media have implicated that bicycle riding increases the risk of erectile dysfunction and prostatic diseases. So, we evaluate the impact of bicycle riding on erectile function and lower urinary tract symptoms (LUTS) in healthy general men.MethodsFrom 26 June 2010 to 20 July 2010, we investigate degree of LUTS (voiding and storage symptoms), using International Continence Society-male Questionnaire (ICS-mQ) and erectile function using International Index of Erectile Function-5 Questionnaire (IIEF-5) in 5 work places (personnel of public office, hospital, university, etc.) of which bicycle riding club members were doing active club activities. Respondents, who participated in club activities for 6 months and longer, were classified as the bicycle club (142 men; age, 44.02±8.56). Ones who do not ride bicycles were classified as the control group (83 men; age, 42.13±7.85). People who were having the history of urological and other chronic diseases (diabetes, vascular disease, heart disease, etc) were excluded from both groups.ResultsBicycle club is not significantly associated with increased prevalence of LUTS (bicycle club, 2.1 to 57.7% control, 4.8 to 73.5%) and erectile dysfunction (bicycle club, 46.1% control, 55.4%). The total mean score (storage/voiding/erectile function) of bicycle club (13.93±1.95/11.14±3.49/20.46±5.30) were not significantly different from control (14.35±2.49/11.52±3.38/20.40±4.07) (P=0.190 to 0.968).ConclusionsThese results suggested that bicycle riding as exercise or hobby has no negative effect on LUTS and erectile function in healthy general men, although this research data were limited to the questionnaire analysis.

To investigate the effects of photobiomodulation applied to respiratory muscles on lung function, thoracoabdominal mobility, respiratory muscle strength, and functional capacity in COPD patients. This is a randomized double-blind crossover clinical trial. Twelve male COPD patients participated in the study. Participants were randomly allocated to receive two photobiomodulation sessions, 1week apart: (1) an effective photobiomodulation session applied at the main respiratory muscles by means of a cluster with 69 light-emitting diodes (LEDs), containing 35 red (630 ± 10nm; 10mW; 0.2cm2) and 34 near-infrared (830 ± 20nm; 10mW; 0.2cm2) LEDs and (2) a sham photobiomodulation session, following the same procedures without emitting light. The primary outcomes were pulmonary function (spirometric indexes); thoracoabdominal mobility (cirtometry); respiratory muscle strength (maximal respiratory pressures), assessed at three moments: (1) baseline, (2) 1h after intervention, and (3) 24h after intervention; and the functional capacity, assessed by the 6-min walk test (6MWT) at baseline and 24h after intervention. No significant interactions were found for spirometric variables, maximal respiratory pressures, and cirtometry. However, there was a Time × Condition interaction (F = 18.63; p = 0.001; η2p = 0.62) in the walked distance on the 6MWT, with a significant increase after photobiomodulation intervention (p < 0.01) compared with the baseline. Photobiomodulation applied to respiratory muscles was effective in improving acute functional capacity in COPD patients. To the best of our knowledge, this is the first study assessing the effects of photobiomodulation applied to respiratory muscles in patients with COPD.

This cross-sectional, observational study was planned to compare pulmonary function, respiratory and peripheral muscle strength, and functional capacity in different functional classes of heart failure patients. Thirty-four heart failure patients, in New York Heart Association (NYHA) Class II and III (68.59±9.84 years, left ventricular ejection fraction (LVEF) =34.24±7.59%) were included. Class II and III patients' pulmonary function was assessed using spirometry, respiratory muscle strength using a mouth pressure device, functional capacity using six minute walk test (6MWT), quadriceps femoris and biceps brachii muscle strength were evaluated using a hand-held dynamometer, and variables were compared. Student t, Chi-square, Mann-Whitney U tests, and Spearman correlation coefficients were used for statistical analysis. There were no statistically significant differences in pulmonary function and respiratory muscle strength between the two groups (p>0.05). The 6MWT distance (328.35±101.56 m; vs. 480.05±104.19 m) quadriceps femoris (218.83±63.62 N; vs. 290.69±115.53 N) and biceps brachii (164.22±44.78 N; vs. 219.19±49.37 N) muscle strength of Class III patients were significantly lower than of Class II patients (p<0.05 for all). The NYHA classification system was significantly correlated with measured and predicted 6MWT distance (r=-0.59, r=-0.65, respectively), biceps brachii muscle strength (r=-0.46, r=-0.40, respectively), and % quadriceps femoris muscle strength (r=-0.43) (p<0.05). Functional capacity and peripheral muscle strength decrease as the illness progresses in heart failure. Pulmonary function and respiratory muscle strength are preserved. The NYHA classification system is a reliable method in the detection of changes in functional capacity and peripheral muscle strength. Changes in functional capacity and peripheral muscle strength are consistent with the NYHA classification system.

Primary ciliary dyskinesia (PCD) impairs pulmonary function, respiratory and peripheral muscle strength, and exercise capacity. We aimed to investigate the effects of active video games (AVGs) on pulmonary function, respiratory and peripheral muscle strength, exercise capacity, muscle oxygenation (SMO2), physical activity, activities of daily living (ADL), and quality of life (QOL) in PCD. Thirty-two PCD patients were randomly assigned to AVG group (n = 16) and the control group (n = 16). AVG group underwent AVGs using Xbox-Kinect-360 device for 40 min/day, 3 days/week for 8 weeks plus airway clearance techniques (ACT), and the control group was applied ACT only. Pulmonary function, respiratory and quadriceps muscle strength, exercise capacity (6-min walk test [6MWT], incremental shuttle walk test [ISWT]), and ADL (Glittre ADL test) were assessed. SMO2 during ISWT and ADL test was also recorded. Physical activity and QOL (PCD-QOL) were evaluated. Pulmonary function; respiratory and quadriceps muscle strength; 6MWT and ISWT distance; physical activity; ADL performance; SMO2; physical, emotional, and social functioning; treatment burden; and upper and lower symptom parameters of PCD-QOL significantly improved after 8 weeks in the AVG group (p < 0.05). There were no significant differences in measured parameters except emotional function and upper respiratory symptom scores of PCD-QOL in the control group (p > 0.05). Conclusion: The AVGs positively affect pulmonary (pulmonary function, respiratory muscle strength) and extrapulmonary (peripheral muscle strength, exercise capacity, SMO2, physical activity, ADL, and QOL) characteristics in children with PCD. The AVGs may be added to the pulmonary rehabilitation program as an exercise training modality in patients with PCD. Trial registration: This study registered at ClinicalTrials.gov with NCT03832491 on February 6, 2019.What is Known:• It is indicated that exercise capacity is increased with traditional exercise-training in a case report of Kartagener Syndrome.What is New:• No randomized controlled study investigated the effects of exercise-training in PCD.• 8-week moderate-intensity active video gaming (AVGs) improves pulmonary and extrapulmonary features in children with PCD. AVGs may be preferable due to being enjoyable, providing visual and audial feedback in the pulmonary rehabilitation programs of PCD.

Effects of inspiratory muscle training in patients with heart failure

Respiratory muscle weakness occurs in sarcoidosis and is related to decreased exercise capacity, greater fatigue, dyspnea, and lower quality of life in sarcoidosis patients. The effects of inspiratory muscle training in this population have not been comprehensively investigated so far. This study was planned to investigate the effects of inspiratory muscle training on exercise capacity, respiratory and peripheral muscle strength, pulmonary function and diffusing capacity, fatigue, dyspnea, depression, and quality of life in subjects with sarcoidosis. This was a prospective, randomized, controlled, and double blind study. Fifteen sarcoidosis subjects (treatment group) received inspiratory muscle training at 40% of maximal inspiratory pressure (P(Imax)), and 15 subjects (control group) received sham therapy (5% of P(Imax)) for 6 weeks. Functional and maximal exercise capacity, respiratory and peripheral muscle strength, pulmonary function and diffusing capacity, fatigue, dyspnea, depression, and quality of life were evaluated. Functional (P < .001) and maximal exercise capacity (P = .038), respiratory muscle strength (P(Imax) [P < .001] and P(Emax) [P = .001]), severe fatigue (P = .002), and dyspnea perception (P = .02) were statistically significantly improved in the treatment group compared with controls; no significant improvements were observed in pulmonary function and diffusing capacity, peripheral muscle strength, fatigue, depression, and quality of life between groups after inspiratory muscle training. Inspiratory muscle training improves functional and maximal exercise capacity and respiratory muscle strength and decreases severe fatigue and dyspnea perception in subjects with early stages of sarcoidosis. Inspiratory muscle training can be safely and effectively included in rehabilitation programs. (ClinicalTrials.gov registration NCT02270333.).

Introduction: Studies widely investigated the effects of inspiratory muscle strength training in heart failure (HF) patients. No study compared the effects of inspiratory muscle strength or endurance training in patients with pacemaker. Aims: To investigate the effects of inspiratory muscle strength or endurance training on exercise capacity, quality of life, peripheral muscle strength, respiratory (MIP, MEP) muscle strength and endurance, pulmonary function and dyspnea in HF patients with pacemaker. Methods: Sixteen patients received inspiratory strength training at 50% of MIP, 20 patients received endurance training at 30% of MIP 7days/8 weeks. Functional exercise capacity [6-min.walking test (6-MWT)], incremental shuttle walking test (ISWT)], pulmonary function (spirometry), respiratory muscle strength (mouth pressure device) and endurance (threshold loading), peripheral muscle strength (dynamometer), dyspnea (Modified Medical Research Council dyspnea scale (MMRC) and quality of life [Minnesota Living with Heart Failure (MLHFQ), SF-36 questionnaires] were evaluated before and after. Results: There were statistically significantly improvements were present in MIP, MEP, respiratory muscle endurance, peripheral muscle strength, 6-MWT and ISWT walking distances, MMRC, MLHFQ and SF-36 Scales within groups however there were no significant differences between groups (p≥0,05). Conclusions: Inspiratory muscle strength or endurance training similarly improves respiratory and peripheral muscle strength, exercise capacity, quality of life and decreases dyspnea and are safe, effective in HF patients with pacemakers.

BackgroundMuscle weakness, balance, and functional capacity are affected in patients with chronic kidney disease (CKD) in dialysis. However, studies about kinesiophobia, peripheral and respiratory muscle strength, balance, exercise capacity, fatigue, and physical activity level in patients with CKD 3–4 are limited. The study aimed to compare the functional exercise capacity, peripheral and respiratory muscle strength, pulmonary function, balance, kinesiophobia, physical activity, fatigue, and dyspnea between patients with CKD 3–4 and controls.MethodsThis cross-sectional study included 43 patients and 45 controls. Functional exercise capacity [6-Minute Walking Test (6MWT)], peripheral and respiratory muscle strength, pulmonary function, dyspnea, fatigue, physical activity, balance [Berg Balance Scale (BBS)], and kinesiophobia were evaluated.ResultsDemographic characteristics were similar in patients [53(50–57) y, 26 M/17F] and controls [51(4.506-55) y, 33 M/12F] (p > 0.05). The 6MWT, respiratory and peripheral muscle strength, pulmonary function, physical activity, and BBS were significantly lower, and the level of dyspnea and kinesiophobia were higher in patients compared with controls (p < 0.05).ConclusionsPatients had impaired functional exercise capacity, upper and lower extremity muscle strength, respiratory muscle strength, pulmonary function, and balance, increased perception of dyspnea and kinesiophobia, and reduced physical activity level compared with controls. Patients should be directed to cardiopulmonary rehabilitation programs.

<b>Background:</b> COVID-19 survivors have reported persistent symptoms: extreme fatigue, breathlessness, limited exercise capacity, impaired pulmonary function, and cognitive and psychological consequences. Respiratory muscle training (RMT) might be beneficial to decreases fatigue and breathlessness and increases exercise capacity. <b>Objective:</b> To investigate the effect of a high-intensity home-based RMT programme on quality of life, physical and pulmonary function, psychological and cognitive state in Post-COVID syndrome. <b>Methods:</b> Double-blind randomized controlled trial. 28 participants were allocated into 4 groups: (1) Inspiratory muscle training (IMT) (n=7); (2) Inspiratory and Expiratory muscle training (IEMT) (n=7); (3) Sham-IMT (n=7); (4) Sham-IEMT (n=7). All groups performed a home-based training for 8 weeks (6 days/week, twice a day). Quality of life, symptoms, respiratory and peripheral muscle strength, cardiorespiratory endurance, pulmonary and psychological function, post-traumatic stress disorder and cognitive function were evaluated at baseline, at 4 weeks and after 8 weeks. <b>Results:</b> The experimental groups improved quality of life, symptoms (breathlessness, fatigue/muscle weakness, and headache), respiratory muscle strength, cardiorespiratory endurance, anxiety and depression levels, post-traumatic stress disorder and cognition function. There were no differences on pulmonary function and peripheral muscle strength. The combined intervention group showed a slight superiority. <b>Conclusions:</b> A home-based RMT programme can improve quality of life, symptoms, physical function, cognitive and psychological function in the short-term in Post-COVID syndrome

Chronic kidney disease (CKD) represents the irreversible stages of renal failure and is a growing worldwide public health issue associated with increases in morbidity, mortality, and decreased quality of life. Kidney transplantation is considered one of the best treatment options in this population. However, even after surgery, respiratory muscle strength is below normal values, and inspiratory muscle training (IMT) improves respiratory muscle function, strength, and endurance. This study aimed to evaluate the effects of IMT regarding respiratory muscle strength, functional capacity, and pulmonary function in pediatric kidney transplant recipients with CKD, and secondarily, to assess the biochemical profile of patients after intervention. This is a randomized, double-blind, placebo-controlled trial. Patients were randomized into two groups, intervention (IG) and control (CG) and performed IMT home-based training for 6weeks. In the IG, the load was adjusted to 40% of the maximal inspiratory pressure and in the CG was adjusted to a minimum placebo load (9cm H2O). Thirty-one patients were randomly allocated to the intervention (n = 16) or control (n = 15) groups. There were no differences at baseline between groups. Increase of 35% in the maximal inspiratory pressure predicted and 26% in the maximal expiratory pressure predicted in the IG were found, compared with 5 and 4% in the CG. There was an increase in hemoglobin and hematocrit values in the IG. Home-based IMT provides a significant increase in respiratory muscle strength, without changes in functional capacity and pulmonary function. Benefits regarding biochemical markers (hemoglobin and hematocrit) were also observed.

A comparison of the effects of inspiratory muscle strength and endurance training on exercise capacity, respiratory muscle strength and endurance, and quality of life in pacemaker patients with heart failure: A randomized study

BackgroundFunctional capacity and muscle weakness are affected in patients with systemic sclerosis (SSc). However, upper extremity functional exercise capacity has not been sufficiently studied in patients with SScObjectiveThe primary objective was to compare upper extremity functional exercise capacity; secondary objectives were to compare functional exercise capacity, pulmonary function, respiratory muscle strength, balance, peripheral muscle strength, dyspnea, fatigue, quality of life (QoL), and physical activity in patients with SSc and healthy controls.MethodsTwenty-five patients and 25 healthy controls were included in this cross-sectional study. The upper extremity functional exercise capacity [6-min pegboard and ring test (6-PBRT)], functional exercise capacity [6-Minute Walking Test (6-MWT)], pulmonary function, respiratory muscle strength, balance, peripheral muscle strength, fatigue, dyspnea, QoL, and physical activity were assessed. Between-group comparisons used Student's t-test, the Mann-Whitney U test, or the Chi-square test as appropriate. Effect sizes (Cohen's d) were calculated for key outcomes.ResultsCompared to controls, patients with SSc had significantly lower 6-PBRT scores (Cohen's d = 3.29), 6-MWT distances (Cohen's d = 1.87), pulmonary function, respiratory and peripheral muscle strength, balance, QoL, and physical activity levels, with higher dyspnea and fatigue levels (p < 0.05).ConclusionsPatients exhibited impaired upper extremity functional exercise capacity, functional exercise capacity, pulmonary function, respiratory muscle strength, balance, peripheral muscle strength, QoL, and physical activity, as well as increased levels of dyspnea and fatigue compared to healthy controls. Therefore, after a comprehensive assessment including upper extremity functional exercise capacity, patients with SSc should be initiated into cardiopulmonary rehabilitation programs.