Improvement In Vital Capacity Research Articles

The effects of kettlebell training versus resistance training using the own body mass on physical fitness and physiological adaptations in obese adults: a randomized controlled trial

Aim of studyThis study aimed to explore the effects of different types of resistance training using kettlebells versus the own body mass, in comparison to a passive control, on key physical fitness and physiological parameters in young, obese adults.MethodsData from 60 sedentary, obese male college students, aged 17–26, were used for final analyses. Participants were randomly assigned to one of three groups: a control group (CG, n = 20, no training), a kettlebell resistance training group (KRTG, n = 20), or a bodyweight resistance training group (BWRTG, n = 20). Selected measures of physical fitness were tested using the 12-minutes run test, the push-up test, the sit-up test, and the sit-and-reach test. Physiological measures included vital capacity, resting and maximum heart rate (HRmax), mean arterial blood pressure, breath holding time, and respiratory rate. Biochemical variables were measured in the morning, in a fasted state, and comprised high and low density lipoprotein, total cholesterol, and triglycerides. The 12-weeks progressive KRTG and BWRTG were specifically tailored using sets, repetitions, and intensity levels.ResultsNotable findings include significant body fat reductions in BWRTG (p < 0.001; d = 1.53) and KRTG (p < 0.001; d = 1.43), and a substantial increase in VO2max for BWRTG (p < 0.001; d = 1.32) and KRTG (p < 0.001; d = 1.34) compared to CG. KRTG also showed significant improvements in vital capacity (p < 0.001; d = 1.61) and reductions in resting heart rate (p = 0.024, d = 1.05) and respiratory rate (p = 0.001, d = 1.55), with BWRTG showing similar trends (resting heart rate: p = 0.041, d = 1.35; respiratory rate: p = 0.001, d = 1.98). Both intervention groups significantly improved breath holding time (KRTG: p = 0.001, d = 1.58; BWRTG: p < 0.001, d = 1.98) and reduced total cholesterol and low-density lipoprotein levels compared to CG.ConclusionsThis study demonstrates that both KRTG and BWRTG are effective in improving body composition and selected fitness and physiological measures. Thus, resistance training using kettlebells or bodyweight training are recommended if the goal is to improve body composition and fitness in obese male adults.Trial RegistrationOSF, September, 28th 2023. https://doi.org/10.17605/OSF.IO/Z6Y9Gosf.io/2mb98

Safety and efficacy evaluation of personalized exercise prescription during chemotherapy for lung cancer patients.

To explore the safety and effectiveness of personalized exercise intervention during chemotherapy for lung cancer patients who were relatively weak and with compromised cardiopulmonary function. Thirty-eight lung cancer patients treated with chemotherapy at Peking University Third Hospital were enrolled in this prospective study. The exercise group (N = 21) received individualized exercise guidance based on personal test results and exercised regularly, while the control group (N = 17) only received exercise education and planed exercise methods according to their own preferences. Both groups underwent three fitness tests and clinical indicator assessments at 0, 6, and 12 weeks after starting the exercise, and the differences in trends of various indicators between the two groups were compared. No exercise-related adverse events occurred during the 12-week exercise period. After 12 weeks of exercise training, in terms of fitness, the exercise group showed significant improvements in 6-min walk test (6MWT) (p < 0.001), peak oxygen consumption (VO2peak) (p = 0.005), muscle content (p < 0.001), muscle percentage (p < 0.001), and grip strength (p = 0.008) compared to the control group. In terms of clinical indicators, the exercise group showed significant improvements in vital capacity (p = 0.018), D-dimer (p = 0.031), and C-reactive protein (CRP) (p = 0.01), uric acid (p = 0.003), triglycerides (p < 0.001), functional average score (p < 0.001), and main symptom average score (p = 0.004) compared to the control group in trends over time. Rehabilitation exercises using individualized exercise prescriptions tailored by exercise prescription specialists during chemotherapy are safe for lung cancer patients. Adhering to exercise can achieve comprehensive improvements in physical fitness and quality of life at 12 weeks.

The therapeutic value of vacuum external fixation in polytrauma patients with multiple ribs fracture.

Multiple displaced rib fractures often result in a poor prognosis. Open reduction and internal fixation has been shown to provide benefits for patients with displaced rib fractures and flail chest. Nevertheless, for patients who are unwilling or unsuitable for surgery, the therapeutic options are limited. We developed a novel plastic vacuum device for rib fractures external stabilization. This study aims to compare the therapeutic efficacy of this device against a traditional chest strap in polytrauma patients with multiple rib fractures. A retrospective investigation was conducted on polytrauma patients with multiple rib fractures admitted to our trauma center between March 2020 and March 2023. Patients were categorized into two groups: vacuum external fixation and chest strap. Comparative analysis was conducted on baseline parameters, injury characteristics, and clinical outcomes between the two groups. In this study, 54 patients were included, with 28 receiving chest strap and 26 undergoing vacuum external fixation. Results showed that, at 3days and 7days postintervention, the vacuum external fixation group had significantly lower visual analog scale scores during deep breathing and coughing (P< .05). Vacuum external fixation also reduced pleural drainage duration and volume, as well as lowered the risk of pneumonia and other complications (P< .05). Furthermore, the vacuum external fixation group demonstrated notable improvements in vital capacity, tidal volume, blood-gas test results, and a shorter hospital length of stay. According to the study findings, vacuum external fixation appears to offer benefits to patients with multiple rib fractures, potentially reducing the risk of complications and improving overall clinical outcomes.

Jumping Rope Improves the Physical Fitness of Preadolescents Aged 10-12 Years: A Meta-Analysis.

To systematically review the effects of jumping rope on physical fitness among 10 to 12-year-old preadolescents, and to provide evidence-based support for its use in school physical education curriculum work. The PubMed, Web of Science, SPORTDiscus, ScienceDirect, and CNKI databases were searched for randomized controlled trials that assessed jumping rope and physical fitness among preadolescents aged 10-12 years. Meta-analyses were used to calculate the standardized mean difference (SMD) values and 95% confidence intervals (CI), and subgroup analyses were conducted on intervention duration, frequency and period. A total of 1048 subjects from 15 studies were included. Compared to regular physical education courses, jumping rope did not show a significant advantage in terms of body morphology. In terms of physical function, boys showed greater improvements in vital capacity, and girls showed greater improvements in resting HR. In terms of physical performance, boys showed greater improvements in speed, upper-body strength, lower-body strength, muscular endurance and agility, while girls showed greater improvements in coordination and balance. Boys experienced a minimal improvement in flexibility, while girls did not show a significant difference. Combining the results of the subgroup analyses, the optimal session time, frequency and intervention length of jumping rope for significantly improving the physical fitness of preadolescents were >40 min, 2 times/week and 8-12 weeks, respectively. In conclusion, jumping rope provides small to large benefits over regular physical education for both boys and girls aged 10-12 years in terms of physical function and physical performance indicators other than flexibility, while showing no significant advantage in terms of body morphology. Based on the available research, it is recommended that children aged 10-12 years participate in jump rope sessions for at least 40 minutes once or twice a week for 8-12 weeks to better develop physical fitness.

Home-based Pulmonary Rehabilitation in Patients with COVID-19: The Efficiency in Pulmonary Function

Background: Coronavirus disease (COVID-19) is a viral disease that mostly affects the respiratory system and leads to respiratory failure. Alongside, pulmonary rehabilitation is one of the most important components in the management of respiratory system diseases and can rehabilitate persons after lung-damaged disease. Objectives: The present study aimed to determine the efficiency of Home-Based Pulmonary Rehabilitation in pulmonary function in patients with COVID-19 Methods: This simple randomized interventional study was conducted on 70 COVID-19 patients in Kerman, Iran. They were assigned to two equal groups of control and intervention. In the control group, patients received only routine post-discharge care, and in the intervention group, patients received home-based pulmonary rehabilitation procedures containing some movements to improve pulmonary function for four weeks after discharge. Results: Forced expiratory volume in 1 second (P&lt;0.001), vital capacity (P&lt;0.001) and these two parameters ratio (P&lt;0.02), peak expiratory flow (P&lt;0.001), in four weeks after discharge from the hospital in the intervention group was significantly higher than in the control group. Moreover, 6-min walk distance (P&lt;0.001) was significantly increased, and the severity of dyspnea (P&lt;0.001) was significantly reduced in the intervention group. As well, the number of patients with severe dyspnea decreased significantly (P&lt;0.001). Conclusion: It seems that our home-based program can result in a marked improvement in vital capacity and other pulmonary function tests, as well as a reduction in dyspnea after discharge. In conclusion, this rehabilitation procedure is effective in pulmonary recovery in COVID-19 patients and can be used as a treatment procedure for recovery in these patients.

Efectividad de la respiración glosofaríngea en pacientes con enfermedades neuromusculares y lesión medular: Revisión sistemática exploratoria

BackgroundNeuromuscular diseases and spinal cord injuries compromise respiratory muscles and lung function, causing respiratory complications. Acute respiratory failure and chronic respiratory compromise cause high risk of morbidity and mortality. The use of glossopharyngeal respiration has been described to improve pulmonary and respiratory muscle function variables that promote more effective coughing and increased time off mechanical ventilation. ObjectiveDescribe and present the current evidence of the effectiveness of glossopharyngeal respiration in improving lung and respiratory muscle function in adult and pediatric patients with neuromuscular diseases or spinal cord injury with or without mechanical ventilation. DesignExploratory review with the PRISMA-ScR methodology. A search was carried out in the PEDro, Web of Science, Scopus, PubMed, ScienceDirect, Springer, Medline, Cochrane, SciELO, Lilacs, Google Academic databases, keywords and MeSH terms were used in Spanish, English and Portuguese languages, among the years 2000–2020. The results are presented in a descriptive way. Results491 studies were identified and 12 were included. 58.3% were conducted in European countries. 41.6% of the studies were critically appraised and none fully met the quality criteria. The effectiveness of glossopharyngeal breathing in lung and respiratory muscle function was related to an improvement in vital capacity in 66.6% and peak cough flow in 33.3% of the studies. Improvement in thoracic expansion was reported in 66.6% of the studies and complications such as syncope, dizziness in 33.3%. ConclusionThe effectiveness of glossopharyngeal respiration in patients with neuromuscular diseases and spinal cord injury is related to increased vital capacity and peak flow of cough. Studies with more scientific rigor are recommended to support the validity of these results.

A preliminary randomized, single-blinded, placebo-controlled clinical dose–response study to elucidate the effect of ongoing isometric contraction of muscles on the vital capacity of lungs on administering Blatta orientalis

Introduction: Blatta orientalis is an indicated remedy for asthma and other chronic obstructive pulmonary diseases in homeopathic medicine. Preclinical studies indicate that B. orientalis shows anti-asthmatic properties in animals when induced with bronchospasm using acetylcholine through nonselective anticholinergic and antihistaminic activities. However, no studies have explored the changes in the vital capacity of the lungs on administering the homeopathic remedy, B. orientalis. It is shown that isometric contraction of pectoral muscles enhances the vital capacity of lungs by increasing ventilation and decreasing alveolar partial pressure of carbon dioxide. It can act as a valuable tool for monitoring the vital capacity of the lungs before and after administration of B. orientalis. AIM: This preliminary research takes the first step toward exploring vital capacity through a randomized, placebo-controlled study elucidating the effects of ongoing isometric contraction of muscles on the vital capacity of lungs of healthy individuals on the administration of B. orientalis in different potencies. It aims to compare changes in the vital capacity of lungs in healthy participants during an acute bout of isometric contraction by handgrip dynamometer after administration of B. orientalis. Materials and Methods: Eighteen participants who fulfilled the inclusion criteria gave voluntary consent to participate in this research study. The research team measured the Tmax (measured by handgrip dynamometer) and the vital capacity (measured by a vitalograph) of these participants at the baseline. The participants were then placed into three-medicine arms to administer medicine orally: Arm 1 – B. orientalis Q, Arm 2 – B. orientalis 30C, and Arm 3 – placebo, following allocation of six participants in each medicine arm. Lottery method was used for grouping participants randomly to each medicine arm. The participants were numbered from 1 to 18 using the lottery method, and it was made sure that each arm had one male and five females to have similar gender distribution. The research team blindfolded the participants with a cloth bandage (dupatta) before categorizing them into different medicine arms. The team measured each participant's Tmax and vital capacity, and then administered one dose of the assigned medicine. The team measured the Tmax and vital capacity of the participants after 10 min of administering the medicine. The process was repeated after every 24 h for 3 consecutive days. Results: The effect of ongoing isometric contractions of the skeletal muscles on the vital capacity acted as a great tool to measure improvement in vital capacity. The vital capacity of the lungs was significantly decreased after oral administration of B. orientalis Q and B. orientalis 30C, whereas there was no significant effect found in the arm that received a placebo. Conclusion: This preliminary study shows that B. orientalis decreases the vital capacity of lungs in healthy subjects and calls for further exploration of its action in higher potencies and with wider experimental parameters. Following the Law of Similimum, this inference also adds to the research scope on the potential of this homeopathic medicine in patients with restrictive lung diseases where the vital lung capacity gets significantly decreased.

The Feasibility of High-Intensity Interval Training in Patients with Intensive Care Unit-Acquired Weakness Syndrome Following Long-Term Invasive Ventilation

BackgroundIntensive care unit-acquired weakness syndrome (ICUAWS) can be a consequence of long-term mechanical ventilation. Despite recommendations of early patient mobilisation, little is known about the feasibility, safety and benefit of interval training in early rehabilitation facilities (ERF) after long-term invasive ventilation.Methods and ResultsWe retrospectively analysed two established training protocols of bicycle ergometry in ERF patients after long-term (> 7 days) invasive ventilation (n = 46). Patients conducted moderate continuous (MCT, n = 24, mean age 70.3 ± 10.1 years) or high-intensity interval training (HIIT, n = 22, mean age 63.6 ± 12.6 years). The intensity of training was monitored with the BORG CR10 scale (intense phases ≥ 7/10 and moderate phases ≤ 4/10 points). The primary outcome was improvement (∆-values) of six-minute-walk-test (6 MWT), while the secondary outcomes were improvement of vital capacity (VCmax), forced expiratory volume in 1 s (FEV1), maximal inspiratory pressure (PImax) and functional capabilities (functional independence assessment measure, FIM/FAM and Barthel scores) after 3 weeks of training. No adverse events were observed. There was a trend towards a greater improvement of 6 MWT in HIIT than MCT (159.5 ± 64.9 m vs. 120.4 ± 60.4 m; p = .057), despite more days of invasive ventilation (39.6 ± 16.8 days vs. 26.8 ± 16.2 days; p = .009). VCmax (∆0.5l ± 0.6 vs. ∆0.5l ± 0.3; p = .462), FEV1 (∆0.2l ± 0.3 vs. ∆0.3l ± 0.2; p = .218) PImax (∆0.8 ± 1.1 kPa vs. ∆0.7 ± 1.3pts; p = .918) and functional status (FIM/FAM: ∆29.0 ± 14.8pts vs. ∆30.9 ± 16.0pts; p = .707; Barthel: ∆28.9 ± 16.0 pts vs. ∆25.0 ± 10.5pts; p = .341) improved in HIIT and MCT.ConclusionsWe demonstrate the feasibility and safety of HIIT in the early rehabilitation of ICUAWS patients. Larger trials are necessary to find adequate dosage of HIIT in ICUAWS patients.

A Review of Pirfenidone as an Anti-Fibrotic in Idiopathic Pulmonary Fibrosis and Its Probable Role in Other Diseases.

Fibrosis is the result of chronic inflammation and is known to pathologically occur in many organs and systems. Pirfenidone (PFD) is an anti-fibrotic known for its use in idiopathic pulmonary fibrosis (IPF). In addition to being an anti-fibrotic, it acts as an anti-inflammatory and antioxidant as well. There have been studies on PFD in other diseases, some clinical and others preclinical. We have compiled and reviewed them to highlight just how widespread PFD use could be. Among many benefits of PFD in IPF, PFD has effectively improved patients' survival in those who had an acute exacerbation of IPF and has reduced respiratory-related hospitalization, among few others. PFD also has shown an improvement in vital capacity in patients with chronic hypersensitive pneumonitis. Also, it has demonstrated anti-fibrotic effects in systemic sclerosis-associated interstitial lung disease. In other diseases outside the lungs, PFD has reversed insulin resistance and proven to be effective in non-alcoholic steatohepatitis (NASH). It has prevented blindness post-alkali injury to the eye and has proven to decrease the proliferation of mesothelioma cells, just to name a few. This review encourages further research in connection with PFD and its use in other diseases and PFD pros in IPF.

The Effects of Cardiovascular Exercises on Body Mass Index and Vital Capacity among Students of Sargodha University

This research was designed to evaluate the effect of cardiovascular exercises on body mass index (BMI) and vital capacity (VC) among student aged between 21-27 years (M � SD 22.3� 3.05). The experimental research study was applied to 54 University students of Sargodha. Data were analyzed by using SPSS version 24.0. P-value ? 0.05 was considered significant. The result showed that the average BMI of the control group and experimental groups was 20.73�3.02 vs 21.51�3.21. The effectiveness of cardiovascular exercise on Vital capacity on Pre and post-test of the experimental group was -56.91272 � 22.03192 with a pvalue of 0.000, which was showed there was a highly significant improvement in vital capacity of students and compare with the control group. It was concluded that body masses index and vital capacity is significantly improved in university students of the experimental group as a result of 10 weeks of the cardiovascular exercise training program. Conclude that there is a significant difference between the effects of cardiovascular exercise and daily routine sports activities on BMI.

Efeito da reabilitação pulmonar aliado à capacidade funcional e função ventilatória de asmáticos

Objetivo: verificar o efeito de um programa de reabilitação pulmonar sobre a função ventilatória e capacidade funcional em asmáticos. Métodos: Estudo experimental o qual participaram 19 adultos de ambos os sexos, divididos em Grupo Controle (GC) e Grupo Tratamento (GT). Foram avaliadas variáveis espirométricas e o teste de caminhada de 6 minutos (TC6). O grupo GT realizou 24 sessões de reabilitação pulmonar, três vezes na semana, com duração de uma hora cada. Resultados: Tanto no momento pré quanto no pós-tratamento não houve diferença significativa (p&gt;0,05) entre GC e GT. Nas comparações intragrupos, verificou-se diferença significativa (p &lt; 0,05) no TC6 e no fluxo expiratório forçado (FEF) tanto no GT quanto no GC. No GT também houve melhora da capacidade vital após o programa de reabilitação pulmonar. Conclusão: O programa de reabilitação pulmonar não apresentou melhoras significativas.

The Impact of Myofascial Release on Vital Capacity and Diaphragmatic Excursion in Postsurgical Pleural Effusion

AbstractBackground: Accumulation of fluid in pleural space may affect on function of respiratory muscles primarily because of increase of chest wall volume. Force-length relationship of respiratory muscles indicate that for a given neural acti-vation, the pressure developed by muscles decrease with decreasing length. An increase of chest wall volume decrease length of respiratory muscles mainly diaphragm and increase of expiratory muscles length. It follows that with pleural effusion, all else being the same for a given, neural activation, pressure developed by the inspiratory and expiratory muscles should decrease and increase, respectively. So, the aim of the study to maintain flexibility of the diaphragm and intercostal muscles in order to get the optimum action of theses muscles, increase chest expansion, improve the respiratory function of these patients.Aim of Study: To evaluate the effect of of myofascial release for diaphragm and intercostal muscles on vital capacity and diaphragmatic excursion in post surgical pleural effusion.Subject and Methods: Forty subjects (male only) were randomly assigned into two groups equal in number. (Study group A): Consisted of 20 patients was enrolled in the myo-fascial release protocol in addition to traditional physical therapy program for pleural effusion. (Study group B): Con-sisted of 20 patients was enrolled in the traditional physical therapy program for pleural effusion only. Their vital capacity and diaphragmatic excursion were measured before and after 8 weeks of training program for both groups. The myofascial release protocol performed a 1-hour session 3 times a week for 8 weeks.Results: Group (A) myofascial release group, showed a statistical significant improvement in vital capacity and diaphragmatic excursion, that was 13.49%, more than the improvement in group (B) traditional physical therapy group, that was 8.68%.Conclusions: The myofascial release for diaphragm and intercostal muscles is effective on vital capacity and diaphrag-matic excursion in post surgical pleural effusion.

RA02.09: THE EFFECT OF PREOPERATIVE BREATHING EXERCISE IN PATIENTS UNDERGOING ESOPHAGECTOMY FOR ESOPHAGEAL CANCER

Abstract Background Patients with esophageal cancer often have impaired respiratory function. Postoperative pulmonary complications frequently occur in patients undergoing esophagectomy. We instructed patients undergoing esophagectomy to do breathing exercise with Incentive Spirometer Coach 2 (Smiths medical) for at least two weeks before surgery, as well as smoking cessation. Methods We retrospectively reviewed medical records of 52 esophageal cancer patients who underwent spirometry both pre- and post- Coach 2 exercise between 2009 and 2017. We evaluated the change of respiratory function and postoperative complications. The influence of exercise was analyzed between patients who underwent neoadjuvant chemotherapy (NAC group, n = 36) and those treated without NAC (non-NAC group, n = 16). Results 39 males and 13 females were included. Median age was 65 (45–82). Surgical procedures were 48 subtotal esophagectomy, 3 transhiatal esophagectomy, and 1 pharyngo-laryngo-esophagectomy. Vital capacity (VC) and forced expiratory volume in one second (FEV1.0) were significantly improved through exercise; 3405 to 3600ml (P = 0.021) and 2485 to 2555 ml (P = 0.008), respectively. NAC group included more advanced-staged cases but age and baseline respiratory function were not significantly different from non-NAC group. Interval between first and second spirometry was 31 days for non-NAC group, 69 days for NAC group. After exercise, non-NAC group showed significant improvement in VC (3135 to 3600ml, P = 0.006), FEV1.0 (2255 to 2565ml, P = 0.004), whereas NAC group showed little change in VC (3560 to 3630ml, P = 0.514), FEV1.0 (2585 to 2555ml, P = 0.514). Postoperative complication occurred in 27 of 52 cases. Postoperative pneumonia occurred in 7 (13.5%) in the present cohort, which was less frequent than 42% in the historical control cohort without breathing exercise. Conclusion Preoperative breathing exercise with Coach 2 improved respiratory function in patients without NAC. In patients with NAC, the effect of exercise was smaller than non-NAC group, still exercise might suppress the decrease of respiratory function during NAC. Breathing exercise may reduce postoperative pulmonary complications. Disclosure All authors have declared no conflicts of interest.

Resisted breathing exercise versus incentive spirometer training on vital capacity in postoperative radical cystectomy cases: a pilot randomized controlled trial

Radical cystectomy at times involves respiratory physical therapy aiming to reverse pulmonary dysfunction, thus avoiding postoperative pulmonary complications that increase hospital morbidity. The aim of this study was to investigate the effects of resisted breathing exercise versus incentive spirometer (IS) training on vital capacity (VC) outcomes in postoperative radical cystectomy cases. Forty male and female patients between 40 and 80 years of age who had undergone radical cystectomy participated in this study. Patients were randomly assigned into two equal groups of 20 each; both groups received traditional physical approaches. In addition, group A (19 men and 1 woman) received IS training for 15 min daily for 6 weeks, and group B (16 men and 4 women) received resisted breathing exercise for 15 min daily, for 6 weeks. The primary outcome was VC, which was measured using an electronic spirometer. This study showed a significant increase (P<0.05) in VC in both groups on comparing pretreatment and post-treatment values within each group. After 6 weeks of treatment, between-group statistical analysis showed equal improvements in VC (P=0.52). Nevertheless, the percentage of improvement in VC was 43.5% (2.46±0.64), higher than that in the resisted breathing exercise group at 23.9% (2.34±0.53). IS produced better objective improvement in VC compared with the usage of resistive breathing exercise. However, both are considered as a gold therapeutic tool in the management of pulmonary complication after radical cystectomy.

Severe progressive scoliosis in an adult female possibly secondary thoracic surgery in childhood treated with scoliosis specific Schroth physiotherapy: Case presentation.

BackgroundScoliosis is a complex three-dimensional (3D) spinal deformity. Acquired scoliosis in early childhood may progress into adulthood and pose an increased risk of health problems and reduction in quality of life. In Canada, patients with scoliosis are not referred for physiotherapeutic scoliosis-specific exercises (PSSE) despite the fact that Schroth physiotherapy, a scoliosis-specific 3D posture training and exercise program, can be effective in reducing pain and improving scoliosis curves, vital capacity, and overall quality of life in scoliosis patients. This case presentation shows that indeed adult curve progression can be stopped and even reversed with scoliosis specific Schroth physiotherapy (SSSPT) in an adult patient with scoliosis.MethodsThis is a retrospective case presentation involving a 23-year-old female scoliosis patient who began an outpatient Schroth physiotherapy exercise program and was initially monitored monthly and then annually for improvement in measurements of angle of trunk rotation (ATR) and chest expansion and improvement in vital capacity measured with incentive spirometry. Photos were taken to document body image periodically throughout Schroth physiotherapy treatment. Additionally, the patient completed SRS-22 quality of life questionnaires every 2 years to evaluate daily function, pain, self-imagine, mental health, and scoliosis management satisfaction.ResultsWithin one month of beginning SSSPT, the patient reported no more back pain and within 2 months, reported improved breathing. The patient also benefitted from improved chest expansion, reduced scoliosis curve angles (measured in Cobb degrees), increased vital capacity, decreased ATR, and higher SRS-22 scores. She became more active and resumed all athletic activity within 8 months of beginning Schroth physiotherapy.ConclusionsAdult scoliosis patients are not routinely referred for PSSE in Canada, even though Schroth physiotherapy, a form of PSSE, is shown to be effective in this case presentation. The patient in this case presentation was successfully treated with Schroth physiotherapy. Long-term comprehensive Schroth physiotherapy, to help correct and maintain proper posture in all aspects of daily living, should be part of scoliosis management for adult scoliosis patients in Canada to stop and reverse curve progression and to improve overall quality of life.

Surgical Therapy of Acquired Unilateral Diaphragmatic Paralysis: Indication and Results

Unilateral elevation of the diaphragm may be due to various causes and requires further elucidation when the aetiology is unknown. Elevation of the diaphragm is often caused by diaphragmatic paralysis, either due to damage to the phrenic nerve or to the phrenic muscle. Patients typically complain of increased respiratory distress when lying down, bending or swimming. Basic diagnostic testing consists of a chest X-ray, as well as spirometry and computer tomography of the neck and chest. In many cases, no cause can be identified for the diaphragmatic paralysis. In symptomatic patients, diaphragm plication leads to fixation and thus to a reduction in the paradoxal respiratory movement of the paralysed diaphragm. In a large majority of studies, this results in significant and lasting improvement in vital capacity and respiratory distress. Spontaneous recovery of diaphragm paralysis is possible, even after several months, so a waiting period of at least 6 months should elapse before diaphragmatic plication is performed, if the clinical situation allows. The procedure can be performed minimally invasively, with low morbidity and mortality. When cutting the phrenic nerve, a nerve suture is recommended, if possible, or otherwise diaphragm plication during the procedure, especially in the case of pneumonectomy. This review provides an overview of the causes, pathophysiology, symptoms, diagnosis, therapy and results of diaphragmatic plication in acquired, unilateral diaphragmatic paralysis in adults, and suggests an algorithm for diagnostic testing and therapy.

Impact of respiratory therapy in vital capacity and functionality of patients undergoing abdominal surgery.

ABSTRACTObjective To evaluate the vital capacity after two chest therapy techniques in patients undergoing abdominal surgical.Methods A prospective randomized study carried out with patients admitted to the Intensive Care Unit after abdominal surgery. We checked vital capacity, muscular strength using the Medical Research Council scale, and functionality with the Functional Independence Measure the first time the patient was breathing spontaneously (D1), and also upon discharge from the Intensive Care Unit (Ddis). Between D1 and Ddis, respiratory therapy was carried out according to the randomized group.Results We included 38 patients, 20 randomized to Positive Intermittent Pressure Group and 18 to Volumetric Incentive Spirometer Group. There was no significant gain related to vital capacity of D1 and Ddis of Positive Intermittent Pressure Group (mean 1,410mL±547.2 versus 1,809mL±692.3; p=0.979), as in the Volumetric Incentive Spirometer Group (1,408.3mL±419.1 versus 1,838.8mL±621.3; p=0.889). We observed a significant improvement in vital capacity in D1 (p<0.001) and Ddis (p<0.001) and in the Functional Independence Measure (p<0.001) after respiratory therapy. The vital capacity improvement was not associated with gain of muscle strength.Conclusion Chest therapy, with positive pressure and volumetric incentive spirometer, was effective in improving vital capacity of patients submitted to abdominal surgery.

Effects of Incentive Spirometry on Respiratory Motion in Healthy Subjects Using Cine Breathing Magnetic Resonance Imaging.

ObjectiveTo investigate the effectiveness of incentive spirometry on respiratory motion in healthy subjects using cine breathing magnetic resonance imaging (MRI).MethodsTen non-smoking healthy subjects without any history of respiratory disease were studied. Subjects were asked to perform pulmonary training using incentive spirometry every day for two weeks. To assess the effectiveness of this training, pulmonary function tests and cine breathing MRI were performed before starting pulmonary training and two weeks after its completion.ResultsAfter training, there were significant improvements in vital capacity (VC) from 3.58±0.8 L to 3.74±0.8 L and in %VC from 107.4±10.8 to 112.1±8.2. Significant changes were observed in the right diaphragm motion, right chest wall motion, and left chest wall motion, which were increased from 55.7±9.6 mm to 63.4±10.2 mm, from 15.6±6.1 mm to 23.4±10.4 mm, and from 16.3±7.6 mm to 22.0±9.8 mm, respectively.ConclusionTwo weeks of training using incentive spirometry provided improvements in pulmonary function and respiratory motion, which suggested that incentive spirometry may be a useful preoperative modality for improving pulmonary function during the perioperative period.

Intensive care and non-invasive mechanical ventilation in kyphoscoliosis: are new perspectives still needed?

Non-invasive ventilation (NIV) assists breathing and thus improves oxygenation in patients with Kyphoscoliosis. The benefits of short- and long-term intermittent nocturnal in such patients have been reported previously (improvement of vital capacity, total lung capacity, muscle strength, daytime oxygenation, exercise capacity, and pulmonary hypertension). We review this important study reporting patients with kyphoscoliosis and acute respiratory failure along with their long-term outcomes. We believe that this letter may provide important information regarding the prognosis and efficacy of NIV.

Update on Stem Cell Transplantation for Systemic Sclerosis: Recent Trial Results

Systemic sclerosis (SSc) is a heterogeneous condition characterized by the deposition of excess collagen in skin and internal organs due to vasculopathy, immune activation, low grade inflammation, and fibrosis. Progressive diffuse cutaneous SSc with organ involvement has a poor prognosis. The employment of autologous hematopoietic stem cell transplantation (HSCT) as a means to escalate immunosuppressive therapy has resulted in rapid and sustained improvement of skin thickening and functional ability, stabilization of major organ function with some improvement of vital capacity in pilot studies, registry analyses, and the phase II ASSIST trial. Results from the phase III ASTIS trial corroborate these findings and show long-term survival benefit of HSCT. The ASTIS and SCOT trials will determine whether the benefits of HSCT outweigh the risks of serious adverse events including treatment-related mortality of around 6-10% and potential long-term complications. Better patient selection and safer transplant regimens may improve the outcome of HSCT for SSc.