Inspiratory Muscle Training Group Research Articles

Inspiratory muscle training, with or without concomitant pulmonary rehabilitation, for chronic obstructive pulmonary disease (COPD).

Inspiratory muscle training, with or without concomitant pulmonary rehabilitation, for chronic obstructive pulmonary disease (COPD).

Effects of inspiratory muscle training on blood pressure- and sleep-related outcomes in patients with obstructive sleep apnea: a meta-analysis of randomized controlled trials.

Obstructive sleep apnea (OSA) is frequently accompanied by hypertension, resulting in cardiovascular comorbidities. Continuous positive airway pressure is a standard therapy for OSA but has poor adherence. Inspiratory muscle training (IMT) may reduce airway collapsibility and sympathetic output, which may decrease OSA severity and blood pressure. In this meta-analysis of randomized controlled trials (RCTs), we evaluated the efficacy of IMT in patients with OSA. We searched PubMed, EMBASE, Cochrane Library, Web of Science, and ClinicalTrials.gov databases for relevant RCTs published before November 2022. Seven RCTs with a total of 160 patients with OSA were included. Compared with the control group, the IMT group exhibited significantly lower systolic and diastolic blood pressure (mean difference [MD]: - 10.77 and - 4.58mmHg, respectively), plasma catecholamine levels (MD: - 128.64pg/mL), Pittsburgh Sleep Quality Index (MD: - 3.06), and Epworth Sleepiness Scale score (MD: - 4.37). No significant between-group differences were observed in the apnea-hypopnea index, forced vital capacity (FVC), ratio of forced expiratory volume in 1s to FVC, or adverse effects. The data indicate comprehensive evidence regarding the efficacy of IMT for OSA. However, the level of certainty (LOC) remains low. IMT improved blood pressure- and sleep-related outcomes without causing adverse effects and may thus be a reasonable option for lowering blood pressure in patients with OSA. However, additional studies with larger sample sizes and rigorous study designs are warranted to increase the LOC.

The Effects of Manual Therapy and Inspiratory Muscle Training on Respiratory Parameters in Young Adults with Postural Problems: A Randomized Trial

Objective: It was aimed to compare the effects of manual therapy (MT) and Inspiratory Muscle Training (IMT) on respiratory functions and postural problems of young adults in this study.
 Material-Method: Thirty-five volunteers were randomly allocated into IMT and MT groups. All participants received twenty minutes of IMT twice a week for four weeks. Eight sessions of manual therapy were applied to the MT group in addition to IMT. Forced Expiratory Volume in 1 Second (FEV1), Forced Vital Capacity (FVC), FEV1/FVC ratio, Peak Expiratory Flow (PEF), forward head posture (FHP), and thoracic hyperkyphosis were evaluated before and after the treatments.
 Results: Although there were significant improvements in the FEV1, FVC, FEV1/FVC ratio, and PEF scores of the MT group (p0.05). The comparisons of post-treatment scores of the FEV1, FVC, FEV1/FVC ratio, and PEF between the groups revealed greater improvements in the MT group than IMT group (p

Top-down modulation impairs priming susceptibility in complex decision-making with social implications

Could social context variables prime complex decisions? Could top-down processes impair this priming susceptibility? Complex decisions have been mainly studied from economic and moral perspectives, and Dual Process Theories provide evidence of how these processes could be affected. To address these issues from a political perspective, online experiments were conducted. Participants (n = 252) were asked to choose a face from 4 options, each associated with different frequencies (repetition priming) or with phrases with different emotional valence (emotional priming), for an unspecified task (UST group) or an important task (IMT group). The most repeated face was chosen most in the UST group, and was associated with lower response times. Positive faces were equally chosen by both groups. To compare results in a more ecological situation, a social study was conducted during the 2019 Argentine Presidential Election, including online surveys (n = 3673) and analysis of news media mentioning candidates. The familiarity and trust to each candidate explained the voting-probability for most of them, as well as correlated with their frequency of mentions in the news, their positive associations, and election results. Our results suggest complex decision-making is susceptible to priming, depending on top-down modulation.

Effect of Intramammary Dry Cow Antimicrobial Treatment on Fresh Cow’s Milk Microbiota in California Commercial Dairies

This study used 16S rRNA sequencing to evaluate the effects of dry cow antimicrobial therapy on the udder milk microbiota by comparing the microbial populations in milk at dry-off (DRY) (~60 days before calving) and post-partum (FRESH) (4–11 days after calving) from cows receiving an intramammary antibiotic infusion prior to dry-off (IMT) and cows that did not receive treatment (CTL). Milk was collected from 23 cows from the IMT group and 27 cows from the CTL group. IMT and DRY samples had a greater correlation with the genera Brevibacterium and Amaricoccus, and the family Micrococcaceae, when compared to IMT and FRESH samples. CTL group samples collected at DRY had a greater correlation with the genera Akkermansia and Syntrophus, when compared to FRESH samples; no bacterial taxa were observed to have a significant correlation with FRESH samples in the CTL group. DRY samples collected from the CTL group had a greater correlation with the genus Mogibacterium when compared to IMT and CTL samples. For DRY samples collected from the IMT group, a greater correlation with the genus Alkalibacterium when compared to DRY and CTL samples, was observed. The lack of a correlation for FRESH samples between the CTL and IMT treatment groups indicated that intramammary antimicrobial dry cow therapy had no significant effect on the udder milk microbiota post-partum.

Effect of Threshold Inspiratory Muscle Training on Functional Fitness and Respiratory Muscle Strength Compared to Incentive Spirometry in Children and Adolescents With Obesity: A Randomized Controlled Trial.

BackgroundTo determine the effect of threshold inspiratory muscle training (IMT) on functional fitness and respiratory muscle strength (RMS) compared to incentive spirometry (IS) in children/adolescents with obesity.MethodsA total of 60 obese children/adolescents aged 8–15 years were randomized into the threshold IMT group (n = 20), the IS group (n = 20), or the control group (n = 20). The IMT group performed 30 inspiratory breaths with the intensity set at 40% of baseline maximal inspiratory pressure (MIP) twice daily for 8 weeks; the IS group performed 30 breaths with sustained maximum inspiration twice daily for 8 weeks; and, the control group was assigned no training device for 8 weeks. Six-min walk test (6-MWT), RMS, and spirometry were compared between baseline and 8 weeks.ResultsSix-MWT distance (528.5 ± 36.2 vs. 561.5 ± 35.2 m, p = 0.002) and MIP (121.2 ± 26.8 vs. 135.3 ± 32.1%Predicted, p = 0.03) were significantly improved after 8 weeks of IMT training. There was no significant difference in any evaluated pulmonary function parameters between baseline and 8 weeks in the IS or control groups; however, 6-MWT distance demonstrated a trend toward significant improvement in the IS group (526.9 ± 59.1 vs.549.0 ± 50.6 m, p = 0.10). No significant difference among groups was found for any variable relative to change from baseline to post-training.ConclusionEight weeks of threshold IMT training significantly improved both inspiratory muscle strength (MIP) and functional fitness (6-MWT) in children/adolescents with obesity. Eight weeks of IS training yielded a trend toward significantly improved functional fitness.

Training the equine respiratory muscles: Inspiratory muscle strength.

Little is known about the response of the equine respiratory muscles to training. To measure an index of inspiratory muscle strength (IMSi) before and after a period of conventional exercise training (phase 1) and inspiratory muscle training (IMT), comparing high-load (treatment) and low-load (control) groups (phase 2). Prospective randomised controlled trial. Phase 1: Twenty National Hunt Thoroughbred racehorses performed an inspiratory muscle strength test (IMST) twice on two occasions; when unfit at timepoint A (July), and when race fit at timepoint B (October). Phase 2: Thirty-five Thoroughbred racehorses at race fitness were randomly assigned into a high-load (treatment, n=20) or low-load (control, n=15) IMT group. The high-load group followed an IMT protocol that gradually increased the inspiratory pressure applied every 4 days. The low-load group underwent sham IMT with a low training load. The IMT was performed 5 days/week for 10 weeks. The IMST was performed twice on two occasions, timepoint B (October) and timepoint C (January). Conventional exercise training and racing continued during the study period. The peak IMSi values obtained from the different groups at timepoints A, B and C were compared using a Wilcoxon Signed Rank Test. Phase 1: There was a significant increase in IMSi from timepoint A: 22.5 cmH2 O (21-25) to timepoint B: 26 cmH2 O (24-30) (p =0.015). Phase 2: From timepoint B to C there was a significant increase in IMSi for the high-load group 34 cmH2 O (28-36) (p =0.001) but not the low-load group 26 cmH2 O (24-30) (p =0.929). The peak IMSi at timepoint C was significantly higher for the high-load than low-load group (p =0.019). Single centre study with only National Hunt horses undergoing race-training included. In horses undergoing race training there is a significant increase in IMSi in response to conventional exercise training and high-load IMT.

MO768: The Association among Carotid IMT, Pulse Wave Velocity and Vascular Access Failure in Haemodialysis Patients

Abstract BACKGROUND AND AIMS Patients with chronic kidney disease (CKD) or end-stage renal disease (ESRD) have an increased risk of cardiovascular mortality and morbidity. We aimed to compare the value of IMT with tests such as coronary CT and pulse wave velocity (PWV) as predictors of cardiovascular risk in ESRD patients undergoing maintenance dialysis and examine their association with cardiovascular disease. METHOD We reviewed the participants’ medical records, including height, body weight, smoking status, alcohol intake, medication history, aetiology of ESRD, HD vintage and blood pressure which were measured during haemodialysis. Carotid doppler was performed by a skilled sonographer who was unaware of the aims of the study and blinded to the laboratory findings. For PWV measurement, patients lie down, rest for at least 5 minutes and stop smoking and coffee for 3 h before the measurement. BaPWV is measured by recording pulse waves of both arms and ankles from the pressure signal obtained by measuring 4-extremity blood pressure. RESULTS A total of 100 patients were included, of whom 51 (50.5%) were men. The median age was 66 years (interquartile range 58–76 years). The median vintage of haemodialysis was 47.5 months (range 31.3–89.1 months). There were no significant differences between the high IMT group and the low IMT group in sex, haemodialysis vintage, ESRD aetiology and type of vascular access. However, age was significantly older in the high IMT group. IMT was significantly associated with PWV [hazard ratio (HR) 2.109; 95% confidence interval (95% CI) 1.037–4.291, P = 0.039). After adjusting for age, sex and presence of diabetes, IMT was independently associated with PWV (HR 2.110, 95% CI 1.036–4.298, P = 0.040). The risk of recurrent vascular access failure was higher in the high IMT group (HR 1.615, 95% CI 1.460–5.669, P = 0.034). CONCLUSION IMT was associated with PWV and recurrent access failure. Thus, IMT may be suggested as a potential predictor of vascular access failure.

Chronic Lower Back Pain and Its Relationship with Vibration Exposure and Sitting Duration; A Cross-Sectional Study Among Commercial Motorcycle Driver

Background: Lower back pain (LBP) complaints are a health issue that may lead to restrictions on work activities. Motorcycles vibrations and long sitting duration on the motorcycles can cause chronic lower back pain complaints. Base motorcycles drivers receive motorcycles vibration exposure while riding a motorcycle. With the large number of base motorcycles drivers in Indonesia, the specific health problems (LBP complaints) in this group need to be examined.Methods: This research method uses a cross sectional study design to examine the relationship of motor vibration exposure and length of sitting to chronic low back pain with sampling technique used is Consecutive sampling. Consecutive sampling is a way of taking samples by selecting samples that meet the inclusion criteria until a certain time period so that the number of samples is met. The sampling period in this study is 2 days. The variables that measured were chronic lower back pain complaints, vibration, long sitting time, age, IMT, smoking, and working time. Data analysis using SPSS Statistics version 25.0. Results: A total of 95 subjects were included in this study. Based on Fisher’s test, the result of the correlation of chronic lower back pain complaints with motor vibrations > 0.5 m/s2 was obtained p = 0.102; OR = N / A). While for long sitting time of >4 hours result in p = 0.717; OR 0.85; CI 95% = 0.34-2.09. There is no difference in age-related chronic lower back pain complaints. At age> 35 years of age p = 0.722; OR 1.57; CI 95% = 0.31-7,9. No significant association between IMT and chronic lower back pain was found. In the IMT group> 25, p = 0.103 was obtained; OR 2.14; 95% CI = 0.85-5.36. There was no significant difference in chronic lower back pain complaints based on smoking status, where smoking group had p = 0.451; OR 1,45; CI 95% = 0.55-3.78. According to the Fisher test, there was no difference in chronic lower back pain complaints based on working age, where groups with> 4 years of work had a p = 0.908 value; OR 1.07; CI 95% = 0.31-3.91. Conclusion: In this study the hypothesis was rejected. There is no association between motorcycles vibration exposure and the occurrence of chronic lower back pain complaints in the base motorcycles driver in Bekasi city. There is no association long sitting time with the occurrence of chronic lower back pain complaints in the base motorcycles driver in Bekasi city.

Effectiveness of 12-week inspiratory muscle training with manual therapy in patients with COPD: A randomized controlled study.

The benefits of inspiratory muscle training (IMT) in patients with COPD were reported. However, its effects are limited in severe COPD patients. Further researches are required in new and complementary modalities demonstrating IMT efficacy in severe COPD patients. This study aims to investigate effects of manual therapy (MT) additional over IMT on functional capacity, respiratory muscle strength, pulmonary function, dyspnea, fatigue, and quality of life in severe COPD patients. Sixty patients with COPD in GOLD stage III–IV were included in this prospective single‐blind randomized trial. Patients were randomly assigned to receive either MT additional over IMT at 40% of maximal inspiratory pressure (MIP) (n = 30) or only IMT (n = 30) for 12 weeks. MT group received MT during 12 weeks for 30 min additional to IMT. Pulmonary function, respiratory muscle strength, functional capacity, dyspnea, fatigue, and quality of life were evaluated by spirometry, mouth pressure device, six‐minute walk test, Modified Medical Research Council (mMRC) dyspnea scale, fatigue severity scale, and St. George's Respiratory Questionnaire (SGRQ), respectively. MT group had significantly greater improvement in FEV1%, FVC%, PEF%, respiratory muscle strength, function, dyspnea, fatigue, and quality of life compared with IMT group (p < 0.05). 6MWT (p < 0.001, effect size Cohen's d: 0.915), MIP (p < 0.001, effect size Cohen's d: 1.235), and mMRC score (p < 0.001, effect size Cohen's d: 0.982) were significantly improved in IMT with MT group. This study demonstrated that subjects in IMT with MT group had improved outcomes in functional capacity, respiratory muscle strength, pulmonary function, dyspnea, fatigue perception, and quality of life compared with alone IMT group.

Resistance Training of Inspiratory Muscles After Coronary Artery Disease May Improve Obstructive Sleep Apnea in Outpatient Cardiac Rehabilitation: RICAOS Study

BackgroundObstructive sleep apnea (OSA) affects 5% of the adult population and its prevalence is up to 13 times higher in coronary artery disease (CAD) patients. However, OSA in this population is less symptomatic, leading to lower adherence to positive airway pressure (CPAP). While oropharyngeal exercise showed a significant decrease in apnea-hypopnea index (AHI) in patients with moderate OSA, there have been no studies testing the impact of specific inspiratory muscle training (IMT) for these patients. The aim of our study was to assess the effectiveness of IMT on AHI reduction in CAD patients with moderate OSA.MethodsWe included patients with CAD involved in a cardiac rehabilitation program and presenting an AHI between 15 and 30. Patients were randomized in a 1:1 allocation to a control group (CTL – classic training) or an IMT group (classic training + IMT). IMT consisted in 60 deep inspirations a day, 6 days a week, into a resistive load device set at 70% of the maximum inspiratory pressure (MIP). After 6 weeks, we compared AHI, neck circumference, Epworth Sleepiness Scale, Pittsburgh Sleep Quality index, and quality of life with the 12-item Short Form Survey before and after rehabilitation.ResultsWe studied 45 patient (60 ± 9 y, BMI = 27 ± 6 kg.m−2). The IMT group (n = 22) significantly improved MIP ( p < 0.05) and had a significant decrease in AHI by 25% (−6.5 ± 9.5, p = 0.02). In the CTL group (n = 23), AHI decreased only by 3.5% (−0.7 ± 13.1; p = 0.29). Between groups, we found a significant improvement in MIP ( p = 0.003) and neck circumference ( p = 0.01) in favor of the IMT group. However, we did not find any significant improvement of AHI in the IMT group compared to CTL ( p = 0.09).ConclusionA specific IMT during cardiac rehabilitation contributes to reduce significantly AHI in CAD patients with moderate OSA. Magnitude of the decrease in OSA severity could be enhanced according to implementation of specific IMT in this population.

Effects of Cough Training and Inspiratory Muscle Training on Cough Strength in Older Adults: A Randomized Controlled Trial.

While the need for preventive strategies to reduce the incidence of aspiration pneumonia has been indicated, it is also important to investigate effective training methods to improve cough function, which is associated with the development of aspiration pneumonia. This study aimed to investigate whether a 4-week home-based unsupervised cough training (CT) or inspiratory muscle training (IMT) program was effective in improving cough strength in older adults. Fifty-three ambulatory older adults without airflow limitations were randomly assigned to one of three groups: a CT group (n = 18), an IMT group (n = 18), or a control group (n = 17). The CT and IMT groups performed home-based unsupervised training with a device for 4weeks. Cough strength (cough peak flow), forced vital capacity, and respiratory muscle strength were assessed at the 4-week and 16-week follow-up. Intention-to-treat analyses were performed to investigate differences between the three groups using linear mixed models. At the 4-week follow-up, the CT group showed significant increases in cough peak flow and forced vital capacity compared with the control group, while the IMT group showed significant increases in inspiratory muscle strength compared with the cough training and control groups. At the 16-week follow-up, the CT group showed a significant increase in cough peak flow compared with the IMT group. These preliminary results suggest that a 4-week home-based CT program may have short-term effectiveness in improving cough peak flow in ambulatory older adults. This trial was registered on UMIN-CTR on 01/05/2018 (UMIN000031656).

Effect of core strengthening with inspiratory muscle training versus core strengthening on pain, strength and range of motion in chronic low back pain individuals: A randomized control trial

Topic: &ldquo;Effect of core strengthening with inspiratory muscle training versus core strengthening on pain, strength and range of motion in chronic low back pain individuals: A Randomized Control Trial.&rdquo; Background: Low back pain is one of the most common health problems among all the population of the world. Men and women are equally reported to be affected by this condition. 50% of adults and 30% of adolescents are affected at least once. Low back pain often involves altered muscle length relationships, postural changes, Muscular imbalances, variations in location of the centers of mass and of pressure. It has been suggested that the diaphragm plays a role in contributing to spinal stiffness via its influence on intra-abdominal pressure, as well as via direct mechanical effect via the attachments of the diaphragm crurae. The diaphragm, a component of core Stability, plays a role in respiration and trunk stability by controlling intra-abdominal pressure and reducing the stress on the spine through cooperative action with the abdominal and pelvic floor muscles. Objectives: To compare the effect of core strengthening with inspiratory muscle training versus core strengthening on pain, strength and range of motion in chronic low back pain individuals at the end of 6 weeks. Methodology: Ethical committee clearance was taken for the study A written consent was taken from every subject and the entire procedure was explained to the patient in a language understood by the patient. The subjects were divided into two groups by randomization: Group A (n=31) and Group B (n=31) Group A was to continue with the inspiratory muscle training exercises with core strengthening exercises and Group B received the core strengthening exercises for three times a week Single - blinding was maintained throughout the process by blinding the subject to the treatment Numerical Pain Rating Scale, Pressure Biofeedback and Modified Schobar&#39;s test were conducted pre and post intervention. Result: Total 62 male and female of age group 18-35 years, with chronic low back pian volunteered to participate in the study, after 7 dropouts due to various reasons, 30 males (54.5%) and 25 females (45.5%) have completed the 6 weeks of protocol. There was statistically significant difference in NPRS, Pressure Biofeedback values and Modified Schober&rsquo;s Test scores in both the groups. Conclusion: In the present study core strengthening with inspiratory muscle training and core strengthening both were effective in reducing pain and improving strength and range of motion after completing the treatment protocols. But the improvement in extension range of motion is more in core strengthening group when compared with core strengthening with inspiratory muscle training group.

Effect of Inspiratory Muscle Training Versus Core Stability Training on Balance Problems in Older Adults

We proposed to compare the implications of inspiratory muscle training versus core stability on the stability of the elderly. A total of 75 older individuals were randomly and evenly split into three groups: (A) the core stability group (n=25) received core stability training plus traditional balance exercises, (B) the IMT group (n=25) received IMT training plus traditional balance exercises, (C) the control group (n=25) was assigned to undergo conventional balancing exercises. The evaluation process included both pre-and post-testing, which encompassed the measurement of the time taken to complete the Time Up and Go (TUG) test, as well as the 30 Second Chair Stand Test (30CST). Following eight weeks of training, there was a significant rise in TUG in group A (P&lt;0.05) and 30CST in both groups A and B (P&lt;0.05 and p=0.002), respectively. Post-training, a significant disparity in the TUG and 30CST scores across the three groups was found, with corresponding pvalues of 0.038 and 0.006. So it was concluded that Core muscle stability training with a traditional balance program improves stability in the elderly more than IMT training with a traditional balance program or traditional balance program alone.

Effects of Inspiratory Muscle Training in Patients With COPD: A Systematic Literature Search and Narrative Review

urpose : This study aimed to investigate the effects of inspiratory muscle training on pulmonary function, respiratory muscle strength, exercise capacity, dyspnea, and health-related quality of life in patients with COPD. Methods : The MEDLINE and PEDro databases were searched from September 1, 2019, to September 30, 2021. Three studies were included, with a total 41 subjects. The intervention methods consisted of inspiratory muscle training. Results : Results showed that, compared with the control group, inspiratory muscle training had a significant effect on maximum inspiratory pressures. However, there was no improvement in exercise capacity. Conclusion : Only inspiratory muscle training improved inspiratory muscle strength and pulmonary function. Both the pulmonary rehabilitation plus inspiratory muscle training group and the pulmonary rehabilitation group were compared but no significant difference was found in exercise capacity in patients with COPD.

Combining aerobic interval, inspiratory and resistance trainings induces better cardiac remodelling and exercise capacity in heart failure patients

Aim The aim of this study is to evaluate the effect of a combined program of two or three modalities: aerobic interval training (AIT), inspiratory muscle training (IMT), and resistance training (RT), on cardiac function, exercise capacity and dyspnoea in heart failure (HF). Moreover, this study aims to find the best training exercise that could have additional benefits on measured parameters, thus providing a novel application in cardiac rehabilitation programs. Methods 60 patients with HF, left ventricle ejection fraction ≤45% and inspiratory muscle weakness were randomly assigned to one of the six following groups (n = 10, for each group): Control, AIT, IMT, RT, AIT + IMT and AIT + IMT + RT (combined group: CT). AIT was performed at 60% of maximum heart rate, IMT at 60% of maximal inspiratory pressure and RT at 60% of 1 repetition maximum. The control group patients had no training at all. The training regimens were performed 3 times per week for 12 weeks. Results All groups showed significant positive effects on almost all the measured parameters. However, the combination of IMT to AIT and the addition of RT to IMT and AIT (CT group) were the most powerful modalities and resulted in additional benefits over all training modalities. For example, the improvements (post-training vs pre-training) on ejection fraction was 29% (p < 0.001) and on exercise time 68.5% (p = 0.001) in CT group. However, the improvements for the same parameters were lower in AIT + IMT group (ejection fraction 18% (p < 0.001) and exercise time 62% (p < 0.001)). Conclusion The addition of RT to AIT and IMT (CT group) resulted in additional benefits in some of the measured parameters over the double combined group: AIT + IMT and all training modalities, which make the combination of three exercise training the most recommended protocol in cardiac rehabilitation programs and prevention protocols.

Application of Inspiratory Muscle Training to Improve Physical Tolerance in Older Patients with Ischemic Heart Failure.

Regardless of the management regime for heart failure (HF), there is strong evidence supporting the early implementation of exercise-based cardiac rehabilitation (CR). Respiratory therapy is considered to be an integral part of such secondary prevention protocols. The aim of the study was to evaluate the effect of inspiratory muscle training (IMT) on exercise tolerance and the functional parameters of the respiratory system in patients with heart failure involved in cardiac rehabilitation. The study included 90 patients with HF who took part in the second-stage 8-week cycle of cardiac rehabilitation (CR). They were randomly divided into three groups: Group I underwent CR and IMT; Group II only CR; and patients in Group III underwent only the IMT. Before and after the 8-week cycle, participants were assessed for exercise tolerance and the functional parameters of respiratory muscle strength. Significant statistical improvement concerned the majority of the hemodynamic parameters, lung function parameters, and respiratory muscle strength in the first group. Moreover, the enhancement in the exercise tolerance in the CR + IMT group was accompanied by a negligible change in the HRpeak. The results confirm that the addition of IMT to the standard rehabilitation process of patients with heart failure can increase the therapeutic effect while influencing some of the parameters measured by exercise electrocardiography and respiratory function.

In vitro Maturation of Buffalo Oocytes and Expression of Selected Biomarker Candidate Genes

Background: Number of genes expressed during in vitro maturation (IVM) of which selected genes can be used as the potential biomarkers of oocyte competence. Hence, this study was planned to evaluate selected gene expression of GDF9, HAS2, SPRY, ARHGAP22, COL18A1 and GPC4 in IVM and immature cumulus oocyte complexes (COCs). Methods: The COCs were recovered from slaughter origin ovaries of buffaloes. Of which first three grade COCs were randomly allotted in immature (IMT; n=217) and IVM group (n=272). IVM of COCs was performed under drops of BO-maturation media in CO2 incubator at 39.0°C for 24 hours. The expression of genes was evaluated using qPCR and the relative expression of each gene was calculated using the ΔΔCt method with efficiency correction. The logarithmic transformation of fold change of each candidate genes in the IVM group was computed against the IMT group using the Ct values. Result: The expression obtained for IVM group of earlier reported up-regulated genes (GDF9, HAS2, SPRY1) was higher (upto 10xfold) compared to the IMT group. Relatively lower expression was observed for the rest of the three candidate genes (ARHGAP22, COL18A1, GPC4) in the bovine transcripts of oocyte which were earlier also reported as down regulated.

A randomized trial comparing inspiratory training and positive pressure training in immediate lung recovery after minor pleuro-pulmonary surgery.

BackgroundTwo respiratory physiotherapy modalities were compared in a randomized controlled trial on patients undergoing minor pleuro-pulmonary surgery.MethodsForty-five patients were randomly allocated into positive expiratory pressure (PEP) therapy (n=23) and inspiratory muscle training (IMT) groups (n=22). Individualized group specific physiotherapeutic guidance was administered preoperatively, and once a day postoperatively. Patients also performed independent exercises and kept a logbook. Pain was assessed on a numerical reference scale (NRS). Volumetric pulmonary function values and walking distance were recorded preoperatively, and on first (POD1) and second postoperative days (POD2). Pre- and postoperative values were compared using two-way repeated measures analysis of variance.ResultsPatient characteristics and pleuro-pulmonary interventions were similar between the groups. Thoracotomy was performed in 14/45 and video assisted surgery (VATS) in 31/45 of cases. Preoperative volumetric pulmonary functions were normal or slightly decreased in 29/45, and fell significantly (P<0.001) on the first postoperative day (POD1) and improved but remained significantly lower on the second postoperative day. The recovery of mean FEV1, FIV1 and FIVC values was greater in the IMT than in the PEP group between POD1 and POD2, but without significant difference. The corresponding relative to preoperative values were higher in the IMT group, with a significant difference in FEV1 (P=0.045). Also relative PEF and FIV1 values seemed to be slightly higher in the IMT compared to the PEP group, but not significantly. Average NRS values for pain were lower in the IMT group (P=0.010) but only on POD1. Air leak was noted in 4/45 patients, two in each group, on POD1, and two in PEP groups and one in IMT group on POD2. Mean measured walking distances between groups did not differ. Mean hospital stay was 4 days in the PEP group and 3 days in the IMT group. There was no hospital mortality.ConclusionsPulmonary function values decreased significantly after minor lung resections, supporting rehabilitative respiratory physiotherapy to avoid postoperative pulmonary complications (PPCs). Both PEP and IMT training were well tolerated and equally efficient when comparing spirometry values at three time points. IMT appeared advantageous regarding relative FEV1 recovery and immediate postoperative pain.

Comparative efficacy of inspiratory, expiratory and combined respiratory muscle training on the pulmonary functions and chest expansion in acute stroke survivors

Background: Respiratory muscle strength can be reduced in patients diagnosed with stroke, which reasonably justifies the use of respiratory muscle training in this population. This study determines the comparative efficacy of inspiratory, expiratory, and combined respiratory muscle training on the pulmonary functions and chest expansion in acute stroke survivors. Method: Forty-five acute stroke survivors (15 in each group) completed all protocols of the study. Participants were randomly assigned to any one of three groups. In addition to the conventional exercise therapy, participants received any one of the three respiratory muscle training protocols (inspiratory muscle training, expiratory muscle training or combined respiratory muscle training). Chest expansion was assessed using tape measure and pulmonary function parameters were assessed using a spirometer. Results: Paired t-test analysis showed significant improvements in the chest expansion and the pulmonary function parameters following training in each group. One-way ANOVA showed significant improvements in the pulmonary function parameters across the three groups but not in the chest expansion with p - value = 0.405. Least significant difference (LSD), post-hoc analysis shows that the significant difference for FEV1, FVC and FEV1/FVC lies between inspiratory muscle training group and expiratory muscle training group. Conclusion: When the three training methods were compared, it was found that expiratory muscle training was the most beneficial in improving the pulmonary functions and chest expansion in acute stroke survivors.