Perception Of Dyspnea Research Articles

Impact of upper extremity robotic rehabilitation on respiratory parameters, functional capacity and dyspnea in patients with stroke: a randomized controlled study.

Stroke leads to reduced mobility and functional capacity, also negatively affects respiratory functions and muscle strength. To examine the effects of adding upper extremity robotic rehabilitation to conventional treatment on respiratory parameters, functional capacity, mobility, and dyspnea. Thirty-four stroke patients aged 18-65/years were randomized into Conventional Rehabilitation (CR) or Upper Extremity Robotic Rehabilitation (RR) groups. Both groups received conventional treatment for 5 days/week, for 6 weeks. Additionally, the RR group participated in upper extremity robotic rehabilitation (ExoRehab X, Houston Bionics) twice/week. Respiratory muscle strength (Maximum Inspiratory Pressure-MIP and Maximum Expiratory Pressure-MEP) and respiratory functions (forced expiratory flow first second (FEV1)), forced vital capacity (FVC), FEV1/FVC, peak expiratory flow (PEF), and forced expiratory flow-25-75% (FEF 25-75%) were assessed. Functional capacity was evaluated with 6-minute walk test (6-MWT), mobility was assessed with Timed Up and Go (TUG) test, and dyspnea was measured using Dyspnea-12 test. Both groups showed improvements in MIP, MEP, 6MWT and TUG scores. Additionally, significant increases were observed in PEF in the CR group and in FVC, FEV1, %FEF 25-75, and reduced dyspnea in the RR group (all p < 0.05). The groups were similar in terms of mean changes, except for FVC (p = 0.004) and FEV1 (p = 0.002), which were significantly higher in RR group. Combining upper extremity robotic rehabilitation with conventional rehabilitation in stroke patients led to similar improvements in respiratory muscle strength, functional capacity, and mobility while also improving some respiratory parameters and reducing the perception of dyspnea. NCT05550311.

Prior self-control exertion decreases pre-frontal cortex oxygenation during a CO2rebreathing challenge but does not affect perceptions of dyspnoea or tolerance time.

Dyspnoea perception is influenced by a complex interplay of physiological, psychological, and environmental factors. Recently, we showed that males with high trait self-control experience less dyspnoea and persist for longer in a carbon dioxide (CO2) rebreathing challenge than males with low trait self-control. As self-control can also vary within individuals (state self-control), the primary aim of the present study was to investigate whether prior self-control exertion influenced perceptions of dyspnoea and tolerance of a CO2 rebreathing challenge in healthy young males. We also used functional near-infrared spectroscopy (fNIRS) to assess haemodynamic activity of the pre-frontal cortex (PFC) which is a region of interest (ROI) in dyspnoea research, and the primary brain region associated with exertion of self-control. In a within-subjects design, fifteen healthy young males completed an easy (congruent) Stroop task (control condition) and a difficult (incongruent) Stroop task (prior self-control exertion, experimental condition) followed by a CO2 rebreathing challenge until the limit of tolerance. Changes in oxyhaemoglobin (ΔO2Hb) and deoxyhaemoglobin (ΔHHb) were assessed continuously in the Stroop task and CO2 rebreathing challenge. During the CO2 rebreathing challenge, dyspnoea intensity and unpleasantness were rated every 30s. Prior self-control exertion did not affect perceptions of dyspnoea or tolerance time in the CO2 rebreathing challenge (all P > 0.05). ΔO2Hb from baseline was higher in the left (+38%) and right (+44%) pre-frontal cortices during the difficult Stroop task than the easy Stroop task (both P < 0.05). During the subsequent CO2 rebreathing challenge, ΔO2Hb was attenuated following prior self-control exertion in the left PFC. Although prior self-control exertion decreased pre-frontal cortex oxygenation during a subsequent CO2 rebreathing challenge, there was no change in tolerance time or perceptions of dyspnoea.

Effects of home-based telerehabilitation-assisted inspiratory muscle training in patients with idiopathic pulmonary fibrosis: A randomized controlled trial.

There are few studies that have used inspiratory muscle training (IMT) as an intervention for patients with isolated idiopathic pulmonary fibrosis (IPF). This study aimed to investigate and interpret the effects of home-based telerehabilitation-assisted IMT in patients with IPF. Twenty-eight participants with IPF took part in the study. Lung function tests, functional exercise capacity by 6-min walk distance (6MWD), dyspnoea perception by modified medical research council dyspnoea scale (mMRC), and inspiratory muscle strength by maximal inspiratory pressure (MIP) were assessed. IMT was performed twice a day, 7 days/week, for 8 weeks. The intervention group (n = 14) performed IMT at 50% of their baseline MIP while the control group (n = 14) performed IMT without applied resistance. Loading intensity was progressed by keeping the load at 4-6 on a modified Borg scale for the highest tolerable perceived respiratory effort for each patient. Dyspnoea based on mMRC score (p < 0.001, η2 effect size = 0.48) significantly decreased within the intervention group compared with the control group. There were significant increases in the intervention group compared to the control group based on 6MWD (p < 0.001, η2 effect size = 0.43), MIP (p = 0.006, η2 effect size = 0.25) and MIP % predicted (p = 0.008, η2 effect size = 0.25). The findings of this study suggest that an 8-week home-based telerehabilitation-assisted IMT intervention produced improvements in inspiratory muscle strength, leading to improvements in functional exercise capacity and dyspnoea.

Effect of Home-Based Pulmonary Rehabilitation on Pulmonary Fibrosis.

Pulmonary fibrosis is a chronic, progressive lung condition that involves lung tissue scarring and thickening. The effects of home-based pulmonary rehabilitation (PR) in post-covid pulmonary fibrosis (PCPF) and other forms of fibrosis together have not been evaluated. This study aims to evaluate the effectiveness of home-based pulmonary rehabilitation on pulmonary function, functional capacity, and health-related quality of life in people with pulmonary fibrosis (post-COVID pulmonary fibrosis, pulmonary fibrosis secondary to pulmonary tuberculosis (TB), pulmonary fibrosis secondary to interstitial lung disease(ILD), pulmonary fibrosis secondary to bronchiectasis). A single-group pretest-posttest experimental study was performed after recruiting 98 pulmonary fibrosis subjects from K.M.C hospitals. After being screened for the inclusion and exclusion criteria, 45 subjects were analyzed, and 6 subjects were lost to follow-up. A home-based pulmonary rehabilitation program was carried out for 8 weeks (warm-up, stretching exercises, aerobic exercise, strength training for upper limb and lower limb, breathing exercises mainly involved; others: energy saving techniques, controlled coughing techniques, dyspnea relieving positions). The program was supervised via weekly phone calls. Pulmonary function (Pulmonary function test), exercise capacity (6-minute walk test), dyspnea (modified Borg scale), and health-related quality of life (SF-36) were evaluated before and after the intervention. During the enrollment and after the 6-minute walk test, saturation of peripheral oxygen (SPO2) level was also evaluated pre-intervention and after the 8-weeks program. Pulmonary function [FVC(L) t = -12.52, p<0.05; FEV1(L) t = -2.56, p<0.05; FEV1/FVC t = 7.98, p<0.05 and DLCO (ml/min/mmHg) t = -5.13, p<0.05], 6MWD [MD 88.66; p<0.05] and HRQOL measured by SF-36 scores (p<0.05) were improved significantly. Both the baseline SPO2 level before the 6MWT [MD 1.07, p<0.05] and the SPO2 level after the 6MWT [MD 1.16, p<0.05] showed a significant improvement. The rating of perceived exertion(dyspnea) [MD 1.30, p<0.05] was reduced significantly after the 8-week program. Our study shows that home-based pulmonary rehabilitation is an effective option for improving lung function and physical functional capacity by reducing dyspnea perception and improving the saturation of peripheral oxygen (SPO2) level, and enhancing the quality of life in people with pulmonary fibrosis.

Inspiratory verses expiratory muscles Kinesio taping effect on dyspnea perception in COPD patient

Inspiratory verses expiratory muscles Kinesio taping effect on dyspnea perception in COPD patient

Neural Respiratory Drive During Different Dyspnea Relief Positions and Breathing Exercises in Individuals With COPD.

When the work load of the respiratory muscles increases and/or their capacity decreases in individuals with COPD, respiratory muscle activation increases to maintain gas exchange and respiratory mechanics, and perception of dyspnea occurs. The present study aimed to compare diaphragm and accessory respiratory muscle activation during normal breathing, pursed-lip breathing, and breathing control in different dyspnea relief positions, supine and side lying. A cross-sectional study design was used. Sixteen individuals with COPD age between 40-75 y were included. Pulmonary function was evaluated by spirometry, muscle activation by surface electromyography, and dyspnea by the modified Borg scale. Muscle activation was measured in the diaphragm, scalene, sternocleidomastoid, and parasternal muscles. The evaluation was made in the dyspnea relief positions (sitting leaning forward, sitting leaning forward at a table, leaning forward with back against a wall, standing leaning forward, and high lying), seated erect, supine, and side lying. There were significant differences between the 8 positions (P < .001). There was no significant difference in muscle activation between sitting leaning forward and sitting leaning forward at a table position with analyzing post hoc test results (P > .99 for each muscle). However, muscle activation was lower in these 2 positions than in the other positions (P < .001 for each muscle). Muscle activation was greater in the supine position than in the other positions (P < .001 for each muscle). No difference was observed in muscle activation between the seated erect, leaning forward with back against a wall, standing leaning forward, high-lying, or side-lying positions (P > .05 for each muscle with a minimum P value of .09). The use of sitting leaning forward and sitting leaning forward at a table positions together with breathing control may help people with COPD to achieve more effective dyspnea relief and greater energy efficiency.

Relationship of computed tomography-based measurements with symptom perception and quality of life in patients with severe asthma

BackgroundSymptom perception and quality of life (QOL) are important domains for properly managing severe asthma. This study aimed to assess the relationship between airway structural and parenchymal variables measured using chest computed tomography (CT) and subjective symptom perception and QOL in patients with severe asthma enrolled in the Korean Severe Asthma Registry. MethodsThis study used CT-based objective measurements, including airway wall thickness (WT), hydraulic diameter, functional small airway disease (fSAD), and emphysematous lung (Emph), to assess their association with subjective symptom (cough, dyspnea, wheezing, and sputum) perception measured using the visual analog scale, and QOL measured by the Severe Asthma Questionnaire (SAQ). ResultsA total of 94 patients with severe asthma were enrolled in this study. The WT and fSAD% were significantly positively associated with cough and dyspnea, respectively. For QOL, WT and Emph% showed significant negative associations with the SAQ. However, there was no significant association between lung function and symptom perception or between lung function and QOL. ConclusionOverall, WT, fSAD%, and Emph% measured using chest CT were associated with subjective symptom perception and QOL in patients with severe asthma. This study provides a basis for clarifying the clinical correlates of imaging-derived metrics and for understanding the mechanisms of respiratory symptom perception.

Inspiratory muscles pre-activation in young swimmers submitted to a tethered swimming test: effects on mechanical, physiological, and skin temperature parameters

Inspiratory muscles pre-activation (IMPA) has been studied to improve subsequent performance in swimming. However, the effects of IMPA on various parameters in swimmers are still unknown. Therefore, this study aimed to investigate the effects of IMPA on the mechanical parameters, physiological responses, and their possible correlations with swimming performance. A total of 14 young swimmers (aged 16 ± 0 years) underwent a 30-s all-out tethered swimming test, preceded or not by IMPA, a load of 40% of the maximal inspiratory pressure (MIP), and with a volume of 2 sets of 15 repetitions. The mechanical (strength, impulse, and fatigue index) and physiological parameters (skin temperature and lactatemia) and the assessment of perceived exertion and dyspnea were monitored in both protocols. The IMPA used did not increase the swimming force, and skin temperature, decrease blood lactate concentration, or subjective perception of exertion and dyspnea after the high-intensity tethered swimming exercises. Positive correlations were found between mean force and blood lactate (without IMPA: r = 0.62, P = 0.02; with IMPA: r = 0.65, P = 0.01). The impulse was positively correlated with blood lactate (without IMPA: r = 0.71, P < 0.01; with IMPA: r = 0.56, P = 0.03). Our results suggest that new IMPA protocols, possibly with increased volume, should be developed in order to improve the performance of young swimmers.

Effect of face masks on dyspnea perception, cardiopulmonary parameters, and facial temperature in healthy adults.

Respiratory droplets, naturally produced during expiration, can transmit pathogens from infected individuals. Wearing a face mask is crucial to prevent such transmission, yet the perception of dyspnea and uncomfortable breathing remains a common concern, particularly during epidemics. The aim of this study was to investigate the impact of face mask use on the perception of dyspnea, cardiopulmonary parameters, and facial temperature during physical activity. A randomized crossover study was conducted on healthy adults at a physiology laboratory located in the Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia, in November 2022. Participants underwent five stages of physical exercise tests based on the Bruce Protocol under three conditions: without any face mask (control), wearing a surgical mask, and an N95 mask, forming the study's main groups. Dyspnea perception (measured by the Modified Borg Dyspnea Scale), cardiopulmonary parameters (heart rate, oxygen saturation, respiratory rate, blood pressure, and mean arterial pressure) and facial temperature were measured before the exercise test (pre-workout), at the end of stage 1, 2, 3, 4, 5, and after the whole exercise test (post-workout). A two-way repeated measures ANOVA was conducted, considering two factors: the type of mask (control, surgical mask, N95 mask) and the various stages of the exercise test. A total of 36 healthy adults were included in the study. We found that dyspnea perception was much worse in the N95 mask group, particularly during vigorous exercise. There was no significant difference between groups in cardiopulmonary parameters. However, participants wearing N95 had a greater supralabial temperature than those wearing surgical masks or no mask at all. It is recommended to undertake a more in-depth evaluation of cardiopulmonary physiological measures.

Body composition, pulmonary function tests, exercise capacity, and quality of life in chronic obstructive pulmonary disease patients with obesity.

Larger proportions of chronic obstructive pulmonary disease (COPD) patients are currently overweight or with obesity than underweight, and the combination of COPD and obesity is increasing. The purpose of this study was to investigate differences in the body composition, pulmonary function tests, exercise capacity, and health-related quality of life among normal weight, overweight, and obese patients with COPD. A total of 514 patients with COPD were included in the study. According to the World Health Organization criteria for body mass index, the patients were classified as normal weight, overweight, and obese. Evaluations included fat-free mass, fat-free mass index, phase angle, pulmonary function tests, and 6-minute walk test. Dyspnea was assessed using the modified Medical Research Council dyspnea scale, and the health-related quality of life was evaluated using COPD Assessment Test and St. George's Respiratory Questionnaire. Values were compared among the three groups. There were 315 male and 199 female patients, with a mean age of 66.7 ± 8.4years. Fat-free mass, fat-free mass index, and phase angle values were significantly higher in COPD patients with obesity than in other patients (P < .001, P < .001, P < .001). Forced expiratory volume in 1 s, forced expiratory volume in 1 s/forced vital capacity, and diffusing capacity of lung for carbon monoxide value in pulmonary function tests were significantly higher in COPD patients with obesity than in other patients (P = .046, P < .001, P < .001), while the forced vital capacity values were similar in all groups. Exercise capacity (6-min walk test distance), dyspnea symptoms (modified Medical Research Council scale), and health-related quality of life (COPD Assessment Test and St. George's Respiratory Questionnaire) did not differ significantly between groups. According to our study, obesity has no negative effect on pulmonary function tests, dyspnea perception, exercise capacity, and health-related quality of life.

Reliability and validity of the online application of London Chest Activity of Daily Living scale in assessing dyspnea-related functional impairment in individuals after hospitalization for COVID-19

Purpose To investigate the test-retest reliability and construct validity of the LCADL scale applied via online form in individuals after hospitalization for COVID-19. Methods Methodological study. After hospitalization for COVID-19 individuals completed the LCADL via online form at two separate times. They also answered the post-COVID-19 Functional Status Scale (PCFS), dyspnea, fatigue, and health perception scales, modified Medical Research Council (MRCm), Short Form Health Survey 36 (SF-36). Hospitalization data were collected from the individual’s medical record. Results 104 individuals participated in the study (57 men, 45.2 ± 11.9 years). The LCADL showed moderately to high test-retest reliability (ICC: 0.73–0.86; p < 0.001), there was no difference in scores between test and retest (p > 0.05), the mean difference between the applications was smaller than the standard error of measurement and the internal consistency was adequate (Cronbach’s α = 0.70–0.94). In addition, it demonstrated adequate construct validity, showing correlations with PCFS, dyspnea perception, fatigue and health scales, mMRC, SF-36, and length of stay in the Intensive Care Unit (p < 0.05). The LCADL as percentage of the total score presented a significant floor effect (25%). Conclusion The LCADL applied online was reliable and valid for assessing limitations due to dyspnea in ADL in individuals after hospitalization for COVID-19.

Impairments of functional exercise capacity, muscle strength, balance and kinesiophobia in patients with chronic kidney disease: a cross-sectional study

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.

Changes in lung function and dyspnea perception in Colombian Covid-19 patients after a 12-week pulmonary rehabilitation program.

Although moderate and severe Covid-19 patients have shown obstructive and restrictive disorders in pulmonary function after recovery from the disease, studies evaluating the effectiveness of rehabilitation programs that seek to improve lung function are scarce. Herein, we evaluate changes in lung function and perceived dyspnea in Covid-19 patients after undergoing 12 weeks of a pulmonary rehabilitation (PR) program. Retrospective observational study. Cesar, Colombia Neumocesar Pneumological Center. 100 outpatients with a history of Covid-19. Respiratory function using spirometry parameters, as well as perceived dyspnea, measured by the modified Medical Research Council (mMRC) dyspnea scale, was evaluated in 100 patients with a history of Covid-19. We used univariate and multivariate statistical approaches to assess changes in lung function and perceived dyspnea before and after a PR program to determine whether gender, age, height, weight, comorbidities, and oxygen delivery system affects the recovery of lung function and perceived dyspnea. It was found that PR treatment has positive effects on respiratory pathologies caused by SARS-CoV-2 infection regardless of patient gender (S = 0,029), indicating that rehabilitation provided benefits regardless of the physical characteristics of the patients. Both univariate and multivariate statistical analyses indicated that FVC (P = 0,0001), FEV1(P = 0,0001), and mMRC (P = 0,0001) are robust diagnostic indicators of lung function recovery and perceived dyspnea. Both invasive and non-invasive positive pressure ventilatory support had deleterious effects on lung function prolongating patient recovery (P = 0,0001). Rehabilitation programs can benefit patients facing respiratory pathologies caused by SARS-CoV-2 infection. Additional research on the long-term effects of the sequelae of Covid-19 is needed. PR programs have positive effects on patients facing respiratory pathologies caused by SARS-CoV-2 infection.

Investigation of the Effects of Remote Online Exercise Training in Individuals Self-Isolating at Home Due to COVID-19 Disease: A Randomized Controlled Study

Objective: Effectiveness of a 4-week telerehabilitation program including thoracic expansion exercises (TEE), non-specific general body exercises (NSGBE), and physical activity recommendations (PAR) which started at quarantine in individuals with acute mild-COVID-19 was investigated in current study. Methods: This is a randomized controlled study which was performed between May 2021 and February 2022. Adult individuals with acute mild-COVID-19 were randomly grouped as training (TG) (telerehabilitation program under supervision for 3 days/week) and control (CG) (home program including TEE and PAR). Dyspnea (Modified Borg Scale and Modified Medical Research Council Dyspnea Scale), chronic fatigue (Checklist Individual Strength Questionnaire), anxiety and depression (Hospital Anxiety and Depression Scale), balance (Berg Functional Balance Scale) and lower body strength (a 30-s chair stand test) were evaluated remotely in the individuals before and after a 4-week follow-up. Results: Baseline characteristics and balance scores were similar between groups (p&gt;0.05). After 4-week from baseline, there were no significant differences in dyspnea, chronic fatigue, anxiety, depression, balance, and lower body strength between the groups (p&gt;0.05). However, as dyspnea, chronic fatigue, anxiety, and depression scores decreased, lower body strength increased significantly within TG after follow-up (p&lt;0.05). Dyspnea, chronic fatigue, and anxiety scores decreased while lower body strength increased significantly within CG after follow-up (p&lt;0.05). Conclusion: Dyspnea, severe fatigue, anxiety, and depression are commonly observed in individuals with mild-COVID-19 in the acute period. In these individuals, dyspnea perception, chronic fatigue, anxiety, depression, and functional performance improve after a 4-week light-intensity online tele-program applied either supervised or unsupervised. Mild exercises and PAR are safe and effective in these individuals.

Predictors of reduced incremental shuttle walk test performance in patients with long post-COVID-19.

One of the common limitations after COVID-19 pneumonia is the decrease in exercise capacity. The identification of the factors affecting exercise capacity and the assessment of patients at risk are important for determining treatment strategy. This study was conducted to determine the predictors of decreased exercise capacity in long post-COVID-19 patients. We investigated the association of exercise capacity as measured by the incremental shuttle walk test (ISWT) with age, sex, spirometric variables, respiratory and peripheral muscle strength, quality of life, fatigue, hospital anxiety depression scale, chest X-ray involvement, and hospitalization. The patients were divided into three groups: outpatients, inpatients, and ICU patients. Regression analysis was used to determine which parameters were significant predictors of exercise capacity. Of the 181 patients included in the study, 56 (31%) were female. The mean ISWT in percentage of predicted values (ISWT%pred) was 43.20% in the whole sample, whereas that was 52.89%, 43.71%, and 32.21% in the outpatient, inpatient, and ICU patient groups, respectively. Linear regression analysis showed that predictors of decreased ISWT%pred were sex (b = 8.089; p = 0.002), mMRC scale score (b = -7.004; p ≤ 0.001), FVC%pred (b = 0.151; p = 0.003), and handgrip strength (b = 0.261; p = 0.030). In long post-COVID-19 patients, sex, perception of dyspnea, restrictive pattern in respiratory function, and decrease in peripheral muscle strength are predictors of reduced exercise capacity that persists three months after COVID-19. In this context, we suggest that pulmonary rehabilitation might be an important therapy for patients after COVID-19.

Effects of Delayed-Onset Muscle Pain on Respiratory Muscle Function.

Delayed-onset muscle soreness (DOMS) has been widely examined in the peripheral muscles; however, studies showing the potential effects of DOMS on respiratory function are limited. DOMS in trunk muscles has a negative effect on respiratory function parameters, respiratory muscle strength, respiratory muscle endurance, and exercise capacity. Prospective cohort study. Level 2. In 24 healthy participants with a mean age of 21 ± 2 years, DOMS was induced for the trunk muscles with a load equal to 80% of the maximum repetitive voluntary contraction. Pulmonary function parameters, respiratory muscle strength and endurance, exercise capacity, pain, fatigue, and dyspnea perception severity were recorded before DOMS and at 24 and 48 hours after DOMS. After DOMS, decreases were observed in respiratory function parameters, namely, forced vital capacity, forced expiratory volume in the first second, vital capacity, and 25% to 75% flow rate value of forced expiratory volume (25% to 75%) (P = 0.02, P = 0.02, P < 0.01, P = 0.01, respectively). Maximal inspiratory pressure and exercise capacity also decreased (P = 0.02, P < 0.01, respectively). No difference was observed between all 3 measurements of maximal expiratory pressure (MEP) and MEP% values (P1 = P2 = P3 ≥ 0.99). The results of the respiratory muscle endurance tests did not reveal a significant difference in terms of load and time in all 3 conditions (P > 0.05). After DOMS, there was a 4% to 7.5% decrease in respiratory function parameters, and a 6.6% decrease in respiratory muscle strength. The occurrence of DOMS before a competition can have a detrimental impact on pulmonary performance. Hence, it is imperative to consider this factor when devising training and exercise programs. In addition, the development of treatment protocols becomes crucial if DOMS arises.

The 6-minute walk test and fall risk in patients with heart failure: A cross-sectional study

BackgroundGiven the increased risk of falls in patients with heart failure (HF), there is limited information in the literature about the possible relationship between fall risk and functional capacity. ObjectiveTo investigate the relationship between functional capacity and fall risk in patients with HF and to determine whether there are differences in clinical parameters between patients with and without fall risk. MethodsThe study included 64 patients with HF. The Activity-Specific Balance Confidence Scale (ABC) determined the fall risk. Functional capacity was assessed with the 6-minute walk test (6MWT). The Berg Balance Scale (BBS), the timed up-and-go test (TUG), and the five times sit-to-stand (5-STS) test were used to evaluate functional balance and mobility. Comorbidities and dyspnea perception were assessed with the Charlson Comorbidity Index (CCI) and modified Medical Research Council (mMRC), respectively. ResultsThe 6MWT was associated with fall risk in logistic regression with an odds ratio of 0.979 (0.970–0.989, p < 0.001). Furthermore, the 6MWT had a discriminative value for increased fall risk in patients with HF, with a cutoff value of 248 m. Patients with increased fall risk had lower 6MWT distance, BBS, and gait speed, and higher CCI and mMRC, number of falls, duration of TUG and 5STS compared to patients with no increased fall risk (p < 0.05). ConclusionsThe study results demonstrated that 6MWT may be a clinically useful tool in quickly identifying potential balance problems and increased fall risk by providing insight into fall risk/balance confidence in addition to assessing functional capacity.

The Therapeutic Role of Inspiratory Muscle Training in The Management of Asthma: A Narrative Review.

Asthma is a disorder of the airways characterized by chronic airway inflammation, hyperresponsiveness, and variable recurring airway obstruction. Treatment options for asthma include pharmacological strategies, while non-pharmacological strategies are limited. Established pharmacological approaches to treating asthma may cause unwanted side effects and do not always afford adequate protection against asthma, possibly due to an individual's variable response to medications. A potential non-pharmacological intervention that is most available and cost-effective is inspiratory muscle training (IMT), which is a technique targeted at increasing the strength and endurance of the diaphragm and accessory muscles of inspiration. Studies examining the impact of IMT on asthma have reported increases in inspiratory muscle strength, and a reduction in the perception of dyspnea and medication use. However, due to the limited number and discordant methods between studies more evidence is required to elucidate in asthmatics the efficacy of IMT on inspiratory muscle endurance, exercise capacity, asthma control, symptoms, quality of life, as well as adolescents with differing severities of asthma. Large randomized controlled trials would be a significant step forward in clarifying the effectiveness of IMT in asthmatics. While IMT may have favorable effects on inspiratory muscle strength, dyspnea and medication use, the current evidence that IMT is an effective treatment for asthma is inconclusive.

Effects of chronic obstructive pulmonary disease stage on muscle oxygenation during exercise

Aims: The aim of this study was to investigate peripheral muscle oxygenation in patients with chronic obstructive pulmonary disease (COPD) at rest, during submaximal exercise, and during recovery, and to determine the effects of disease stage on peripheral muscle oxygenation. &#x0D; Methods: Of the 35 stable COPD patients (62.49±8.45 years), 18 patients in GOLD 1 and 2 were assigned to Group 1 and 17 patients in GOLD 3 and 4 were assigned to Group 2. Dyspnea perception of the patients was evaluated with the Modified Medical Research Council (mMRC) Dyspnea Scale, severity of the disease affecting daily life was evaluated with the COPD Assessment Test (CAT-COPD Assessment Test), respiratory function was evaluated with the Pulmonary Function Test, and quadriceps muscle strength was evaluated with a manual muscle testing device. Muscle oxygenation of the patients was measured with Near-infrared spectroscopy (NIRS) for 5 minutes at rest, 6 minutes during the 6-Minute Walk Test (6-MWT), and 5 minutes during recovery after the end of the test. The results of the two groups were compared.&#x0D; Results: Intragroup comparisons of muscle oxygenation at rest, during 6-MWT and during recovery; in Group 1, there was a statistically significant decrease between resting SmO2 mean and test SmO2 mean (p=0.001), a increase between test SmO2 mean and recovery SmO2 mean (p

Pulmonary rehabilitation in sarcoidosis: A systematic review and meta-analysis

BackgroundExercise intolerance, muscle weakness, dyspnoea, and fatigue are frequent complications in symptomatic sarcoidosis patients. Pulmonary rehabilitation improves exercise capacity, symptoms, and quality of life in patients with chronic respiratory diseases. Our objective was to systematically determine the effects of pulmonary rehabilitation in patients with sarcoidosis. MethodsA systematic review was conducted in seven databases. Studies that applied pulmonary rehabilitation in patients with sarcoidosis were reviewed. Two independent reviewers analysed the studies, extracted the data and assessed the quality of evidence. ResultsOf the 406 reports returned by the initial search, five articles reporting on 184 patients were included in the data synthesis. Two studies included multi-component exercise, one inspiratory muscle training, one a physical activity incentivisation programme, and one a telerehabilitation program. In the intervention group (IG), we found significant improvement in exercise capacity (SMD 1.65, 95%CI 0.45, 2.86 points, p = 0.006). If we only analyse the studies that performed the 6-min walking test, the IG walked 40.3 (CI95% 20.3, 60.2) m higher than the control group (CG) (p < 0.001). Additionally, dyspnoea score was reduced (MD -0.42 95%CI -0.75, −0.10, p = 0.002). However, fatigue, quality of life and pulmonary function did not show any change. ConclusionPulmonary rehabilitation could improve exercise capacity and dyspnoea perception in patients with sarcoidosis.