Peripheral Muscle Strength Research Articles

The Effect of Different Virtual Reality-Based Exercise Trainings on Pulmonary Function, Respiratory and Peripheral Muscle Strength, Functional Capacity and Balance in Children With Bronchiectasis

The Effect of Different Virtual Reality-Based Exercise Trainings on Pulmonary Function, Respiratory and Peripheral Muscle Strength, Functional Capacity and Balance in Children With Bronchiectasis

Minimum Clinically Important Difference in 30-s Sit-to-Stand Test After Pulmonary Rehabilitation in Subjects With COPD.

The sit-to-stand (STS) test is a feasible tool for measuring peripheral muscle strength of the lower limbs. There is evidence of increasing use of STS tests in patients with COPD. We sought to evaluate in subjects with COPD the minimum clinically important difference in 30-s STS test after pulmonary rehabilitation. Stable COPD subjects undergoing a 30-s STS test and a 6-min walk test (6MWT) before and after pulmonary rehabilitation were included. Responsiveness to pulmonary rehabilitation was determined by the change in 30-s STS test results (Δ 30-s STS) before and after pulmonary rehabilitation. The minimum clinically important difference was evaluated using an anchor-based method. 96 subjects with moderate-to-severe COPD were included. At baseline, 30-s STS test results were significantly related to distance covered in a 6MWT (6MWD) (r = 0.65, P < .001), FVC (r = 0.46, P < .001), PaCO2 (r = -0.42, P < .001), FEV1 (r = 0.39, P < .001), and age (r = -0.31, P = .002). After pulmonary rehabilitation, a significant improvement in 30-s STS test results was observed (mean difference +2 repetitions, P < .001). The Δ30-s STS was positively related to Δ6MWD (r = 0.62, P < .001), transitional dyspnea index (r = 0.67, P < .001), and baseline residual volume (r = 0.27, P = .007). The receiver operating characteristic curves method identified a Δ 30-s STS cut-off of 2 repetitions as the best discriminating value (area under the curve: 0.892, P < .001) to identify the minimum clinically important difference for Δ6MWD (30 m). In a multivariate logistic regression model, baseline 30-s STS (odds ratio 2.63; 95% CI 1.09-6.35, P = .031) and diffusing capacity of the lung for carbon monoxide (< 53% predicted) (odds ratio 2.49, 95% CI 1.04-5.98, P = .041) predict the risk to have a Δ 30-s STS ≥ 2 repetitions. Our study indicates that in stable subjects with moderate-to-severe COPD, the 30-s STS test was a sensitive tool to assess the efficacy of pulmonary rehabilitation. A Δ 30-s STS of ≥ 2 repetitions represented the minimum clinically important difference, which may be predicted by the baseline ability in the 30-s STS test and lung function in terms of diffusing lung capacity (ClinicalTrials.gov registration NCT03627624).

The Power of Music: Enhancing Muscle Strength in Older People.

Sarcopenia is a major problem occurring in the aging population. Based on previous research, music appears to have a positive influence on many aspects of life, including physical performance. This led to the question of whether listening to self-selected favorite music could improve peripheral muscle strength in older people. In this crossover study, community-dwelling people aged 65 and older were included. All participants performed handgrip strength measurements in three different circumstances: while listening to their favorite music, their most disliked music, and no music at all. As the primary outcome measurement, the within-person differences in maximum handgrip strength between the three music conditions were analyzed. A total of 153 participants (aged 73.0 ± 6 years) were included. Listening to favorite music resulted in an increase in maximum handgrip strength of +0.87 kgf (0.54–1.21, p < 0.001) compared to no music, and of +0.97 kgf (0.56–1.37, p < 0.001) compared to least favorite music. Thus, listening to favorite music has a positive effect on handgrip strength in older people. Apart from its implications for scientific grip strength measurements, this effect may be used as a fun and innocent stimulant in rehabilitation and workout classes with seniors, which could be further tested in a range of older people.

Does hand grip strength decrease in chronic obstructive pulmonary disease exacerbation? A cross-sectional study

Background/aim Respiratory and peripheral muscle strength are reduced in chronic obstructive pulmonary disease (COPD). There is a well-known correlation between handgrip strength (HGS) and strenght extremity muscles. Our aim in this study was to measure HGS and investigate the related factors in COPD patients with exacerbation.Materials and methods Subjects with COPD exacerbation (n = 101) and stable COPD (n = 22), and subjects without COPD (n = 201), were enrolled in this study. Age, sex, and body mass index were similar. HGS was measured using a Vigorimeter. Pulmonary function tests and 6-min walk tests were performed.Results The mean HGS was significantly lower in subjects with COPD exacerbation than those with stable COPD and subjects without COPD. The mean HGS was similar between stable COPD and non-COPD subjects. The mean 6-min walk distance (6MWD) was significantly lower in subjects with COPD exacerbation than stable COPD. There was a significant correlation between HGS and 6MWD but no correlation between HGS and pulmonary function tests.Conclusion In subjects with COPD exacerbation, the HGS was lower than that of stable COPD patients, and this difference was not explained by age, comorbidities, severity of obstruction, or smoking. Physical inactivity and steroid use during exacerbation might be possible factors affecting HGS. HGS was moderately correlated with 6MWD in cases of exacerbation. It may be used as a measure of muscle performance in COPD exacerbation, especially when the 6-min walk test cannot be performed.

Individualized in-hospital exercise training program for people undergoing hematopoietic stem cell transplantation: a feasibility study

Purpose The purpose of this study is to evaluate the feasibility of an individualized exercise program for people undergoing hematopoietic stem cell transplantation. Methods This is a feasibility study of an individualized in-hospital exercise training program for people undergoing hematopoietic stem cell transplantation. Participants performed the exercise program based on daily clinical, hemodynamic and hematological assessment. The program was carried out on a daily basis for 20–40 min during their hospital admission. The primary outcome was feasibility (recruitment, adherence and attrition rates) of the exercise program. The secondary outcomes were functional capacity, peripheral muscle strength, and health-related quality of life evaluated on admission and prior to hospital discharge. The adverse events rate was recorded during the intervention. Results Twenty-six participants (58% female), aged 40 ± 15 (mean ± SD) years were included. The exercise program feasibility was demonstrated by 100% recruitment, 86% exercise adherence and 12% attrition rates with no adverse events recorded. Significant differences were observed in functional capacity (p = 0.03), upper and lower-limb muscle strength (p = 0.01) from admission to discharge (23 ± 7 d). Conclusions An individualized exercise training program based on daily clinical parameters is feasible for hospitalized patients undergoing hematopoietic stem cell transplantation. This intervention warrants further investigation in a randomized controlled trial. Implications for rehabilitation The individualized in-hospital exercise training program guided by daily clinical, hemodynamic and hematologic parameters is feasible, safe and with good adherence in people undergoing hematopoietic stem cell transplantation. People undergoing hematopoietic stem cell transplantation may improve functional capacity and upper and lower limb muscle strength following in-hospital exercise training program. The individualized in-hospital exercise training program could tentatively be introduced as part of the rehabilitation process in people undergoing hematopoietic stem cell transplantation.

Effect of high-flow nasal therapy during exercise training in COPD patients with chronic respiratory failure: study protocol for a randomised controlled trial

BackgroundThe benefit of pulmonary rehabilitation (PR) in symptomatic chronic obstructive pulmonary disease (COPD) is well known. However, advanced patients with chronic respiratory failure (CRF), a category excluded from most studies, are frequently unable to sustain a work-load sufficiently high to obtain the full benefit of PR on exercise tolerance. Recent studies involving heated and humidified high flow oxygen therapy (HFOT) showed positive effects on breathing pattern and ventilatory efficiency during effort. We thus plan to compare, in COPD patients with CRF undergoing a high-intensity exercise programme, the effect of using HFOT versus standard oxygen delivery via Venturi Mask (V-mask), at the same inspiratory oxygen fraction, on improving exercise endurance.Methods/DesignThis is a multicentre randomised controlled trial that will involve 156 COPD inpatients with CRF recruited from seven PR hospitals. Patients will be randomised to one of two groups – V-mask versus HFOT. All patients will undergo the same high-intensity exercise programme using either of the oxygen delivery devices as per their group allocation. Training will consist of 20 sessions, over 1 month (5 sessions per week) within the hospitalisation period. Anthropometric and clinical data, including body mass index, diagnosis, spirometry and comorbidities (Cumulative Rating Scale) will be collected at baseline. At baseline and at the end of the exercise programme (primary assessment time) evaluation will include exercise tolerance (Constant Work Rate Exercise Test) (primary outcome), functional capacity (6-min walk test), maximal inspiratory pressure/maximal expiratory pressure, peripheral muscle strength (biceps and quadriceps) by manual dynamometer, respiratory exchanges (blood gases analysis), disability (Barthel Index and Barthel Dyspnoea Index), impact of disease (COPD Assessment test), and quality of life (Maugeri Respiratory Failure Scale-26). At the end of the training period, patient satisfaction will be evaluated.DiscussionThis study will add knowledge about the exercise response in advanced COPD with CRF and verify if an alternative tool, namely HFOT, can increase the benefit obtained from PR.Trial registrationClinicalTrials.gov ID NET03322787Registered: 6 November 2017

Acute low-level laser therapy effects on peripheral muscle strength and resistance in patients with fibromyalgia.

Acute low-level laser therapy effects on peripheral muscle strength and resistance in patients with fibromyalgia.

Functional Capacity Change Impacts the Quality of Life of Hospitalized Patients Undergoing Hematopoietic Stem Cell Transplantation.

The aim of the study was to compare the quality of life (QOL) of patients undergoing hematopoietic stem cell transplantation who improved their functional capacity during hospitalization (increased functional capacity group) with that of patients who maintained or decreased functional capacity during hospitalization (decreased functional capacity group). This observational, longitudinal study included 27 hospitalized patients undergoing hematopoietic stem cell transplantation. Patients were divided into increased functional capacity group (16 patients) and decreased functional capacity group (11 patients). Functional capacity (6-min step test), peripheral muscle strength (sit-to-stand test and handgrip strength), and QOL (European Organization for Research and Treatment of Cancer) were assessed at admission and at hospital discharge. Increased functional capacity patients had increased functional capacity and peripheral muscle strength of the lower and upper limbs at hospital discharge (P < 0.01, <0.01, and 0.02, respectively). The patients in the increased functional capacity group demonstrated an increase in global health and reduced symptoms at discharge (P = 0.02 and 0.03, respectively). No significant differences were observed between groups in the functional domain. Patients undergoing hematopoietic stem cell transplantation, who have improved functional capacity at discharge, also experience an improved QOL, with no such improvement noted among patients who have stable or reduced functional capacity. We recommend that the treatment protocol for hospitalized patients undergoing hematopoietic stem cell transplantation include an exercise program aimed at improving functional capacity.

Improving access to community-based pulmonary rehabilitation: 3R protocol for real-world settings with cost-benefit analysis

BackgroundPulmonary rehabilitation (PR) has demonstrated patients’ physiological and psychosocial improvements, symptoms reduction and health-economic benefits whilst enhances the ability of the whole family to adjust to illness. However, PR remains highly inaccessible due to lack of awareness of its benefits, poor referral and availability mostly in hospitals. Novel models of PR delivery are needed to enhance its implementation while maintaining cost-efficiency. We aim to implement an innovative community-based PR programme and assess its cost-benefit.MethodsA 12-week community-based PR will be implemented in primary healthcare centres where programmes are not available. Healthcare professionals will be trained. 73 patients with CRD and their caregivers (dyads patient-caregivers) will compose the experimental group. The control group will include dyads age- and disease-matched willing to collaborate in data collection but not in PR. Patients/family-centred outcomes will be dyspnoea (modified Medical Research Council Questionnaire), fatigue (Checklist of individual strength and Functional assessment of chronic illness therapy – fatigue), cough and sputum (Leicester cough questionnaire and Cough and sputum assessment questionnaire), impact of the disease (COPD Assessment Test), emotional state (The Hospital Anxiety and Depression Scale), number of exacerbations, healthcare utilisation, health-related quality of life and family adaptability/cohesion (Family Adaptation and Cohesion Scale). Other clinical outcomes will be peripheral (biceps and quadriceps-hand held dynamometer, 1 or 10 repetition-maximum) and respiratory (maximal inspiratory and expiratory pressures) muscle strength, muscle thickness and cross sectional area (biceps brachialis, rectus femoris and diaphragm-ultrasound imaging), exercise capacity (six-minute walk test and one-minute sit to stand test), balance (brief-balance evaluation systems test) and physical activity (accelerometer). Data will be collected at baseline, at 12 weeks, at 3- and 6-months post-PR.Changes in the outcome measures will be compared between groups, after multivariate adjustment for possible confounders, and effect sizes will be calculated. A cost-benefit analysis will be conducted.DiscussionThis study will enhance patients access to PR, by training healthcare professionals in the local primary healthcare centres to conduct such programmes and actively involving caregivers. The cost-benefit analysis of this intervention will provide an evidence-based insight into the economic benefit of community-based PR in chronic respiratory diseases.Trial registrationThe trial was registered in the ClinicalTrials.gov U.S. National Library of Medicine, on 10th January, 2019 (registration number: NCT03799666).

Impact of Home Oxygen Therapy on the Level of Physical Activities in Daily Life in Subjects With COPD.

Chronic hypoxemia in patients with COPD is a limiting factor that is associated with disease progression and significantly contributes to decreased physical activity. Although correction of hypoxemia results in physiological improvements, oxygen therapy may be related to social isolation and inactivity. However, few studies have objectively investigated the level of physical activity in daily life (PADL) in these patients. The objective of this study was to compare the level of PADL in subjects with COPD on home oxygen therapy and in subjects with no oxygen therapy, and to investigate whether home oxygen therapy is associated with the level of PADL. In this study, 29 subjects with COPD composed the home oxygen therapy group, and 30 subjects with COPD composed the control group. All of them underwent assessment of anthropometric measurements, spirometry, peripheral muscle strength, limitations in activities of dalily living, perception of dyspnea, health status, as well as PADL monitoring. Home oxygen therapy subjects showed less time walking (P = .001), in active physical activities (P = .003), in physical activities ≥ 3 METs (P = .001), and in physical activities < 1.5 METs (P = .042), as well as fewer steps (P = .001). Physical inactivity was present in 24 home oxygen subjects (82.8%) and 18 control subjects (60%). Oxygen therapy was associated with severe physical inactivity (Cramer's V = 0.29, P = .040). The time using oxygen therapy (h/d) was the strongest predictor of the level of PADL (r2 = 0.38-0.43, P < .001). Subjects with COPD using oxygen at home showed reduced level of PADL. The results indicate that oxygen therapy is associated with severe physical inactivity and may be a predictor of the level of PADL.

Effectiveness of high intensity interval training supplemented with peripheral and inspiratory resistance training in chronic heart failure: a pilot study

Background: Cardiac rehabilitation (CR) is an evidence-based therapy in chronic heart failure (CHF). There is still debate about the optimal training protocol in CHF. The use of high intensity interval training (HIIT) supplemented with peripheral (PRT) and inspiratory resistance training (IRT) might be more beneficial because of the higher impact on the peripheral and inspiratory muscles, with less symptoms of dyspnoea and lower amount of dropouts as a result. We compared our standard exercise-based CR programme, mainly consisting of moderate intensity interval training to a programme combining HIIT, PRT and IRT (resistance training supplemented HIIT (RHIIT) programme).Design: Randomised controlled pilot study.Methods: Twenty patients with CHF were randomised on a 1:1 basis to the standard or RHIIT programme. At baseline and after 3 months, peak exercise capacity (VO2peak), peripheral (QF) and inspiratory respiratory muscle strength (MIP), quality of life (QOL) and physical activity were measured.Results: The RHIIT programme resulted in a significantly larger improvement in QF (ΔQF RHIIT programme: 19.3 ± 11.8 vs standard programme: –6.89 ± 19.0 Nm (p < .01)) and MIP (ΔMIP RHIIT programme: –44.9 ± 29.9 vs standard programme: 0.56 ± 19.4 cmH2O (p < .01)). Both programmes equally improved in VO2peak (p = .91), whereas ventilatory efficiency and physical activity remained stable.Conclusion: HIIT supplemented with PRT and IRT might be applicable as standard protocol in CHF. Larger studies are warranted to confirm our findings. The RHIIT programme resulted in similar training effects in VO2peak in a shorter training period. This might be beneficial in a chronic patient population such as CHF, where adherence is difficult.

Dynamic strength training intensity in cardiovascular rehabilitation: is it time to reconsider clinical practice? A systematic review.

When added to endurance training, dynamic strength training leads to significantly greater improvements in peripheral muscle strength and power output in patients with cardiovascular disease, which may be relevant to enhance the patient's prognosis. As a result, dynamic strength training is recommended in the rehabilitative treatment of many different cardiovascular diseases. However, what strength training intensity should be selected remains under intense debate. Evidence is nonetheless emerging that high-intensity strength training (≥70% of one-repetition maximum) is more effective to increase acutely myofibrillar protein synthesis, cause neural adaptations and, in the long term, increase muscle strength, when compared to low-intensity strength training. Moreover, multiple studies report that high-intensity strength training causes fewer increments in (intra-)arterial blood pressure and cardiac output, as opposed to low-intensity strength training, thus potentially pointing towards sufficient medical safety for the cardiovascular system. The aim of this systematic review is therefore to discuss this line of evidence, which is in contrast to current clinical practice, and to re-open the debate as to what dynamic strength training intensities should actually be applied.

Effects of different modalities of inspiratory muscle training as an add-on to conventional treatment of patients with chronic obstructive pulmonary disease (COPD): study protocol for a randomized controlled trial

BackgroundChronic obstructive pulmonary disease (COPD) leads to peripheral and respiratory muscle dysfunctions. Nowadays, inspiratory muscle training can be geared toward strength or endurance gains. This study aims to investigate the effects of an inspiratory muscle training (IMT) protocol using different therapeutic modalities to be implemented in pulmonary rehabilitation programs. The effects of IMT on exercise capacity were considered as the primary endpoint, and the effects of IMT on inspiratory muscle function, health-related quality of life, and daily physical activity level were considered as the secondary outcomes.MethodsThis study is a blinded-investigator randomized controlled clinical trial. Sixty subjects will be randomly allocated into three groups: (1) pulmonary rehabilitation (PR) associated with inspiratory muscle training without any load (PRWIMT), (2) PR associated with inspiratory muscle training with a linear load (PRIMTLL), and (3) PR associated with inspiratory muscle training with isocapnic voluntary hyperpnea (PRIMTIVH). The protocol will be performed 5 days a week (3 days with supervision) for 10 weeks. The study will assess anthropometric data, lung function, respiratory muscle strength, and functional capacity by the Incremental Shuttle Walking Test and the Six-Minute Walk Test, lung volumes during the submaximal endurance test, peripheral muscle strength of the upper and lower limbs, dyspnea, and quality of life related to health, before and after the training protocol. Normality will be tested using the Kolmogorov-Smirnov test, and variables will be compared by two-way analysis of variance. The significance level was set at p < 0.05. Ethics approval was obtained from the Institutional Ethics Committee in Research (1.663.411). The study results will be disseminated through presentation at specific scientific conferences and publication in peer-reviewed journals.DiscussionThe different IMT protocols used in our study will be able to guide respiratory therapists to understand and to include in conventional PR programs the most effective respiratory muscle training type in subjects with COPD.Trial registrationBrazilian Clinical Trials Registry, RBR-94v6kd. Registered on 11 March 2017.

Intensive care unit–acquired weakness: unanswered questions and targets for future research

Intensive care unit–acquired weakness (ICU-AW) is the most common neuromuscular impairment in critically ill patients. We discuss critical aspects of ICU-AW that have not been completely defined or that are still under discussion. Critical illness polyneuropathy, myopathy, and muscle atrophy contribute in various proportions to ICU-AW. Diagnosis of ICU-AW is clinical and is based on Medical Research Council sum score and handgrip dynamometry for limb weakness and recognition of a patient’s ventilator dependency or difficult weaning from artificial ventilation for diaphragmatic weakness (DW). ICU-AW can be caused by a critical illness polyneuropathy, a critical illness myopathy, or muscle disuse atrophy, alone or in combination. Its diagnosis requires both clinical assessment of muscle strength and complete electrophysiological evaluation of peripheral nerves and muscles. The peroneal nerve test (PENT) is a quick simplified electrophysiological test with high sensitivity and good specificity that can be used instead of complete electrophysiological evaluation as a screening test in non-cooperative patients. DW, assessed by bilateral phrenic nerve magnetic stimulation or diaphragm ultrasound, can be an isolated event without concurrent limb muscle involvement. Therefore, it remains uncertain whether DW and limb weakness are different manifestations of the same syndrome or are two distinct entities. Delirium is often associated with ICU-AW but a clear correlation between these two entities requires further studies. Artificial nutrition may have an impact on ICU-AW, but no study has assessed the impact of nutrition on ICU-AW as the primary outcome. Early mobilization improves activity limitation at hospital discharge if it is started early in the ICU, but beneficial long-term effects are not established. Determinants of ICU-AW can be many and can interact with each other. Therefore, future studies assessing early mobilization should consider a holistic patient approach with consideration of all components that may lead to muscle weakness.

Risco de quedas, força muscular periférica e capacidade funcional em idosos hospitalizados

Introdução: a longevidade vem acompanhada pelo declínio das capacidades funcionais, especialmente em idosos hospitalizados. Objetivo: avaliar o risco de queda, a força muscular periférica e a capacidade funcional em idosos hospitalizados. Métodos: participaram 100 voluntários que foram submetidos à avaliação fisioterapêutica, por meio da escala de Kendall, força de preensão palmar, teste Time UpGo, escala de Morse e escala de PS-ECOG. Resultados: em relação ao risco de queda, 46% dos indivíduos apresentaram risco moderado e 37% revelaram funcionalidade restrita para atividades exaustivas. Na realização do teste de força muscular periférica, o resultado teve média geral de 4,47kg/f, configurando força muscular moderada, para força de preensão palmar os indivíduos atingiram resultados insatisfatórios, apresentando no membro dominante média de 17,7Kg/f e no membro contralateral média de 17,3Kg/f. Na variável “Timed UpGo”, os indivíduos obtiveram um tempo de 12,25 segundos, no qual foram classificados como independentes. Conclusão: Os idosos hospitalizados apresentaram moderado risco de queda, capacidade funcional reduzida, embora sejam classificados como independentes.

Avaliação da prevalência da polineuromiopatia do doente crítico em uma unidade de terapia intensiva

Objetivo: Avaliar a prevalência da polineuromiopatia do doente crítico (PNMDC), através da mensuração de força muscular, correlacionando com o tempo de ventilação mecânica (VM), desmame e período de internação em unidade de terapia intensiva.Materiais e Métodos: Estudo transversal prospectivo, onde participaram do estudo homens e mulheres maiores de 18 anos. Foram realizadas avaliações por pesquisadores treinados, durante a pausa da sedação e com paciente apto para desmame. A força muscular periférica foi avaliada através da escala MRC (Medical Research Council), e a força de preensão palmar através de DPP (dinamometria de preensão palmar) da mão dominante. As variáveis quantitativas foram descritas por média e desvio padrão; as categóricas, por frequências absolutas e relativas. Para verificar as correlações entre os dados foi realizado o teste de correlação de Spearman, com nível de significância estatística de 5%.Resultados: Amostra de 39 pacientes com predomínio do sexo masculino (n=21; 53,8%), média de idade de 63,67±17,61. Observou-se um total de 66,7% (n=26) pacientes que preenchiam algum critério para diagnóstico de polineuromiopatia. A prevalência de PNMDC, diagnosticada pela tabela do MRC foi observada em 23 pacientes (59%), enquanto que utilizando a DPP, em 10 indivíduos (25,6%). Quando associadas, as avaliações diagnósticas detectaram 7 polineuropatas (17,9%). Não foram observadas correlações entre diagnóstico de PNMDC, com o tempo de VM, de UTI ou de desmame.Conclusão: As ferramentas utilizadas para diagnóstico de PNMDC, de forma isolada ou associadas, identificaram a prevalência de pacientes fracos. Não foram identificadas correlações entre tal fraqueza e tempo maior em VM, tempo de desmame e permanência prolongada na UTI.

The relationship between peripheral muscle strength and respiratory function and respiratory muscle strength in athletes.

The aim of this study is to determine the relationship between peripheral muscle strength, respiratory function and respiratory muscle strength in athletes. The study included a total of 150 elite athletes (judo, rowing, gymnastics) (age, 16.94±2.37 years; length, 167.70±12.23 cm; body weight, 62.87±17.33 kg; body mass index, 21.95±2.92 kg/m2). Isomed 2000 isokinetic dynamometer was used to assess peripheral muscle strength. The strength of the dominant side knee flexor and extensor muscles was evaluated at 60°/sec and 180°/sec. At the end of the evaluation; knee flexion and extension peak torque (PT) values and flexion and extension PT values rates were obtained at 60°/sec and 180°/sec. Respiratory function and respiratory muscle strength of the athletes were evaluated using a digital spirometer. To assess respiratory function, forced vital capacity maneuver and maximal minute ventilation test; to assess the strength of the respiratory muscles, maximum inspiratory pressure and maximal expiratory pressure tests were performed. There was a strong relationship between muscle strength of knee flex-or and extensor muscles and respiratory function (r=−0.268/0.813, P<0.05). There was a strong moderate correlation between knee flexor and extensor muscle strength and all parameters of respiratory muscle strength (r=0.206/0.411, P<0.05). The knee flexor and extensor muscle strength, respiratory function and respiratory muscle strength develops parallel to each other and the codevelopment of these parameters together with special exercises to increase respiratory muscle strength will improve the performance of the athletes.

The relationship between peripheral muscle strength and respiratory function and respiratory muscle strength in athletes

The aim of this study is to determine the relationship between peripheral muscle strength, respiratory function and respiratory muscle strength in athletes. The study included a total of 150 elite athletes (judo, rowing, gymnastics) (age, 16.94±2.37 years; length, 167.70±12.23 cm; body weight, 62.87±17.33 kg; body mass index, 21.95±2.92 kg/m2). Isomed 2000 isokinetic dynamometer was used to assess peripheral muscle strength. The strength of the dominant side knee flexor and extensor muscles was evaluated at 60°/sec and 180°/sec. At the end of the evaluation; knee flexion and extension peak torque (PT) values and flexion and extension PT values rates were obtained at 60°/sec and 180°/sec. Respiratory function and respiratory muscle strength of the athletes were evaluated using a digital spirometer. To assess respiratory function, forced vital capacity maneuver and maximal minute ventilation test; to assess the strength of the respiratory muscles, maximum inspiratory pressure and maximal expiratory pressure tests were performed. There was a strong relationship between muscle strength of knee flex-or and extensor muscles and respiratory function (r=−0.268/0.813, P<0.05). There was a strong moderate correlation between knee flexor and extensor muscle strength and all parameters of respiratory muscle strength (r=0.206/0.411, P<0.05). The knee flexor and extensor muscle strength, respiratory function and respiratory muscle strength develops parallel to each other and the codevelopment of these parameters together with special exercises to increase respiratory muscle strength will improve the performance of the athletes. Keywords: Athletes, Muscle strength, Respiratory muscle, Respiratory function

Peripheral muscle strength is associated with lung function and functional capacity in patients with cystic fibrosis.

AbstractPurposeCystic fibrosis (CF) is an inherited disease that causes important multisystemic impairments. The present study aimed to evaluate the association of peripheral muscle strength with lung function and functional capacity in adolescents and adults with CF.MethodsCross‐sectional study with prospective data of patients enrolled in the Program for Adults with CF at Hospital de Clínicas de Porto Alegre. The testing procedures included peripheral muscle strength testing, pulmonary function tests, and the 6‐minute walk test.ResultsThe sample consisted of 41 subjects (27 women) with a mean age of 24.6. Upper extremity muscle strength was associated with forced vital capacity and forced expiratory volume in the first second, and lower extremity muscle strength was associated with the distance covered in the 6‐minute walk test, oxygen saturation, forced expiratory volume in the first second, and forced vital capacity.ConclusionsMuscle strength was positively associated with lung function variable and functional capacity in patients with CF.

The Effect of Pulmonary Rehabilitation on the Physical Activity Level and General Clinical Status of Patients with Bronchiectasis.

We aimed to investigate the effects of pulmonary rehabilitation (PR) on the level of physical activity (PA) and the general clinical status in adult patients with non-cystic fibrosis bronchiectasis. The patients were included prospectively in the study and followed a home-based PR program for 2 months comprising breathing exercises, training in chest hygiene techniques, peripheral muscle strengthening training, and self-walking. The outcomes measurements were the following: 6-minute walking distance, pulmonary function test, peripheral and respiratory muscle strength measurements, International Physical Activity Questionnaire (IPAQ), Saint George Respiratory Questionnaire, and modified Medical Research Council dyspnea scores. Of the total 25 patients included in the study, six were excluded due to follow-up and adherence problems. A comparison of the outcome measures recorded before and after PR showed statistically significant improvements in the IPAQ total (p=0.015) and walking scores (p=0.011). While the proportion of patients in the low PA category was 73% (n=14) prior to PR, this rate decreased to 42% (n=8) post-PR. The proportion of patients in the moderate PA category was 26% (n=5) prior to PR and increased to 52% (n=10) post-PR. While positive improvements were seen in all clinically monitored parameters, aside from spirometric values, these changes did not reach a statistically significant level. The majority of patients with bronchiectasis have a low level of PA. PR ensures positive improvements in the level of PA and general physical clinical status of such patients.