Respiratory Exercise Research Articles

Respiratory Exercise Solutions in Precision Radiation Therapy for Lung Cancer

Objective: To study the intervention effect of incorporating respiratory motion solutions in precision radiotherapy for lung cancer. Methods: In the survey sample collected by the enterprise from 2022 to 2023, we selected 60 patients for sample study. They were randomly divided into two groups. Both groups received precision radiotherapy. The control group (n=30) received health education to help patients understand the importance of cervical radiotherapy for lung cancer. The observation group (n=30) received resistance respiratory training and lung function training. The lung function indicators, Piper fatigue scale, cancer-related quality of life score, and symptom score were compared before and after intervention in both groups. Results: Before intervention, there were no significant differences in lung function indicators, Piper fatigue scale, cancer-related quality of life score between the two groups (P>0.05). After intervention, the lung function indicators, Piper fatigue scale, and cancer-related quality of life score were significantly better in the observation group than in the control group (P<0.05). The observation group also had a lower symptom score than the control group (P<0.05). Conclusion: Incorporating resistance respiratory training and lung function training during precision radiotherapy for lung cancer can improve respiratory motion, enhance treatment effectiveness, and improve lung function. These findings are worth promoting.

Inspiratory Muscle Training Intensity in Patients Living with Cardiovascular Diseases: A Systematic Review

The benefits of inspiratory muscle training (IMT) have been demonstrated in patients with cardiovascular diseases (CVD); however, the optimal training intensity is not yet fully clarified. The purpose of this study was to review the impact of IMT intensity on respiratory muscle strength, functional and exercise capacity, pulmonary function, and quality of life in patients with CVD. This systematic review was carried out according to PRISMA statement and registered in the PROSPERO database (review protocol: CRD42023442378). Randomized controlled trials were retrieved on 3 July 2023 in the following electronic databases: Web of Science, PubMed, EMBASE, and SCOPUS. Studies were included if they assessed the impact of isolated IMT on CVD patients in comparison with sham, different intensities and/or intervention groups. Eight studies were included for final analysis; IMT consistently led to significantly greater improvements in inspiratory muscle strength compared to control (CON) groups. The intensity of IMT varied in the studies based on different percentages of maximal inspiratory pressure (MIP), ranging from 25% to 60% of MIP. The time of intervention ranged from 4 to 12 weeks. Despite this variability, the studies collectively suggested that IMT is beneficial for enhancing CVD patients’ conditions. However, the optimal intensity range for benefits appeared to vary, and no single intensity emerged as universally superior across all studies.

Effects of motor imagery and action observation on respiratory function in mild smokers: a randomized single-blind controlled pilot trial

Background: Motor imagery (MI) and action observation (AO) training can activate brain areas involved in planning, adjusting, and automating voluntary movement in a manner similar to that when these activities are being performed. Aim: The main objective of this study was to assess the effects of MI and AO training on respiratory function in mild smokers. Methods: A single-blind placebo-controlled pilot trial was designed. A total of 27 mild smokers were randomized into three groups: MI (n = 9), AO (n = 9), and sham observation (SO; n = 9) groups. The MI and AO groups performed mental training of breathing exercises while the SO group observed a landscape without a human agent. The primary outcomes were pulmonary function parameters (forced expiratory volume during the 1st s [FEV1], forced vital capacity [FVC], FEV1/FVC ratio, maximum voluntary ventilation [MVV], and peak expiratory flow [PEF]), and the secondary outcomes were maximal inspiratory/expiratory pressures (MIP/MEP) and perceived fatigue. All outcome measures were assessed at baseline and post-intervention. Results: Regarding the pulmonary function parameters, only the AO group showed significant within-group differences in FEV1 (mean differences [MD] = 0.37 L (0.17 – 0.56), P = 0.001), FVC (MD = 0.1 L (0.02 – 0.16), P = 0.008), and PEF (MD = 0.74 L/s (0.29 – 1.18), P = 0.002) with a small-to-moderate effect size. No differences were found in FEV1/FVC ratio and MVV. With regard to the maximal static pressures, only the AO group showed significant within-group differences in MEP with a small effect size (MD = 11.22 cm H2O (0.19 – 22.2), P = 0.046). Finally, both AO and MI groups showed significantly greater perceived fatigue with regard to SO group with a large effect size (P < 0.05). Conclusion: AO training has a slight impact on some pulmonary function parameters, such as FEV1, FVC, or PEF, as well as on MEP when applied in isolation and in a single session. Relevance for Patients: Although it is still early to draw some solid conclusions, AO training could be used in combination with respiratory exercises to see if the effect is greater than exercises in isolation. The study of movement representation strategies on pulmonary function is a field that has been sparingly explored so far. This paper offers some interesting data to be considered for further research.

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.

The effect of respiratory muscle training on respiratory muscle strength, diaphragm thickness/mobility, and exercise capacity in patients with systemic lupus erythematosus and associated shrinking lung syndrome.

Systemic lupus erythematosus (SLE) is a chronic autoimmune disorder that can impact any organ in the body. The pathophysiology of shrinking lung syndrome (SLS), a rare pulmonary complication of SLE, remains unknown. The objective of the current case series was to investigate the effects of inspiratory muscle training (IMT) on diaphragm thickness/mobility, respiratory muscle strength, peripheral muscle thickness/strength, and functional exercise capacity in patients with SLE and associated SLS. Three patients with SLE were included in the case series. Respiratory muscle strength, peripheral muscle strength, peripheral muscle thickness, diaphragm muscle thickness, diaphragm muscle mobility, functional exercise capacity, and pulmonary function test were assessed. A significant improvement has been determined in respiratory muscle strength, functional exercise capacity, peripheral muscle strength, peripheral muscle thickness, diaphragm muscle thickness, and diaphragm muscle mobility. This is the first case series showing the beneficial effects of IMT on respiratory muscle strength, diaphragm thickness/mobility, peripheral muscle thickness/strength, and exercise capacity in patients with SLE.

The Efficiency of Respiratory Exercises in Rehabilitation of Low Back Pain: A Systematic Review and Meta-Analysis.

Low back pain (LBP) is a common musculoskeletal disorder, and respiratory exercise is considered a nonsurgical management method. Therefore, this systematic review and meta-analysis aims to estimate the results of randomized controlled trials on the effect of respiratory training in reducing LBP and its dose relationship. The present study was conducted from January 2020 to January 2022, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (2020). Relevant studies were searched in multiple databases including PubMed, Web of Science, the Cochrane Library, EBSCO, Scopus, ScienceDirect, Wan Fang and China Knowledge Network, ClinicalTrials.gov, and Google Scholar, using a combination of MeSH/Emtree terms and free-text words. The heterogeneity of the studies was assessed using the I2 statistic. A total of 14 publications were included in the meta-analysis, with a total sample size of 698 individuals, aged 60-80years. Respiratory exercise was effective in relieving LBP (standardized mean difference = -0.87, P < .00001) and improving physical disability (standardized mean difference = -0.79, P < .00001). The type of breathing and the total duration of breathing exercises were found to be the source of heterogeneity in this study by subgroup analysis. Subgroup analysis revealed that the most significant effect sizes of breathing resistance exercise to reduce LBP and the most significant effect sizes of breathing relaxation techniques to alleviate physical disability were performed 3 to 5 times per week and period >4weeks. Respiratory exercise reducing LBP and improving functional disability was most effective when the total duration of the intervention was >500minutes. Funnel plots showed that the results of the 2 overall studies were reliable without publication bias. Respiratory exercise can effectively reduce LBP and improve physical disability. Therefore, these exercises can be regarded as a part of a LBP management plan. We recommend an exercise program with 30 to 50 minutes, 3 to 5 times per week, and >4weeks of breathing resistance exercise program as the most effective for treating LBP.

Effects of a cardiopulmonary rehabilitation programme on submaximal exercise in Tunisian patients with long-COVID19: A randomized clinical trial.

There is a lack of randomized clinical trials (RCTs) exploring the outcomes of cardiopulmonary rehabilitation programmes (CPRPs) on submaximal aerobic capacity of long COVID-19 patients (LC19Ps). This RCT aimed to evaluate the effect of an ambulatory CPRP on the 6-min walk test (6MWT) data (main outcome: 6-min walk distance (6MWD)) of LC19Ps. Conducted as a single-blinded RCT, the study included Tunisian LC19Ps with persistent dyspnoea (i.e. modified medical research council (mMRC) level ≥2) at least three months postdiagnosis. LC19Ps were randomly assigned to the intervention (IG, n = 20) or control (CG, n = 10) groups. Pre- and post-CPRP evaluations included dyspnoea assessments (Borg and mMRC scales), anthropometric data, spirometry, and 6MWT. The CPRP (i.e. 18 sessions over six weeks) encompassed warm-up, aerobic training, resistance training, respiratory exercises, and therapeutic education. The CPRP significantly improved i) dyspnoea, i.e. IG exhibited larger reductions compared to the CG in Borg (-3.5 ± 2.0 vs. -1.3 ± 1.5) and mMRC (-1.5 ± 0.8 vs. -0.1 ± 0.3) scales, and ii) 6MWD, i.e. IG demonstrated larger improvements compared to the CG in 6MWD (m, %) (168 ± 99 vs. 5 ± 45 m, 28 ± 8 vs. 1 ± 8%, respectively), and resting heart rate (bpm, % maximal predicted heart rate) (-9 ± 9 vs. 1 ± 7 bpm; -5 ± 6 vs. 0 ± 4%, respectively), with small effect sizes. In the IG, the 1.5-point decrease in mMRC and the 168 m increase in 6MWD exceeded the recommended minimal clinical important differences of 1 point and 30 m, respectively. CPRP appears to be effective in enhancing the submaximal exercise capacity of LC19Ps, particularly in improving 6MWD, dyspnoea, and resting heart rate. RCT registration: www.pactr.org; PACTR202303849880222.

An Integrative Approach to the Development of the "Mental Retreat" Wellness Program to Prevent Early Aging

In today's society, where everyday challenges and pressures can significantly impact one's psych-emotional state, it is crucial to develop effective stress reduction strategies and maintain mental well-being. Prolonged stress, as recognized in global practice, can trigger the development of various ailments, such as cardiovascular pathologies, endocrine disorders, and psychosomatic deviations, and can also predispose individuals to autoimmune and oncological conditions. Furthermore, the influence of stressful situations over one's lifetime is a well-acknowledged risk factor that heightens the likelihood of early-onset age-associated illnesses and premature death. The primary objective of this study is to analyze and assess the effectiveness of health-promoting procedures in reducing stress levels and to develop a comprehensive wellness Program called "Mental Retreat." The application of this Program aims to mitigate the risk of various chronic diseases and preempt changes at the gene expression level to decelerate intracellular aging, enhance the body's antioxidant system, and stimulate the immune system. This work lays the groundwork for understanding the effects of procedures with substantial empirical support, highlighting synergistic influences in their combination, such as meditative practices, respiratory exercises, aromatherapy, outdoor physical activities, thermal and contrast procedures with elements of aroma and halotherapy, as well as lymphatic drainage massage effects, among others. The developed wellness Program is intended to be evaluated through dynamic observation and monitoring of integrative organism indicators: based on results from bioimpedance analysis (body composition), assessment of stress levels, and biological age accounting for the imbalance between the parasympathetic and sympathetic nervous systems and heart rate variability. Based on a global analysis of existing research, it has been found that the use of a variety of wellness methods has proven to improve concentration and overall psycho-emotional well-being, have a positive effect on the respiratory and cardiovascular systems, promote relaxation and improve sleep, strengthen the immune system and metabolism, increase stress tolerance, and can also have a positive effect on skin health. It's worth underscoring that the successful implementation of such a wellness Program could have immense implications for public healthcare by preventing the onset of numerous chronic diseases and contributing to an overall enhancement of quality of life.

Efficacy of Advanced Allied Interventions for Dyspnoea, Exercise Capacity, and Quality of Life among the Geriatric Population: A Literature Review

Ageing is a gradual and irreversible pathophysiological process that results in the decline of function in all the body's systems, including the respiratory system. With age, the respiratory muscles lose their strength and become tight, thus affecting lung function. Exercise has been seen to have a positive influence on delaying the ageing process, reducing its ill effects on all systems. Apart from conventional physiotherapy, studies show that other allied therapies, such as the Buteyko breathing technique, respiratory muscle stretch gymnastics, fan therapy, Tai Chi exercise, and many others, have an influence on the cardiorespiratory system. These allied therapies help improve breath control, increase the strength and flexibility of respiratory muscles, stimulate the trigeminal nerve, and contribute differently to reducing symptoms of dyspnoea and fatigue, increasing exercise capacity, and improving Quality of Life (QoL). The purpose of present literature review is to identify various allied therapies that decrease dyspnoea associated with ageing and increase exercise capacity and QoL in the elderly population. A literature search was conducted to find relevant guidelines on interventions for dyspnoea, exercise capacity, and improving QoL in the geriatric population. Total 13 studies related to treatments for dyspnoea and exercise capacity among the geriatric population, aimed at decreasing symptoms and improving QoL, were included in present review article. The number of new and advanced allied methods developed was limited, so more articles could not be added as they did not serve the purpose. The search keywords used were geriatric, dyspnoea, exercise capacity, QoL, and allied therapies. Electronic databases such as PubMed, Google Scholar, Medline, and ResearchGate were used to complete the study. The findings reveal that advanced allied therapies, including fan therapy, Tai Chi exercise, respiratory muscle stretch exercises, pranayama, and video-assisted exercises, are easier and more entertaining ways to engage in regular physical activity, increase exercise capacity, decrease dyspnoea, and improve QoL among the geriatric population.

Cross-sectional insights into exercise physiology knowledge among medical students in Jordan.

Exercise physiology is a branch of physiology that studies how physical activity and exercise alter the structure and function of living organisms. Knowledge of exercise physiology is crucial to improve athletic performance, improve people's ability to cope with extreme circumstances and approach chronic diseases. This research aimed to evaluate the knowledge of future healthcare professionals, namely, the medical students in Jordan regarding exercise physiology. Responses were collected from 524 undergraduate medical students enrolled in clinical clerkship. An online survey that evaluated participants' basic understanding of various physiological concepts related to physical exercises, such as respiratory exchange ratio, physical fitness, V̇O2 max and exercise at high altitudes was employed in the study. 63.2% of participants had a poor level of exercise physiology knowledge. Misconceptions regarding V̇O2 max definition (93.3%), application (46.4%), significance (35.6%) and related physiological factors (48.7%) were observed. Students had misconceptions about physical fitness evaluation questions (52.5%, 39%, and 41.8%, respectively). Student proportions of 37%, 41%, 80.3% and 73.1% showed misconceptions about muscle groups and energy systems during training, training prescription variables, respiratory exchange ratio, and high-altitude performance, respectively. Significant differences in knowledge levels were found based on respondent characteristics (p < 0.05). Knowledge of exercise physiology is more than desirable for medical professionals. Therefore, efforts must be made to increase awareness and improve knowledge about basic physiological fundamentals related to exercise physiology among medical students in Jordan, as they represent the backbone of healthcare professionals of the future who will deal with medical conditions related to physical activity and exercise.

Your preoperative rehabilitation assistant: A study protocol for the impact of a telemedicine-supported preoperative home rehabilitation program on the prognosis of patients undergoing thoracoscopic surgery.

Reduced cardiorespiratory fitness levels are associated with increased short-term complications after surgery, and potentially exert long-lasting effects on the postoperative lives, work and educational pursuits of patients. Currently, research suggests that lifestyle interventions, such as preoperative physical exercise undertaken by patients themselves, may improve patients' cardiopulmonary fitness and reduce post-operative complications. This study aims to investigate the effectiveness and feasibility of a remote medical supervision model for prehabilitation exercise in patients undergoing thoracoscopic lung tumour resection surgery. All enrolled patients will participate in a 4-week pre-operative exercise intervention to improve their cardiorespiratory fitness. During this period, patients will wear wearable devices and exercise at home based on exercise prescriptions. The exercise prescription comprises aerobic exercise (three times a week or more), muscle strengthening exercise (twice a week or more), and respiratory muscle exercise (once a day). The primary aim is to investigate whether baseline VO2max could be improved following a 4-week preoperative exercise program. Secondary objectives include changes in forced expiratory volume in 1 s and forced vital capacity, degree of acceptance of the technology, quality of life, handgrip strength, postoperative complication rate and length of hospital stay. This study aims to evaluate the influence of preoperative prehabilitation exercises in a telemedicine active supervision mode in patients undergoing thoracoscopic lung tumour resection. As such, results of this trial might have some impact on future implementations of group- and home-based prehabilitation exercises in lung cancers. This study was approved by the Medical Ethics Committee of Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology (approval number: TJ-IRB20220564) with registration at ClinicalTrials.gov (identifier: NCT05608759).

The Effect of Respiratory Exercises on People with Ongoing Dyspnea and Recovered from COVID-19

The Effect of Respiratory Exercises on People with Ongoing Dyspnea and Recovered from COVID-19

Investigation of respiratory muscle function, pulmonary function, and exercise capacity in women and men with obstructive sleep apnea syndrome

Amaç: Bu çalışmada Obstrüktif Uyku Apne Sendromu (OUAS) tanısı almış kadın ve erkek hastalarda elektromiyografik respiratuar kas fonksiyonu, solunum kas kuvveti, solunum fonksiyonları ve egzersiz kapasitenin karşılaştırılması amaçlandı.&#x0D; Yöntem: Çalışmaya 19 OUAS olgusu (yaş ortalaması=54,68±13,15 yıl, 10 E, 9 K) dahil edildi. Polisomnografi (PSG) değerlendirmesinden apne/hipopne indeksi (AHİ) ve en düşük oksijen satürasyonu (SpO2) değerleri kaydedildi. Solunum fonksiyon testinde birinci saniyedeki zorlu ekspirasyon volümü (FEV1) ve zorlu vital kapasite (FVC) değerleri kaydedildi. Maksimal inspiratuar basınç (MIP) ve maksimal ekspiratuar basınç (MEP) ölçüldü. Respiratuar kas fonksiyonu, diyafragma yüzeyel elektromiyografi (EMGdi) ve sternoclediomasteoid elektromiyografi (EMGscm) ölçümleri ile değerlendirildi. Altı dakika yürüme testi (6DYT) ve Pittsburgh Uyku Kalitesi İndeksi (PUKİ) uygulandı.&#x0D; Bulgular: Erkek OUAS hastalarının FEV1, FVC, %MIP, MEP, EMGdi, EMGscm ve 6DYT mesafesi değerleri kadın olgulardan daha yüksekti (p

Oddychanie – ważny element profilaktyki uniwersalnej

The aim of the article is to reflect on the properties of respiratory, which should be the main element of the prevention of voice and speech disorders. Theoretical considerations include the issues of physiological respiratory. A contemporary, narrow concept of prevention is also signaled, which deserves attention due to its significant practical importance. With a view to being useful for teachers and speech therapists, the last part includes suggestions for respiratory exercises to be used when planning and conducting activities at the level of universal prevention. The study assumes a close connection between theoretical reflection and solutions to real preventive-diagnostic-therapeutic problems, because, as Franciszek Grucza wrote, “science and practice mutually determine each other, are mutually dependent on each other”.

Right hepatectomy with thrombectomy in treatment of hepatocellular carcinoma with portal vein thrombosis: A case report

Hepatocellular carcinoma (HCC) attacks the intrahepatic vasculature, particularly the portal vein. One of the most important criteria for a poor prognosis in individuals with HCC is the presence of portal vein tumour thrombus (PVTT). There is no global consensus or standard guidelines on the management of HCC with PVTT. We present a 48-year-old male manual labourer with a mass in the right hypochondriac region associated with dull, aching pain for four months. His preoperative preparation, involved addressing and rectifying any existing deficits. Standard precautions were taken for a major liver resection, specifically a right hepatectomy with the removal of a blood clot from the right portal vein. Postoperatively, the patient was mobilized on the first day, engaged in respiratory exercises, and received preventive measures against deep vein thrombosis. We have successfully performed a right hepatectomy with thrombectomy for HCC right lobe with PVTT, which showed a better outcome for the patient. He was leading a normal life at 14-day and 45-day follow-up visits.

The role of early rehabilitation in the ICU management of a severe COVID-19 patient: a case report

Patients admitted to the intensive care unit (ICU) with severe COVID-19, are at high risk of developing ICU acquired weakness and deconditioning syndrome. Early rehabilitation is a critical therapeutic intervention to reduce the complications of immobilization. We present the case of a 51-year-old woman with acute respiratory distress syndrome (ARDS) due to COVID-19. The patient underwent early rehabilitation program, starting from her fourth day after ICU admission. The rehabilitation program included: (1) prone and semi- prone positioning; (2) respiratory exercises, such as diaphragmatic deep breathing, chest stretch, and effective coughing; (3) other exercises which included mobilization, range of motion exercises, and joint relaxation. The patient’s respiratory function eventually improved (as indicated by improved SpO2. Her ability to perform activities of daily living also improved so that she was able to walk independently to the toilet without respiratory distress. Although further research is required, this report suggests that patients with severe COVID-19 admitted to the ICU will benefit from early rehabilitation program.&#x0D; Key words: SARS CoV-2; COVID-19; Early Rehabilitation; Mobilization; Breathing Exercises&#x0D; Citation: Rosyalynda H. The role of early rehabilitation in the ICU management of a severe COVID-19 patient: a case report. Anaesth. pain intensive care 2023;27(6):783−785; DOI: 10.35975/apic.v27i6.2092&#x0D; Received: September 03, 2023; Reviewed: September 16, 2023; Accepted: September 16, 2023

Remote respiratory resistance exercise training improves respiratory function in individuals with VCP multisystem proteinopathy

Valosin-containing protein (VCP) disease is an autosomal dominant multisystem proteinopathy associated with hereditary inclusion body myopathy, Paget disease of bone, and frontotemporal dementia. Myopathy frequently results in respiratory muscle weakness, leading to early mortality due to respiratory failure. We investigated the effects of a remotely administered inspiratory muscle training program in individuals with VCP disease. Nine adults with VCP mutation-positive familial myopathy without evidence of dementia were recruited for a 40-week remotely administered study. Baseline performance was established during the first 8 weeks, followed by 32 weeks of inspiratory muscle training. The primary outcome was maximum inspiratory pressure (MIP). The secondary and exploratory endpoints included spirometry, grip strength, Inclusion Body Myopathy Functional Rating Scale (IBMFRS), Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS), timed up and go, and six-minute walk test (6MWT). During the treatment phase, MIP increased significantly by a weekly mean of 0.392cm. H2O (p=0.023). In contrast, grip strength and ALSFRS significantly decreased by 0.088 lbs. (p=0.031) and 0.043 points (p=0.004) per week, respectively, as expected from the natural progression of this disease. A remotely administered inspiratory muscle training program is therefore feasible, safe, and well-tolerated in individuals with VCP disease and results in improved inspiratory muscle strength.

The feasibility of self-performing measurements of peripheral oxygen saturation and respiratory exercises in home-isolated COVID-19 patients—a single-arm prospective trial

BackgroundCOVID-19 is a highly contagious disease where isolation of infected individuals is deemed warranted. If possible, home isolation is preferred over hospitalization. This implies a need for methods of observation that can ensure the safety of these patients. Preventive treatment methods that can both decrease the probability for development of critical disease and hopefully decrease the need for hospitalization would be an added benefit. This was a single-arm prospective pilot study performed to assess the feasibility of performing self-measurements of SpO2 and respiratory exercises in at-home isolated COVID-19 patients.MethodA total of 40 ambulant SARS-CoV-2-positive individuals in home isolation were followed up for a period of 14 days. At baseline, they were equipped with a pulse oximeter, PEF meter, a project diary to note all measurements, and simple instructions on how to perform respiratory exercises. No other contact was made, but participants were instructed to contact the hospital based on given criteria for blood oxygenation levels and dyspnea severity and to return study equipment and the project diary at the end of study.ResultsDuring the follow-up period, 35 participants (87.5%) recorded daily SpO2 measurements, and 12 (30%) adhered to daily respiratory exercises as instructed. Four participants (10%) were admitted to hospital during the follow-up period. Five participants terminated follow-up prematurely.ConclusionsPerforming self-measurements of SpO2 during home isolation due to COVID-19 infection is feasible. The feasibility of performing respiratory exercises in ambulant patients is questionable and may require more motivational interventions to increase adherence.Trial registrationClinicalTrials.gov identifier: NCT04647747.

Eficacia de las intervenciones fisioterápicas sobre la musculatura respiratoria mediante técnicas de entrenamiento respiratorio en el postoperatorio de trasplantados pulmonares: una revisión sistemática

IntroductionRespiratory muscles are a limiter of exercise capacity in lung transplant patients. It is necessary to know the effectiveness of specific respiratory muscle training techniques carried out in the management of adult lung transplant patients in the postoperative period. Material and methodsA systematic review of clinical trials was carried out, which included adult lung transplant patients undergoing post-transplant respiratory training. A search was carried out in the databases PubMed/Medline, EMBASE, Scopus, Web of Science, Cochrane Library between January 2012 and September 2023, using the terms: “breathing exercise”, “respiratory muscle training”, “inspiratory muscle training”, “respiratory exercise”, “pulmonary rehabilitation”, “lung rehabilitation”; in combination with “lung transplantation”, “lung transplant”, “posttransplant lung”. No language limit. ResultsEleven trials were included with a total of 639 patients analyzed. Most training programs begin upon hospital discharge (more than one month post-transplant), few do so early (Intensive Care Unit). The duration varies from 1-12 months post-transplant. The interventions were based on aerobic training and peripheral muscle strength. Some of them included breathing exercises and chest expansions. The most used outcome variable was submaximal exercise capacity measured with the 6-minute walk test. ConclusionsTraining the respiratory muscles of the adult transplant patient favors the improvement of exercise capacity and quality of life. Aerobic training, as well as strength training of the rest of the peripheral muscles, contribute to the improvement of respiratory muscles.

Fatigue and neuropsychiatric manifestations of post-acute sequelae of COVID-19 (PASC): examining the relationship with clinical and inflammatory markers

ABSTRACT Background and aims Fatigue and neuropsychiatric (NP) symptoms are frequently observed in patients with Post-Acute Sequelae of SARS-CoV-2 Infection (PASC). This study aims to explore the relationship between clinical characteristics, inflammatory markers, and severity of fatigue and NP manifestations in COVID-19 survivors following the acute phase. Methods This cross-sectional study included adult participants who experienced any post-COVID NP symptoms. Questionnaires for fatigue (CFQ-11), anxiety-depression (DASS-21), insomnia (PSQI), cognitive impairment (ACE-III), and delayed processing speed (TMT-B) were administered. Demographic data, clinical characteristics of COVID-19 infection, and laboratory tests for inflammatory markers (CRP, IL-6, albumin, hemoglobin, and NL-ratio) were collected. Results The most common symptoms reported by 82 participants were fatigue (85.4%), insomnia (84.2%), anxiety (62.2%), subjective brain fog (61%), and depression (50%). There was no observed association between the severity of any target symptoms and the inflammatory markers. In multivariable analysis, a strong positive correlation was found between the number of PASC symptoms and the severity of fatigue, depression, anxiety, and sleep problems (p < 0.01). Those who had been infected more than once experienced more fatigue (p = 0.03). Patients with respiratory tract diseases were more likely to experience depression (p = 0.01), and smoking was associated with more sleep disturbances (p = 0.02). Lack of exercise was associated with slower processing speed (p = 0.02). Conclusion The severity of fatigue and NP symptoms of PASC is not correlated with changes in the inflammatory markers. However, certain clinical factors can predict the severity, including the number of PASC symptoms, frequency of COVID-19 infections, respiratory tract diseases, smoking, and exercise.