Respiratory Function In People Research Articles

Effects of extracorporeal diaphragm pacing combined with inspiratory muscle training on respiratory function in people with stroke: a randomized controlled trial

ABSTRACT Objectives To evaluate the effect of external diaphragmatic pacing (EDP) combined with inspiratory muscle training on respiratory function in post-stroke patients. Methods Patients with stroke were enrolled from the First Affiliated Hospital of Soochow University in China between 2021 and 2022. The patients were randomized into an EDP treatment group (control group) or an EDP treatment plus inspiratory muscle training group (experimental group). Each therapy was administered once a day for 6 days per week. The peak inspiratory flow (PIF), maximal inspiratory pressure (MIP), forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), FEV1/FVC% ratio, and diaphragm thickness and mobility were measured and compared between the two groups after 4 weeks. Results After 4 weeks of intervention, respiratory muscle function indicators including PIF (95% CI: 0.21–1.28, p = 0.008) and MIP (95% CI: 6.92–25.44, p = 0.001) significantly improved in the experimental group. Diaphragmatic thickness also significantly increased in the experimental group (p < 0.05), while diaphragmatic excursion showed no significant difference between the two groups. Additionally, FVC (95% CI: 0.14–1.14, p = 0.013) and FEV1 (95% CI: 0.20–1.06, p = 0.005) demonstrated a significant increase in the experimental group, whereas FEV1/FVC% (95% CI: −0.84 to 9.36, p = 0.099) exhibited no significant group difference. Conclusion EDP combined with inspiratory muscle training in individuals with stroke provides greater benefits than EDP alone in terms of respiratory function recovery, except for the parameters of diaphragmatic excursion and FEV1/FVC%.

Does inspiratory muscle training improve lung function and quality of life in people with inclusion body myositis? A pilot study

Inclusion body myositis is the most common acquired myositis in adults, predominantly weakening forearm flexor and knee extensor muscles. Subclinical respiratory muscle weakness has recently been recognised in people with inclusion body myositis, increasing their risk of respiratory complications. Inspiratory muscle training, a technique which demonstrates efficacy and safety in improving respiratory function in people with neuromuscular disorders, has never been explored in those with inclusion body myositis. In this pilot study, six adults with inclusion body myositis (age range 53 to 81 years) completed eight weeks of inspiratory muscle training. Measures of respiratory function, quality of life, sleep quality and a two-minute walk test were performed pre and post-intervention. All participants improved their respiratory function, with maximal inspiratory pressure, sniff nasal inspiratory pressure and forced vital capacity increasing by an average of 50 % (p = .002), 43 % (p = .018) and 13 % (p = .003) respectively. No significant change was observed in quality of life, sleep quality or two-minute walk test performance. No complications occurred due to inspiratory muscle training This pilot study provides the first evidence that inspiratory muscle training may be safe and effective in people with Inclusion Body Myositis, potentially mitigating the complications of poor respiratory function.

Effect of high-intensity intermittent aerobic exercise on blood pressure, heart rate variability, and respiratory function in people with methamphetamine use disorder

Effect of high-intensity intermittent aerobic exercise on blood pressure, heart rate variability, and respiratory function in people with methamphetamine use disorder

WITHDRAWN: Effect of high-intensity intermittent aerobic exercise on blood pressure, heart rate variability, and respiratory function in people with methamphetamine use disorder

WITHDRAWN: Effect of high-intensity intermittent aerobic exercise on blood pressure, heart rate variability, and respiratory function in people with methamphetamine use disorder

TU-213. Transcutaneous spinal cord stimulation combined with respiratory rehabilitation for respiratory function in people with cervical SCI with respiratory dysfunction

TU-213. Transcutaneous spinal cord stimulation combined with respiratory rehabilitation for respiratory function in people with cervical SCI with respiratory dysfunction

Inspiratory Muscle Performance and Anthropometric Measures—Novel Assessments Related to Pulmonary Function in People with Spinal Cord Injury: A Pilot Study

ObjectiveTo investigate the feasibility and validity of using the novel axillary:umbilical (A:U) ratio and sustained maximal inspiratory pressure (SMIP) as supplementary measures in the assessment of respiratory function in people with spinal cord injury. DesignPilot study with a single day of data collection. All measurements were taken with participants in their personal wheelchairs to best represent normal functioning and positioning for each individual. SettingResearch institution. ParticipantsA convenience sample of 30 community dwelling volunteers with chronic spinal cord injury (C2-T12, American Spinal Injury Association Impairment Scale A-D) participated. InterventionsNot applicable. Main Outcome MeasuresParticipants underwent anthropometric measurements (trunk height, abdominal circumference, axillary circumference) and assessment of inspiratory muscle performance, incluidng maximal inspiratory pressure, SMIP, and inspiratory duration, as well as standard pulmonary function tests. ResultsThe A:U ratio and SMIP were recorded for all participants. The SMIP was significantly related to more respiratory performance measures than the maximal inspiratory pressure (P<.05) and the A:U ratio was significantly related to more respiratory performance measures than any other anthropometric measure (P<.05). Additionally, an A:U ratio cutoff point detected individuals with a peak expiratory flow ≥ 80% of their predicted value with a sensitivity and specificity of 85.7% and 91.3%, respectively (area under the curve: 0.92). ConclusionsIt is feasible to capture the A:U Ratio and SMIP in individuals with spinal cord injury. Further, the strong significant relationships of SMIP and the A:U ratio to respiratory performance measures suggests their clinical importance in the pulmonary assessment and risk stratification of people with chronic spinal cord injury.

Selective serotonin reuptake inhibitor use is associated with worse sleep-related breathing disturbances in individuals with depressive disorders and sleep complaints: a retrospective study.

The effects of serotonergic agents on respiration neuromodulation may vary according to differences in the serotonin system, such as those linked to depression. This study investigated how sleep-related respiratory disturbances relate to depression and the use of medications commonly prescribed for depression. Retrospective polysomnography was collated for all 363 individuals who met selection criteria out of 2,528 consecutive individuals referred to a specialized sleep clinic (Ottawa, Canada) between 2006 and 2016. The apnea-hypopnea index (AHI), oxygen saturation nadir, and oxygen desaturation index during REM and NREM sleep were analyzed using mixed analyses of covariance comparing 3 main groups: (1) medicated individuals with depressive disorders (antidepressant group; subdivided into the selective serotonin reuptake inhibitor and norepinephrine-dopamine reuptake inhibitor subgroups), (2) non-medicated individuals with depressive disorders (non-medicated group), and (3) mentally healthy control patients (control group). Individuals with depressive disorders (on antidepressants or not) had significantly higher AHIs compared to control patients (both P ≤ .007). The antidepressant group had a lower NREM sleep oxygen saturation nadir and a higher NREM sleep oxygen desaturation index than the control and non-medicated groups (all P ≤ .009). Within individuals with depressive disorders, independent of depression severity, the selective serotonin reuptake inhibitor group had a lower oxygen saturation nadir and a higher oxygen desaturation index during NREM sleep than the norepinephrine-dopamine reuptake inhibitor (both P ≤ .045) and non-medicated groups (both P < .001) and a higher NREM sleep AHI than the non-medicated group (P = .014). These findings suggest that the use of selective serotonin reuptake inhibitors may be associated with impaired breathing and worse nocturnal oxygen saturation in individuals with depressive disorders and sleep complaints, but this needs to be confirmed by prospective studies.

The Amiantus Program in Poland - 20 years of implementation

Despite the ban on the production of asbestos-containing materials, introduced in Poland over 20 years ago, new cases of asbestos-related diseases are still being recorded. Systematic control of respiratory function in people exposed to asbestos dust is, therefore, extremely important due to the biological properties of this mineral. The Amiantus preventive medical examination program was undertaken in 2000 to implement the legal rights of former employees of asbestos processing plants for this type of examinations. People who have ever been employed in such factories have been authorized to use preventive medical examinations for the rest of their lives. The research is continuous, spread over time and focused, in particular, on the assessment of the respiratory system. Since the beginning of the program, throughout 20 years of its implementation, 8329 people have been examined, including 5199 (62.4%) men for whom a total of 34 454 medical examinations have been carried out. During the program period, the percentage of diagnosed pathologies increased from 8% in 2000 to 25% in 2019. Overall, 2078 asbestos-related diseases were diagnosed among former employees of asbestos processing plants under the Amiantus Program, which accounted for 25% of this group. Among all diseases caused by exposure to asbestos, the most common were: asbestosis (1880 cases - 90.5%), lung cancer (121 cases - 5.8%) and pleural mesothelioma (77 cases - 3.7%). Diseases of pleura in the form of plaques and diffuse pleural thickening were diagnosed in 40% of the examined patients, while radiological pulmonary shadows affected over 65% of former employees of asbestos processing plants. The Amiantus Program, thanks to the long observation period, enabled monitoring the health of former employees exposed to asbestos, and created a unique opportunity to carry out epidemiological analyzes. These studies allowed the authors to expand their knowledge of the natural history of asbestos-related diseases. Med Pr. 2020;71(5):595-601.

Inhaled mannitol for cystic fibrosis.

Inhaled mannitol for cystic fibrosis.

Potential of the Cardiovascular Drug Levosimendan in the Management of Amyotrophic Lateral Sclerosis: An Overview of a Working Hypothesis.

Levosimendan is a calcium sensitizer that promotes myocyte contractility through its calcium-dependent interaction with cardiac troponin C. Administered intravenously, it has been used for nearly 2 decades to treat acute and advanced heart failure and to support the heart function in various therapy settings characterized by low cardiac output. Effects of levosimendan on noncardiac muscle suggest a possible new application in the treatment of people with amyotrophic lateral sclerosis (ALS), a neuromuscular disorder characterized by progressive weakness, and eventual paralysis. Previous attempts to improve the muscle response in ALS patients and thereby maintain respiratory function and delay progression of disability have produced some mixed results. Continuing this line of investigation, levosimendan has been shown to enhance in vitro the contractility of the diaphragm muscle fibers of non-ALS patients and to improve in vivo diaphragm neuromuscular efficiency in healthy subjects. Possible positive effects on respiratory function in people with ALS were seen in an exploratory phase 2 study, and a phase 3 clinical trial is now underway to evaluate the potential benefit of an oral form of levosimendan on both respiratory and overall functions in patients with ALS. Here, we will review the various known pharmacologic effects of levosimendan, considering their relevance to people living with ALS.

ParkinSong: A Controlled Trial of Singing-Based Therapy for Parkinson’s Disease

Background. Communication impairment is one of the most common symptoms of Parkinson’s disease (PD), significantly affecting quality of life. Singing shares many of the neural networks and structural mechanisms used during speech and, thus, has potential for therapeutic application to address speech disorders. Objective. To explore the effects of an interdisciplinary singing-based therapeutic intervention (ParkinSong) on voice and communication in people with PD. Methods. A controlled trial compared the effects of the ParkinSong intervention with an active control condition at 2 dosage levels (weekly vs monthly) over 3 months, on voice, speech, respiratory strength, and voice-related quality-of-life outcomes for 75 people living with PD. The interdisciplinary ParkinSong model comprised high-effort vocal and respiratory tasks, speech exercises, group singing, and social communication opportunities. Results. ParkinSong intervention participants demonstrated significant improvements in vocal intensity (P = .018), maximum expiratory pressure (P = .032), and voice-related quality of life (P = .043) in comparison to controls. Weekly ParkinSong participants increased vocal intensity more than monthly participants (P = .011). Vocal intensity declined in nontreatment control groups. No statistical differences between groups on maximum phonation length or maximum inspiratory pressure were observed at 3 months. Conclusions. ParkinSong is an engaging intervention with the potential to increase loudness and respiratory function in people with mild to moderately severe PD.

Inhaled mannitol for cystic fibrosis.

Inhaled mannitol for cystic fibrosis.

The Effectiveness of Singing or Playing a Wind Instrument in Improving Respiratory Function in Patients with Long-Term Neurological Conditions: A Systematic Review.

Many long-term neurological conditions adversely affect respiratory function. Singing and playing wind instruments are relatively inexpensive interventions with potential for improving respiratory function; however, synthesis of current evidence is needed to inform research and clinical use of music in respiratory care. To critically appraise, analyze, and synthesize published evidence on the effectiveness of singing or playing a wind instrument to improve respiratory function in people with long-term neurological conditions. Systematic review of published randomized controlled trials and observational studies examining singing or playing wind instruments to improve respiratory function in individuals with long-term neurological conditions. Articles meeting specified inclusion criteria were identified through a search of the Medline, Embase, PsycINFO, Cochrane Library, CINAHL, Web of Science, CAIRSS for Music, WHO International Clinical Trials Registry Platform Search Portal, and AMED databases as early as 1806 through March 2015. Information on study design, clinical populations, interventions, and outcome measures was extracted and summarized using an electronic standardized coding form. Methodological quality was assessed and summarized across studies descriptively. From screening 584 references, 68 full texts were reviewed and five studies included. These concerned 109 participants. The studies were deemed of low quality, due to evidence of bias, in part due to intervention complexity. No adverse effects were reported. Overall, there was a trend toward improved respiratory function, but only one study on Parkinson's disease had significant between-group differences. The positive trend in respiratory function in people with long-term neurological conditions following singing or wind instrument therapy is of interest, and warrants further investigation.

Topical cystic fibrosis transmembrane conductance regulator gene replacement for cystic fibrosis-related lung disease.

Cystic fibrosis is caused by a defective gene encoding a protein called the cystic fibrosis transmembrane conductance regulator (CFTR), and is characterised by chronic lung infection resulting in inflammation and progressive lung damage that results in a reduced life expectancy. To determine whether topical CFTR gene replacement therapy to the lungs in people with cystic fibrosis is associated with improvements in clinical outcomes, and to assess any adverse effects. We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Trials Register comprising references identified from comprehensive electronic database searches, handsearching relevant journals and abstract books of conference proceedings.Date of most recent search: 05 May 2016.An additional search of the National Institutes for Health (NIH) Genetic Modification Clinical Research Information System (GeMCRIS) was also performed for the years 1992 to 2015.Date of most recent search: 20 April 2016. Randomised controlled studies comparing topical CFTR gene delivery to the lung, using either viral or non-viral delivery systems, with placebo or an alternative delivery system in people with confirmed cystic fibrosis. The authors independently extracted data and assessed study quality. Authors of included studies were contacted and asked for any available additional data. Meta-analysis was limited due to differing study designs. Four randomised controlled studies met the inclusion criteria for this review, involving a total of 302 participants lasting from 29 days to 13 months; 14 studies were excluded. The included studies differed in terms of CFTR gene replacement agent and study design, which limited the meta-analysis. One study only enrolled adult males, the remaining studies included both males and females aged 12 years and over.Risk of bias in the studies was moderate. Random sequence generation and allocation concealment was only described in the more recent study; the remaining three studies were judged to have an unclear risk of bias. All four studies documented double-blinding to the intervention, but there is some uncertainty with regards to participant blinding in one study. Some outcome data were missing from all four studies.There were no differences in either the number of respiratory exacerbations or the number of participants with an exacerbation between replacement therapy or placebo groups at any time point. Meta-analysis of most respiratory function tests showed no difference between treatment and placebo groups, but the smallest study (n = 16) reported forced vital capacity (litres) increased more in the placebo group at up to 24 hours. A further study reported a significant improvement in forced expiratory volume at one second (litres) at 30 days after participants had received their first dose of favouring the gene therapy agent, but this finding was not confirmed when combined with at second study in the meta-analysis. The more recent study (n = 140) demonstrated a small improvement in forced vital capacity (per cent predicted) at two and three months and again at 11 and 12 months for participants receiving CFTR gene replacement therapy compared to those receiving placebo. The same study reported a significant difference in the relative change in forced expiratory volume at one second (per cent predicted) at two months, three months and 12 months.One small study reported significant concerns with "influenza-like" symptoms in participants treated with CFTR gene replacement therapy; this was not reported on repeated use of the same agent in a larger recent study.There was no other evidence of positive impact on outcomes, in particular improved quality of life or reduced treatment burden.Two studies measured ion transport in the lower airways; one (n = 16) demonstrated significant changes toward normal values in the participants who received gene transfer agents (P < 0.0001), mean difference 6.86 (95% confidence interval 3.77 to 9.95). The second study (n = 140) also reported significant changes toward normal values (P = 0.032); however, aggregate data were not available for analysis. In the most recent study, there was also evidence of increased salt transport in cells obtained by brushing the lower airway. These outcomes, whilst important, are not of direct clinical relevance. One study of liposome-based CFTR gene transfer therapy demonstrated some improvements in respiratory function in people with CF, but this limited evidence of efficacy does not support this treatment as a routine therapy at present. There was no evidence of efficacy for viral-mediated gene delivery.Future studies need to investigate clinically important outcome measures.

The effect of elastic abdominal binder use on respiratory function on persons with high spinal cord injury at orthostatic position.

Introduction: Spinal cord injury causes respiratory muscles paralysis, especially in high thoracic paraplegia and tetraplegia with injury above or right on the sixth thoracic segment, and also biomechanics, volumes, capacities and respiratory pressures changes in affected people. The elastic abdominal binder provides a mechanical support for respiratory function treatment, assisting with abdominal restraint and abdominal compliance reduction while at orthostatic position. Objective: To verify the elastic abdominal binder effect on the respiratory function of people with spinal cord injuries during standing position with the help of orthostatic table, from vertical angle position of 60° and 90°. Method: The study included 56 people suffering from spinal cord injury with motor level above or right on the sixth thoracic segment. They were randomly divided into four distinct groups regarding the use or not of the binder and different inclinations of the orthostatic table during the evaluation procedure. The measured outcomes were vital capacity, tidal volume, inspiratory and expiratory pressure and oxygen saturation. The descriptive analysis presented according to average and standard deviation or median and interquartile. For the outcomes analysis of the five evaluations, the Analysis of Variance (ANOVA) of two factors with repeated measures was used. Statistical significance was set at 5%. Results: The values obtained from respiratory parameters showed no statistical significance regarding the elastic abdominal binder intervention nor on the angle of the standing position. Conclusion: There was no contrasting effect regarding the use of the binder among the evaluated people, therefore it should not be nominated as a standard procedure in the treatment of spinal cord injury at orthostatic position. However, this procedure should not be absolute contraindicated, thus its effect has not demonstrated any harm to participants.

Inhaled mannitol for cystic fibrosis

Inhaled mannitol for cystic fibrosis

The use of bronchodilators in people with recently acquired tetraplegia: a randomised cross-over trial

A within-participant, double-blind, cross-over, randomised control trial. To determine the short-term effects of bronchodilator therapy on respiratory function in people with recently acquired motor complete tetraplegia. Hospital, Australia. A total of 12 people with recently acquired tetraplegia were randomised to receive either a one-off dose of a bronchodilator followed by an equivalent dose of a placebo propellant between 1 day and 1 week later or visa versa. The three outcomes were forced expiratory volume in 1 s (FEV1), peak expiratory flow rate (PEF) and forced vital capacity (FVC). These were measured while supine by a blinded assessor 10 and 30 min after treatment. Data were analysed on 11 participants and reported as percentage of predicted. The FEV1, FVC and PEF mean between-group differences (95% confidence interval) at 10 min post treatment were 7.3% (2.7-11.9%; P=0.003), 5.5% (1.6-9.4%; P=0.008) and 20.1% (1.1-40.4%; P=0.039). Similar effects were observed at 30 min for FVC and FEV1 but not for PEF. Bronchodilator therapy has a beneficial effect on FEV1, FVC and PEF in participants with recently acquired tetraplegia.

Respiratory function of people with amyotrophic lateral sclerosis and caregiver distress level: a correlational study

BackgroundAmyotrophic Lateral Sclerosis (ALS) is a rare, fatal neurodegenerative disorder with no curative treatment characterized by degeneration of motor neurons involving a progressive impairment of motor and respiratory functions. Most patients die of ventilator respiratory failure. Caregivers have a great influence on the patient”s quality of life as well as on the quality of care. Home influence of the caregiver on patient care is notable. To date, no study has investigated how psychological issues of caregivers would influence respiratory variables of ALS patients. The study aimed at finding out if there is a relationship between the respiratory function of ALS patients and the level of distress of their caregivers.MethodsA cross-sectional study was conducted to investigate respiratory issues (PCF and FVC) and the perception of social support of ALS patients. Caregivers filled questionnaires about trait anxiety, depression, and burden of care. Forty ALS patients and their caregivers were recruited.ResultsFVC and PCF were positively related to patient perception of social support and negatively related to caregiver anxiety, depression, and burden.DiscussionThe distress of ALS caregivers is related to patient respiratory issues. The first and more intuitive explanation emphasizes the impact that the patient’s clinical condition has with respect to the caregiver. However, it is possible to hypothesize that if caregivers feel psychologically better, their patient’s quality of life improves and that a condition of greater well-being and relaxation could also increase ventilatory capacity. Furthermore, care management could be carried out more easily by caregivers who pay more attention to the patient's respiratory needs.ConclusionPatient perception of social support and caregiver distress are related to respiratory issues in ALS.

J11 A pilot study on respiratory function in people with huntington's disease

BackgroundHuntington's disease (HD) is a neurodegenerative condition resulting in motor, cognitive and behavioural dysfunction. Physiotherapists are involved in the management of respiratory problems during the later stages of the disease1...

Human Exposure Chamber for Known Formaldehyde Levels: Generation and Validation

Formaldehyde is a common air pollutant of the indoor environment. It has a potential effect on the respiratory function of people and so studies have been performed to assess this using exposure methods with high concentrations of formaldehyde. However, epidemiology studies have shown its impact on allergic diseases at lower domestic levels. The aim of this study was to develop an exposure chamber to study effects of low controlled concentrations of formaldehyde. Concentrations in the chamber were quantified by a simple DNHP-derivatisation method followed by liquid chromatography coupled to UV detection. Experiments to assess formaldehyde generation yield and reproducibility of formaldehyde levels in the chamber were performed in an empty chamber. The temporal decay of formaldehyde concentration in the exposure chamber was also investigated for more than 2h under different experimental conditions, for example in darkness or with somebody inside the chamber. Actual measured levels of formaldehyde were found to be 78-91% of the calculated value expected. The study of the temporal decay showed that subject’s breathing accounted for the fate of approximately 50% of the formaldehyde lost. Leaks, wall deposition, photolysis and adsorption on clothes were processes identified to explain the remaining 50%. However, this study has shown that both homogeneity and stability of formaldehyde concentration in the gas phase can be maintained acceptably to carry out future human exposure experiments.