Condition Of Respiratory Muscles Research Articles

RespiCo: A novel, flexible, and stand-alone electronic respiratory coaching device

Conscious respiratory pattern and rate control is desired by patients with some forms of pulmonary disease that are undergoing respiratory muscle conditioning and rehabilitation, by practitioners of meditation hoping to improve mindfulness and wellbeing, by athletes striving to obtain breathing control in order to increase competitiveness, and by engineers and scientists that wish to use the data from breathing subjects to test hypotheses and develop physiological monitoring systems. Although prerecorded audio sources and computer applications are available that guide breathing exercises, they often suffer from being inflexible and allow only limited customization of the breathing cues. Here we describe a small, lightweight, battery-powered, microprocessor-based respiratory coaching device (RespiCo), which through wireless or wired connections, can be easily customized to precisely guide subjects to breathe at desired respiratory rates using specific breathing patterns through visual, auditory, or haptic cues. Digital signals can also be captured from the device to document the breathing cues provided by the device for research purposes. It is anticipated that this device will have important utility for those who wish to be guided to breathe in a precise manner or in research and development of physiologic monitoring systems.

An Indian study of postural variation in peak expiratory flow rates in healthy, adult, male participants

Background Peak expiratory flow rate (PEFR) reflects the strength and condition of respiratory muscles and the degree of airflow limitation in large airways. PEFR showing postural variation that follows a specific pattern in asthmatics and healthy individuals has been identified. Adequate data are not available for postural variation in normal individuals who are students of professional courses with a sedentary lifestyle. Lung volumes in normal individuals were significantly higher in the standing position. Some studies have reported that in healthy participants spirometric indices were higher while standing in comparison with the sitting position, whereas other studies have reported no differences between spirometric values obtained in the lying, sitting and standing positions. Hence, this study was undertaken to study the postural variation in PEFRs in healthy, adult, male participants in south India. Materials and methods PEFR was recorded in 50 adult, healthy, male participants aged 18–23 years who were students of professional courses. Mini Wright’s peak flow meter was used to measure the PEFR. Three readings were taken in the standing and lying positions. The best of the three recordings was considered as the final value. Results PEFR was decreased while lying down compared with standing in the participants studied, and the quantum of difference was noted. Conclusion With postural changes, the PEFR significantly differs on the basis of whether the measurements are taken in the standing or in the lying posture in healthy participants. The effect of posture may be of importance in recording PEFR, and changing to a better posture may be especially useful for those with weak expiration.

Evaluation of diurnal variation in peak expiratory flow rates in healthy Indian adult male and female subjects

Background: Peak expiratory flow rate (PEFR) reflects the strength and condition of respiratory muscles and the degree of airflow limitation in large airways. PEFR shows hour-to-hour variation that follows a specific pattern, which has been identified in both asthmatics and healthy individuals. Adequate data were not available for the diurnal variation in normal individuals who are students in professional courses and lead a sedentary lifestyle. Hence, this study was undertaken to study the diurnal variation in PEFRs in healthy adult male and female subjects in South India. Materials and Methods: PEFR was recorded in 50 healthy adult male and 50 healthy adult female students aged 18-23 years who were enrolled in professional courses [e.g. Bachelor of Medicine (MBBS), Bachelor of Dental Surgery (BDS), Nursing, and Master of Science (M.Sc.)]. Mini-Wright peak flow meter was used to measure the PEFR. The PEFRs were recorded at 7-8 AM, 10-11 AM, 1-2 PM, 4-5 PM, and 7-8 PM for 2 consecutive days. Results: On analysis of the PEFR records of individual subjects, it was seen that there was an overall dip in the morning at 7-8 AM PEFR, which increased in the daytime, peaking in the afternoon at 4-5 PM and eventually decreased in the night. The subjects did not show the peak PEFR values at the same time point, 16% of the subjects had a rise in PEFR in the early morning, afternoon (1-2 PM) peak was observed in 22% of subjects, and evening (4-5 PM) peak was observed in 36% of subjects. Only 2% of subjects showed a peak in the night time (7-8 PM) PEFR values. Conclusion: This study provided the preliminary reference data of diurnal variation of PEFR in healthy adults. There is a variation in the PEFR recorded during different time points of the day; hence, in order to compare the PEFR between individuals it is advisable to record the PEFR at the same time point. The difference in diurnal variation may be due to the difference in the waking up time between the male and the female subjects as the peak PEFR is generally seen at the midtime of the entire duration when the subject is awake.

A study of postural variation in peak expiratory flow rates in healthy adult female subjects in South India

Background: Peak expiratory flow rate (PEFR) reflects the strength and condition of respiratory muscles and the degree of airflow limitation in large airways. PEFR shows postural variation that follows a specific pattern in asthmatics and healthy individuals has been identified. Adequate data are not available for the postural variation in normal individuals, who are students in professional courses, and had a sedentary lifestyle. Lung volumes in normal subjects were significantly higher in a standing position. Others have reported that in healthy subjects spirometric indices were higher in the standing in comparison with the sitting position whereas other studies have reported no differences between spirometric values obtained in lying, sitting, and standing positions. Hence, this study is undertaken to study the postural variation in PEFR in healthy adult female subjects in South India. Methods: PEFR was recorded in 50 adult healthy female students aged 18-23 years and studying in professional courses (MBBS, BDS, Nursing, and MSc). Mini wright's peak flow meter was used to measure the PEFR. Three readings were taken PEFR in standing and lying posture. Best of three recordings is taken as the final value. Results: PEFR is decreased in lying posture compared to standing posture in subjects studied, and the quantum of difference was noted. Conclusion: In postural changes, PEFR measurements significantly differ based on whether the measurements are taken in the standing or in the lying posture in healthy participants. The effect of posture may be of importance in recording PEFR and changing to a better posture may be especially useful for those patients with weak expiration.

Study of diurnal variation in peak expiratory flow rates in healthy men in South India

Background Peak expiratory flow rate (PEFR) reflects the strength and condition of respiratory muscles and the degree of airflow limitation in large airways. PEFR shows hour-to-hour variation that follows a specific pattern in asthmatics and in healthy individuals. Adequate data are not available on the diurnal variation in normal individuals who are students in professional courses and living a sedentary lifestyle. Hence, this study was undertaken to study the diurnal variation in PEFRs in healthy men in South India. Participants and methods PEFR was recorded in 50 adult healthy male students who were nonsmokers, between 18 and 23 years of age and studying in professional courses (MBBS, BDS, Nursing and MSc). Mini Wright's peak flow meter was used to measure the PEFR. PEFRs were recorded at 7-8 a.m., 10-11 a.m., 1-2 p.m., 4-5 p.m. and 7-8 p.m. for 2 consecutive days. Results On analysis of PEFR records of each individual, it was seen that there was an overall dip in the morning at 7-8 h PEFR, which increased during the daytime, peaking in the afternoon at 4-5 p.m. and eventually decreased in the night. Participants did not show the peak PEFR values at the same time point: 16% of participants had a rise in PEFR in the early morning hours; afternoon (1-2 p.m.) peak was observed in 22% of participants; and evening (4-5 p.m.) peak was observed in 36% of participants. Only 2% of participants showed a peak in the night time (7-8 p.m.) PEFR values. Conclusion This study provided the preliminary reference data of diurnal variation of PEFR in healthy adults. As there is a variation in the PEFR recorded during different time points of the day, it is advisable to record the PEFR at the same time point to compare the PEFR between individuals.

A study of diurnal variation in peak expiratory flow rates in healthy adult female subjects in South India

Background: Peak Expiratory Flow Rate (PEFR) reflects the strength and condition of respiratory muscles and the degree of airflow limitation in large airways. PEFR shows hour to hour variation that follows a specific pattern in asthmatics and healthy individuals. Adequate data is not available for the diurnal variation in normal individuals who are students in professional courses and had a sedentary life style. Hence, this study was undertaken to study the diurnal variation in peak expiratory flow rates in healthy adult female subjects in South India. Materials and Methods: Peak expiratory flow rate was recorded in 50 adult healthy female students aged 18-23 years and studying in professional courses. Mini Wright's peak flow meter was used to measure the peak expiratory flow rate. PEFR were recorded at 7-8 a.m., 10-11 a.m., 1-2 p.m., 4-5 p.m., and 7-8 p.m. for two consecutive days. Results: On analysis of PEFR records of individual subjects, it was seen that there was an overall dip in the morning at 7-8 h PEFR, which increased in the daytime, peaking in the afternoon at 1-2 p.m. and eventually decreased in the night. Subjects did not show the peak PEFR values at the same time point, 10% of subjects had a rise in PEFR in the early morning, afternoon (1-2 p.m.) peak was observed in 48% subjects and evening (4-5 p.m.) peak was observed in 16% subjects. 14% subjects showed a peak in the night time (7-8 p.m.) PEFR values. Conclusion: This study provided the preliminary reference data of diurnal variation of peak expiratory flow rate in healthy adults. Since, there is a variation in the peak expiratory flow rate recorded during different time points of the day; hence, to compare the PEFR between individuals it is advisable to record the PEFR at the same time point.

Estudo das variações de pressão inspiratória máxima em tetraplégicos, tratados por meio de incentivador respiratório, em regime ambulatorial

INTRODUÇÃO: O crescente número de vitimas de lesão medular nos tempos atuais, suas incapacidades e consequências físico-funcionais motivaram-nos a abordar no presente estudo a intervenção fisioterapêutica respiratória ambulatorial nesta população. OBJETIVO: Escolhemos pesquisar sujeitos com lesão adquirida traumática oriundos de uma associação na cidade de Curitiba, PR. Considerando-se que o prognóstico relaciona-se ao nível sensitivo e motor, selecionamos sujeitos com lesões cervicais, por se tratarem de quadros que estão acompanhados de disfunções respiratórias, estas decorrentes do acometimento dos músculos acessórios da respiração. Portanto, essa população é merecedora de uma abordagem preventiva, uma vez que as referidas disfunções podem produzir complicações e piora de prognóstico geral. Tivemos a preocupação de demonstrar as possíveis alterações da capacidade de força respiratória, em função da intervenção fisioterapêutica. METODOLOGIA: Utilizamos, para tanto, o instrumento de medida, comparação e controle da força muscular inspiratória denominado manovacuometria. No tratamento, utilizamos o Threshold IMT, que é um incentivador respiratório. Para os critérios metodológicos, optamos por amostra conveniente, de corte longitudinal, em que foi realizada uma avaliação de força inspiratória inicial, objetivando-se alcançar os valores de pressão inspiratória máxima (PImáx), para comparar com a posterior reavaliação, pós intervenção. Os sujeitos foram submetidos a 30 atendimentos de 15 minutos cada, três vezes por semana. Após este período foram reavaliados sob os mesmos critérios técnicos, para as devidas comparações. RESULTADOS: Os resultados permitiram constatar significativa melhora no condicionamento muscular respiratório, o qual atingiu o nível relevante do desvio padrão (p < 0,05). CONCLUSÃO: Concluímos, portanto, que a proposta de tratamento é eficaz.

Respiratory Muscle Conditioning and the Work of Breathing: A Critical Balance in the Weaning Patient

Normal ventilatory function depends on a balance between ventilatory demand and ventilatory capacity. The respiratory muscles play a critical role in achieving this balance. For patients experiencing ventilatory dysfunction, interventions that improve respiratory muscle function and therefore increase ventilatory capacity may be one way of restoring the balance and promoting ventilatory function. Respiratory muscle conditioning, or training the muscles to improve their strength and endurance, may be a useful clinical intervention in the weaning patient. Results of research show that muscle training may increase the ability of some patients to resume spontaneous ventilation. Continued research is needed to identify the appropriate training protocols for patients experiencing an acute imbalance between ventilatory demand and capacity.

A rationale for training respiratory muscles.

In planning a training programme for respiratory muscles several factors should be considered: establish the objective according to the patient's pathology, provide an adequate stimulus (both in intensity and quality), define if the goal is to increase coordination, strength, endurance, or all three. Several respiratory muscle conditioning plans have been used, mostly derived from three major protocols: sustained hyperventilation, resistive breathing, and manipulations of the breathing pattern. They have proved to be effective in quadriplegia, cystic fibrosis and to some extent in COPD patients. Respiratory muscle recovery and training in patients with respiratory failure is discussed.

Sensitive Indices of Improvement in a Pulmonary Rehabilitation Program

It is often difficult to demonstrate objective evidence of physiologic improvement following a pulmonary rehabilitation program, despite subjective increases in exercise tolerance. In an attempt to identify sensitive indices of improvement, we studied resting and exercise lung function extensively in 15 patients (age range 45 to 73) with severe chronic obstructive lung disease before and after a pulmonary rehabilitation program. The six-week outpatient rehabilitation program consisted of exercise at 70 percent of the maximum predicted heart rate and diaphragmatic breathing for 20 minutes three times weekly. There were no significant changes in resting pulmonary function following exercise training. Exercise measurements were unchanged after completion of the program, with the exception of two parameters: heart rate and arterial lactate levels. The observed small but significant reductions in exercise heart rate and blood lactate levels following training may be due to conditioning of skeletal muscles, although respiratory muscle conditioning may be a contributing factor. Measurements of blood lactate may be a useful marker of conditioning in patients with chronic obstructive pulmonary disease who complete a pulmonary rehabilitation program.