Respiratory Muscle Training Research Articles

Pulmonary Hypertension: Exercise Intolerance and the Benefits of Respiratory Muscle and Exercise Training

Pulmonary hypertension is characterized by significant remodeling of the pulmonary vasculature, leading to raised pulmonary vascular resistance. Despite advances in medical therapy, decreased exercise tolerance remains a predominant symptom experienced by patients. Reduced exercise capacity has been shown to have implications on quality of life and prognosis. There is growing acknowledgment that the etiology of exercise tolerance is multifactorial with cardiac, respiratory, and skeletal muscle contributors. There has been a shift in management approach with exercise training now included as a Class 1 recommendation indication in recent guidelines. In this review, we summarize the literature on the pathophysiology of exercise intolerance in pulmonary hypertension and then describe the literature assessing the safety and efficacy of inspiratory muscle and exercise training in patients with pulmonary arterial hypertension or chronic thromboembolic pulmonary hypertension.

Adverse postoperative outcomes in elderly patients with sarcopenia

PurposeNo study has compared 30-day and 90-day adverse postoperative outcomes between old-age patients with and those without sarcopenia.Patients and methodsWe categorize elderly patients receiving major surgery into two groups according to the presence or absence of preoperative sarcopenia that were matched at a 1:4 ratio through propensity score matching (PSM). We analyzed 30-day or 90-day adverse postoperative outcomes and mortality in patients with and without sarcopenia receiving major surgery.ResultsMultivariate logistic regression analyses revealed that the patients with preoperative sarcopenia were at significantly higher risk of 30-day postoperative mortality (adjusted odds ratio [aOR]. = 1.25; 95% confidence interval [CI]. = 1.03–1.52) and 30-day major complications such as postoperative pneumonia (aOR = 1.15; 95% CI = 1.00-1.40), postoperative bleeding (aOR = 2.18; 95% CI = 1.04–4.57), septicemia (aOR = 1.31; 95% CI = 1.03–1.66), and overall complications (aOR = 1.13; 95% CI = 1.00-1.46). In addition, surgical patients with sarcopenia were at significantly higher risk of 90-day postoperative mortality (aOR = 1.50; 95% CI = 1.29–1.74) and 90-day major complications such as pneumonia (aOR = 1.27; 95% CI = 1.10–1.47), postoperative bleeding (aOR = 1.90; 95% CI = 1.04–3.48), septicemia (aOR = 1.52; 95% CI = 1.28–1.82), and overall complications (aOR = 1.24; 95% CI = 1.08–1.42).ConclusionsSarcopenia is an independent risk factor for 30-day and 90-day adverse postoperative outcomes such as pneumonia, postoperative bleeding, and septicemia and increases 30-day and 90-day postoperative mortality among patients receiving major surgery.Condensed abstractNo study has compared 30-day and 90-day adverse postoperative outcomes between patients with and those without sarcopenia. We conducted a propensity score?matched (PSM) population-based cohort study to investigate the adverse postoperative outcomes and mortality in patients undergoing major elective surgery with preoperative sarcopenia versus those without preoperative sarcopenia. We demonstrated that sarcopenia is an independent risk factor for 30-day and 90-day adverse postoperative outcomes, such as postoperative pneumonia, bleeding, septicemia, and mortality after major surgery. Therefore, surgeons and anesthesiologists should attempt to correct preoperative sarcopenia, swallowing function, and respiratory muscle training before elective surgery to reduce postoperative complications that contribute to the decrease in surgical mortality.

“Effects of threshold respiratory muscle training on respiratory muscle strength, pulmonary function and exercise endurance after stroke: a meta-analysis”

BackgroundMost studies on improvements in respiratory muscle strength, activities of daily living (ADL) and quality of life (QoL) in stroke patients receiving threshold respiratory muscle training (TRMT) have small sample sizes, and some studies have contradictory results. ObjectivesTo evaluate the effectiveness of TRMT on respiratory muscle strength, pulmonary function and exercise endurance in stroke patients. Materials and MethodsPubMed, Cochrane Library, Physical Therapy Evidence Database (PEDro), Embase (via OVID) and Web of Science databases were searched for randomized controlled trial (RCT) from inception to January 17, 2024. The primary outcome was maximum inspiratory pressure (MIP) or maximum expiratory pressure (MEP). Secondary outcomes included pulmonary function measured by forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1) and peak expiratory flow (PEF), and exercise endurance measured by 6-minute walk test (6MWT). ResultsA total of eight randomized controlled trials(RCTs), including 305 persons, were included in this study. The training time ranged from 3 weeks to 10 weeks. Among them, the intervention group in 4 studies used inspiratory muscle training, and the other 4 studies used inspiratory muscle training and expiratory muscle training. For the primary outcome, TRMT significantly improved MIP (mean=14.68 cmH2O, 95 %CI=2.28 to 27.09 cmH2O, P=0.02) and MEP (mean=9.37 cmH2O, 95 %CI=2.89 to 15.84 cmH2O, P=0.005) in stroke patients. Regarding the secondary outcomes, TRMT improved FVC, FEV1 and 6MWT (P<0.05) but did not significantly improve PEF. ConclusionTRMT improved inspiratory muscle strength and expiratory muscle strength, improved exercise endurance, and improved FVC and FEV1 of pulmonary function but did not significantly improve PEF.

Potential Therapeutic Role of Respiratory Muscle Training in Dyspnea Management of Cancer Survivors: A Narrative Review.

Dyspnea is a disabling symptom presented in approximately half of all cancer survivors. From a clinical perspective, despite the availability of pharmacotherapies, evidence-based effective treatments are limited for relieving dyspnea in cancer survivors. Preliminary evidence supports the potential of respiratory muscle training to reduce dyspnea in cancer survivors, although large randomized controlled studies are warranted. The aims of this article were to review the relevant scientific literature on the potential therapeutic role of respiratory muscle training in dyspnea management of cancer survivor, and to identify possible mechanisms, strengths and limitations of the evidence as well as important gaps for future research directions.

Dyspnea management in patients with pneumonia and coronary artery disease: A case study

Background: Cardiovascular disease, particularly Coronary Artery Disease (CAD), is strongly linked to pneumonia. Patients suffering from both pneumonia and CAD frequently experience dyspnea as a symptom. Dyspnea, caused by both conditions, can significantly impact the patient's quality of life. Consequently, it is crucial to address and manage dyspnea in individuals with pneumonia and CAD. Purpose: To provide a thorough overview of managing dyspnea in patients with pneumonia and CAD in public hospitals in West Java, Indonesia. Method: Employing a case study methodology using a nursing care approach, encompassing nursing assessment, data analysis, diagnosis, intervention, implementation, evaluation, and documentation. The assessment indicated that the patient experienced shortness of breath, with a blood pressure of 145/86 mmHg, a respiratory rate of 24 breaths per minute, a pulse rate of 95 beats per minute, and an oxygen saturation level of 88%. The patient received 5 liters per minute of oxygen via a nasal cannula, and their body temperature measured 36.4ºC. Results: In this case study, dyspnea management involved positioning the patient, administering oxygen therapy in stages, and providing pharmacological treatments, including diuretics and antibiotics. Additional therapies included respiratory muscle training and effective cough exercises. These interventions successfully reduced the patient's respiratory rate to 18 breaths per minute and increased their oxygen saturation to 97% with a nasal cannula. Additionally, the patient's Medical Research Council (MRC) dyspnea scale score decreased to 1 out of 5. Conclusion: Nursing care management that includes positioning the patient in a semi-Fowler's position while resting and a Fowler's position when awake, administering oxygen therapy in stages, providing pharmacological treatments such as diuretics and antibiotics, and conducting respiratory muscle training, can lower the breathing rate and alleviate symptoms of shortness of breath in patients with pneumonia and coronary artery disease.

Effect of lung breather on hospital stay in patients with acquired pneumonia: a randomized clinical study

INTRODUCTION. Acquired pneumonia is a severe medical condition that is addressed as life-threating issue requiring intensive care. The Medical Breather device can activate and strengthen both the inspiratory and expiratory muscles, so it can be useful for patients with pneumonia. AIM. To investigate the breather effect on length of hospital stay in patients with pneumonia. MATERIALS AND METHODS. Sixty participants diagnosed with acquired pneumonia “30 women, 30 men stayed in hospital in ICU for two weeks; aged 30–40 years old” selected from chest department of Kasr Al-Aini Intensive Care Unit (ICU) at Cairo University. They were randomly allocated into equal groups; Group A received respiratory training via incentive spirometer, and traditional chest physiotherapy; and Group B received respiratory training via Breather, and traditional chest physiotherapy, both received 3 session daily/2 weeks. Diaphragmatic excursion, Respiratory Distress Observation Scale, and ICU discharge were assessed before and after the treatment. RESULTS. Both groups revealed significant improvement after the treatment, while Breather group showed a high significant increase in pH 1.23 %, PaO2 11.79 %, SaO2 6.1 %, and diaphragmatic excursion by 36.97 %, also decrease in PaCO2 2.78 %, RDOS 39.06 % and NEWS2 by 50.72 % in comparison to incentive spirometer group that recorded significant increase in pH 0.68 %, PaO2 6.69 %, SaO2 by 2.66 %, and diaphragmatic excursions by 8.15 %, also significant decrease in PaCO2 12.12 %, RDOS 15.01 % and NEWS2 by 20.93 %. HCO3 revealed no significant difference post treatment (p 0.05). DISCUSSION. Breather usage in inspiratory musculatures training (IMT) gained Maximum Inspiratory Pressure (Pimax) significant improvement. IMT enforces both diaphragm and accessory respiratory musculatures. Probably functional capabilities improvements based on enhanced respiratory musculatures’ both endurance and strength that improve pulmonary oxygen uptake thus minimize dyspnea severity. Respiratory muscles training program improves not only cognitive function. Moreover, IMT could be addressed as a prime component of respiratory training in combine with expiratory one that is why whom has preserved pulmonary function. CONCLUSION. Breather as a respiratory training technique has remarkable results in reducing hospital stays in patients with acquired pneumonia, and significant positive effects on diaphragmatic function, oxygenation levels. Therefore, it is recommended to use Breather for routine acquired pneumonia care. REGISTRATION: Clinicaltrials.gov identifier: No NCT06062862; registered April 30, 2022.

Effects of Respiratory Muscle Training on Functional Ability, Pain-Related Outcomes, and Respiratory Function in Individuals with Low Back Pain: Systematic Review and Meta-Analysis.

Objectives: The aim of this meta-analysis was to determine the effects of respiratory muscle training (RMT) on functional ability, pain-related outcomes, and respiratory function in individuals with sub-acute and chronic low back pain (LBP). Methods: The study selection was as follows: (participants) adult individuals with >4 weeks of LBP; (intervention) RMT; (comparison) any comparison RMT (inspiratory or expiratory or mixed) versus control; (outcomes) postural control, lumbar disability, pain-related outcomes, pain-related fear-avoidance beliefs, respiratory muscle function, and pulmonary function; and (study design) randomized controlled trials. Results: 11 studies were included in the meta-analysis showing that RMT produces a statistically significant increase in postural control (mean difference (MD) = 21.71 [12.22; 31.21]; decrease in lumbar disability (standardized mean difference (SMD) = 0.55 [0.001; 1.09]); decrease in lumbar pain intensity (SMD = 0.77 [0.15; 1.38]; increase in expiratory muscle strength (MD = 8.05 [5.34; 10.76]); and increase in forced vital capacity (FVC) (MD = 0.30 [0.03; 0.58]) compared with a control group. However, RMT does not produce an increase in inspiratory muscle strength (MD = 18.36 [-1.61; 38.34]) and in forced expiratory volume at the first second (FEV1) (MD = 0.36 [-0.02; 0.75]; and in the FEV1/FVC ratio (MD = 1.55 [-5.87; 8.96]) compared with the control group. Conclusions: RMT could improve expiratory muscle strength and FVC, with a moderate quality of evidence, whereas a low quality of evidence suggests that RMT could improve postural control, lumbar disability, and pain intensity in individuals with sub-acute and chronic LBP. However, more studies of high methodological quality are needed to strengthen the results of this meta-analysis.

Incremental Load Respiratory Muscle Training Improves Respiratory Muscle Strength and Pulmonary Function in Children with Bronchiectasis.

Participants underwent respiratory muscle training for 24 weeks. The main results were changes in respiratory muscle strength and pulmonary function indices (forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), FEV1/FVC, peak expiratory flow rate (PEF), forced expiratory flow 25-75% (FEF25-75%), and maximal midexpiratory flow 75/25 (MMEF75/25)) before, 12 weeks after, and 24 weeks after the intervention. The secondary outcomes were changes in the exercise load and work rate, exercise work, Leicester Cough Questionnaire (LCQ) scale, and Fatigue Severity Scale (FSS). Compared with before the intervention, after 24 weeks of respiratory muscle training, the maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) were significantly enhanced (P < 0.05), while FVC, FEV1, and PEF were significantly increased (P < 0.01). FEF25-75 and MMEF75/25 values showed significant improvement compared to those before training (P < 0.05). The exercise loading, work, and exercise work rate of expiratory muscle training were significantly improved compared to those before intervention (P < 0.05). The LCQ score increased significantly (P < 0.001), and the FSS score decreased significantly (P < 0.001). Incremental load respiratory muscle training effectively improved children's lung function over the long term, improved the strength of their inspiratory and expiratory muscles, and improved their quality of life.

AIM AND MEANING OF BREATHING EXERCISES: INTERDISCIPLINARY LITERATURE REVIEW

Respiration is an indispensable aspect of life that significantly influences both the physical and mental well-being of individuals, depending on such factors as depth and rhythm. Exploring the distinctions between chest and abdominal breathing is crucial for understanding their profound impacts, and embracing appropriate breathing exercises has proven to be advantageous for short-term relief and long-term holistic health. While acknowledged for diverse therapeutic applications, such as mitigating vocal cord fatigue, a comprehensive exploration of breathing exercises remains essential. Sport scientists and coaches are encouraged to acquire a set of breathing exercises for future implementation in the training routines. This study strives to conduct an interdisciplinary literature review to shed light on the aims, meaning, and classification of breathing exercises. Employing a literature review methodology, were analysed peer-reviewed articles from PubMed and ScienceDirect published during the years from 2000 to 2023, focusing on such keywords as breathing exercises, deep breathing, nasal breathing, abdominal breathing, thoracic breathing, pursed-lip breathing, breathing control, and respiratory muscle training. The research findings illustrate the multifaceted definitions, components, aims, and classifications of breathing exercises. This study establishes a foundation for identifying distinct subtypes, contributing to a more nuanced understanding of the significance and purpose of breathing exercises in enhancing overall well-being.

Evaluation of the therapeutic effects of rehabilitation therapy on patients with amyotrophic lateral sclerosis-a meta-analysis.

To investigate the effect of rehabilitation therapy on the global function, respiratory function, and quality of life in patients with amyotrophic lateral sclerosis (ALS). PubMed, Web of Science, and The National Library of Medicine (NLM) were systematically searched and the search period was between the date of database establishment and December 31, 2023. The outcome measures finally analyzed included the ALS functional rating scale/revised (ALSFRS/ALSFRS-R), forced vital capacity percentage predicted (FVC%), fatigue severity scale (FSS), and maximal expiratory pressure (MEP). A total of 13 randomized controlled trials (RCTs) were included, and 5 outcome measures were pooled and analyzed. A total of 657 patients with ALS were enrolled, with 299 in the experimental group (rehabilitation therapy, such as resistance training, endurance training, aerobic training, respiratory muscle training, and standard rehabilitation therapy) and 358 in the control group (conventional interventions, such as simple joint movements or daily stretching). The ALSFRS scores were better in the experimental group than in the control group at 0-4 months (MD = 3.36, 95% CI: 0.82, 5.91, Z = 2.59, p = 0.009) and at 5-8 months (MD = 5.00, 95% CI: -2.42, 7.58, Z = 3.80, p < 0.001). Moreover, the ALSFRS-R scores of the experimental group was better than that of the control group at 5-8 months (MD = 2.83, 95% CI: 1.21, 4.45, Z = 3.42, p < 0.001) and 9-12 months (MD = 1.87, 95% CI: -0.37, 4.11, Z = 1.63, p = 0.10). It was also found that the MEP value of the experimental group was significantly better than that of the control group after intervention (MD = 18.49, 95% CI: 1.47, 35.50, Z = 2.13, p = 0.03). However, there were no significant differences in FVC% value and FSS scores at 0-5 months and 6-12 months between the two groups. Rehabilitation therapy is helpful in improving the short-, medium-, and long-term global function score of patients with ALS, with positive effects on respiratory function.

Impact of Respiratory Muscle Training on Exercise Tolerance in Hypobaric Hypoxia

Hypoxia and certain chronic diseases can intensify the work of breathing, potentially impacting the muscle hyperemic response during exercise and overall exercise performance. Respiratory muscle training (RMT) has been observed to decrease perceived effort under hypoxic conditions; however, it remains unclear if RMT boosts exercise performance in acute hypoxia. We investigated whether 4 weeks of RMT could enhance maximal and submaximal exercise performance in hypoxia (PB=425 mmHg, ~4876 m). Seven adult males underwent a 250 kJ submaximal (RPE 15-17) cycling trial in hypoxia, followed by an incremental test to maximal exertion. After 4 weeks of RMT under normoxic conditions, these tests were repeated in hypoxia. Although six of the participants displayed improvements in submaximal exercise performance, these numerical differences failed to reach statistical significance. However, RMT did raise VO2max peak power (Pre-RMT: 242.62 ± 35, Post-RMT: 251.85 ± 38 W, p=0.04). Moreover, even with an increased HR during the submaximal exercise trial after RMT (Pre-RMT:154.14 ± 16, Post-RMT: 160.86 ± 12, p&lt;0.05), the RPE showed no significant difference during the test (Pre-RMT: 17.43 ± 0.79, Post-RMT: 17.43 ± 0.53, P&gt;0.05). Despite this, no substantial increase in hypoxic submaximal exercise performance was observed, likely due to the small sample size. These findings suggest RMT might increase hypoxic exercise tolerance by reducing perceived exertion for a given HR. This work was supported by funding from the United States Special Operations Command (USSOCOM) and the National Institutes of Health (2L30HL134123-03). This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Internet of Things-Based Home Respiratory Muscle Training for Patients with Chronic Obstructive Pulmonary Disease: A Randomized Clinical Trial.

Whether Internet of Things (IoT)-based home respiratory muscle training (RMT) benefits patients with comorbid chronic obstructive pulmonary disease (COPD) remains unclear. Therefore, this study aims to evaluate the effectiveness of IoT-based home RMT for patients with COPD. Seventy-eight patients with stable COPD were randomly divided into two groups. The control group received routine health education, while the intervention group received IoT-based home RMT (30 inspiratory muscle training [IMT] and 30 expiratory muscle training [EMT] in different respiratory cycles twice daily for 12 consecutive weeks). Assessments took place pre-intervention and 12 weeks post-intervention, including lung function tests, respiratory muscle strength tests, the mMRC dyspnea scale, CAT questionnaires, the HAMA scale, and 6-month COPD-related readmission after intervention. Seventy-four patients with COPD were analyzed (intervention group = 38, control group = 36), and the mean age and FEV1 of the patients were 68.65 ± 7.40 years, 1.21 ± 0.54 L. Compared to those of the control population, the intervention group exhibited higher FEV1/FVC (48.23 ± 10.97 vs 54.32 ± 10.31, p = 0.016), MIP (41.72 ± 7.70 vs 47.82 ± 10.99, p = 0.008), and MEP (42.94 ± 7.85 vs 50.29 ± 15.74, p = 0.013); lower mMRC (2.00 [2.00-3.00] vs 1.50 [1.00-2.00], p < 0.001), CAT (17.00 [12.00-21.75] vs 11.00 [9.00-13.25], p < 0.001), and HAMA (7.00 [5.00-9.00] vs 2.00 [1.00-3.00], p < 0.001) scores; and a lower incidence rate of 6-month readmission (22% vs 5%, p = 0.033). Compared with no intervention, IoT-based home RMT may be a more beneficial intervention for patients with COPD.

Using Inspiratory Muscle Training to Improve Respiratory Strength, Functional Capacity, Fatigue, and Stress in Breast Cancer Patients Undergoing Surgery.

The main aim of the trial was to assess the effectiveness of inspiratory muscle training on respiratory muscle strength, functional capacity, fatigue, and stress in post-surgical breast cancer survivors. Forty-seven females who had undergone unilateral post-mastectomy were randomly assigned to an intervention group (IG; n = 24) and a control group (CG; n = 23). Both groups received aerobic exercise training. In addition, the intervention group received inspiratory muscle training 3 days a week for 8 weeks. Maximum inspiratory and expiratory pressure (Pimax) (Pemex), 6-minute walk test, Handgrip strength by hand-held dynamometer, Fatigue Assessment Scale (FAS), and Perceived Stress Scale pss 10 values were measured before the training and then at the eighth week for both groups. No differences were detected between the groups in terms of sample and clinical characteristics 8 weeks post-intervention. In favor of the intervention group, a significant difference with medium to high effect size was found in terms of Pimax, Pemax, FAS, PS, and 6MWT (p < 0.05). However, there was no difference in terms of handgrip strength (p-value: 0.072), with a medium effect size (0.070). Regarding within-group comparisons, IG exhibited substantial differences in all outcome measures (p < 0.05) compared to CG, with the exception of PImax and 6MWT. In post-operative breast cancer survivors, respiratory muscle training combined with aerobic training increases respiratory muscle strength and functional ability while lowering stress and tiredness.

The effect of respiratory muscle training on children and adolescents with cystic fibrosis: a systematic review and meta-analysis

BackgroundCystic fibrosis is a chronic genetic disease that can affect the function of the respiratory system. Previous reviews of the effects of respiratory muscle training in people with cystic fibrosis are uncertain and do not consider the effect of age on disease progression. This systematic review aims to determine the effectiveness of respiratory muscle training in the clinical outcomes of children and adolescents with cystic fibrosis.MethodsUp to July 2023, electronic databases and clinical trial registries were searched. Controlled clinical trials comparing respiratory muscle training with sham intervention or no intervention in children and adolescents with cystic fibrosis. The primary outcomes were respiratory muscle strength, respiratory muscle endurance, lung function, and cough. Secondary outcomes included exercise capacity, quality of life and adverse events. Two review authors independently extracted data and assessed study quality using the Cochrane Risk of Bias Tool 2. The certainty of the evidence was assessed according to the GRADE approach. Meta-analyses where possible; otherwise, take a qualitative approach.ResultsSix studies with a total of 151 participants met the inclusion criteria for this review. Two of the six included studies were published in abstract form only, limiting the available information. Four studies were parallel studies and two were cross-over designs. There were significant differences in the methods and quality of the methodology included in the studies. The pooled data showed no difference in respiratory muscle strength, lung function, and exercise capacity between the treatment and control groups. However, subgroup analyses suggest that inspiratory muscle training is beneficial in increasing maximal inspiratory pressure, and qualitative analyses suggest that respiratory muscle training may benefit respiratory muscle endurance without any adverse effects.ConclusionsThis systematic review and meta-analysis indicate that although the level of evidence indicating the benefits of respiratory muscle training is low, its clinical significance suggests that we further study the methodological quality to determine the effectiveness of training.Trial registrationThe protocol for this review was recorded in the International Prospective Register of Systematic Reviews (PROSPERO) under registration number CRD42023441829.

Testing for periodicity at an unknown frequency under cyclic long memory, with applications to respiratory muscle training

AbstractA frequent problem in applied time series analysis is the identification of dominating periodic components. A particularly difficult task is to distinguish deterministic periodic signals from periodic long memory. In this paper, a family of test statistics based on Whittle’s Gaussian log-likelihood approximation is proposed. Asymptotic critical regions and bounds for the asymptotic power are derived. In cases where a deterministic periodic signal and periodic long memory share the same frequency, consistency and rates of type II error probabilities depend on the long-memory parameter. Simulations and an application to respiratory muscle training data illustrate the results.

Practical Application of Respiratory Muscle Training in Endurance Sports

ABSTRACT Since traditional sport-specific training or exercise programs do not create enough stimulus to improve the function of the respiratory muscles, the rationale to introduce respiratory muscle training (RMT) emerged. RMT is associated with improved endurance performance and pulmonary function, and it reduced respiratory fatigue, perceived exertion, or breathlessness. The purpose of this article is to provide coaches with tools to select the appropriate form of RMT in the context of the athletes' needs, using appropriate methods, techniques, devices, and testing protocols. The video abstract is presented in Supplemental Digital Content as SDC 1.

가상현실을 이용한 호흡근 훈련의 집중력 변화가 흡연자의 폐 기능에 미치는 효과

Purpose: This study aimed to investigate the effect of changes in concentration through respiratory muscle training using virtual reality on training concentration and pulmonary function in male smokers who have decreased concentration because of academics, employment, and smoking. Methods: The study included 15 male university students who had smoked for &gt;2 years. They were randomly allocated to the control group (n=8) that performed respiratory muscle training using breathing exercise equipment and experimental group (n=7) that performed respiratory muscle training using virtual reality. The training was performed three times a day, three times a week, for a total of 4 weeks. During training, concentration was measured considering changes in the RAHB and heart rate variability (low frequency to high frequency [LF/HF] ratio) using QEEG-32FX, and pulmonary functions were measured based on changes in forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and FEV1/FVC using Spiropalm. Results: After the intervention, the experimental group showed significant improvement in the LF/HF ratio (p &lt;.01), FVC (p&lt;.05), and FEV1(p&lt;.05), whereas the control group showed significant improvement in the LF/HF ratio (p&lt;.05) and FVC(p&lt;.05). Conclusion: The result of this study revealed that respiratory muscle training using virtual reality is more effective in improving pulmonary function by further enhancing training concentration.

The Effect of Respiratory Muscle Training on Swallowing Function in Patients With Stroke: A Systematic Review and Meta-Analysis.

The improvement of swallowing function after stroke is a significant challenge faced by patients and health care professionals. However, the current evidence synthesis of the effects of respiratory muscle training (RMT) on swallowing function is limited. To assess the effectiveness of RMT on swallowing recovery in patients undergoing stroke. The CKNI, WanFang Data, PubMed, CINAHL, Web of Science, Embase, MEDLINE, and Cochrane Library databases were searched for studies evaluating RMT interventions' effect on swallowing outcomes. Risks of bias were evaluated using the approach recommended by the Cochrane Collaboration tool and a summary of findings table was generated using the GRADE approach. Outcomes were synthesized using a random-effects meta-analysis model. RMT interventions reduced the risk of aspiration (SMD = 1.19; 95% CI, 0.53-1.84), the recovery process of water swallowing function (RR = 1.22; 95% CI, 1.05-1.42), and the activity of the swallowing muscles (SMD = 2.91; 95% CI, 2.22-3.61). However, there was no significant effect of RMT on the functional level of oral intake (SMD = 0.70; 95% CI, -0.03 to 1.42). RMT can be regarded as an innovative, auxiliary means in the near future to better manage and improve swallowing function, given its improving effect on work outcomes in this review.

Effect of respiratory muscle training in patients with stable chronic obstructive pulmonary disease: A systematic review and meta-analysis

ObjectivesChronic obstructive pulmonary disease (COPD) is a prevalent respiratory disorder characterized by progressive airflow limitation. This meta-analysis aims to evaluate the effectiveness of respiratory muscle training (RMT) on key pulmonary function parameters, inspiratory muscle strength and quality of life in patients with stable COPD. MethodsA comprehensive search was conducted in the databases including PubMed, Cochrane, Web of Science, Embase, and ClinicalTrials.gov, from their inception to June 12, 2023. Randomized controlled trials (RCTs) evaluating the impact of RMT on stable COPD were included for meta-analysis. ResultsIn total, 12 RCTs involving 453 participants were included in the meta-analysis. RMT demonstrated a significant increase in maximal inspiratory pressure (PImax, MD, 95% CI: 14.34, 8.17 to 20.51, P < 0.001) but not on maximal expiratory pressure (PEmax). No significant improvement was observed in 6-Min walk test (6MWT), dyspnea, forced expiratory volume in 1 s (FEV1), forced vital capacity ratio (FVC) and quality of life between RMT and control groups. However, subgroup analysis revealed a significant negative effect of RMT alone on FEV1/FVC (MD, 95% CI: 2.59, −5.11 to −0.06, P = 0.04). When RMT was combined with other interventions, improvements in FEV1/FVC and FEV1 were found, although not statistically significant. ConclusionRMT can effectively improve maximal inspiratory pressure in stable COPD patients, but the effect is slight in improving lung function, dyspnea and quality of life. It is recommended to combine with other treatment strategies to comprehensively improve the prognosis of COPD patients.

A preliminary exploration of the regression equation for performance in amateur half-marathon runners: a perspective based on respiratory muscle function.

This document presents a study on the relationship between physical characteristics, respiratory muscle capacity, and performance in amateur half-marathon runners. The aim of this study was to establish a preliminary predictive model to provide insights into training and health management for runners. Participants were recruited from the 2023 Beijing Olympic Forest Park Half-Marathon, comprising 233 individuals. Personal information including age, gender, height, weight, and other relevant factors were collected, and standardized testing methods were used to measure various parameters. Correlation analysis revealed significant associations between gender, height, weight, maximum expiratory pressure, maximal inspiratory pressure, and half-marathon performance. Several regression equations were developed to estimate the performance of amateur marathon runners, with a focus on gender, weight, maximum expiratory pressure, and height as predictive factors. The study found that respiratory muscle training can delay muscle fatigue and improve athletic performance. Evaluating the level of respiratory muscle capacity in marathon athletes is crucial for defining the potential speed limitations and achieving optimal performance. The information from this study can assist amateur runners in optimizing their training methods and maintaining their physical wellbeing.