Possibilities of Assessing Respiratory Muscle Strength and Trunk Muscle Mass in the Prevention of Sarcopenia in Older People Living in the Community

Objective: The purpose of this study was to clarify the relationship between respiratory muscle strength and skeletal muscle mass (trunk, upper limbs, and lower limbs) in older people who were certified as requiring nursing or supportive care. Methods: Thirty-five older people (65 years or older) who were certified as requiring nursing care or support were included in the study. The subjects were divided into a non-sarcopenic group (n = 12) and a sarcopenic group (n = 23) according to the sarcopenia diagnostic criteria proposed by the Asian Working Group for Sarcopenia. Maximum inspiratory pressure, maximum expiratory pressure, skeletal muscle mass (trunk, upper and lower limbs), and hand grip strength were measured. Pearson’s correlation coefficient and multiple regression analysis were used for statistical processing. Results: In the non-sarcopenic group, both expiratory muscle strength and hand grip strength were correlated with skeletal muscle mass. In the sarcopenia group, expiratory muscle strength was not correlated with skeletal muscle mass, and only hand grip strength was correlated with upper limb muscle mass. Multiple regression analysis revealed that, in the non-sarcopenic group, trunk muscle mass was the primary factor in expiratory muscle strength and upper limb muscle mass was the primary factor in hand grip strength. In the sarcopenia group, upper limb muscle mass was found to be the main factor in hand grip strength. Conclusion: Our results highlight the importance of assessing expiratory muscle strength and trunk muscle mass before sarcopenia develops in older people who require support and nursing care.

Perioperative respiratory muscle training improves respiratory muscle strength and physical activity of patients receiving lung surgery:A meta-analysis

BACKGROUND The clinical role of perioperative respiratory muscle training(RMT),including inspiratory muscle training(IMT)and expiratory muscle training(EMT)in patients undergoing pulmonary surgery remains unclear up to now.AIM To evaluate whether perioperative RMT is effective in improving postoperative outcomes such as the respiratory muscle strength and physical activity level of patients receiving lung surgery.METHODS The PubMed,EMBASE(via OVID),Web of Science,Cochrane Library and Physiotherapy Evidence Database(PEDro)were systematically searched to obtain eligible randomized controlled trials(RCTs).Primary outcome was postoperative respiratory muscle strength expressed as the maximal inspiratory pressure(MIP)and maximal expiratory pressure(MEP).Secondary outcomes were physical activity,exercise capacity,including the 6-min walking distance and peak oxygen consumption during the cardio-pulmonary exercise test,pulmonary function and the quality of life.RESULTS Seven studies involving 240 participants were included in this systematic review and meta-analysis.Among them,four studies focused on IMT and the other three studies focused on RMT,one of which included IMT,EMT and also combined RMT(IMT-EMT-RMT).Three studies applied the intervention postoperative,one study preoperative and the other three studies included both pre-and postoperative training.For primary outcomes,the pooled results indicated that perioperative RMT improved the postoperative MIP(mean=8.13 cmH_(2)O,95%CI:1.31 to 14.95,P=0.02)and tended to increase MEP(mean=13.51 cmH_(2)O,95%CI:-4.47 to 31.48,P=0.14).For secondary outcomes,perioperative RMT enhanced postoperative physical activity significantly(P=0.006)and a trend of improved postoperative pulmonary function was observed.CONCLUSION Perioperative RMT enhanced postoperative respiratory muscle strength and physical activity level of patients receiving lung surgery.However,RCTs with large samples are needed to evaluate effects of perioperative RMT on postoperative outcomes in patients undergoing lung surgery.

Relationship between Respiratory Muscle Strength and Static Balance in Older People Requiring Support and Care

Purpose: This study aimed to clarify the relationship between respiratory muscle strength and balance in older people requiring support or nursing care. Methods: Thirty-seven older subjects aged 65 years or older who were certified as requiring nursing care or support were included in the study. Maximal inspiratory pressure (PIMAX), maximal expiratory pressure (PEMAX), and one-leg standing time were measured. Additionally, the Functional Reach Test (FRT) was performed. Pearson correlation coefficient and multiple regression analyses were performed. Results: One-leg standing time was positively correlated with PEMAX, and was particularly correlated with PIMAX, while FRT score was not correlated with respiratory muscle strength. Multiple regression analysis with one-leg standing time as the dependent variable and PIMAX and PEMAX as independent variables showed that only PIMAX was significantly correlated with one-leg standing time. Conclusion: Focusing on expiratory and inspiratory muscle strength is important for improving one-leg standing ability and thus preventing falls in older people.

Effects of Water Immersion in Different Water Depths on Respiratory Function and Respiratory Muscle Strength among Elderly People: An Observational Study

The aim was to investigate the effect of three water levels (umbilical, 4th rib, and clavicular) on the respiratory function and respiratory muscle strength among elderly. Spirometry and respiratory strength were measured on land as baseline data. Next, water depth conditions were determined randomly, and spirometry and respiratory muscle strength were measured at each water level. The Vital Capacity and Expiratory reserve volume in the clavicular level were significantly lower than those in the land and umbilical trials. No significant difference was observed in other respiratory functions. Chest circumference and respiratory muscle strength were not significantly different among all conditions.

Comparison of Effects of Liuzijue Exercise and Conventional Respiratory Training on Patients after Cardiac Surgery:A Randomized Controlled Trial

Objective To evaluate the feasibility and safety of Liuzijue exercise(LE)for the clinical effect in patients after cardiac surgery.Methods Totally 120 patients who underwent cardiac surgery and were admitted to the Cardiothoracic Intensive Care Unit of Nanjing Drum Tower Hospital between July and Oclober,2022 were allocated to the LE group,the conventional respiratory training(CRT)group,and the control group by a random number table at a ratio of 1:1:1;40 patients in each group.All patients received routine treatment and cardiac rehabilitation.LE group and CRT group respectively performed LE and CRT once a day for 30 min for 7 days.Control group did not receive specialized respiratory training.The forced vital capacity,forced expiratory volume in 1 s,peak inspiratory flow rate,peak expiratory flow rate,maximum inspiratory pressure,maximum expiratory pressure,modified Barthel index(MBI),and Hamilton Rating Scale for Anxiety(HAM-A)were evaluated before,after 3 and 7 days of intervention.In addition,the postoperative length of hospital stay(LOS)and the adverse events that occurred during the intervention period were compared.Results A total of 107 patients completed the study,120 patients were included in the analysis.After 3 days of intervention,the pulmonary function,respiratory muscle strength,MBI and HAM-A of all 3 groups improved compared with that before the intervention(P<0.05 or P<0.01).Compared with the control group,pulmonary function and respiratory muscle strength were significantly improved in the CRT and LE groups(P<0.05 or P<0.01).MBI and HAM-A were significantly improved in the LE group compared with the control and CRT groups(P<0.05 or P<0.01).On the 7th day after intervention,the difference was still statistically significant(P<0.01),and was significantly different from that on the 3rd day(P<0.05 or P<0.01).In addition,on the 7th day of intervention,the pulmonary function and respiratory muscle strength in the LE group were significantly improved compared with those in the CRT group(P<0.01).MBI and HAM-A were significantly improved in the CRT group compared with the control group(P<0.01).There were no significant differences in postoperative LOS among the 3 groups(P>0.05).No training-related adverse events occurred during the intervention period.Conclusions LE is safe and feasible for improving pulmonary function,respiratory muscle strength,the ability to complete activities of daily living and for relieving anxiety of patients after cardiac surgery(Registration No.ChiCTR2200062964).