Effects of respiratory muscle training on post-stroke rehabilitation:A systematic review and meta-analysis

BACKGROUND Stroke often results in significant respiratory dysfunction in patients.Respiratory muscle training(RMT)has been proposed as a rehabilitative intervention to address these challenges,but its effectiveness compared to routine training remains debated.This systematic review and meta-analysis aim to evaluate the effects of RMT on exercise tolerance,muscle strength,and pulmonary function in post-stroke patients.AIM To systematically assess the efficacy of RMT in improving exercise tolerance,respiratory muscle strength,and pulmonary function in patients recovering from a stroke,and to evaluate whether RMT offers a significant advantage over routine training modalities in enhancing these critical health outcomes in the post-stroke population.METHODS Following the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines,a comprehensive search across PubMed,Embase,Web of Science,and the Cochrane Library was conducted on October 19,2023,without temporal restrictions.Studies were selected based on the predefined inclusion and exclusion criteria focusing on various forms of RMT,control groups,and outcome measures[including forced expiratory volume in the first second(FEV1),forced vital capacity(FVC),maximal voluntary ventilation(MVV),peak expiratory flow(PEF),maximal inspiratory pressure(MIP),maximal expiratory pressure(MEP),and 6-min walking test(6MWT)].Only randomized controlled trials(RCTs)were included.Data extraction and quality assessment were conducted independently by two reviewers using the Cochrane Collaboration's risk of bias tool.Statistical analyses,including those using the fixed-effect and random-effects models,sensitivity analysis,and publication bias assessment,were performed using Review Manager software.RESULTS A total of 15 RCTs were included.Results indicated significant improvements in MIP(12.51 cmH2O increase),MEP(6.24 cmH2O increase),and various pulmonary function parameters(including FEV1,FVC,MVV,and PEF).A substantial increase in 6MWT distance(22.26 meters)was also noted.However,the heterogeneity among studies was variable,and no significant publication bias was detected.CONCLUSION RMT significantly enhances walking ability,respiratory muscle strength(MIP and MEP),and key pulmonary function parameters(FEV1,FVC,MVV,and PEF)in post-stroke patients.These findings support the incorporation of RMT into post-stroke rehabilitative protocols.

A Bibliometric Study on The Application of Progressive Muscle Relaxation Training in The Nursing Field in China

Objective:To systematically analyze the research status and application of progressive muscle relaxation training(PMRT)in the nursing field in China,and provide a reference basis for scientific research in this field.Methods:The bibliometric method was adopted in“progressive muscle relaxation training”or“PMRT,”and“nursing.”The established database was included in the China National Knowledge Infrastructure(CNKI)and the Wanfang Medical Network.The relevant articles in the Chinese Science and Technology Periodical Database(VIP)were analyzed.Results:A total of 169 literatures were included.The journals,years,and regions of literature publication were uneven,mainly originating from the eastern region(43.19%),and listed the application of progressive muscle relaxation training in the field of nursing in China.Intervention literature information was mainly dominated by experimental studies(97%).Conclusion:The related research and application of progressive muscle relaxation training in nursing in China is increasing,but there is a lack of objective evaluation of outcome indicators and a short intervention period.Further research should be conducted in the future to effectively guide the development of PMRT in the field of nursing in China.

Effects of Progressive Muscle Relaxation Training on Anxiety, Depression, and Quality of Life in Patients with Cerebral Small Vessel Disease

Objective:To explore the effects of progressive muscle relaxation training on anxiety,depression,and quality of life in patients with cerebral small vessel disease(CSVD).Methods:Sixty-one patients with CSVD in the Department of Neurology of a tertiary hospital were divided into an observation group(28 patients)and a control group(33 patients)by lottery method.The control group received conventional nursing care,while the observation group received progressive muscle relaxation training interventions in addition to the conventional care.The Hamilton Anxiety Scale(HAMA),the Hamilton Depression Scale(HAMD),and the Stroke-Specific Quality of Life Scale(SS-QOL)were used to compare the effects before the intervention,7 days after the intervention,and 30 days after the intervention.Results:Over time,at different time points after the intervention,the anxiety and depression scores of patients with CSVD in the observation group were significantly lower than those in the control group(P<0.05).The quality of life scores were significantly higher in the observation group compared to the control group(P<0.05),and these differences were statistically significant.Conclusion:Progressive muscle relaxation training can improve anxiety and depression in patients with cerebral small vessel disease and can effectively enhance their quality of life.

The Effects of Functional Training on Pain, Function, and Performance in Taekwondo Players with Mechanical Low Back Pain

Background: The aim of this study was to assess the effects of functional training (FT) on pain, function, and performance in elite male taekwondo players with CMLBP. Method: 27 elite male taekwondo players (mean ± standard deviation: age 24.4 ± 4.9 years, body mass 75.7 ± 15.1 kg, height 181.4 ± 7.8 cm) were allocated to two experimental (n = 15) and control (n = 12) groups. The eight-week FT was divided into four distinct phases for the subjects of the experimental group. Variables of pain and function were assessed by Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI), respectively. The movement time of Ap Douliou Chagi kick (MTAK) and speed of Ap Douliou Chagi kick (SAK) was used for the variable of performance. Results: Considering the results of pretest before the implementation of the scores protocol, after FT intervention, VAS (p = 0.004), ODI (p = 0.005), MTAK on the right leg (p = 0.029) and the left leg (p = 0.013) decreased and SAK on both legs (p = 0.000) increased significantly in comparison with the control group. Conclusion: It is assumed that FT can reduce the pain intensity and improve the function and performance in taekwondo players.

Slacklining as therapy to address non-specific low back pain in the presence of multifidus arthrogenic muscle inhibition

Low back pain(LBP)represents the most prevalent,problematic and painful of musculoskeletal conditions that affects both the individual and society with health and economic concerns.LBP is a heterogeneous condition with multiple diagnoses and causes.In the absence of consensus definitions,partly because of terminology inconsistency,it is further referred to as non-specific LBP(NSLBP).In NSLBP patients,the lumbar multifidus(MF),a key stabilizing muscle,has a depleted role due to recognized myocellular lipid infiltration and wasting,with the potential primary cause hypothesized as arthrogenic muscle inhibition(AMI).This link between AMI and NSLBP continues to gain increasing recognition.To date there is no‘gold standard’or consensus treatment to alleviate symptoms and disability due to NSLBP,though the advocated interventions are numerous,with marked variations in costs and levels of supportive evidence.However,there is consensus that NSLBP management be cost-effective,self-administered,educational,exercise-based,and use multi-modal and multi-disciplinary approaches.An adjuvant therapy fulfilling these consensus criteria is‘slacklining’,within an overall rehabilitation program.Slacklining,the neuromechanical action of balance retention on a tightened band,induces strategic indirect-involuntary therapeutic muscle activation exercise incorporating spinal motor control.Though several models have been proposed,understanding slacklining’s neuro-motor mechanism of action remains incomplete.Slacklining has demonstrated clinical effects to overcome AMI in peripheral joints,particularly the knee,and is reported in clinical case-studies as showing promising results in reducing NSLBP related to MF deficiency induced through AMI(MF-AMI).Therefore,this paper aims to:rationalize why and how adjuvant,slacklining therapeutic exercise may positively affect patients with NSLBP,due to MF-AMI induced depletion of spinal stabilization;considers current understandings and interventions for NSLBP,including the contributing role of MF-AMI;and details the reasons why slacklining could be considered as a potential adjuvant intervention for NSLBP through its indirect-involuntary action.This action is hypothesized to occur through an over-ride or inhibition of central down-regulatory induced muscle insufficiency,present due to AMI.This subsequently allows neuroplasticity,normal neuro-motor sequencing and muscle re-activation,which facilitates innate advantageous spinal stabilization.This in-turn addresses and reduces NSLBP,its concurrent symptoms and functional disability.This process is hypothesized to occur through four neuro-physiological processing pathways:finite neural delay;movement-control phenotypes;inhibition of action and the innate primordial imperative;and accentuated corticospinal drive.Further research is recommended to investigate these hypotheses and the effect of slacklining as an adjuvant therapy in cohort and control studies of NSLBP populations.

The Effect of Requester Training on the Relevance of Lumbar Spine X-Ray Request for Low Back Pain in Adults at Yaounde

Background: Despite the availability of guidelines, the requests for medical imaging examinations for the exploration of low back pain remain irrelevant in the majority of cases. Objective: To assess the impact of requester training on the justification of lumbar spine X-rays for low back pain in adults in Yaounde. Materials and Methods: We carried out an interventional study from December 2017 to April 2018 in Yaounde (Cameroon). We analyzed the relevance of the prescription of X-rays for low back pain before and after an interactive training of the requesters. Results: Among the 16 requesters who were trained, the proportion of irrelevant requests dropped from 58.22% (46/79) before training to 44.44% (20/45) after training, representing a decrease of 13.78% (p = 0.012). The highest drop in the proportion of irrelevant requests was found among general practitioners (-21.98%) and requesters having less than 10 years of experience in medical practice (-31.8%). Conclusion: The training of requesters moderately reduces the rate of irrelevant examinations. Other factors of irrelevant prescription must be investigated and corrected for this decrease to be more significant.

Efficacy of biofeedback on stress urinary incontinence in women receiving pelvic floor muscle training: a meta-analysis

Background:To systematically evaluate the effect of pelvic floor muscle training with biofeedback v.s.pelvic floor muscle exercise alone on stress urinary incontinence in women.Methods:PubMed,the Cochrane Library,Web of Science,Ovid,Ebsco,PEDro,WanFang Data,VIP and CNKI databases were electronically searched to collect randomized controlled trials that meet inclusion criteria.After quality assessment,meta-analysis was conducted by RevMan 5.3 software.Results:A total of 8 randomized controlled trials were included.The results of meta-analysis supported the effectiveness of biofeedback on improving pelvic floor muscle strength(MD=4.67,95%CI(1.86,7.49),P=0.001),increasing short(up to 1 hour)pad test(SMD=−1.11,95%CI(−1.84,−0.37),P=0.003),enhancing quality of life(SMD=−0.34,95%CI(−0.67,−0.01),P=0.04)and social activity index(MD=0.1,95%CI(0.06,0.15),P<0.001).Conclusion:Pelvic floor muscle training with biofeedback could improve pelvic floor muscles’strength and help these patients integrate into society,more high quality studies are required to verify above conclusions.

Back Muscle Electromyographic Changes in Rehabilitation of Occupational Low Back Pain

This study is to investigate the changes of back muscle electromyography (EMG) in occupational low back pain (LBP) patients pre-and post-rehabilitation.20 occupational LBP patients were asked to perform sepcially designed symmetrical and asymmetrical actions,which include"carrying"weights up and down with a 45° left rotation.Back muscle EMG signals were recorded from surface of paraspinal muscles.The tests performed in the weeks immediately before and after 12-week rehabilitation treatment.The profile and mean power frequency (MPF) of EMG were compared between pre-and post-rehabilitation.EMG profiles showed unchangeable,but the MPF showed significantly increase in post-rehabilitation comparing to pre-rehabilitation.That suggested that the muscle activity strategies could not be modified by rehabilitation,but the rehabilitation would increase the threshold of fatigue and reduce the possible muscle pain in back paraspinal muscles.

Low skeletal muscle mass and high visceral adiposity are associated with recurrence of acute cholecystitis after conservative management:A propensity score-matched cohort study

Background:Recurrent acute cholecystitis(RAC)can occur after non-surgical treatment for acute cholecystitis(AC),and can be more severe in comparison to the first episode of AC.Low skeletal muscle mass or adiposity have various effects in several diseases.We aimed to clarify the relationship between RAC and body parameters.Methods:Patients with AC who were treated at our hospital between January 2011 and March 2022 were enrolled.The psoas muscle mass and adipose tissue area at the third lumbar level were measured using computed tomography at the first episode of AC.The areas were divided by height to obtain the psoas muscle mass index(PMI)and subcutaneous/visceral adipose tissue index(SATI/VATI).According to median VATI,SATI and PMI values by sex,patients were divided into the high and low PMI groups.We performed propensity score matching to eliminate the baseline differences between the high PMI and low PMI groups and analyzed the cumulative incidence and predictors of RAC.Results:The entire cohort was divided into the high PMI(n=81)and low PMI(n=80)groups.In the propensity score-matched cohort there were 57 patients in each group.In Kaplan-Meier analysis,the low PMI group and the high VATI group had a significantly higher cumulative incidence of RAC than their counterparts(log-rank P=0.001 and 0.015,respectively).In a multivariate Cox regression analysis,the hazard ratios of low PMI and low VATI for RAC were 5.250(95%confidence interval 1.083-25.450,P=0.039)and 0.158(95%confidence interval:0.026-0.937,P=0.042),respectively.Conclusions:Low skeletal muscle mass and high visceral adiposity were independent risk factors for RAC.

Low rank optimization for efficient deep learning:making a balance between compact architecture and fast training

Deep neural networks(DNNs)have achieved great success in many data processing applications.However,high computational complexity and storage cost make deep learning difficult to be used on resource-constrained devices,and it is not environmental-friendly with much power cost.In this paper,we focus on low-rank optimization for efficient deep learning techniques.In the space domain,DNNs are compressed by low rank approximation of the network parameters,which directly reduces the storage requirement with a smaller number of network parameters.In the time domain,the network parameters can be trained in a few subspaces,which enables efficient training for fast convergence.The model compression in the spatial domain is summarized into three categories as pre-train,pre-set,and compression-aware methods,respectively.With a series of integrable techniques discussed,such as sparse pruning,quantization,and entropy coding,we can ensemble them in an integration framework with lower computational complexity and storage.In addition to summary of recent technical advances,we have two findings for motivating future works.One is that the effective rank,derived from the Shannon entropy of the normalized singular values,outperforms other conventional sparse measures such as the?_1 norm for network compression.The other is a spatial and temporal balance for tensorized neural networks.For accelerating the training of tensorized neural networks,it is crucial to leverage redundancy for both model compression and subspace training.

Analysis of the Effect of Transcutaneous Electrical Stimulation of Acupoints Combined with Rehabilitation Training in The Treatment of Upper Limb Dysfunction After Stroke

Objective:To analyze the effect of combining transcutaneous electrical acupoint stimulation(TEAS)with rehabilitation training in patients with upper limb dysfunction after stroke(ULDAS).Methods:A total of 130 ULDAS patients who were hospitalized and rehabilitated in Wuxi Xinwu District Rehabilitation Hospital from May 2021 to May 2023 were selected and randomly divided into Group A(65 cases,rehabilitation training)and Group B(65 cases,rehabilitation training+TEAS).The effects of the two groups were compared.Results:After treatment,the upper limb functional indexes of Group B were better than those of Group A(P<0.05).The rate of muscle tone grades 0-4 in Group B was higher than those of Group A(P<0.05).Conclusion:The function of upper limbs and muscle strength of ULDAS patients improved by combining TEAS with rehabilitation training.

Influence of Oxidized Low Density Lipoprotein on the Proliferation of Human Artery Smooth Muscle Cells in vitro

The effects of oxidized low density lipoprotein （ox-LDL） on the proliferation of cultured human vascular smooth muscle cells （vSMC） were investigated in vitro. By using NaBr density gradient centrifugation, LDL was isolated and purified from human plasma. Ox-LDL was produced from LDL by being incubated with CuSO4. ox-LDL was then added to the culture medium at different concentrations （35, 60, 85, 110, 135 and 160μg/mL） for 7 days. The influence of ox-LDL on vSMC proliferation was observed in growth curve, mitosis index, and in situ determination of apoptosis. The data were analyzed with SPSS 10.0 software. The results showed that the ox-LDL produced in vitro had a good purity and optimal oxidative degree, which was similar to the intrinsic ox-LDL in atherosclerotic plaque, ox-LDL at a concentration of 35 μg/mL demonstrated the strongest proliferation inducement, and at a concentration of 135 μg/mL, ox-LDL could inhibit the growth of vSMC. ox-LDL at concentrations of 35 and 50 μg/mL presented powerful mitotic trigger, and with the increase of ox-LDL concentration, the mitotic index of vSMC was decreased gradually, ox-LDL at higher concentrations promoted more apoptotic vSMCs, ox-LDL at lower concentrations triggered proliferation of vSMCs, and at higher concentrations induced apoptosis in vSMCs, ox-LDL played a promotional role in the pathogenesis and development of atherosclerosis by affecting vSMC proliferation and apoptosis.

Spinal and supraspinal control of motor function during maximal eccentric muscle contraction:Effects of resistance training

Neuromuscular activity is suppressed during maximal eccentric(ECC)muscle contraction in untrained subjects owing to attenuated levels of central activation and reduced spinal motor neuron(MN)excitability indicated by reduced electromyography signal amplitude,diminished evoked H-reflex responses,increased autogenic MN inhibition,and decreased excitability in descending corticospinal motor pathways.Maximum ECC muscle force recorded during maximal voluntary contraction can be increased by superimposed electrical muscle stimulation only in untrained individuals and not in trained strength athletes,indicating that the suppression in MN activation is modifiable by resistance training.In support of this notion,maximum ECC muscle strength can be increased by use of heavy-load resistance training owing to a removed or diminished suppression in neuromuscular activity.Prolonged(weeks to months)of heavy-load resistance training results in increased H-reflex and V-wave responses during maximal ECC muscle actions along with marked gains in maximal ECC muscle strength,indicating increased excitability of spinal MNs,decreased presynaptic and/or postsynaptic MN inhibition,and elevated descending motor drive.Notably,the use of supramaximal ECC resistance training can lead to selectively elevated V-wave responses during maximal ECC contraction,demonstrating that adaptive changes in spinal circuitry function and/or gains in descending motor drive can be achieved during maximal ECC contraction in response to heavy-load resistance training.

The effects of 12 weeks of functional strength training on muscle strength,volume and activity upon exposure to elevated Gz forces in high-performance aircraft personnel

Background:Technological advancements in modern military and acrobatic jet planes have resulted in extraordinary psychophysiological loads being exerted upon flying personnel,including inducing neck and back pain.The purpose of this study was to examine the effects of 12 weeks of functional strength training on 1)the volume and strength of the neck and shoulder muscles and 2)muscular activity upon exposure to helmets of different masses and elevated Gz forces in a long-arm centrifuge in high-performance aircraft personnel.Methods:Eighteen participants underwent 12 weeks of functional strength training(n=12)or the control protocol(n=6)without additional strength training.Pre-and post-intervention tests included evaluations of isometric strength of the head extensor muscles,flexion,and lateral flexion and rotation,as well as magnetic resonance imaging(MRI)to measure the volume of the m.sternocleidomastoideus,m.trapezius,and deep neck muscles.Furthermore,during a long-arm centrifuge(+1.4 and+3Gz)protocol,the muscular activity levels of the m.sternocleidomastoideus,m.trapezius and m.erector spinae muscles were assessed without a flight helmet,with a helmet,and with a helmet and night vision goggles.Each participant’s perception of muscular strain was noted immediately after the long-arm centrifuge protocol.Results:The maximal isometric strength in all exercises and muscle volumes increased in the training group but not the control group(P<0.05).Relative muscle activity(%MVC)with a helmet decreased after the intervention in the training but not the control group(P=0.01).Relative muscle activity while wearing a helmet and night vision goggles was higher after intervention in the control group than in the training group(P<0.01).The perceived muscular strain of the neck muscles induced by the long-arm centrifuge did not differ between the groups.Conclusions:Twelve weeks of functional strength training improves the maximal isometric strength and volume of neck and shoulder muscles and leads to lower relative muscle activation upon exposure to elevated Gz forces in a long-arm centrifuge.

Low-Load Bench Press Training to Fatigue Results in Muscle Hypertrophy Similar to High-Load Bench Press Training

The purpose of this study was to determine whether the training responses observed with low-load resistance exercise to volitional fatigue translates into significant muscle hypertrophy, and compare that response to high-load resistance training. Nine previously untrained men (aged 25 [SD 3] years at the beginning of the study, standing height 1.73 [SD 0.07] m, body mass 68.9 [SD 8.1] kg) completed 6-week of high load-resistance training (HL-RT) (75% of one repeti-tion maximal [1RM], 3-sets, 3x/wk) followed by 12 months of detraining. Following this, subjects completed 6 weeks of low load-resistance training (LL-RT) to volitional fatigue (30% 1 RM, 4 sets, 3x/wk). Increases (p 0.05) in magnetic resonance imaging-measured triceps brachii and pectorals major muscle cross-sectional areas were similar for both HL-RT (11.9% and 17.6%, respectively) and LL-RT (9.8% and 21.1%, respectively). In addition, both groups increased (p 0.05) 1RM and maximal elbow extension strength following training;however, the percent increases in 1RM (8.6% vs. 21.0%) and elbow extension strength (6.5% vs. 13.9%) were significantly (p 0.05) lower with LL-RT. Both protocols elicited similar increases in muscle cross-sectional area, however differences were observed in strength. An explanation of the smaller relative increases in strength may be due to the fact that detraining after HL-RT did not cause strength values to return to baseline levels thereby producing smaller changes in strength. In addition, the results may also suggest that the consistent practice of lifting a heavy load is necessary to maximize gains in muscular strength of the trained movement. These results demonstrate that significant muscle hypertrophy can occur without high-load resistance training and suggests that the focus on percentage of external load as the important deciding factor on muscle hypertrophy is too simplistic and inappropriate.

Skeletal muscle atrophy,regeneration,and dysfunction in heart failure:Impact of exercise training

This review highlights some established and some more contemporary mechanisms responsible for heart failure(HF)-induced skeletal muscle wasting and weakness.We first describe the effects of HF on the relationship between protein synthesis and degradation rates,which determine muscle mass,the involvement of the satellite cells for continual muscle regeneration,and changes in myofiber calcium homeostasis linked to contractile dysfunction.We then highlight key mechanistic effects of both aerobic and resistance exercise training on skeletal muscle in HF and outline its application as a beneficial treatment.Overall,HF causes multiple impairments related to autophagy,anabolic-catabolic signaling,satellite cell proliferation,and calcium homeostasis,which together promote fiber atrophy,contractile dysfunction,and impaired regeneration.Although both wasting and weakness are partly rescued by aerobic and resistance exercise training in HF,the effects of satellite cell dynamics remain poorly explored.

Muscle capacity and physical function in older women:What are the impacts of resistance training?

The number of older adults （individuals ≥65 years）, particularly women, in our society is increasing and understanding the impact of exercise on muscle capacity （e.g., strength and power） and subsequently physical function is of utmost importance to prevent disability and maintain independence. Muscle capacity declines with age and this change negatively impacts physical function in older women. Exercise, specifically resistance training, is recommended to counteract these declines; however, the synergistic relationships between exercise, muscle capacity, and physical function are poorly understood. This review will summarize the literature regarding age-related changes in the aforementioned variables and review the research on the impact of resistance training interventions on muscle capacity and physical function in older women. Recommendations for future research in this area will be discussed.

Effects of Progressive Muscle Relaxation Training Combined with Emotion Nursing of Traditional Chinese Medicine on Motor Function and Quality of Life in Patients with Cerebral Stroke Complicated with Hemiplegia

OBJECTIVE: To explore the effects of progressive muscle relaxation training combined with emotion nursing of traditional Chinese medicine(TCM) on the motor function and quality of life in patients with cerebral stroke complicated with hemiplegia. METHODS: A total of 100 cases of patients with cerebral stroke complicated with hemiplegia who were admitted to Rehabilitation Medicine Department of Suzhou Municipal Hospital from May 2016 to May 2017 were selected and randomly divided into study group(50 cases) and control group(50 cases), and they were nursed for 1 month. Control group was given routine nursing, and study group was given progressive muscle relaxation training combined with TCM emotion nursing on the basis of routine nursing. The scores of all items were obtained by nurses through questionnaires, and the motor function and quality of life were analyzed and compared between the 2 groups. RESULTS: After nursing, the scores of muscle strength, Barthel index(BI) and Fugl-Meyer motor function scales in study group were higher than those in control group(P < 0.05). The facing scores of coping style in study group were higher than those in control group, and the avoidance score and yielding score were lower than those in control group(P < 0.05). The scores of depression and anxiety in study group were lower than those in control group(P < 0.05). The scores of items in SF-36 life scale in study group were higher than those in control group(P < 0.05). CONCLUSION: Progressive muscle relaxation training combined with TCM emotion nursing is conducive to the recovery of motor function and improvement of quality of life in patients with cerebral stroke complicated with hemiplegia.

Impact of Association between Functional Training and Respiratory Muscle Training in Elderly: A Randomized Controlled Trial

The elderly population in Brazil has been growing exponentially according to data presented by the IBGE. It is estimated that by 2025 the population will have reached 32 million, placing the country sixth in the world in the population of elderly people. To assess the results of respiratory training associated with functional training on respiratory muscle strength, lung function, and functionality of the elderly. The sample was composed of 40 elderlies, divided into four groups, the experimental group with functional training, one experimental group with functional training associated with respiratory training, one experimental group with respiratory training, and the fourth group, the control group. After the initial and final evaluations, the variables measured were: The Breathing Test, Sit to Stand Test, the SF-36 Quality of Life Questionnaire, and Spirometry. Twenty appointments were conducted twice a week. There were significant differences for variables maximum inspiratory and expiratory pressure;more accentuated in the associated group when compared to the respiratory group;forced vital capacity and forced expiratory volume in the first second/forced vital capacity were meaningful in the associated group;peak expiratory flow means values increased after the intervention;in the six-minute walk test, we noticed a trend to increase values after the intervention. Functional training as well as associated respiratory muscle training provide the most beneficial changes compared only to functional and respiratory training. Therefore, this may be an effective clinical training method for patients’ elderly.

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.