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Sample records for inspiratory muscle strength

  1. Inspiratory muscle strength in chronic obstructive pulmonary disease.

    PubMed

    Larson, Janet L; Covey, Margaret K; Corbridge, Susan

    2002-05-01

    Chronic obstructive pulmonary disease is associated with a functional weakness of the inspiratory muscles. Multiple factors contribute to the decline in functional strength including hyperinflation of the chest, deterioration in nutritional status, and the indirect effects of an exacerbation. The decreased inspiratory muscle strength contributes to sensations of dyspnea and places individuals at risk for respiratory muscle fatigue. The worsening dyspnea causes individuals to reduce their physical activities and ultimately become physically deconditioned. Maximal inspiratory pressure is commonly used to measure functional strength of the inspiratory muscles, and interventions to minimize the extent of decline include inspiratory muscle training, aerobic exercise training, nutritional supplementation, and methods to prevent exacerbations. In the critical care unit, multiple comorbid conditions contribute to further decline in inspiratory muscle strength, making it important to assess respiratory muscle function regularly.

  2. Diagnostic methods to assess inspiratory and expiratory muscle strength*

    PubMed Central

    Caruso, Pedro; de Albuquerque, André Luis Pereira; Santana, Pauliane Vieira; Cardenas, Leticia Zumpano; Ferreira, Jeferson George; Prina, Elena; Trevizan, Patrícia Fernandes; Pereira, Mayra Caleffi; Iamonti, Vinicius; Pletsch, Renata; Macchione, Marcelo Ceneviva; Carvalho, Carlos Roberto Ribeiro

    2015-01-01

    Impairment of (inspiratory and expiratory) respiratory muscles is a common clinical finding, not only in patients with neuromuscular disease but also in patients with primary disease of the lung parenchyma or airways. Although such impairment is common, its recognition is usually delayed because its signs and symptoms are nonspecific and late. This delayed recognition, or even the lack thereof, occurs because the diagnostic tests used in the assessment of respiratory muscle strength are not widely known and available. There are various methods of assessing respiratory muscle strength during the inspiratory and expiratory phases. These methods are divided into two categories: volitional tests (which require patient understanding and cooperation); and non-volitional tests. Volitional tests, such as those that measure maximal inspiratory and expiratory pressures, are the most commonly used because they are readily available. Non-volitional tests depend on magnetic stimulation of the phrenic nerve accompanied by the measurement of inspiratory mouth pressure, inspiratory esophageal pressure, or inspiratory transdiaphragmatic pressure. Another method that has come to be widely used is ultrasound imaging of the diaphragm. We believe that pulmonologists involved in the care of patients with respiratory diseases should be familiar with the tests used in order to assess respiratory muscle function.Therefore, the aim of the present article is to describe the advantages, disadvantages, procedures, and clinical applicability of the main tests used in the assessment of respiratory muscle strength. PMID:25972965

  3. Diagnostic methods to assess inspiratory and expiratory muscle strength.

    PubMed

    Caruso, Pedro; Albuquerque, André Luis Pereira de; Santana, Pauliane Vieira; Cardenas, Leticia Zumpano; Ferreira, Jeferson George; Prina, Elena; Trevizan, Patrícia Fernandes; Pereira, Mayra Caleffi; Iamonti, Vinicius; Pletsch, Renata; Macchione, Marcelo Ceneviva; Carvalho, Carlos Roberto Ribeiro

    2015-01-01

    Impairment of (inspiratory and expiratory) respiratory muscles is a common clinical finding, not only in patients with neuromuscular disease but also in patients with primary disease of the lung parenchyma or airways. Although such impairment is common, its recognition is usually delayed because its signs and symptoms are nonspecific and late. This delayed recognition, or even the lack thereof, occurs because the diagnostic tests used in the assessment of respiratory muscle strength are not widely known and available. There are various methods of assessing respiratory muscle strength during the inspiratory and expiratory phases. These methods are divided into two categories: volitional tests (which require patient understanding and cooperation); and non-volitional tests. Volitional tests, such as those that measure maximal inspiratory and expiratory pressures, are the most commonly used because they are readily available. Non-volitional tests depend on magnetic stimulation of the phrenic nerve accompanied by the measurement of inspiratory mouth pressure, inspiratory esophageal pressure, or inspiratory transdiaphragmatic pressure. Another method that has come to be widely used is ultrasound imaging of the diaphragm. We believe that pulmonologists involved in the care of patients with respiratory diseases should be familiar with the tests used in order to assess respiratory muscle function.Therefore, the aim of the present article is to describe the advantages, disadvantages, procedures, and clinical applicability of the main tests used in the assessment of respiratory muscle strength.

  4. Determinants of inspiratory muscle strength in healthy humans.

    PubMed

    Brown, Peter I; Johnson, Michael A; Sharpe, Graham R

    2014-06-01

    We investigated (1) the relationship between the baseline and inspiratory muscle training (IMT) induced increase in maximal inspiratory pressure (P(I,max)) and (2) the relative contributions of the inspiratory chest wall muscles and the diaphragm (P(oes)/P(di)) to P(I,max) prior to and following-IMT. Experiment 1: P(I,max) was assessed during a Müeller manoeuvre before and after 4-wk IMT (n=30). Experiment 2: P(I,max) and the relative contribution of the inspiratory chest wall muscles to the diaphragm (P(oes)/P(di)) were assessed during a Müeller manoeuvre before and after 4-wk IMT (n=20). Experiment 1: P(I,max) increased 19% (P<0.01) post-IMT and was correlated with baseline P(I,max) (r=-0.373, P<0.05). Experiment 2: baseline P(I,max) was correlated with P(oe)/P(di) (r=0.582, P<0.05) and after IMT PI,max increased 22% and Poe/Pdi increased 5% (P<0.05). In conclusion, baseline P(I,max) and the contribution of the chest wall inspiratory muscles relative to the diaphragm affect, in part, baseline and IMT-induced P(I,max). Great care should be taken when designing future IMT studies to ensure parity in the between-subject baseline P(I,max).

  5. Inspiratory Muscle Strength and Endurance in Children and Adolescents with Cystic Fibrosis.

    PubMed

    Vendrusculo, Fernanda M; Heinzmann-Filho, João P; Piva, Taila C; Marostica, Paulo J C; Donadio, Márcio V F

    2016-02-01

    Pulmonary changes that occur in cystic fibrosis may influence inspiratory muscle strength and endurance. We evaluated inspiratory muscle strength and endurance in children and adolescents with cystic fibrosis in comparison with healthy subjects. This is a cross-sectional observational study with subjects with cystic fibrosis and paired healthy individuals, age 6-18 y. Spirometry, impulse oscillometry, plethysmography, manovacuometry, and a protocol of inspiratory muscle endurance were performed. Subjects with cystic fibrosis (n = 34) had higher maximum percent-of-predicted inspiratory pressure (PImax) than healthy (n = 68) subjects (118.5 ± 25.8% vs 105.8 ± 18.0%) and no significant difference in endurance (60.9 ± 13.3% vs 65.3 ± 12.3%). When restricting the analysis to subjects without Pseudomonas aeruginosa colonization and with FEV1 > 80%, PImax values were significantly higher, and inspiratory muscle endurance was lower, in comparison with the control group. PImax correlated significantly with FVC (r = 0.44, P = .02) and FEV1 (r = 0.41, P = .02), whereas endurance correlated better with total airway resistance (r = 0.35, P = .045) and with central airway resistance (r = 0.48, P = .004). Children and adolescents with cystic fibrosis with no colonization by P. aeruginosa and normal lung function present increased inspiratory muscle strength and decreased endurance compared with healthy individuals, indicating that changes in the respiratory muscle function seem to be distinctly associated with pulmonary involvement. Strength was related to pulmonary function parameters, whereas endurance was associated with airway resistance. Copyright © 2016 by Daedalus Enterprises.

  6. Role of maximal inspiratory presure in the evaluetion of respiratory muscle strength in asthmatics - Systematic review.

    PubMed

    Cavalcante Marcelino, Alessandra M F; da Silva, Hilton Justino

    2010-01-01

    Asthma is a chronic illness of the airways that can reduce respiratory muscle strength due to the resulting hyperinflation or treatment with corticosteroids. One of the ways to evaluate this respiratory muscular weakness is the Maximal Inspiratory Pressure (PImax). A systematic review of the databases PUBMED/MEDLINE, LILACS and SCIELO was carried through, using the key words: Asthma, respiratory muscle and muscle strength. Fifty were found and six articles that evaluated the PImax in asthmatics, from these, thirty were excluded, making a total of twenty six articles. Through the present revision we show the effectiveness of PImax in evaluating respiratory muscle strength in asthmatics. More studies are needed, however, fot better understanding of the asthmatic individual. Rev Port Pneumol 2010; XVI (3): 463-470. © 2010 Sociedade Portuguesa de Pneumologia/SPP.

  7. Inspiratory muscle strength training improves weaning outcome in failure to wean patients: a randomized trial

    PubMed Central

    2011-01-01

    Introduction Most patients are readily liberated from mechanical ventilation (MV) support, however, 10% - 15% of patients experience failure to wean (FTW). FTW patients account for approximately 40% of all MV days and have significantly worse clinical outcomes. MV induced inspiratory muscle weakness has been implicated as a contributor to FTW and recent work has documented inspiratory muscle weakness in humans supported with MV. Methods We conducted a single center, single-blind, randomized controlled trial to test whether inspiratory muscle strength training (IMST) would improve weaning outcome in FTW patients. Of 129 patients evaluated for participation, 69 were enrolled and studied. 35 subjects were randomly assigned to the IMST condition and 34 to the SHAM treatment. IMST was performed with a threshold inspiratory device, set at the highest pressure tolerated and progressed daily. SHAM training provided a constant, low inspiratory pressure load. Subjects completed 4 sets of 6-10 training breaths, 5 days per week. Subjects also performed progressively longer breathing trials daily per protocol. The weaning criterion was 72 consecutive hours without MV support. Subjects were blinded to group assignment, and were treated until weaned or 28 days. Results Groups were comparable on demographic and clinical variables at baseline. The IMST and SHAM groups respectively received 41.9 ± 25.5 vs. 47.3 ± 33.0 days of MV support prior to starting intervention, P = 0.36. The IMST and SHAM groups participated in 9.7 ± 4.0 and 11.0 ± 4.8 training sessions, respectively, P = 0.09. The SHAM group's pre to post-training maximal inspiratory pressure (MIP) change was not significant (-43.5 ± 17.8 vs. -45.1 ± 19.5 cm H2O, P = 0.39), while the IMST group's MIP increased (-44.4 ± 18.4 vs. -54.1 ± 17.8 cm H2O, P < 0.0001). There were no adverse events observed during IMST or SHAM treatments. Twenty-five of 35 IMST subjects weaned (71%, 95% confidence interval (CI) = 55% to 84

  8. Immediate effect of manual therapy on respiratory functions and inspiratory muscle strength in patients with COPD

    PubMed Central

    Yilmaz Yelvar, Gul Deniz; Çirak, Yasemin; Demir, Yasemin Parlak; Dalkilinç, Murat; Bozkurt, Bülent

    2016-01-01

    Objective The objective of this study was to investigate the immediate effect of manual therapy (MT) on respiratory functions and inspiratory muscle strength in patients with COPD. Participants and methods Thirty patients with severe COPD (eight females and 22 males; mean age 62.4±6.8 years) referred to pulmonary physiotherapy were included in this study. The patients participated in a single session of MT to measure the short-term effects. The lung function was measured using a portable spirometer. An electronic pressure transducer was used to measure respiratory muscle strength. Heart rate, breathing frequency, and oxygen saturation were measured with a pulse oximeter. For fatigue and dyspnea perception, the modified Borg rating of perceived exertion scale was used. All measurements were taken before and immediately after the first MT session. The ease-of-breathing visual analog scale was used for rating patients’ symptoms subjectively during the MT session. Results There was a significant improvement in the forced expiratory volume in the first second, forced vital capacity, and vital capacity values (P<0.05). The maximal inspiratory pressure and maximal expiratory pressure values increased significantly after MT, compared to the pre-MT session (P<0.05). There was a significant decrease in heart rate, respiratory rate (P<0.05), and dyspnea and fatigue perception (P<0.05). Conclusion A single MT session immediately improved pulmonary function, inspiratory muscle strength, and oxygen saturation and reduced dyspnea, fatigue, and heart and respiratory rates in patients with severe COPD. MT should be added to pulmonary rehabilitation treatment as a new alternative that is fast acting and motivating in patients with COPD. PMID:27382271

  9. Increased inspiratory and expiratory muscle strength following respiratory muscle strength training (RMST) in two patients with late-onset Pompe disease.

    PubMed

    Jones, Harrison N; Moss, Tronda; Edwards, Laurie; Kishnani, Priya S

    2011-11-01

    Respiratory muscle strength training (RMST) is an exercise-based intervention which targets respiratory muscle weakness. We implemented RMST in two patients with late-onset Pompe disease (LOPD), both who had received long-term enzyme replacement therapy and had severe respiratory weakness. Over 16-32 weeks, inspiratory muscle strength increased by 73-74%. Expiratory muscle strength increased 31-48% over 12-22 weeks. These findings suggest that RMST may increase respiratory muscle strength, even in the setting of LOPD and severe baseline weakness.

  10. [Effect of inspiratory muscle training on muscle strength and quality of life in patients with chronic airflow limitation: a randomized controlled trial].

    PubMed

    Serón, P; Riedemann, P; Muñoz, S; Doussoulin, A; Villarroel, P; Cea, X

    2005-11-01

    Chronic airflow limitation (CAL) is a significant cause of illness and death. Inspiratory muscle training has been described as a technique for managing CAL. The aim of the present study was to evaluate the effectiveness of inspiratory muscle training on improving physiological and functional variables. Randomized controlled trial in which 35 patients with CAL were assigned to receive either an experimental (n=17) or control (n=18) intervention. The experimental intervention consisted of 2 months of inspiratory muscle training using a device that administered a resistive load of 40% of maximal static inspiratory mouth pressure (PImax). Inspiratory muscle strength, exercise tolerance, respiratory function, and quality of life were assessed. Significant improvement in inspiratory muscle strength was observed in the experimental training group (P=.02). All patients improved over time in both groups (P<.001). PImax increased by 8.9 cm H2O per month of training. Likewise, the health-related quality of life scores improved by 0.56 points. Use of a threshold loading device is effective for strengthening inspiratory muscles as measured by PImax after the first month of training in patients with CAL. The long-term effectiveness of such training and its impact on quality of life should be studied in a larger number of patients.

  11. Inspiratory Muscle Strength Training in Infants With Congenital Heart Disease and Prolonged Mechanical Ventilation: A Case Report

    PubMed Central

    Bleiweis, Mark S.; Neel, Cimaron R.; Martin, A. Daniel

    2013-01-01

    Background and Purpose Inspiratory muscle strength training (IMST) has been shown to improve maximal pressures and facilitate ventilator weaning in adults with prolonged mechanical ventilation (MV). The purposes of this case report are: (1) to describe the rationale for IMST in infants with MV dependence and (2) to summarize the device modifications used to administer training. Case Description Two infants with congenital heart disease underwent corrective surgery and were referred for inspiratory muscle strength evaluation after repeated weaning failures. It was determined that IMST was indicated due to inspiratory muscle weakness and a rapid, shallow breathing pattern. In order to accommodate small tidal volumes of infants, 2 alternative training modes were devised. For infant 1, IMST consisted of 15-second inspiratory occlusions. Infant 2 received 10-breath sets of IMST through a modified positive end-expiratory pressure valve. Four daily IMST sets separated by 3 to 5 minutes of rest were administered 5 to 6 days per week. The infants' IMST tolerance was evaluated by vital signs and daily clinical reviews. Outcomes Maximal inspiratory pressure (MIP) and rate of pressure development (dP/dt) were the primary outcome measures. Secondary outcome measures included the resting breathing pattern and MV weaning. There were no adverse events associated with IMST. Infants generated training pressures through the adapted devices, with improved MIP, dP/dt, and breathing pattern. Both infants weaned from MV to a high-flow nasal cannula, and neither required subsequent reintubation during their hospitalization. Discussion This case report describes pediatric adaptations of an IMST technique used to improve muscle performance and facilitate weaning in adults. Training was well tolerated in 2 infants with postoperative weaning difficulty and inspiratory muscle dysfunction. Further systematic examination will be needed to determine whether IMST provides a significant performance

  12. Inspiratory muscle strength is correlated with carnitine levels in type 2 diabetes.

    PubMed

    Kiliçli, Fatih; Dökmetaş, Sebila; Candan, Ferhan; Ozşahin, Sefa; Korkmaz, Serdal; Amasyali, Elvan; Fakioğlu, Koray; Dal, Kürşat; Acibucu, Fettah; Cakir, Ilkay

    2010-05-01

    Plasma carnitine insufficiency has been known to cause muscle weakness. Carnitine levels and pulmonary functions were lower in patients with diabetes. To determine whether pulmonary functions are correlated with carnitine levels in patients with type 2 diabetes. In this study, we evaluated pulmonary functions and carnitine concentrations in 49 patients with type 2 diabetes and 34 healthy controls. Carnitine levels were lower in type 2 diabetes group than control group (52.56 +/- 12.38 and 78.96 +/- 10.66 hmol/mL, respectively, p < 0.0001). Pulmonary functions were not significantly different between groups. Carnitine levels were not correlated with age, duration of diabetes, fasting blood glucose levels, and glycemic control (HbA1c%) in patients with type 2 diabetes. However, carnitine levels in patient group were correlated with % forced vital capacity (FVC%) (r = 0.35, p = 0.016), % forced expiratory volume in 1 s (FEV1%) (r = 0.318, p= 0.029), FEV1/FVC (r= 0.302, p= 0.039), inspiratory muscle strength (PImax) (r = 0.407, p = 0.023), and PImax% (r = 0.423, p= 0.018). This study suggests that low carnitine levels may be associated with lower PImax and PImax% in type 2 diabetes.

  13. Is serial determination of inspiratory muscle strength a useful prognostic marker in chronic heart failure?

    PubMed

    Frankenstein, Lutz; Meyer, Franz Joachim; Sigg, Caroline; Nelles, Manfred; Schellberg, Dieter; Remppis, Andrew; Katus, Hugo A; Zugck, Christian

    2008-04-01

    Little data exists on the prognostic role of inspiratory muscle strength (PImax) in chronic heart failure (CHF). Training studies, however, frequently use it as a therapeutic target and surrogate marker for prognosis. The prognostic value of changes of PImax that allow this extrapolation is unknown. Patients with stable CHF were prospectively included and 1-year and all-time event rates recorded for endpoint analysis. In 158 patients (85% men; New York Heart Association functional class: 2.4+/-0.6), PImax was measured along with clinical evaluations at two visits, the initial visit and the second visit, 6.4+/-1.4 months apart. The mean follow-up was 59+/-34 months. Overall, 59 patients (37%) reached the primary endpoint of death or hospitalization (endpoint positive), and overall mortality rate (secondary endpoint) was 26% (42 patients). PImax did not differ between endpoint-negative and endpoint-positive patients, both at the initial and at the second visit (8.3+/-5.6 vs. 7.3+/-3.4 kPa and 8.8+/-6.0 vs. 7.9+/-3.6 kPa, respectively; P=NS), and both groups showed increased PImax (0.6+/-2.6 vs. 0.6+/-2.8 kPa; P=NS). Cox analyses found neither the absolute nor the relative change of PImax to be significant predictors for the primary and secondary endpoints (P=NS for both), both for the 1-year and for the all-time event rates. Endpoint rates did not differ between patients showing increasing or decreasing PImax (P=NS; relative risk (RR): 0.77; 95% confidence interval: 0.47-1.27). Trials focusing on inspiratory muscle function should use the actual levels of PImax as a surrogate marker to represent prognostic information, rather than relative or absolute changes. This is the first study to investigate the prognostic information of the changes of PImax over time, regarding both short-term and long-term morbidity and mortality in patients with stable CHF.

  14. Effects of inspiratory muscle training on lung volumes, respiratory muscle strength, and quality of life in patients with ataxia telangiectasia.

    PubMed

    Félix, Erika; Gimenes, Ana Cristina; Costa-Carvalho, Beatriz Tavares

    2014-03-01

    Ataxia telangiectasia (AT) is a genetic syndrome caused by a mutation of chromosome 11. The clinical features are cerebellar ataxia, telangiectasia, and progressive loss of muscular coordination, including an inefficient cough secondary to progression of neurological disease. To evaluate the effects of inspiratory muscle training (IMT) on ventilation, lung volume, dyspnoea, respiratory muscle strength, and quality of life in patients with AT. A longitudinal study was conducted with 11 AT patients and nine healthy volunteers. Ventilometry, subjective sensation of dyspnoea, maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), and quality of life were assessed before and after a 24-week IMT program. The IMT load used was set at 60% of the MIP, and the training was performed for 20 min daily. Patients with AT had lower height and weight and also had lower respiratory muscle strength and lung volume compared with healthy volunteers. Furthermore, patients with AT showed a significant improvement when pre- and post-IMT were compared for ventilatory pattern: Vt (476.5 ± 135 ml vs. 583.3 ± 66 ml, P = 0.015) and f (23.3 ± 6 rpm vs. 20.4 ± 4 rpm, P = 0.018), and VC (1,664 ± 463 ml/kg vs. 2,145 ± 750 ml/kg, P = 0.002). IMT also significantly improved the sensation of dyspnoea (median 0.5; minimum 0; maximum 1.0; P = 0.022) and respiratory muscle strength: MIP (-22.2 ± 2 cmH2O vs. -38 ± 9 cmH2O, P < 0.001) and MEP (29 ± 7 cmH2O vs. 40 ± 8 cmH2O, P = 0.001). The health and vitality domains of the SF-36 also showed significant improvement (P = 0.009 and P = 0.014, respectively) post-IMT. IMT was effective in improving ventilatory pattern, lung volume, respiratory muscle strength, and the health and vitality domains for quality of life in patients with AT. IMT may be an effective adjunct therapy to drug treatment for patients with AT. © 2013 Wiley Periodicals, Inc.

  15. Reliability and acceptability of measuring sniff nasal inspiratory pressure (SNIP) and peak inspiratory flow (PIF) to assess respiratory muscle strength in older adults: a preliminary study.

    PubMed

    Barnes, Nicola; Agyapong-Badu, Sandra; Walsh, Bronagh; Stokes, Maria; Samuel, Dinesh

    2014-04-01

    Sniff nasal inspiratory pressure (SNIP) and peak oral inspiratory flow (PIF) are portable, relatively new methods for indirect measurement of respiratory muscle strength. The reliability and acceptability of these measures were investigated in older adults. The study included 21 self-reported healthy adults, aged 65-84 years (mean 73.5; SD 6.4 years). Participants were tested in a sitting position on two occasions, 1 week apart. The best of three attempts for PIF measured through the mouth, and five for each nostril for SNIP were recorded. Reliability was tested using intra-class correlation coefficient (ICC), standard error of measurement, minimal detectable change (MDC) and Bland and Altman analysis. Feedback on the measures in relation to ease of completion and preference was obtained using a semi-structured interview. Between-day reliability of SNIP and PIF were ICC3,1 0.76 (95 % CI 0.49-0.9) and 0.92 (0.81-0.97), respectively. Standard error of measurement for SNIP (11.94 cmH2O) and MDC (33.10 cmH2O) were at the least 61 % higher than for PIF. The participants reported difficulties in performing SNIP, rating it as being less easy and uncomfortable to perform than PIF, with a higher rate of missing data for SNIP due to participants' dislike of the test. The wide range of SNIP readings, lower ICC value and negative user feedback are suggestive of a less robust and unacceptable clinical measure. PIF showed excellent reliability and acceptability and is therefore recommended for assessing inspiratory muscle strength in older people without known obstructive lung disease.

  16. INSPIRATIonAL--INSPIRAtory muscle training in amyotrophic lateral sclerosis.

    PubMed

    Cheah, Benjamin C; Boland, Robert A; Brodaty, Nina E; Zoing, Margie C; Jeffery, Sandra E; McKenzie, David K; Kiernan, Matthew C

    2009-01-01

    Respiratory impairment, due to respiratory muscle weakness, is a major cause of morbidity and mortality in patients with amyotrophic lateral sclerosis/motor neuron disease (ALS/MND). Threshold loading may strengthen the inspiratory muscles and thereby improve patient prognosis. A phase II, double-blind, randomized-controlled trial was undertaken to determine whether a 12-week inspiratory muscle training programme attenuated the decline in respiratory function and inspiratory muscle strength in patients with ALS/MND. Nine patients were randomized to inspiratory muscle training and 10 to sham training. Primary endpoints were respiratory function (forced vital capacity, vital capacity), lung volumes and inspiratory muscle strength. Patients were assessed before, during and immediately after a 12-week training period, and at eight weeks follow-up. While improvements in inspiratory muscle strength were observed in both treatment arms, there was a non-significant increase in maximum inspiratory pressure of 6.1% in the experimental group compared to controls (standard error of mean, 6.93%; 95% confidence interval -8.58 -20.79; p=0.39). The gains in inspiratory muscle strength were partially reversed during a period of training cessation. In conclusion, inspiratory muscle training may potentially strengthen the inspiratory muscles and slow the decline in respiratory function in patients with ALS/MND.

  17. Factors contributing to thixotropy of inspiratory muscles.

    PubMed

    Izumizaki, Masahiko; Shibata, Masahiko; Homma, Ikuo

    2004-06-25

    Thixotropy is a passive property of the skeletal muscle dependent on the muscle's immediate history of contraction and length change. Thixotropic properties of inspiratory muscles, introduced by forceful muscle contraction at an inflated lung volume, cause an increased end-expiratory position (EEP) of the rib cage. We searched for factors contributing to the development of inspiratory muscle thixotropy in nine healthy subjects. Using induction plethysmography, we examined aftereffects on EEP of the duration of inspiratory muscle contraction and subsequent muscle relaxation. We also studied effects of inspiratory effort intensity measured by mouth pressure at different lung volumes. EEP elevation was noted subsequent to 5-s contraction followed by 2-s relaxation and was enhanced when conditioned at higher lung volumes with a strong inspiratory effort. Our results suggest four factors that influence inspiratory muscle thixotropy: (1) intensity of muscle contraction, (2) lung volume when contraction occurs, (3) duration of contraction, and (4) muscle relaxation.

  18. Controlled Frequency Breathing Reduces Inspiratory Muscle Fatigue.

    PubMed

    Burtch, Alex R; Ogle, Ben T; Sims, Patrick A; Harms, Craig A; Symons, T Brock; Folz, Rodney J; Zavorsky, Gerald S

    2017-05-01

    Burtch, AR, Ogle, BT, Sims, PA, Harms, CA, Symons, TB, Folz, RJ, and Zavorsky, GS. Controlled frequency breathing reduces inspiratory muscle fatigue. J Strength Cond Res 31(5): 1273-1281, 2017-Controlled frequency breathing (CFB) is a common swim training modality involving holding one's breath for approximately 7-10 strokes before taking another breath. We sought to examine the effects of CFB training on reducing respiratory muscle fatigue. Competitive college swimmers were randomly divided into either the CFB group that breathed every 7-10 strokes or a control group that breathed every 3-4 strokes. Twenty swimmers completed the study. The training intervention included 5-6 weeks (16 sessions) of 12 × 50-m repetitions with breathing 8-10 breaths per 50-m (control group) or 2-3 breaths per 50-m (CFB group). Inspiratory muscle fatigue was defined as the decrease in maximal inspiratory pressure (MIP) between rest and 46 seconds after a 200-yard freestyle swimming race (115 seconds [SD 7]). Aerobic capacity, pulmonary diffusing capacity, and running economy were also measured pre- and posttraining. Pooled results demonstrated a 12% decrease in MIP at 46 seconds post-race (-15 [SD 14] cm H2O, effect size = -0.48, p < 0.01). After 4 weeks of training, only the CFB group prevented a decline in MIP values before to 46 seconds after race (-2 [13] cm H2O, p > 0.05). However, swimming performance, aerobic capacity, pulmonary diffusing capacity, and running economy did not improve (p > 0.05) posttraining in either group. In conclusion, CFB training appears to prevent inspiratory muscle fatigue; yet, no difference was found in performance outcomes.

  19. Inspiratory muscle training is ineffective in mechanically ventilated critically ill patients.

    PubMed

    Caruso, Pedro; Denari, Silvia D C; Ruiz, Soraia A L; Bernal, Karla G; Manfrin, Gabriela M; Friedrich, Celena; Deheinzelin, Daniel

    2005-12-01

    Invasive mechanical ventilation is associated with complications, and its abbreviation is desirable. The imbalance between increased workload, decreased inspiratory muscle strength and endurance is an important determinant of ventilator dependence. Low endurance may be present due to respiratory muscle atrophy, critical illness, or steroid use. Specific inspiratory muscle training may increase or preserve endurance. The objective of the study was to test the hypothesis that inspiratory muscle training from the beginning of mechanical ventilation would abbreviate the weaning duration and decrease reintubation rate. As a secondary objective, we described the evolution of inspiratory muscle strength with and without inspiratory muscle training. Prospective, randomized clinical trial in an adult clinical-surgical intensive care unit. Twelve patients trained the inspiratory muscles twice a day, and 13 patients did not (control). Training was performed adjusting the sensitivity of the ventilator based on the maximal inspiratory pressure. Patients underwent daily surveillance of the maximal inspiratory pressure. The weaning duration (31 +/- 22 hr, control and 23 +/- 11 hr, training group; P = .24) and reintubation rate (5 control and 3 training group; P = .39) were not statistically different. The maximal inspiratory pressure of the control group showed a trend toward a modest increase. In contrast, the training group showed a small decrease (P = .34). In acute critically ill patients, inspiratory muscle training from the beginning of mechanical ventilation neither abbreviated the weaning duration, nor decreased the reintubation rate. Inspiratory muscle strength tended to stay constant, along the mechanical ventilation, with or without this specific inspiratory muscle training.

  20. Vibrating Platform Training Improves Respiratory Muscle Strength, Quality of Life, and Inspiratory Capacity in the Elderly Adults: A Randomized Controlled Trial.

    PubMed

    Pessoa, Maíra Florentino; Brandão, Daniela Cunha; Sá, Rafaela Barros de; Barcelar, Jacqueline de Melo; Rocha, Taciano Dias de Souza; Souza, Helga Cecília Muniz de; Dornelas de Andrade, Armele

    2017-05-01

    Aging affects respiratory strength that could cause reduction in functional capacity and quality of life, playing a fundamental role in healthy aging and survival. To prevent these declines, the whole body vibration (WBV) has been proposed to increase strength and functional capacity. The aim of the study was to evaluate the effects of WBV on respiratory muscle strength, thoracoabdominal ventilation, and quality of life in the elderly adults. This study was a controlled, randomized double-blind clinical trial. The study included 28 elderly adults randomized into three groups: Resistance (n = 9), WBV (n = 9), or WBV + resistance exercises (n = 10), performing training, sham, or double training for 3 months, twice per week. The variables of the study were as follows: maximal inspiratory and expiratory pressures (MIP and MEP), distribution of thoracoabdominal volumes variation in optoelectronic plethysmography (pulmonary rib cage-VRCp, abdominal rib cage-VRCa, and abdomen-VAB), and quality of life. After training, WBV and WBV + resistance groups increased MIP and MEP (p < .001). During inspiratory capacity maneuver, WBV groups had incremental increases in chest wall total volume (p < .001), showing a rise in pulmonary rib cage (p = .03) and abdominal rib cage (p = .04). Furthermore, WBV groups improved SF-36 scores in functional capacity, physical aspects, energy, pain, and general heath domains. The WBV is a training that could improve respiratory muscle strength and quality of life and promote different ventilatory strategies in chest wall and thoracoabdominal compartments in healthy elderly adults.

  1. Effects of Inspiratory Muscle Training and Calisthenics-and-Breathing Exercises in COPD With and Without Respiratory Muscle Weakness.

    PubMed

    Basso-Vanelli, Renata P; Di Lorenzo, Valéria A Pires; Labadessa, Ivana G; Regueiro, Eloisa M G; Jamami, Mauricio; Gomes, Evelim L F D; Costa, Dirceu

    2016-01-01

    Patients with COPD may experience respiratory muscle weakness. Two therapeutic approaches to the respiratory muscles are inspiratory muscle training and calisthenics-and-breathing exercises. The aims of the study are to compare the effects of inspiratory muscle training and calisthenics-and-breathing exercises associated with physical training in subjects with COPD as an additional benefit of strength and endurance of the inspiratory muscles, thoracoabdominal mobility, physical exercise capacity, and reduction in dyspnea on exertion. In addition, these gains were compared between subjects with and without respiratory muscle weakness. 25 subjects completed the study: 13 composed the inspiratory muscle training group, and 12 composed the calisthenics-and-breathing exercises group. Subjects were assessed before and after training by spirometry, measurements of respiratory muscle strength and test of inspiratory muscle endurance, thoracoabdominal excursion measurements, and the 6-min walk test. Moreover, scores for the Modified Medical Research Council dyspnea scale were reported. After intervention, there was a significant improvement in both groups of respiratory muscle strength and endurance, thoracoabdominal mobility, and walking distance in the 6-min walk test. Additionally, there was a decrease of dyspnea in the 6-min walk test peak. A difference was found between groups, with higher values of respiratory muscle strength and thoracoabdominal mobility and lower values of dyspnea in the 6-min walk test peak and the Modified Medical Research Council dyspnea scale in the inspiratory muscle training group. In the inspiratory muscle training group, subjects with respiratory muscle weakness had greater gains in inspiratory muscle strength and endurance. Both interventions increased exercise capacity and decreased dyspnea during physical effort. However, inspiratory muscle training was more effective in increasing inspiratory muscle strength and endurance, which could

  2. Tutorial on maximum inspiratory and expiratory mouth pressures in individuals with idiopathic Parkinson disease (IPD) and the preliminary results of an expiratory muscle strength training program.

    PubMed

    Silverman, Erin P; Sapienza, Christine M; Saleem, Ahmad; Carmichael, Chris; Davenport, Paul W; Hoffman-Ruddy, Bari; Okun, Michael S

    2006-01-01

    Respiratory symptoms are recognized as sequelae of motor dysfunction in idiopathic Parkinson's disease (IPD) and these symptoms have the potential to cause problems with swallow, cough, voice and speech. Specifically, maneuvers that require rapid activation and coordination of upper airway and chest wall musculature become progressively impaired as motor dysfunction progresses during the natural course of the disease. This study reports on the maximum inspiratory and expiratory pressures produced by 28 participants (average age 64) diagnosed with moderate to severe IPD (average stage 2.5 with a range of 2.0-3.0). All measures were collected during the "medication on" state. Outcomes of a specific respiratory muscle strength training technique for improving maximum expiratory pressure are reported for three of the patients in this study. Techniques that focus on strengthening the respiratory muscles in patients with IPD (other than with low load breathing exercises), have not been previously reported. The results of this pilot study demonstrate that respiratory muscle weakness may be an important factor in the respiratory complications in IPD and that respiratory muscle strength training has the potential to improve expiratory muscle strength for this population. This improvement has the potential to positively impact high forced respiratory activities, such as forced breathing maneuvers, swallow, cough and speech functions that require greater magnitude and duration of expiration.

  3. Respiratory dysfunction in ventilated patients: can inspiratory muscle training help?

    PubMed

    Bissett, B; Leditschke, I A; Paratz, J D; Boots, R J

    2012-03-01

    Respiratory muscle dysfunction is associated with prolonged and difficult weaning from mechanical ventilation. This dysfunction in ventilator-dependent patients is multifactorial: there is evidence that inspiratory muscle weakness is partially explained by disuse atrophy secondary to ventilation, and positive end-expiratory pressure can further reduce muscle strength by negatively shifting the length-tension curve of the diaphragm. Polyneuropathy is also likely to contribute to apparent muscle weakness in critically ill patients, and nutritional and pharmaceutical effects may further compound muscle weakness. Moreover, psychological influences, including anxiety, may contribute to difficulty in weaning. There is recent evidence that inspiratory muscle training is safe and feasible in selected ventilator-dependent patients, and that this training can reduce the weaning period and improve overall weaning success rates. Extrapolating from evidence in sports medicine, as well as the known effects of inspiratory muscle training in chronic lung disease, a theoretical model is proposed to describe how inspiratory muscle training enhances weaning and recovery from mechanical ventilation. Possible mechanisms include increased protein synthesis (both Type 1 and Type 2 muscle fibres), enhanced limb perfusion via dampening of a sympathetically-mediated metaboreflex, reduced lactate levels and modulation of the perception of exertion, resulting in less dyspnoea and enhanced exercise capacity.

  4. [Indirect evaluation of respiratory muscle strength with the help of markers of maximal inspiratory and expiratory pressure in the mouth of healthy individuals].

    PubMed

    Adamiak-Kardas, Magdalena

    2002-03-01

    The aim of the study was the evaluation of respiratory muscle strength by measurement of maximal inspiratory (PImax) and expiratory (PEmax) pressures values. Results for 166 clinically normal subjects (79 female and 87 male) were obtained. The results were as follow: in woman PImax ranged 38-104 cm H2O, average 60 cm H2O, PEmax ranged 46-140 cm H2O average 87.5 cm H2O, in men PImax was 40-120 cm H2O, average 73.2 cm H2O, PEmax ranged 46-140 cm H2O, average 115.9 cm H2O. PImax was negatively correlated with age in both groups. There was no correlation between age and PImax or PEmax in both groups (p > 0.05). There was no correlation between PImax and PEmax and height in women group and men group treated apart. The correlation was found between PImax as well as PEmax and height for whole group (p = 0.00019). There were observed positive correlation between PImax, PEmax and weight in both (male and female) groups. The comparison of results of present study with those obtained in former studies reveals important differences of norms for different populations. The normal values of maximal inspiratory and expiratory pressures in the mouth (PImax, PEmax) should be qualified individually for studied population. The normal values recommended by producers of medical equipment might be inadequate for studied population.

  5. The effect of exercise training with an additional inspiratory load on inspiratory muscle fatigue and time-trial performance.

    PubMed

    McEntire, Serina J; Smith, Joshua R; Ferguson, Christine S; Brown, Kelly R; Kurti, Stephanie P; Harms, Craig A

    2016-08-01

    The purpose was to determine the effect of moderate-intensity exercise training (ET) on inspiratory muscle fatigue (IMF) and if an additional inspiratory load during ET (ET+IL) would further improve inspiratory muscle strength, IMF, and time-trial performance. 15 subjects were randomly divided to ET (n=8) and ET+IL groups (n=7). All subjects completed six weeks of exercise training three days/week at ∼70%V̇O2peak for 30min. The ET+IL group breathed through an inspiratory muscle trainer (15% PImax) during exercise. 5-mile, and 30-min time-trials were performed pre-training, weeks three and six. Inspiratory muscle strength increased (p<0.05) for both groups to a similar (p>0.05) extent. ET and ET+IL groups improved (p<0.05) 5-mile time-trial performance (∼10% and ∼18%) and the ET+IL group was significantly faster than ET at week 6. ET and ET+IL groups experienced less (p<0.05) IMF compared to pre-training following the 5-mile time-trial. In conclusion, these data suggest ET leads to less IMF, ET+IL improves inspiratory muscle strength and IMF, but not different than ET alone.

  6. Inspiratory muscle performance in endurance athletes and sedentary subjects.

    PubMed

    Eastwood, P R; Hillman, D R; Finucane, K E

    2001-06-01

    The aim of this study was to determine whether whole-body endurance training is associated with increased respiratory muscle strength and endurance. Respiratory muscle strength (maximum inspiratory pressure (PImax)) and endurance (progressive threshold loading of the inspiratory muscles) were measured in six marathon runners and six sedentary subjects. PImax was similar between the two groups of subjects but the maximum threshold pressure achieved was greater in marathon runners (90 +/- 8 vs 78 +/- 10% of PImax, respectively, mean +/- SD, P < 0.05). During progressive threshold loading, marathon runners breathed with lower frequency, higher tidal volume, and longer inspiratory and expiratory time. At maximum threshold pressure, marathon runners had lower arterial O2 saturation, but perceived effort (Borg scale) was maximal in both groups. Efficiency of the respiratory muscles was similar in both groups being 2.0 +/- 1.7% and 2.3 +/- 1.8% for marathon runners and sedentary subjects, respectively. The apparent increase in respiratory muscle endurance of athletes was a consequence of a difference in the breathing pattern adopted during loaded breathing rather than respiratory muscle strength or efficiency. This implies that sensory rather than respiratory muscle conditioning may be an important mechanism by which whole-body endurance is increased.

  7. Applicability of a threshold loading device for inspiratory muscle testing and training in patients with COPD.

    PubMed

    Goldstein, R; De Rosie, J; Long, S; Dolmage, T; Avendano, M A

    1989-09-01

    We evaluated application of a Pth device for testing inspiratory muscle endurance among patients with severe but stable COPD. Endurance time in five patients was reproducible. Magnitude of variability was +/- 1.26 minutes with a range of +/- 0.19 to +/- 2.28 minutes. Eleven inpatients completed inspiratory muscle training twice daily for four weeks in addition to their usual program of respiratory rehabilitation. The mean age of our experimental cohort was 65 years; FEV1, 33 +/- 12 percent predicted; and Dsb, 42 +/- 7 percent predicted. Baseline measurements showed no significant differences in pulmonary function, exercise tolerance, inspiratory muscle strength or inspiratory muscle endurance between control and study groups. Following training, the study group significantly improved inspiratory muscle endurance as evidenced by an increase in endurance time while breathing against the same absolute external Pth load used during baseline assessments. There were no associated changes in lung mechanics, muscle strength or exercise tolerance.

  8. Effects of inspiratory muscle training on resistance to fatigue of respiratory muscles during exhaustive exercise.

    PubMed

    Segizbaeva, M O; Timofeev, N N; Donina, Zh A; Kur'yanovich, E N; Aleksandrova, N P

    2015-01-01

    The aim of this study was to assess the effect of inspiratory muscle training (IMT) on resistance to fatigue of the diaphragm (D), parasternal (PS), sternocleidomastoid (SCM) and scalene (SC) muscles in healthy humans during exhaustive exercise. Daily inspiratory muscle strength training was performed for 3 weeks in 10 male subjects (at a pressure threshold load of 60% of maximal inspiratory pressure (MIP) for the first week, 70% of MIP for the second week, and 80% of MIP for the third week). Before and after training, subjects performed an incremental cycle test to exhaustion. Maximal inspiratory pressure and EMG-analysis served as indices of inspiratory muscle fatigue assessment. The before-to-after exercise decreases in MIP and centroid frequency (fc) of the EMG (D, PS, SCM, and SC) power spectrum (P<0.05) were observed in all subjects before the IMT intervention. Such changes were absent after the IMT. The study found that in healthy subjects, IMT results in significant increase in MIP (+18%), a delay of inspiratory muscle fatigue during exhaustive exercise, and a significant improvement in maximal work performance. We conclude that the IMT elicits resistance to the development of inspiratory muscles fatigue during high-intensity exercise.

  9. Inspiratory Muscle Training and Functional Capacity in Patients Undergoing Cardiac Surgery

    PubMed Central

    Cordeiro, André Luiz Lisboa; de Melo, Thiago Araújo; Neves, Daniela; Luna, Julianne; Esquivel, Mateus Souza; Guimarães, André Raimundo França; Borges, Daniel Lago; Petto, Jefferson

    2016-01-01

    Introduction Cardiac surgery is a highly complex procedure which generates worsening of lung function and decreased inspiratory muscle strength. The inspiratory muscle training becomes effective for muscle strengthening and can improve functional capacity. Objective To investigate the effect of inspiratory muscle training on functional capacity submaximal and inspiratory muscle strength in patients undergoing cardiac surgery. Methods This is a clinical randomized controlled trial with patients undergoing cardiac surgery at Instituto Nobre de Cardiologia. Patients were divided into two groups: control group and training. Preoperatively, were assessed the maximum inspiratory pressure and the distance covered in a 6-minute walk test. From the third postoperative day, the control group was managed according to the routine of the unit while the training group underwent daily protocol of respiratory muscle training until the day of discharge. Results 50 patients, 27 (54%) males were included, with a mean age of 56.7±13.9 years. After the analysis, the training group had significant increase in maximum inspiratory pressure (69.5±14.9 vs. 83.1±19.1 cmH2O, P=0.0073) and 6-minute walk test (422.4±102.8 vs. 502.4±112.8 m, P=0.0031). Conclusion We conclude that inspiratory muscle training was effective in improving functional capacity submaximal and inspiratory muscle strength in this sample of patients undergoing cardiac surgery. PMID:27556313

  10. Inspiratory muscle endurance in patients with chronic heart failure.

    PubMed Central

    Walsh, J. T.; Andrews, R.; Johnson, P.; Phillips, L.; Cowley, A. J.; Kinnear, W. J.

    1996-01-01

    OBJECTIVE: To assess the significance of changes in respiratory muscle endurance in relation to respiratory and limb muscle strength in patients with mild to moderate chronic heart failure using a threshold loading technique. SUBJECTS: 20 patients with chronic heart failure (17 male) aged 63.8 (SD 7.4) years and 10 healthy men aged 63.1 (5.6) years. Heart failure severity was New York Heart Association (NYHA) grade II (n = 11) and NYHA grade III/IV (n = 9). METHODS: Respiratory muscle strength was measured from mouth pressures during maximum inspiratory effort (MIP) at functional residual capacity (FRC) and limb muscle strength was measured using a hand grip dynamometer. Inspiratory muscle endurance was measured using a threshold loading technique. The total endurance duration, the maximum threshold pressure achieved (P-Max), and the inspiratory load (% ratio of P-Max/MIP) were recorded in all subjects. RESULTS: Inspiratory muscles were weaker in patients with heart failure than in the controls [MIP 53.6 (16.5) v 70.9 (20.2) cm H2O, P < 0.05]. Hand grip strength was similar in both subject groups [31.6 (SD) v 36.1 (15.9) dynes]. Total endurance duration was significantly reduced in the patient group [494 (223) v 996 (267) s, P < 0.01], as was the maximal threshold pressure achieved [P-Max 18.5 (6.4) v 30.7 (6.6) cm H2O, P < 0.01]. When expressed as a percentage of MIP, P-Max was also lower in the patients [35.2 (11.8) v 44.8 (11.4)%, P < 0.05]. There was no significant correlation between any measure of endurance and limb muscle strength. CONCLUSIONS: Respiratory muscle endurance is reduced in patients with chronic heart failure. These changes probably reflect a generalised skeletal myopathy and provide further evidence of respiratory muscle dysfunction in patients with this disease. Respiratory muscle endurance needs now to be related to symptoms and the effects of treatment and respiratory muscle training should also be explored. PMID:8983680

  11. Influence of noninvasive positive pressure ventilation on inspiratory muscles.

    PubMed

    Goldstein, R S; De Rosie, J A; Avendano, M A; Dolmage, T E

    1991-02-01

    improvement sustained at 14 months. There was no change in measured lung volumes or respiratory muscle strength. We conclude that the improvement in nocturnal gas exchange, daytime functioning, and arterial blood gases resulting from nocturnal positive pressure ventilation is associated with an increase in inspiratory muscle endurance sustained at 14 months.

  12. Effects of Inspiratory Muscle Training in Subjects With Sarcoidosis: A Randomized Controlled Clinical Trial.

    PubMed

    Karadallı, Müşerrefe Nur; Boşnak-Güçlü, Meral; Camcıoğlu, Burcu; Kokturk, Nurdan; Türktaş, Haluk

    2016-04-01

    Respiratory muscle weakness occurs in sarcoidosis and is related to decreased exercise capacity, greater fatigue, dyspnea, and lower quality of life in sarcoidosis patients. The effects of inspiratory muscle training in this population have not been comprehensively investigated so far. This study was planned to investigate the effects of inspiratory muscle training on exercise capacity, respiratory and peripheral muscle strength, pulmonary function and diffusing capacity, fatigue, dyspnea, depression, and quality of life in subjects with sarcoidosis. This was a prospective, randomized, controlled, and double blind study. Fifteen sarcoidosis subjects (treatment group) received inspiratory muscle training at 40% of maximal inspiratory pressure (P(Imax)), and 15 subjects (control group) received sham therapy (5% of P(Imax)) for 6 weeks. Functional and maximal exercise capacity, respiratory and peripheral muscle strength, pulmonary function and diffusing capacity, fatigue, dyspnea, depression, and quality of life were evaluated. Functional (P < .001) and maximal exercise capacity (P = .038), respiratory muscle strength (P(Imax) [P < .001] and P(Emax) [P = .001]), severe fatigue (P = .002), and dyspnea perception (P = .02) were statistically significantly improved in the treatment group compared with controls; no significant improvements were observed in pulmonary function and diffusing capacity, peripheral muscle strength, fatigue, depression, and quality of life between groups after inspiratory muscle training. Inspiratory muscle training improves functional and maximal exercise capacity and respiratory muscle strength and decreases severe fatigue and dyspnea perception in subjects with early stages of sarcoidosis. Inspiratory muscle training can be safely and effectively included in rehabilitation programs. (ClinicalTrials.gov registration NCT02270333.). Copyright © 2016 by Daedalus Enterprises.

  13. Inspiratory muscle training for cystic fibrosis.

    PubMed

    Houston, Brian W; Mills, Nicola; Solis-Moya, Arturo

    2008-10-08

    Cystic fibrosis is the most common life-limiting genetic condition in Caucasians and the life-expectancy of those newly diagnosed is increasing. Inspiratory muscle training may be a way of improving the lung function and quality of life of people with cystic fibrosis. Hence there is a need to establish whether this intervention is beneficial. To determine the effect of inspiratory muscle training on health-related quality of life, pulmonary function and exercise tolerance. We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Trials register comprising of references identified from comprehensive electronic database searches and handsearches of relevant journals and abstract books of conference proceedings.Date of most recent search: April 2008. Randomised or quasi-randomised clinical controlled trials comparing different inspiratory muscle training regimens with each other or a control in people with cystic fibrosis. Three review authors independently applied the inclusion and exclusion criteria to publications and assessed the quality of the included studies. Seven studies were identified. Of these six studies with 140 participants met the review inclusion criteria. There was wide variation in the quality of the included studies. Data were not published in sufficient detail or with sufficiently similar outcome measures in these studies to perform meta-analyses. We have not found any evidence to suggest that this treatment is either beneficial or not. We would advise that practitioners evaluate on a case-by-case basis whether or not to employ this therapy. We recommend that future studies make more use of health-related quality of life and exercise tolerance measures; and that there is an agreement upon a single standard measure of classifying the clinical status of the participants.

  14. Acute effects of inspiratory muscle warm-up on pulmonary function in healthy subjects.

    PubMed

    Özdal, Mustafa

    2016-06-15

    The acute effects of inspiratory muscle warm-up on pulmonary functions were examined in 26 healthy male subjects using the pulmonary function test (PFT) in three different trials. The control trial (CON) did not involve inspiratory muscle warm-up, while the placebo (IMWp) and experimental (IMW) trials involved inspiratory muscle warm-up. There were no significant changes between the IMWp and CON trials (p>0.05). All the PFT measurements, including slow vital capacity, inspiratory vital capacity, forced vital capacity, forced expiratory volume in one second, maximal voluntary ventilation, and maximal inspiratory pressure were significantly increased by 3.55%, 12.52%, 5.00%, 2.75%, 2.66%, and 7.03% respectively, in the subjects in the IMW trial than those in the CON trial (p<0.05). These results show that inspiratory muscle warm-up improved the pulmonary functions. The mechanisms responsible for these improvements are probably associated with the concomitant increase in the inspiratory muscle strength, and the cooperation of the upper thorax, neck, and respiratory muscles, and increased level of reactive O2 species in muscle tissue, and potentially improvement of muscle O2 delivery-to-utilization. However, further investigation is required to determine the precise mechanisms responsible from among these candidates.

  15. Inspiratory Muscle Performance of Former Smokers and Nonsmokers Using the Test of Incremental Respiratory Endurance.

    PubMed

    Formiga, Magno F; Campos, Michael A; Cahalin, Lawrence P

    2017-09-26

    Smoking has potential deleterious effects on respiratory muscle function. Smokers may present with reduced inspiratory muscle strength and endurance. We compared inspiratory muscle performance of nonsmokers with that of former smokers without overt respiratory problems via the Test of Incremental Respiratory Endurance. This study was performed on 42 healthy subjects between the ages of 30 and 79 y (mean ± SD of 56.5 ± 14.4 y). Fourteen male and 7 female former smokers were matched to nonsmokers based on sex, age, height, and weight. Subjects completed a questionnaire about their health and current smoking status. Testing included the best of 3 or more consistent trials. The Test of Incremental Respiratory Endurance measurements included maximal inspiratory pressure measured from residual volume as well as sustained maximal inspiratory pressure and inspiratory duration measured from residual volume to total lung capacity during a maximal sustained inhalation. No significant difference in inspiratory performance of the entire group of former smokers compared with nonsmokers was found. However, separate sex analyses found a significant difference in sustained maximal inspiratory pressure between male former smokers and nonsmokers (518.7 ± 205.0 pressure time units vs 676.5 ± 255.2 pressure time units, P = .041). We found similar maximal inspiratory pressure between former smokers and nonsmokers via the Test of Incremental Respiratory Endurance, but the significant difference in sustained maximal inspiratory pressure between male former smokers and nonsmokers suggests that the sustained maximal inspiratory pressure may have greater discriminatory ability in assessing the effects of smoking on inspiratory muscle performance. Further investigation of the effects of smoking on inspiratory performance via the Test of Incremental Respiratory Endurance is warranted. Copyright © 2017 by Daedalus Enterprises.

  16. Relationship between upper airway and inspiratory pump muscle force in obstructive sleep apnea.

    PubMed

    Shepherd, Kelly L; Jensen, Cathryn M; Maddison, Kathleen J; Hillman, David R; Eastwood, Peter R

    2006-12-01

    Upper airway (UA) patency during inspiration is determined by the balance between dilating forces generated by UA dilator muscle activity and collapsing forces related to the decreased intraluminal pressure that accompanies flow generated by inspiratory muscle activity. It is possible that the relative strengths of UA dilator and inspiratory pump muscles could be an important determinant of the susceptibility to UA collapse during sleep (ie, obstructive sleep apnea [OSA]). Measurements of tongue protrusion (TP) force and maximum inspiratory pressure (Pimax) were obtained in 94 patients admitted for overnight polysomnography for suspected OSA, quantified by apnea-hypopnea index (AHI). There was a direct linear relationship between TP force and Pimax (r(2) = 0.37, p < 0.001). A high ratio of TP force to Pimax (greater than group 90th percentile, 0.027 kg/cm H(2)O) appeared to protect against OSA, as moderate-to-severe OSA (AHI > 20/h) was not observed in any individual with a ratio above this threshold. AHI was not linearly related to TP force, Pimax, or the ratio of TP force to Pimax. UA muscle strength is linearly related to inspiratory pump muscle strength. The ratio of UA muscle strength (TP force) and inspiratory pump muscle strength (Pimax) was not different between individuals with and without OSA; however, a high wakeful ratio of TP force to Pimax appears to be associated with a reduced propensity to moderate-to-severe OSA.

  17. The influence of inspiratory muscle work history and specific inspiratory muscle training upon human limb muscle fatigue.

    PubMed

    McConnell, Alison K; Lomax, Michelle

    2006-11-15

    The purpose of this study was to assess the influence of the work history of the inspiratory muscles upon the fatigue characteristics of the plantar flexors (PF). We hypothesized that under conditions where the inspiratory muscle metaboreflex has been elicited, PF fatigue would be hastened due to peripheral vasoconstriction. Eight volunteers undertook seven test conditions, two of which followed 4 week of inspiratory muscle training (IMT). The inspiratory metaboreflex was induced by inspiring against a calibrated flow resistor. We measured torque and EMG during isometric PF exercise at 85% of maximal voluntary contraction (MVC) torque. Supramaximal twitches were superimposed upon MVC efforts at 1 min intervals (MVC(TI)); twitch interpolation assessed the level of central activation. PF was terminated (T(lim)) when MVC(TI) was <50% of baseline MVC. PF T(lim) was significantly shorter than control (9.93 +/- 1.95 min) in the presence of a leg cuff inflated to 140 mmHg (4.89 +/- 1.78 min; P = 0.006), as well as when PF was preceded immediately by fatiguing inspiratory muscle work (6.28 +/- 2.24 min; P = 0.009). Resting the inspiratory muscles for 30 min restored the PF T(lim) to control. After 4 weeks, IMT, inspiratory muscle work at the same absolute intensity did not influence PF T(lim), but T(lim) was significantly shorter at the same relative intensity. The data are the first to provide evidence that the inspiratory muscle metaboreflex accelerates the rate of calf fatigue during PF, and that IMT attenuates this effect.

  18. Inspiratory muscle training to enhance recovery from mechanical ventilation: a randomised trial

    PubMed Central

    Bissett, Bernie M; Leditschke, I Anne; Neeman, Teresa; Boots, Robert; Paratz, Jennifer

    2016-01-01

    Background In patients who have been mechanically ventilated, inspiratory muscles remain weak and fatigable following ventilatory weaning, which may contribute to dyspnoea and limited functional recovery. Inspiratory muscle training may improve inspiratory muscle strength and endurance following weaning, potentially improving dyspnoea and quality of life in this patient group. Methods We conducted a randomised trial with assessor-blinding and intention-to-treat analysis. Following 48 hours of successful weaning, 70 participants (mechanically ventilated ≥7 days) were randomised to receive inspiratory muscle training once daily 5 days/week for 2 weeks in addition to usual care, or usual care (control). Primary endpoints were inspiratory muscle strength and fatigue resistance index (FRI) 2 weeks following enrolment. Secondary endpoints included dyspnoea, physical function and quality of life, post-intensive care length of stay and in-hospital mortality. Results 34 participants were randomly allocated to the training group and 36 to control. The training group demonstrated greater improvements in inspiratory strength (training: 17%, control: 6%, mean difference: 11%, p=0.02). There were no statistically significant differences in FRI (0.03 vs 0.02, p=0.81), physical function (0.25 vs 0.25, p=0.97) or dyspnoea (−0.5 vs 0.2, p=0.22). Improvement in quality of life was greater in the training group (14% vs 2%, mean difference 12%, p=0.03). In-hospital mortality was higher in the training group (4 vs 0, 12% vs 0%, p=0.051). Conclusions Inspiratory muscle training following successful weaning increases inspiratory muscle strength and quality of life, but we cannot confidently rule out an associated increased risk of in-hospital mortality. Trial registration number ACTRN12610001089022, results. PMID:27257003

  19. The Effect of Inspiratory Muscle Training on Respiratory and Limb Locomotor Muscle Deoxygenation During Exercise with Resistive Inspiratory Loading.

    PubMed

    Turner, L A; Tecklenburg-Lund, S L; Chapman, R; Shei, R-J; Wilhite, D P; Mickleborough, T

    2016-07-01

    We investigated how inspiratory muscle training impacted respiratory and locomotor muscle deoxygenation during submaximal exercise with resistive inspiratory loading. 16 male cyclists completed 6 weeks of either true (n=8) or sham (n=8) inspiratory muscle training. Pre- and post-training, subjects completed 3, 6-min experimental trials performed at ~80%  ˙VO2peak with interventions of either moderate inspiratory loading, heavy inspiratory loading, or maximal exercise imposed in the final 3 min. Locomotor and respiratory muscle oxy-, deoxy-, and total-haemoglobin and myoglobin concentration was continuously monitored using near-infrared spectroscopy. Locomotor muscle deoxygenation changes from 80%  ˙VO2peak to heavy inspiratory loading were significantly reduced pre- to post-training from 4.3±5.6 µM to 2.7±4.7 µM. Respiratory muscle deoxygenation was also significantly reduced during the heavy inspiratory loading trial (4.6±3.5 µM to 1.9±1.5 µM) post-training. There was no significant difference in oxy-, deoxy-, or total-haemoglobin and myoglobin during any of the other loading trials, from pre- to post-training, in either group. After inspiratory muscle training, highly-trained cyclists exhibited decreased locomotor and respiratory muscle deoxygenation during exercise with heavy inspiratory loading. These data suggest that inspiratory muscle training reduces oxygen extraction by the active respiratory and limb muscles, which may reflect changes in respiratory and locomotor muscle oxygen delivery.

  20. Preoperative Ambulatory Inspiratory Muscle Training in Patients Undergoing Esophagectomy. A Pilot Study

    PubMed Central

    Agrelli, Taciana Freitas; de Carvalho Ramos, Marisa; Guglielminetti, Rachel; Silva, Alex Augusto; Crema, Eduardo

    2012-01-01

    A major decline in pulmonary function is observed on the first day after upper abdominal surgery. This decline can reduce vital and inspiratory capacity and can culminate in restrictive lung diseases that cause atelectasis, reduced diaphragm movement, and respiratory insufficiency. The objective of this study was to evaluate the efficacy of preoperative ambulatory respiratory muscle training in patients undergoing esophagectomy. The sample consisted of 20 adult patients (14 men [70%] and 6 women [30%]) with a diagnosis of advanced chagasic megaesophagus. A significant increase in maximum inspiratory pressure was observed after inspiratory muscle training when compared with baseline values (from −55.059 ± 18.359 to −76.286 ± 16.786). Preoperative ambulatory inspiratory muscle training was effective in increasing respiratory muscle strength in patients undergoing esophagectomy and contributed to the prevention of postoperative complications. PMID:23113846

  1. Inspiratory muscle training attenuates the human respiratory muscle metaboreflex

    PubMed Central

    Witt, Jonathan D; Guenette, Jordan A; Rupert, Jim L; McKenzie, Donald C; Sheel, A William

    2007-01-01

    We hypothesized that inspiratory muscle training (IMT) would attenuate the sympathetically mediated heart rate (HR) and mean arterial pressure (MAP) increases normally observed during fatiguing inspiratory muscle work. An experimental group (Exp, n = 8) performed IMT 6 days per week for 5 weeks at 50% of maximal inspiratory pressure (MIP), while a control group (Sham, n = 8) performed IMT at 10% MIP. Pre- and post-training, subjects underwent a eucapnic resistive breathing task (RBT) (breathing frequency = 15 breaths min−1, duty cycle = 0.70) while HR and MAP were continuously monitored. Following IMT, MIP increased significantly (P < 0.05) in the Exp group (−125 ± 10 to −146 ± 12 cmH2O; mean ±s.e.m.) but not in the Sham group (−141 ± 11 to −148 ± 11 cmH2O). Prior to IMT, the RBT resulted in significant increases in HR (Sham: 59 ± 2 to 83 ± 4 beats min−1; Exp: 62 ± 3 to 83 ± 4 beats min−1) and MAP (Sham: 88 ± 2 to 106 ± 3 mmHg; Exp: 84 ± 1 to 99 ± 3 mmHg) in both groups relative to rest. Following IMT, the Sham group observed similar HR and MAP responses to the RBT while the Exp group failed to increase HR and MAP to the same extent as before (HR: 59 ± 3 to 74 ± 2 beats min−1; MAP: 84 ± 1 to 89 ± 2 mmHg). This attenuated cardiovascular response suggests a blunted sympatho-excitation to resistive inspiratory work. We attribute our findings to a reduced activity of chemosensitive afferents within the inspiratory muscles and may provide a mechanism for some of the whole-body exercise endurance improvements associated with IMT. PMID:17855758

  2. Effects of Ramadan Fasting on Inspiratory Muscle Function

    PubMed Central

    Soori, Mohsen; Mohaghegh, Shahram; Hajain, Maryam; Moraadi, Behrooz

    2016-01-01

    Background Ramadan fasting is a major challenge for exercising Muslims especially in warm seasons. There is some evidence to indicate that Ramadan fasting causes higher subjective ratings of perceived exertion (RPE) in fasting Muslims. The mechanisms of this phenomenon are not known exactly. The role of respiratory muscle strength in this regard has not been studied yet. Objectives The aim of this study was investigation of the effects of Ramadan fasting on respiratory muscle strength. Patients and Methods In a before-after study, from 35 fasting, apparently healthy, male adults who had fasted from the beginning of Ramadan, maximal inspiratory muscle pressure (MIP) and peak inspiratory flow (PIF) were measured in the last week of Ramadan month in summer. At the time of test, there was not any sleep problem in participants and all of them had good cooperation. Three months later, after exclusion of incompatible persons mainly because of change in their physical activity level, smoking behavior or drug consumption, the measurements were repeated in 12 individuals. Results Weight, MIP and PIF data had normal distribution (Kolmogorov-Smirnov Test). There was a significant increase in MIP (mean 8.3 cm H2O with 95% confidence interval of 2.2 - 14.3) and PIF (mean 0.55 lit/s with 95% confidence interval of 0.02 - 1.07) and weight (mean 3.4 Kg with 95% confidence interval of 2.2 - 4.5) after Ramadan (Paired t test with P < 0.05). When weight difference was used as a covariate in repeated measure ANOVA test, there was no further significant difference between MIP and PIF measurements. Conclusions Ramadan fasting may cause reduction of respiratory muscle strength through reduction of body weight. PMID:27826401

  3. Relative activity of respiratory muscles during prescribed inspiratory muscle training in healthy people

    PubMed Central

    Jung, Ju-hyeon; Kim, Nan-soo

    2016-01-01

    [Purpose] This study aimed to determine the effects of different intensities of inspiratory muscle training on the relative respiratory muscle activity in healthy adults. [Subjects and Methods] Thirteen healthy male volunteers were instructed to perform inspiratory muscle training (0%, 40%, 60%, and 80% maximal inspiratory pressure) on the basis of their individual intensities. The inspiratory muscle training was performed in random order of intensities. Surface electromyography data were collected from the right-side diaphragm, external intercostal, and sternocleidomastoid, and pulmonary functions (forced expiratory volume in 1 s, forced vital capacity, and their ratio; peak expiratory flow; and maximal inspiratory pressure) were measured. [Results] Comparison of the relative activity of the diaphragm showed significant differences between the 60% and 80% maximal inspiratory pressure intensities and baseline during inspiratory muscle training. Furthermore, significant differences were found in sternocleidomastoid relative activity between the 60% and 80% maximal inspiratory pressure intensities and baseline during inspiratory muscle training. [Conclusion] During inspiratory muscle training in the clinic, the patients were assisted (verbally or through feedback) by therapists to avoid overactivation of their accessory muscles (sternocleidomastoid). This study recommends that inspiratory muscle training be performed at an accurate and appropriate intensity through the practice of proper deep breathing. PMID:27134409

  4. Relative activity of respiratory muscles during prescribed inspiratory muscle training in healthy people.

    PubMed

    Jung, Ju-Hyeon; Kim, Nan-Soo

    2016-03-01

    [Purpose] This study aimed to determine the effects of different intensities of inspiratory muscle training on the relative respiratory muscle activity in healthy adults. [Subjects and Methods] Thirteen healthy male volunteers were instructed to perform inspiratory muscle training (0%, 40%, 60%, and 80% maximal inspiratory pressure) on the basis of their individual intensities. The inspiratory muscle training was performed in random order of intensities. Surface electromyography data were collected from the right-side diaphragm, external intercostal, and sternocleidomastoid, and pulmonary functions (forced expiratory volume in 1 s, forced vital capacity, and their ratio; peak expiratory flow; and maximal inspiratory pressure) were measured. [Results] Comparison of the relative activity of the diaphragm showed significant differences between the 60% and 80% maximal inspiratory pressure intensities and baseline during inspiratory muscle training. Furthermore, significant differences were found in sternocleidomastoid relative activity between the 60% and 80% maximal inspiratory pressure intensities and baseline during inspiratory muscle training. [Conclusion] During inspiratory muscle training in the clinic, the patients were assisted (verbally or through feedback) by therapists to avoid overactivation of their accessory muscles (sternocleidomastoid). This study recommends that inspiratory muscle training be performed at an accurate and appropriate intensity through the practice of proper deep breathing.

  5. Inspiratory Muscle Training in a Child with Nemaline Myopathy and Organ Transplantation

    PubMed Central

    Smith, Barbara K.; Bleiweis, Mark S.; Zauhar, Joni; Martin, A. Daniel

    2013-01-01

    Objective To report the use of inspiratory muscle strength training (IMST) to treat repeated ventilatory insufficiency in a child with nemaline myopathy (NM) who underwent cardiac and renal transplantation. Design Case report. Setting Pediatric intensive care unit of a tertiary care university teaching hospital. Intervention IMST was provided five days weekly for two weeks, accompanied by progressive weaning from non-invasive ventilation. Measurements and Main Results Maximal inspiratory pressure (MIP) increased from −36.7 cm H2O to −77.8 cm H2O, accompanied by improved inspiratory flow, volume, pressure activation and power. During the training period, the patient weaned from continuous non-invasive ventilatory assist to her pre-operative level of ventilatory function. Conclusions Inspiratory muscle training may be a beneficial component of care for children with NM who experience acute ventilatory insufficiency. PMID:20407395

  6. Prevention of pulmonary complications after upper abdominal surgery by preoperative intensive inspiratory muscle training: a randomized controlled pilot study.

    PubMed

    Dronkers, Jaap; Veldman, André; Hoberg, Ellen; van der Waal, Cees; van Meeteren, Nico

    2008-02-01

    To investigate the feasibility and effects of preoperative inspiratory muscle training on the incidence of atelectasis in patients at high risk of postoperative pulmonary complications scheduled for elective abdominal aortic aneurysm surgery. Single-blind randomized controlled pilot study. Gelderse Vallei Hospital Ede, the Netherlands. Twenty high-risk patients undergoing elective abdominal aortic aneurysm surgery were randomly assigned to receive preoperative inspiratory muscle training or usual care. Effectiveness outcome variables were atelectasis, inspiratory muscle strength and vital capacity, and feasibility outcome variables were adverse effects and patient satisfaction with inspiratory muscle training. Despite randomization, patients in the intervention group were significantly older than the patients in the control group (70 +/- 6 years versus 59 +/- 6 years, respectively; P = 0.001). Eight patients in the control group and three in the intervention group developed atelectasis (P = 0.07). The median duration of atelectasis was 0 days in the intervention group and 1.5 days in the control group (P = 0.07). No adverse effects of preoperative inspiratory muscle training were observed and patients considered that inspiratory muscle training was a good preparation for surgery. Mean postoperative inspiratory pressure was 10% higher in the intervention group. Preoperative inspiratory muscle training is well tolerated and appreciated and seems to reduce the incidence of atelectasis in patients scheduled for elective abdominal aortic aneurysm surgery.

  7. Genioglossus muscle activity and inspiratory timing in obstructive sleep apnea.

    PubMed

    Adachi, S; Lowe, A A; Tsuchiya, M; Ryan, C F; Fleetham, J A

    1993-08-01

    Atypical tongue muscle activity during sleep may contribute to the development of obstructive sleep apnea (OSA). Inspiratory genioglossus (GG) muscle activity was investigated in 10 OSA adults and 4 symptom-free controls. On the basis of overnight monitoring during nonREM sleep, the duration of the inspiratory GG activity and the total GG activity cycle is shorter in patients with OSA. The duration of inspiration and the duration of one total respiratory cycle is also shorter in patients with OSA. The commencement time lag between inspiratory GG activity and the onset of inspiration is shorter in patients with OSA during nonapneic breathing which indicates that inspiratory GG activity is activated relatively later in these patients. Furthermore, the inspiratory GG activity occurs after inspiration during an apnea, but the timing of GG activity onset progressively advances during the apnea. Earlier GG reactivation occurs before inspiration during the first nonoccluded breath at the end of an apnea. During subsequent tidal breathing, the timing of the GG onset progressively decreases after the onset of inspiration until the next obstructive apnea occurs. This observation suggests that the timing relationship between GG inspiratory activity and inspiratory effort is of physiologic importance in the pathogenesis of OSA. Furthermore, it may explain why dental appliances, such as the tongue retaining device, are highly effective in the resolution of OSA in selected patients.

  8. Diaphragmatic fatigue during inspiratory muscle loading in normoxia and hypoxia.

    PubMed

    Walker, David Johannes; Farquharson, Franziska; Klenze, Hannes; Walterspacher, Stephan; Storz, Lucia; Duerschmied, Daniel; Roecker, Kai; Kabitz, Hans-Joachim

    2016-06-15

    Diaphragmatic fatigue (DF) occurs during strenuous loading of respiratory muscles (e.g., heavy-intensity whole-body exercise, normocapnic hyperpnea, inspiratory resistive breathing). DF develops early on during normoxia, without further decline toward task failure; however, its progression during inspiratory muscle loading in during hypoxia remains unclear. Therefore, the present study used volume-corrected transdiaphragmatic pressures during supramaximal magnetic phrenic nerve stimulation (Pdi,twc) to investigate the effect of hypoxia on the progression of diaphragmatic fatigue during inspiratory muscle loading. Seventeen subjects completed two standardized rounds of inspiratory muscle loading (blinded, randomized) under the following conditions: (i) normoxia, and (ii) normobaric hypoxia (SpO2 80%), with Pdi,twc assessment every 45 s. In fatiguers (i.e., Pdi,twc reduction >10%, n=10), biometric approximation during normoxia is best represented by Pdi,twc=4.06+0.83 exp(-0.19 × x), in contrast to Pdi,twc=4.38-(0.05 × x) during hypoxia. Progression of diaphragmatic fatigue during inspiratory muscle loading assessed by Pdi,tw differs between normoxia and normobaric hypoxia: in the former, Pdi,tw follows an exponential decay, whereas during hypoxia, Pdi,tw follows a linear decline. Copyright © 2016 Elsevier B.V. All rights reserved.

  9. Diaphragm Thickness and Inspiratory Muscle Functions in Chronic Stroke Patients

    PubMed Central

    Kim, Minkyu; Lee, Kyeongbong; Cho, Jieun; Lee, Wanhee

    2017-01-01

    Background The aims of this study are to investigate the difference between the diaphragm thickness at end expiration and the thickness at total lung capacity (TLC), and to examine differences in inspiratory muscle function between stroke patients and healthy individuals. Material/Methods Forty-five stroke patients and 49 healthy volunteers were included in this study. Diaphragm thickness was measured at end expiration and at TLC by ultrasonography. The maximal inspiratory pressure (MIP), peak inspiratory flow (PIF), vital capacity (VC), and inspiratory muscle endurance (IME) were assess to evaluate inspiratory muscle function. Results In stroke patients, the diaphragm was significantly thinner on the affected side than the less affected side at end expiration and at TLC. The change between the thickness at end expiration and at TLC were also significant on both sides. Between groups, the difference in diaphragm thickness at end expiration was not significant, but at TLC, the diaphragms were significantly thicker in healthy individuals than on either side in stroke patients, and the change in diaphragm thickness was significantly greater for healthy individuals. Inspiratory muscle functions were also significantly greater in healthy individuals. MIP, PIF, and VC were positively correlated with the change in thickness in healthy individuals, and MIP was positively correlated with the change in thickness and IME in stroke patients. Conclusions Stroke patients showed decreases in the thickening ability of the diaphragm at TLC and in inspiratory muscle function. The change between the diaphragm thickness at end expiration and at TLC was positively correlated with MIP, PIF, and VC. PMID:28284044

  10. Inspiratory muscle warm-up and inspiratory muscle training: separate and combined effects on intermittent running to exhaustion.

    PubMed

    Lomax, Mitch; Grant, Ian; Corbett, Jo

    2011-03-01

    In the present study, we examined the independent and combined effects of an inspiratory muscle warm-up and inspiratory muscle training on intermittent running to exhaustion. Twelve males were recruited to undertake four experimental trials. Two trials (Trials 1 and 2) preceded either a 4-week training period of 1 × 30 breaths twice daily at 50% (experimental group) or 15% (control group) maximal inspiratory mouth pressure (PImax). A further two trials (Trials 3 and 4) were performed after the 4 weeks. Trials 2 and 4 were preceded by a warm-up: 2 × 30 breaths at 40% PImax. Pre-training PImax and distance covered increased (P < 0.05) similarly between groups after the warm-up (~11% and ~5-7% PImax and distance covered, respectively). After training, PImax increased by 20 ± 6.1% (P < 0.01; d = 3.6) and 26.7 ± 6.3% (P < 0.01; d = 3.1) when training and warm-up were combined in the experimental group. Distance covered increased after training in the experimental group by 12 ± 4.9% (P < 0.01; d = 3.6) and 14.9 ± 4.5% (P < 0.01; d = 2.3) when training and warm-up interventions were combined. In conclusion, inspiratory muscle training and inspiratory muscle warm-up can both increase running distance independently, but the greatest increase is observed when they are combined.

  11. Pulmonary adaptations to swim and inspiratory muscle training.

    PubMed

    Mickleborough, Timothy D; Stager, Joel M; Chatham, Ken; Lindley, Martin R; Ionescu, Alina A

    2008-08-01

    Because the anomalous respiratory characteristics of competitive swimmers have been suggested to be due to inspiratory muscle work, the respiratory muscle and pulmonary function of 30 competitively trained swimmers was assessed at the beginning and end of an intensive 12-week swim training (ST) program. Swimmers (n = 10) combined ST with either inspiratory muscle training (IMT) set at 80% sustained maximal inspiratory pressure (SMIP) with progressively increased work-rest ratios until task failure for 3-days per week (ST + IMT) or ST with sham-IMT (ST + SHAM-IMT, n = 10), or acted as controls (ST only, ST, n = 10). Measures of respiratory and pulmonary function were assessed at the beginning and end of the 12 week study period. There were no significant differences (P > 0.05) in respiratory and pulmonary function between groups (ST + IMT, ST + SHAM-IMT and ST) at baseline and at the end of the 12 week study period. However, within all groups significant increases (P < 0.05) were observed in a number of respiratory and pulmonary function variables at the end of the 12 week study, such as maximal inspiratory and expiratory pressure, inspiratory power output, forced vital capacity, forced expiratory and inspiratory volume in 1-s, total lung capacity and diffusion capacity of the lung. This study has demonstrated that there are no appreciable differences in terms of respiratory changes between elite swimmers undergoing a competitive ST program and those undergoing respiratory muscle training using the flow-resistive IMT device employed in the present study; as yet, the causal mechanisms involved are undefined.

  12. Specific inspiratory muscle training is safe in selected patients who are ventilator-dependent: a case series.

    PubMed

    Bissett, Bernie; Leditschke, I Anne; Green, Margot

    2012-04-01

    Mechanical ventilation of intensive care patients results in inspiratory muscle weakness. Inspiratory muscle training may be useful, but no studies have specifically described the physiological response to training. Is inspiratory muscle training with a threshold device safe in selected ventilator-dependent patients? Does inspiratory muscle strength increase with high-intensity inspiratory muscle training in ventilator-dependent patients? Prospective cohort study of 10 medically stable ventilator-dependent adult patients. Tertiary adult intensive care unit. Inspiratory muscle training 5-6 days per week with a threshold device attached to the tracheostomy without supplemental oxygen. Physiological response to training (heart rate, mean arterial pressure, oxygen saturation and respiratory rate), adverse events, training pressures. No adverse events were recorded in 195 sessions studied. For each patient's second training session, no significant changes in heart rate (Mean Difference 1.3 bpm, 95% CI -2.7 to 5.3), mean arterial pressure (Mean Difference -0.9 mmHg, 95% CI -6.4 to 4.6), respiratory rate (Mean Difference 1.2 bpm, 95% CI -1.1 to 3.5 bpm) or oxygen saturation (Mean Difference 1.2%, 95% CI -0.6 to 3.0) were detected Training pressures increased significantly (Mean Difference 18.6 cmH(2)O, 95% CI 11.8-25.3). Threshold-based inspiratory muscle training can be delivered safely in selected ventilator-dependent patients without supplemental oxygen. Inspiratory muscle training is associated with increased muscle strength, which may assist ventilatory weaning. Copyright © 2012 Elsevier Ltd. All rights reserved.

  13. The role of the inspiratory muscle weakness in functional capacity in hemodialysis patients

    PubMed Central

    Gomes, Rosalina Tossige; Neves, Camila Danielle Cunha; de Oliveira, Evandro Silveira; Alves, Frederico Lopes; Rodrigues, Vanessa Gomes Brandão; Maciel, Emílio Henrique Barroso

    2017-01-01

    Introduction Inspiratory muscle function may be affected in patients with End-Stage Renal Disease (ESRD), further worsening the functional loss in these individuals. However, the impact of inspiratory muscle weakness (IMW) on the functional capacity (FC) of hemodialysis patients remains unknown. Thus, the present study aimed to evaluate the impact of IMW on FC in ESRD patients undergoing hemodialysis. Materials and methods ESRD patients on hemodialysis treatment for more than six months were evaluated for inspiratory muscle strength and FC. Inspiratory muscle strength was evaluated based on maximal inspiratory pressure (MIP). IMW was defined as MIP values less than 70% of the predicted value. FC was evaluated using the Incremental Shuttle Walk test (ISWT). Patients whose predicted peak oxygen uptake (VO2peak) over the distance walked during the ISWT was less than 16mL/kg/min were considered to have FC impairment. Associations between variables were assessed by linear and logistic regression, with adjustment for age, sex, body mass index (BMI), presence of diabetes and hemoglobin level. Receiver-operating characteristic (ROC) analysis was used to determine different cutoff values of the MIP for normal inspiratory muscle strength and FC. Results Sixty-five ERSD patients (67.7% male), aged 48.2 (44.5–51.9) years were evaluated. MIP was an independent predictor of the distance walked during the ISWT (R2 = 0.44). IMW was an independent predictor of VO2peak < 16mL/kg/min. (OR = 5.7; p = 0.048) in adjusted logistic regression models. ROC curves showed that the MIP cutoff value of 82cmH2O had a sensitivity of 73.5% and specificity of 93.7% in predicting normal inspiratory strength and a sensitivity and specificity of 76.3% and 70.4%, respectively, in predicting VO2peak ≥ 16mL/kg/min. Conclusions IMW is associated with reduced FC in hemodialysis patients. Evaluation of the MIP may be important to functional monitoring in clinical practice and can help in the

  14. Deep breathing heart rate variability is associated with inspiratory muscle weakness in chronic heart failure.

    PubMed

    Reis, Michel Silva; Arena, Ross; Archiza, Bruno; de Toledo, Carlos Fischer; Catai, Aparecida Maria; Borghi-Silva, Audrey

    2014-03-01

    There is a synchronism between the respiratory and cardiac cycles. However, the relationship of inspiratory muscle weakness in chronic heart failure (CHF) on cardiac autonomic modulation is unknown. The purpose of the present investigation was to evaluate the impact of inspiratory muscle strength on the magnitude of respiratory sinus arrhythmia. Ten CHF (62 ± 7 years--left ventricle eject fraction of 40 ± 5% and New York Heart Association class I-III) and nine matched-age healthy volunteers (64 ± 5 years) participated in this study. Heart rate variability (HRV) was obtained at rest and during deep breathing manoeuvre (DB-M) by electrocardiograph. CHF patients demonstrated impaired cardiac autonomic modulation at rest and during DB-M when compared with healthy subjects (p < 0.05). Moreover, significant and positive correlations between maximal inspiratory pressure and inspiratory-expiratory differences (r = 0.79), expiratory/inspiratory ratio (r = 0.83), root mean square of the successive differences (r = 0.77), standard deviation of NN intervals (r = 0.77), low frequency (r = 0.77), and high frequency (r = 0.70) were found during DB-M. At rest, significant correlations were found also. Patients with CHF presented impaired cardiac autonomic modulation at rest. In addition, cardiac autonomic control of heart rate was associated with inspiratory muscle weakness in CHF. Based on this evidence, recommendations for future research applications of respiratory muscle training can bring to light a potentially valuable target for rehabilitation. Copyright © 2013 John Wiley & Sons, Ltd.

  15. Exercise training and inspiratory muscle training in patients with bronchiectasis.

    PubMed

    Newall, C; Stockley, R A; Hill, S L

    2005-11-01

    Bronchiectasis is a chronic suppurative lung disease often characterised by airflow obstruction and hyperinflation, and leading to decreased exercise tolerance and reduced health status. The role of pulmonary rehabilitation (PR) and inspiratory muscle training (IMT) has not been investigated in this group of patients. Thirty two patients with idiopathic bronchiectasis were randomly allocated to one of three groups: PR plus sham IMT (PR-SHAM), PR plus targeted IMT (PR-IMT), or control. All patients (except the control group) underwent an 8 week training programme of either PR or PR plus targeted IMT. Exercise training during PR was performed three times weekly at 80% of the peak heart rate. IMT was performed at home for 15 minutes twice daily over the 8 week period. PR-SHAM and PR-IMT resulted in significant increases in the incremental shuttle walking test of 96.7 metres (95% confidence interval (CI) 59.6 to 133.7) and 124.5 metres (95% CI 63.2 to 185.9), respectively, and in endurance exercise capacity of 174.9% (95% CI 34.7 to 426.1) and 205.7% (95% CI 31.6 to 310.6). There were no statistically significant differences in the improvements in exercise between the two groups. Significant improvements in inspiratory muscle strength were also observed both in the PR-IMT group (21.4 cm H2O increase, 95% CI 9.3 to 33.4; p = 0.008) and the PR-SHAM group (12.0 cm H2O increase, 95% CI 1.1 to 22.9; p = 0.04), the magnitude of which were also similar (p = 0.220). Improvements in exercise capacity were maintained in the PR-IMT group 3 months after training, but not in the PR-SHAM group. PR is effective in improving exercise tolerance in bronchiectasis but there is no additional advantage of simultaneous IMT. IMT may, however, be important in the longevity of the training effects.

  16. Systematic Review of Inspiratory Muscle Training After Cerebrovascular Accident.

    PubMed

    Martín-Valero, Rocío; De La Casa Almeida, Maria; Casuso-Holgado, Maria Jesus; Heredia-Madrazo, Alfonso

    2015-11-01

    This systematic review examines levels of evidence and recommendation grades of various therapeutic interventions of inspiratory muscle training in people who have had a stroke. Benefits from different levels of force and resistance in respiratory muscles are shown in this population. This review was conducted following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) directives and was completed in November 2014. The search limits were studies published in English between 2004 and 2014. Relevant studies were searched for in MEDLINE, PEDro, OAIster, Scopus, PsycINFO, Web of Knowledge, CINAHL, SPORTDiscus, DOAJ, Cochrane, Embase, Academic Search Complete, Fuente Académica, and MedicLatina. Initially, 20 articles were identified. After analyzing all primary documents, 14 studies were excluded. Only 6 studies were relevant to this review. Three different types of interventions were found (maximum inspiratory training, controlled training, and nonintervention) in 3 different groups. One specific study compared 3 inspiratory muscle training groups with a group of breathing exercises (diaphragmatic exercises with pursed lips) and a control group. Future long-term studies with larger sample sizes are needed. It is necessary to apply respiratory muscle training as a service of the national health system and to consider its inclusion in the conventional neurological program. Copyright © 2015 by Daedalus Enterprises.

  17. Inspiratory muscle training is used in some intensive care units, but many training methods have uncertain efficacy: a survey of French physiotherapists.

    PubMed

    Bonnevie, Tristan; Villiot-Danger, Jean-Christophe; Gravier, Francis-Edouard; Dupuis, Johan; Prieur, Guillame; Médrinal, Clément

    2015-10-01

    How common is inspiratory muscle training by physiotherapists in the intensive care unit (ICU)? Which patients receive the training? What methods are used to administer the training? Is maximal inspiratory pressure used to evaluate the need for the training and the patient's outcome after training? Cross-sectional survey of all ICUs in France. Two hundred and sixty-five senior physiotherapists. The response rate was 99% among eligible units. Therapist experience in ICU was significantly associated with the use of inspiratory muscle training (p=0.02). Therapists mainly used inspiratory muscle training either systematically or specifically in patients who failed to wean from mechanical ventilation. The training was used significantly more in non-sedated patients (p<0.0001). The most commonly nominated technique that respondents claimed to use to apply the training was controlled diaphragmatic breathing (83% of respondents), whereas 13% used evidence-based methods. Among those who applied some form of inspiratory muscle training, 16% assessed maximal inspiratory pressure. Six respondents (2%, 95% CI 1 to 5) used both an evidence-based method to administer inspiratory muscle training and the recommended technique for assessment of inspiratory muscle strength. Most physiotherapists in French ICUs who apply inspiratory muscle training use methods of uncertain efficacy without assessment of maximal inspiratory pressure. Further efforts need to be made in France to disseminate information regarding evidence-based assessment and techniques for inspiratory muscle training in the ICU. The alignment of inspiratory muscle training practice with evidence could be investigated in other regions. Copyright © 2015 Australian Physiotherapy Association. Published by Elsevier B.V. All rights reserved.

  18. "Functional" Inspiratory and Core Muscle Training Enhances Running Performance and Economy.

    PubMed

    Tong, Tomas K; McConnell, Alison K; Lin, Hua; Nie, Jinlei; Zhang, Haifeng; Wang, Jiayuan

    2016-10-01

    Tong, TK, McConnell, AK, Lin, H, Nie, J, Zhang, H, and Wang, J. "Functional" inspiratory and core muscle training enhances running performance and economy. J Strength Cond Res 30(10): 2942-2951, 2016-We compared the effects of two 6-week high-intensity interval training interventions. Under the control condition (CON), only interval training was undertaken, whereas under the intervention condition (ICT), interval training sessions were followed immediately by core training, which was combined with simultaneous inspiratory muscle training (IMT)-"functional" IMT. Sixteen recreational runners were allocated to either ICT or CON groups. Before the intervention phase, both groups undertook a 4-week program of "foundation" IMT to control for the known ergogenic effect of IMT (30 inspiratory efforts at 50% maximal static inspiratory pressure [P0] per set, 2 sets per day, 6 days per week). The subsequent 6-week interval running training phase consisted of 3-4 sessions per week. In addition, the ICT group undertook 4 inspiratory-loaded core exercises (10 repetitions per set, 2 sets per day, inspiratory load set at 50% post-IMT P0) immediately after each interval training session. The CON group received neither core training nor functional IMT. After the intervention phase, global inspiratory and core muscle functions increased in both groups (p ≤ 0.05), as evidenced by P0 and a sport-specific endurance plank test (SEPT) performance, respectively. Compared with CON, the ICT group showed larger improvements in SEPT, running economy at the speed of the onset of blood lactate accumulation, and 1-hour running performance (3.04% vs. 1.57%, p ≤ 0.05). The changes in these variables were interindividually correlated (r ≥ 0.57, n = 16, p ≤ 0.05). Such findings suggest that the addition of inspiratory-loaded core conditioning into a high-intensity interval training program augments the influence of the interval program on endurance running performance and that this may be

  19. Effect of negative pressure ventilation on arterial blood gas pressures and inspiratory muscle strength during an exacerbation of chronic obstructive lung disease.

    PubMed Central

    Montserrat, J. M.; Martos, J. A.; Alarcon, A.; Celis, R.; Plaza, V.; Picado, C.

    1991-01-01

    The effects of intermittent negative pressure ventilation have been studied in 20 patients with chronic obstructive pulmonary disease during an exacerbation of their disease. Measurements of arterial blood gas tensions and maximal inspiratory pressure (MIP) were performed before and after six hours of negative pressure ventilation or standard treatment (control day) given in random order on two consecutive days. After negative pressure ventilation the mean (SD) value of MIP increased from 68.1 (21.5) to 74.8 (20) cm H2O;* arterial oxygen tension (PaCO2) fell from 60.6 (12.2) to 50.9 (8.9) mm Hg* but PaO2 changed little (from 48.4 (7.4) to 47.6 (8.2) mm Hg). There were no significant changes on the control day in arterial blood gas tensions (PaO2 47.8 (8.1) and 48.9 (9.4) and Paco2 59.8 (10.9) and 57.5 (8.06) mm Hg) or in MIP (69.4 (22.4) and 70.9 (22.9) cm H2O). Six patients tolerated negative pressure ventilation poorly and these patients showed less improvement after negative pressure ventilation. Our results suggest that intermittent negative pressure ventilation can increase alveolar ventilation in patients with an exacerbation of chronic obstructive lung disease, particularly in those who tolerate the procedure well. Most subjects showed a fall in PaCO2 and an increase in MIP. The fact that PaO2 was unchanged despite the fall in PaCO2 suggests that gas exchange may deteriorate with negative pressure ventilation in these patients. PMID:1908138

  20. The effect of inspiratory muscle fatigue on breathing pattern and ventilatory response to CO2.

    PubMed Central

    Mador, M J; Tobin, M J

    1992-01-01

    1. The effects of inducing inspiratory muscle fatigue on the subsequent breathing pattern were examined during resting unstimulated breathing and during CO2 rebreathing. In addition, we examined whether induction of inspiratory muscle fatigue alters CO2 responsiveness. 2. Global inspiratory muscle fatigue and diaphragmatic fatigue were achieved by having subjects breathe against an inspiratory resistive load while generating a predetermined fraction of either their maximal mouth pressure or maximal transdiaphragmatic pressure until they were unable to generate the target pressure. 3. Induction of inspiratory muscle fatigue had no effect on the subsequent breathing pattern during either unstimulated breathing or during CO2 rebreathing. 4. Following induction of inspiratory muscle fatigue, the slope of the ventilatory response to CO2 was significantly decreased from 18.8 +/- 3.3 during control to 13.8 +/- 2.1 l min-1 (% end-tidal CO2 concentration)-1 with fatigue (P < 0.02). PMID:1484352

  1. Recovery of inspiratory intercostal muscle activity following high cervical hemisection.

    PubMed

    Dougherty, B J; Lee, K Z; Gonzalez-Rothi, E J; Lane, M A; Reier, P J; Fuller, D D

    2012-09-30

    Anatomical and neurophysiological evidence indicates that thoracic interneurons can serve a commissural function and activate contralateral motoneurons. Accordingly, we hypothesized that respiratory-related intercostal (IC) muscle electromyogram (EMG) activity would be only modestly impaired by a unilateral cervical spinal cord injury. Inspiratory tidal volume (VT) was recorded using pneumotachography and EMG activity was recorded bilaterally from the 1st to 2nd intercostal space in anesthetized, spontaneously breathing rats. Studies were conducted at 1-3 days, 2 wks or 8 wks following C2 spinal cord hemisection (C2HS). Data were collected during baseline breathing and a brief respiratory challenge (7% CO(2)). A substantial reduction in inspiratory intercostal EMG bursting ipsilateral to the lesion was observed at 1-3 days post-C2HS. However, a time-dependent return of activity occurred such that by 2 wks post-injury inspiratory intercostal EMG bursts ipsilateral to the lesion were similar to age-matched, uninjured controls. The increases in ipsilateral intercostal EMG activity occurred in parallel with increases in VT following the injury (R=0.55; P<0.001). We conclude that plasticity occurring within a "crossed-intercostal" circuitry enables a robust, spontaneous recovery of ipsilateral intercostal activity following C2HS in rats. Copyright © 2012. Published by Elsevier B.V.

  2. Recovery of inspiratory intercostal muscle activity following high cervical hemisection

    PubMed Central

    Dougherty, B.J.; Lee, K.Z.; Gonzalez-Rothi, E.J.; Lane, M.A.; Reier, P.J.; Fuller, D.D.

    2014-01-01

    Anatomical and neurophysiological evidence indicates that thoracic interneurons can serve a commissural function and activate contralateral motoneurons. Accordingly, we hypothesized that respiratory-related intercostal (IC) muscle electromyogram (EMG) activity would be only modestly impaired by a unilateral cervical spinal cord injury. Inspiratory tidal volume (VT) was recorded using pneumotachography and EMG activity was recorded bilaterally from the 1st to 2nd intercostal space in anesthetized, spontaneously breathing rats. Studies were conducted at 1–3 days, 2 wks or 8 wks following C2 spinal cord hemisection (C2HS). Data were collected during baseline breathing and a brief respiratory challenge (7% CO2). A substantial reduction in inspiratory intercostal EMG bursting ipsilateral to the lesion was observed at 1–3 days post-C2HS. However, a time-dependent return of activity occurred such that by 2 wks post-injury inspiratory intercostal EMG bursts ipsilateral to the lesion were similar to age-matched, uninjured controls. The increases in ipsilateral intercostal EMG activity occurred in parallel with increases in VT following the injury (R = 0.55; P < 0.001). We conclude that plasticity occurring within a “crossed-intercostal” circuitry enables a robust, spontaneous recovery of ipsilateral intercostal activity following C2HS in rats. PMID:22705013

  3. Inspiratory muscle training lowers the oxygen cost of voluntary hyperpnea.

    PubMed

    Turner, Louise A; Tecklenburg-Lund, Sandra L; Chapman, Robert F; Stager, Joel M; Wilhite, Daniel P; Mickleborough, Timothy D

    2012-01-01

    The purpose of this study was to determine if inspiratory muscle training (IMT) alters the oxygen cost of breathing (Vo(2RM)) during voluntary hyperpnea. Sixteen male cyclists completed 6 wk of IMT using an inspiratory load of 50% (IMT) or 15% placebo (CON) of maximal inspiratory pressure (Pi(max)). Prior to training, a maximal incremental cycle ergometer test was performed to determine Vo(2) and ventilation (V(E)) at multiple workloads. Pre- and post-training, subjects performed three separate 4-min bouts of voluntary eucapnic hyperpnea (mimic), matching V(E) that occurred at 50, 75, and 100% of Vo(2 max). Pi(max) was significantly increased (P < 0.05) by 22.5 ± 8.7% from pre- to post-IMT and remained unchanged in the CON group. The Vo(2RM) required during the mimic trial corresponded to 5.1 ± 2.5, 5.7 ± 1.4, and 11.7% ± 2.5% of the total Vo(2) (Vo(2T)) at ventilatory workloads equivalent to 50, 75, and 100% of Vo(2 max), respectively. Following IMT, the Vo(2RM) requirement significantly decreased (P < 0.05) by 1.5% (4.2 ± 1.4% of Vo(2T)) at 75% Vo(2 max) and 3.4% (8.1 ± 3.5% of Vo(2T)) at 100% Vo(2 max). No significant changes were shown in the CON group. IMT significantly reduced the O(2) cost of voluntary hyperpnea, which suggests that a reduction in the O(2) requirement of the respiratory muscles following a period of IMT may facilitate increased O(2) availability to the active muscles during exercise. These data suggest that IMT may reduce the O(2) cost of ventilation during exercise, providing an insight into mechanism(s) underpinning the reported improvements in whole body endurance performance; however, this awaits further investigation.

  4. Effects of inspiratory muscle training on dynamic hyperinflation in patients with COPD.

    PubMed

    Petrovic, Milos; Reiter, Michael; Zipko, Harald; Pohl, Wolfgang; Wanke, Theodor

    2012-01-01

    Dynamic hyperinflation has important clinical consequences in patients with chronic obstructive pulmonary disease (COPD). Given that most of these patients have respiratory and peripheral muscle weakness, dyspnea and functional exercise capacity may improve as a result of inspiratory muscle training (IMT). The aim of the study was to analyze the effects of IMT on exercise capacity, dyspnea, and inspiratory fraction (IF) during exercise in patients with COPD. Daily inspiratory muscle strength and endurance training was performed for 8 weeks in 10 patients with COPD GOLD II and III. Ten patients with COPD II and III served as a control group. Maximal inspiratory pressure (Pimax) and endurance time during resistive breathing maneuvers (tlim) served as parameter for inspiratory muscle capacity. Before and after training, the patients performed an incremental symptom limited exercise test to maximum and a constant load test on a cycle ergometer at 75% of the peak work rate obtained in the pretraining incremental test. ET was defined as the duration of loaded pedaling. Following IMT, there was a statistically significant increase in inspiratory muscle performance of the Pimax from 7.75 ± 0.47 to 9.15 ± 0.73 kPa (P < 0.01) and of tlim from 348 ± 54 to 467 ± 58 seconds (P < 0.01). A significant increase in IF, indicating decreased dynamic hyperinflation, was observed during both exercise tests. Further, the ratio of breathing frequency to minute ventilation (bf/V'(E)) decreased significantly, indicating an improved breathing pattern. A significant decrease in perception of dyspnea was also measured. Peak work rate during the incremental cycle ergometer test remained constant, while ET during the constant load test increased significantly from 597.1 ± 80.8 seconds at baseline to 733.6 ± 74.3 seconds (P < 0.01). No significant changes during either exercise tests were measured in the control group. The present study found that in patients with COPD, IMT results in

  5. Effects of inspiratory muscle training on dynamic hyperinflation in patients with COPD

    PubMed Central

    Petrovic, Milos; Reiter, Michael; Zipko, Harald; Pohl, Wolfgang; Wanke, Theodor

    2012-01-01

    Dynamic hyperinflation has important clinical consequences in patients with chronic obstructive pulmonary disease (COPD). Given that most of these patients have respiratory and peripheral muscle weakness, dyspnea and functional exercise capacity may improve as a result of inspiratory muscle training (IMT). The aim of the study was to analyze the effects of IMT on exercise capacity, dyspnea, and inspiratory fraction (IF) during exercise in patients with COPD. Daily inspiratory muscle strength and endurance training was performed for 8 weeks in 10 patients with COPD GOLD II and III. Ten patients with COPD II and III served as a control group. Maximal inspiratory pressure (Pimax) and endurance time during resistive breathing maneuvers (tlim) served as parameter for inspiratory muscle capacity. Before and after training, the patients performed an incremental symptom limited exercise test to maximum and a constant load test on a cycle ergometer at 75% of the peak work rate obtained in the pretraining incremental test. ET was defined as the duration of loaded pedaling. Following IMT, there was a statistically significant increase in inspiratory muscle performance of the Pimax from 7.75 ± 0.47 to 9.15 ± 0.73 kPa (P < 0.01) and of tlim from 348 ± 54 to 467 ± 58 seconds (P < 0.01). A significant increase in IF, indicating decreased dynamic hyperinflation, was observed during both exercise tests. Further, the ratio of breathing frequency to minute ventilation (bf/V′E) decreased significantly, indicating an improved breathing pattern. A significant decrease in perception of dyspnea was also measured. Peak work rate during the incremental cycle ergometer test remained constant, while ET during the constant load test increased significantly from 597.1 ± 80.8 seconds at baseline to 733.6 ± 74.3 seconds (P < 0.01). No significant changes during either exercise tests were measured in the control group. The present study found that in patients with COPD, IMT results in

  6. Inspiratory muscles experience fatigue faster than the calf muscles during treadmill marching.

    PubMed

    Perlovitch, Renana; Gefen, Amit; Elad, David; Ratnovsky, Anat; Kramer, Mordechai R; Halpern, Pinchas

    2007-04-16

    The possibility that respiratory muscles may fatigue during extreme physical activity and thereby become a limiting factor leading to exhaustion is debated in the literature. The aim of this study was to determine whether treadmill marching exercise induces respiratory muscle fatigue, and to compare the extent and rate of respiratory muscle fatigue to those of the calf musculature. To identify muscle fatigue, surface electromyographic (EMG) signals of the inspiratory (sternomastoid, external intercostals), expiratory (rectus abdominis and external oblique) and calf (gastrocnemius lateralis) muscles were measured during a treadmill march of 2 km at a constant velocity of 8 km/h. The extent of fatigue was assessed by determining the increase in root-mean-square (RMS) of EMG over time, and the rate of fatigue was assessed from the slope of the EMG RMS versus time curve. Results indicated that (i) the inspiratory and calf muscles are the ones experiencing the most dominant fatigue during treadmill marching, (ii) the rate of fatigue of each muscle group was monotonic between the initial and terminal phases of exercise, and (iii) the inspiratory muscles fatigue significantly faster than the calf at the terminal phase of exercise, and are likely to fatigue faster during the initial exercise as well. Accordingly, this study supports the hypothesis that fatigue of the inspiratory muscles may be a limiting factor during exercise.

  7. Biological variation, reference change value (RCV) and minimal important difference (MID) of inspiratory muscle strength (PImax) in patients with stable chronic heart failure.

    PubMed

    Täger, Tobias; Schell, Miriam; Cebola, Rita; Fröhlich, Hanna; Dösch, Andreas; Franke, Jennifer; Katus, Hugo A; Wians, Frank H; Frankenstein, Lutz

    2015-10-01

    Despite the widespread application of measurements of respiratory muscle force (PImax) in clinical trials there is no data on biological variation, reference change value (RCV), or the minimal important difference (MID) for PImax irrespective of the target cohort. We addressed this issue for patients with chronic stable heart failure. From the outpatients' clinic of the University of Heidelberg we retrospectively selected three groups of patients with stable systolic chronic heart failure (CHF). Each group had two measurements of PImax: 90 days apart in Group A (n = 25), 180 days apart in Group B (n = 93), and 365 days apart in Group C (n = 184). Stability was defined as (a) no change in NYHA class between visits and (b) absence of cardiac decompensation 3 months prior, during, and 3 months after measurements. For each group, we determined within-subject (CVI), between-subject (CVG), and total (CVT) coefficient of variation (CV), the index of individuality (II), RCV, reliability coefficient, and MID of PImax. CVT was 8.7, 7.5, and 6.9 % for groups A, B, and C, respectively. The II and RCV were 0.21, 0.20, 0.16 and 13.6, 11.6, 10.8 %, respectively. The reliability coefficient and MID were 0.83, 0.87, 0.88 and 1.44, 1.06, 1.12 kPa, respectively. Results were similar between age, gender, and aetiology subgroups. In patients with stable CHF, measurements of PImax are highly stable for intervals up to 1 year. The low values for II suggest that evaluation of change in PImax should be performed on an individual (per patient) basis. Individually significant change can be assumed beyond 14 % (RCV) or 1.12 kPa (MID).

  8. Effects of inspiratory muscle training on exercise responses in Paralympic athletes with cervical spinal cord injury.

    PubMed

    West, C R; Taylor, B J; Campbell, I G; Romer, L M

    2014-10-01

    We asked whether specific inspiratory muscle training (IMT) improves respiratory structure and function and peak exercise responses in highly trained athletes with cervical spinal cord injury (SCI). Ten Paralympic wheelchair rugby players with motor-complete SCI (C5-C7) were paired by functional classification then randomly assigned to an IMT or placebo group. Diaphragm thickness (B-mode ultrasonography), respiratory function [spirometry and maximum static inspiratory (PI ,max ) and expiratory (PE ,max ) pressures], chronic activity-related dyspnea (Baseline and Transition Dyspnea Indices), and physiological responses to incremental arm-crank exercise were assessed before and after 6 weeks of pressure threshold IMT or sham bronchodilator treatment. Compared to placebo, the IMT group showed significant increases in diaphragm thickness (P = 0.001) and PI ,max (P = 0.016). There was a significant increase in tidal volume at peak exercise in IMT vs placebo (P = 0.048) and a strong trend toward an increase in peak work rate (P = 0.081, partial eta-squared = 0.33) and peak oxygen uptake (P = 0.077, partial eta-squared = 0.34). No other indices changed post-intervention. In conclusion, IMT resulted in significant diaphragmatic hypertrophy and increased inspiratory muscle strength in highly trained athletes with cervical SCI. The strong trend, with large observed effect, toward an increase in peak aerobic performance suggests IMT may provide a useful adjunct to training in this population.

  9. The effect of progressive high-intensity inspiratory muscle training and fixed high-intensity inspiratory muscle training on the asymmetry of diaphragm thickness in stroke patients.

    PubMed

    Jung, Ju-Hyeon; Kim, Nan-Soo

    2015-10-01

    [Purpose] This study investigated the effects of progressive load and fixed load high-intensity inspiratory muscle training on the asymmetry of diaphragm thickness in stroke patients. [Subjects] Twenty-one stroke patients were assigned to one of three groups: progressive load high-intensity inspiratory muscle training (n = 8), fixed load high-intensity inspiratory muscle training (n = 6), and controls (n = 7). [Methods] The progressive load and fixed load high-intensity inspiratory muscle training participants undertook an exercise program for 20 minutes, three times weekly, for 6 weeks. After each session, diaphragm thickness was measured using ultrasonography. The diaphragm asymmetry ratio and diaphragm thickening ratio were standardized using a formula. [Results] After intervention, the diaphragm asymmetry ratio significantly differed among the three groups, and the diaphragm asymmetry ratio significantly increased in the control group. A significant increase was identified in the diaphragm thickening ratio within the progressive load and fixed load high-intensity inspiratory muscle training groups. [Conclusion] Progressive load and fixed load high-intensity inspiratory muscle training decreased the asymmetry of diaphragm thickness in stroke patients; this effect, in turn, increased the diaphragm thickening ratio in stroke patients. The two interventions examined here should be selectively applied to individuals in the clinical field.

  10. Effect of flow-resistive inspiratory loading on pulmonary and respiratory muscle function in sub-elite swimmers.

    PubMed

    Shei, Ren J; Lindley, Martin; Chatham, Ken; Mickleborough, Timothy D

    2016-04-01

    The aim of this study was to evaluate the effects of a 12-week swim training and inspiratory muscle training program on respiratory muscle and pulmonary function in competitively trained sub-elite swimmers. A double-blind, parallel-group experimental design was employed to compare the effects of swim training alone, swim training with sham-inspiratory muscle training, and swim training with true inspiratory muscle training. Twenty-four competitively trained sub-elite swimmers combined swim training with either flow-resistive inspiratory muscle training set at 80% sustained maximal inspiratory pressure with progressively increased work-rest ratios until task failure for 3 days/week (swim training with inspiratory muscle training, N.=8), or swim training with sham-inspiratory muscle training (N.=8), or acted as controls (swim training only, N.=8). Measures of pulmonary and respiratory muscle function were assessed at the beginning and end of the 12-week study period. At baseline, there were no significant differences (P>0.05) in respiratory muscle and pulmonary function between groups. Following the 12-week training period, the swim training with inspiratory muscle training group demonstrated improvements in maximal inspiratory pressure, sustained maximal inspiratory pressure, maximal inspiratory muscle power output, inspiratory muscle work capacity, inspiratory time of contraction, time to fatigue, maximal voluntary ventilation in 12 seconds, and forced inspiratory volume in 1-second (P<0.05). No improvements in pulmonary or respiratory muscle function were observed in the swim training only or swim training with sham-inspiratory muscle training groups (P>0.05). Inspiratory muscle training in conjunction with swim training improves respiratory muscle function in sub-elite swimmers when compared to swim training only.

  11. Inspiratory muscle training facilitates weaning from mechanical ventilation among patients in the intensive care unit: a systematic review.

    PubMed

    Elkins, Mark; Dentice, Ruth

    2015-07-01

    Does inspiratory muscle training improve inspiratory muscle strength in adults receiving mechanical ventilation? Does it improve the duration or success of weaning? Does it affect length of stay, reintubation, tracheostomy, survival, or the need for post-extubation non-invasive ventilation? Is it tolerable and does it cause adverse events? Systematic review of randomised trials. Adults receiving mechanical ventilation. Inspiratory muscle training versus sham or no inspiratory muscle training. Data were extracted regarding: inspiratory muscle strength and endurance; the rapid shallow breathing index; weaning success and duration; duration of mechanical ventilation; reintubation; tracheostomy; length of stay; use of non-invasive ventilation after extubation; survival; readmission; tolerability and adverse events. Ten studies involving 394 participants were included. Heterogeneity within some meta-analyses was high. Random-effects meta-analyses showed that the training significantly improved maximal inspiratory pressure (MD 7 cmH2O, 95% CI 5 to 9), the rapid shallow breathing index (MD 15 breaths/min/l, 95% CI 8 to 23) and weaning success (RR 1.34, 95% CI 1.02 to 1.76). Although only assessed in individual studies, significant benefits were also reported for the time spent on non-invasive ventilation after weaning (MD 16 hours, 95% CI 13 to 18), length of stay in the intensive care unit (MD 4.5 days, 95% CI 3.6 to 5.4) and length of stay in hospital (MD 4.4 days, 95% CI 3.4 to 5.5). Weaning duration decreased in the subgroup of patients with known weaning difficulty. The other outcomes weren't significantly affected or weren't measured. Inspiratory muscle training for selected patients in the intensive care unit facilitates weaning, with potential reductions in length of stay and the duration of non-invasive ventilatory support after extubation. The heterogeneity among the results suggests that the effects of inspiratory muscle training may vary; this perhaps depends

  12. Inspiratory muscle training improves 100 and 200 m swimming performance.

    PubMed

    Kilding, Andrew E; Brown, Sarah; McConnell, Alison K

    2010-02-01

    Inspiratory muscle training (IMT) has been shown to improve time trial performance in competitive athletes across a range of sports. Surprisingly, however, the effect of specific IMT on surface swimming performance remains un-investigated. Similarly, it is not known whether any ergogenic influence of IMT upon swimming performance is confined to specific race distances. To determine the influence of IMT upon swimming performance over 3 competitive distances, 16 competitive club-level swimmers were assigned at random to either an experimental (pressure threshold IMT) or sham IMT placebo control group. Participants performed a series of physiological and performance tests, before and following 6 weeks of IMT, including (1) an incremental swim test to the limit of tolerance to determine lactate, heart rate and perceived exertion responses; (2) standard measures of lung function (forced vital capacity, forced expiratory volume in 1 s, peak expiratory flow) and maximal inspiratory pressure (MIP); and (3) 100, 200 and 400 m swim time trials. Training utilised a hand-held pressure threshold device and consisted of 30 repetitions, twice per day. Relative to control, the IMT group showed the following percentage changes in swim times: 100 m, -1.70% (90% confidence limits, +/-1.4%), 200 m, -1.5% (+/-1.0), and 400 m, 0.6% (+/-1.2). Large effects were observed for MIP and rates of perceived exertion. In conclusion, 6 weeks of IMT has a small positive effect on swimming performance in club-level trained swimmers in events shorter than 400 m.

  13. Specific inspiratory muscle warm-up enhances badminton footwork performance.

    PubMed

    Lin, Hua; Tong, Tom Kwokkeung; Huang, Chuanye; Nie, Jinlei; Lu, Kui; Quach, Binh

    2007-12-01

    The effects of inspiratory muscle (IM) warm-up on IM function and on the maximum distance covered in a subsequent incremental badminton-footwork test (FWmax) were examined. Ten male badminton players were recruited to perform identical tests in three different trials in a random order. The control trial did not involve an IM warm-up, whereas the placebo and experimental trials did involve an IM warm-up consisting of two sets of 30-breath manoeuvres with an inspiratory pressure-threshold load equivalent to 15% (PLA) and 40% (IMW) maximum inspiratory mouth pressure, respectively. In the IMW trial, IM function was improved with 7.8%+/-4.0% and 6.9%+/-3.5% increases from control found in maximal inspiratory pressure at zero flow (P0) and maximal rate of P0 development (MRPD), respectively (p<0.05). FWmax was enhanced 6.8%+/-3.7%, whereas the slope of the linear relationship of the increase in the rating of perceived breathlessness for every minute (RPB/min) was reduced (p<0.05). Reduction in blood lactate ([La-]b) accumulation was observed when the test duration was identical to that of the control trial (P<0.05). In the PLA trial, no parameter was changed from control. For the changes (Delta) in parameters in IMW (n=10), negative correlations were found between DeltaP0 and DeltaRPB/min (r2=0.58), DeltaMRPD and DeltaRPB/min (r2=0.48), DeltaRPB/min, and DeltaFWmax (r2=0.55), but not between Delta[La-]b accumulation and DeltaFWmax. Such findings suggest that the IM-specific warm-up improved footwork performance in the subsequent maximum incremental badminton-footwork test. The improved footwork was partly attributable to the reduced breathless sensation resulting from the enhanced IM function, whereas the contribution of the concomitant reduction in [La-]b accumulation was relatively minor.

  14. Normal values for inspiratory muscle function in children.

    PubMed

    Mellies, Uwe; Stehling, Florian; Dohna-Schwake, Christian

    2014-10-01

    Assessment of inspiratory muscle function (IMF) is limited in children with neuromuscular disorders, because respiratory muscle tests are poorly standardized and valid normative data are unavailable. We investigated maximum inspiratory pressure after exhalation to residual volume (MIP), mouth occlusion pressure (P0.1) and time of inspiration during quiet breathing and derived inspiratory muscle load (P0.1/MIP), and tension time index (TTI) in 301 healthy schoolchildren 6-16 years old. Gender-specific and age-dependent percentile curves for MIP were drawn with the median, 5%, 10%, 25%, 75% and 95% percentile. P0.1 was equal in boys and girls (0.23  ±  0.11 kPa), while MIP was significantly higher in boys (6.8  ±  2.2 versus 5.8  ±  2.4 kPa). Consequently, P0.1/MIP (4.8% ± 3.2% versus 4.0% ± 3.1%) and TTI (0.2  ±  0.14 versus 0.16  ±  0.14) were significantly higher in girls. MIP was 2.90 + 0.36 × age (kPa) and 3.19 + 0.24 × age (kPa) in boys and girls, respectively. The 95% confidence intervals for boys and girls, respectively, were MIP, 6.3-7.3 kPA and 5.4-6.2 kPa; P0.1/MIP, 3.5%-4.5% and 4.3%-5.3%; TTI, 0.14-0.18 and 0.18-0.22; and P0.1, 0.20-0.24 kPa for both. IMF in children has a wide interindividual variability; however percentile curves facilitate a longitudinal assessment of individual patients. Furthermore, narrow confidence intervals allow for comparisons of study populations, making IMF an appropriate endpoint for clinical trials.

  15. Association between inspiratory muscle weakness and slowed oxygen uptake kinetics in patients with chronic obstructive pulmonary disease.

    PubMed

    Wolpat, Andiara; Lima, Francisco V; Silva, Fabiola M; Tochetto, Micheli; Freitas, Andressa; Grandi, Tatiane; Rodrigues, Leonardo; Paiva, Verônica; Cipriano, Gerson; Chiappa, Adriana M; Zago, Julio; Chiappa, Gaspar R

    2017-07-27

    Patients with chronic obstructive pulmonary disease (COPD) may have poor inspiratory muscle function, which reduces minute and alveolar ventilation, leading to increased hypoxemia and slow pulmonary oxygen uptake ( O2) kinetics. However, little is known about the effect of inspiratory muscle weakness (IMW) on oxygen uptake kinetics in patients with COPD. Thus, we tested the hypothesis that COPD patients with IMW have slowed O2 kinetics. An observational study was conducted including COPD patients with moderate to severe airflow limitation and a history of intolerance to exercise. Participants were divided into two groups: (IMW+; n = 22) (IMW-; n = 23) of muscle weakness. Maximal inspiratory (PImax), maximal expiratory (PEmax), maximal sustained inspiratory (PImaxsustained), and maximal endurance inspiratory muscle strength were lower in IMW+ patients (36 ± 9.5 cmH2O; 52 ± 14 cmH2O; 20 ± 6.5 cmH2O; 94 ± 84 s, respectively) than in IMW- patients (88 ± 12 cmH2O; 97 ± 28 cmH2O; 82.5 ± 54 cmH2O; 559 ± 92 s, respectively; p < 0.05). Moreover, the six-minute walk test and peak O2 were reduced in the IMW+ patients. During the constant work test, VO2 kinetics were slowed in the IMW+ compared to IMW- patients (88 ± 29 vs 61 ± 18 s, p < 0.05). Our findings demonstrate that inspiratory muscle weakness in COPD is associated with slowed VO2 kinetics, and thus, reduced functional capacity.

  16. The Role of Inspiratory Muscle Training in the Process of Rehabilitation of Patients with Chronic Obstructive Pulmonary Disease.

    PubMed

    Majewska-Pulsakowska, M; Wytrychowski, K; Rożek-Piechura, K

    2016-01-01

    Chronic obstructive pulmonary disease (COPD) adversely affects the quality of life and life expectancy of patients. Shortness of breath, cough, and fatigue in lower limbs are the main reasons limiting physical activities of patients. The lack of physical activity results in poorer muscle strength. The latest guidelines regarding breathing rehabilitation in COPD patients emphasize a significant role of inspiratory muscle exercises. The objective of the present study was to evaluate the effects of an 8-week long inspiratory muscle training, interval training on a cycle ergometer, and training combining both kinds of rehabilitation, on pulmonary function, health-related quality of life, and the tolerance to exercise in patients with COPD. The study was conducted in a group of 43 patients with diagnosed COPD stage II and III according to GOLD. They were randomly divided into four training groups: inspiratory muscle training (Group 1), cycle ergometer training (Group 2), cycle ergometer and inspiratory muscle training (Group 3), control group - patients who did not participate in any rehabilitation programs (Group 4 - control). Before the rehabilitation process and after its completion the patients were medically examined, they completed a health-related quality of life questionnaire, performed a 6-min walk test, spirometry, and a treadmill exercise test according to the modified Bruce protocol. The results demonstrate a significant improvement in the quality of life measured for Group 3 in comparison with the control group.

  17. Influence of different breathing frequencies on the severity of inspiratory muscle fatigue induced by high-intensity front crawl swimming.

    PubMed

    Jakovljevic, Djordje G; McConnell, Alison K

    2009-07-01

    The aim of the present study was to assess the influence of 2 different breathing frequencies on the magnitude of inspiratory muscle fatigue after high-intensity front crawl swimming. The influence of different breathing frequencies on postexercise blood lactate ([La]) and heart rate (HR) was also examined. Ten collegiate swimmers performed 2 x 200-m front crawl swims at 90% of race pace with the following breathing frequencies: 1) 1 breath every second stroke (B2), and 2) 1 breath every fourth stroke (B4). Maximal inspiratory pressure (PImax) was measured at the mouth from residual volume before (baseline) and after swimming, in a standing position. The HR and [La] were assessed at rest and immediately at the cessation of swimming. The PImax decreased by 21% after B4 and by 11% after B2 compared with baseline (p < 0.05). The [La] was lower by 15% after B4 than after B2 (p < 0.05). The HR was not significantly different between B2 and B4. These data suggest that there is significant global inspiratory muscle fatigue after high-intensity swimming. Inspiratory muscle fatigue is, however, greater when breathing frequency is reduced during high-intensity front crawl swimming. Respiratory muscle training should be used to improve respiratory muscle strength and endurance in swimmers.

  18. Effects of inspiratory muscle training on respiratory muscle electromyography and dyspnea during exercise in healthy men.

    PubMed

    Ramsook, Andrew H; Molgat-Seon, Yannick; Schaeffer, Michele R; Wilkie, Sabrina S; Camp, Pat G; Reid, W Darlene; Romer, Lee M; Guenette, Jordan A

    2017-03-02

    Inspiratory muscle training (IMT) has consistently been shown to reduce exertional dyspnea in health and disease; however, the physiological mechanisms remain poorly understood. A growing body of literature suggests that dyspnea intensity can largely be explained by an awareness of increased neural respiratory drive, as indirectly measured using diaphragmatic electromyography (EMGdi). Accordingly, we sought to determine if improvements in dyspnea following IMT can be explained by decreases in inspiratory muscle EMG activity. Twenty-five healthy recreationally-active men completed a detailed familiarization visit followed by two maximal incremental cycle exercise tests separated by 5 weeks of randomly assigned pressure threshold IMT or sham control training (SC). The IMT group (n=12) performed 30 inspiratory efforts twice daily against a 30 repetition maximum intensity. The SC group (n=13) performed a daily bout of 60 inspiratory efforts against 10% maximal inspiratory pressure (MIP), with no weekly adjustments. Dyspnea intensity was measured throughout exercise using the modified 0-10 Borg scale. Sternocleidomastoid and scalene EMG were measured using surface electrodes whereas EMGdi was measured using a multi-pair esophageal electrode catheter. IMT significantly improved MIP (pre:-138±45 vs. post:-160±43cmH2O, p<0.01) whereas the SC intervention did not. Dyspnea was significantly reduced at the highest equivalent work rate (pre:7.6±2.5 vs. post:6.8±2.9Borg units, p<0.05), but not in the SC group, with no between-group interaction effects. There were no significant differences in respiratory muscle EMG during exercise in either group. Improvements in dyspnea intensity ratings following IMT in healthy humans cannot be explained by changes in the electrical activity of the inspiratory muscles.

  19. A comparison of inspiratory muscle fatigue following maximal exercise in moderately trained males and females.

    PubMed

    Ozkaplan, Atila; Rhodes, Edward C; Sheel, A William; Taunton, Jack E

    2005-09-01

    Exercise-induced inspiratory muscle fatigue (IMF) has been reported in males but there are few reports of IMF in females. It is not known if a gender difference exists for inspiratory muscle strength following heavy exercise, as is reported in locomotor muscles. Therefore, the relationship between fatigue and subsequent recovery of maximal inspiratory pressure (MIP) following exercise to maximal oxygen consumption (VO2max) was examined in a group of moderately trained males and females. Eighteen males (23+/-3 years; mean +/- SD) and 16 females (23+/-2 years) completed ten MIP and ten maximal handgrip (HG) strength maneuvers to establish baseline. Post-exercise MIP and HG were assessed successively immediately following a progressive intensity VO2max test on a cycle ergometer and at 1, 2, 3, 4, 5, 10, and 15 min. VO2max, relative to fat-free mass was not statistically different between males (62+/-7 ml kg(-1) min(-1)) and females (60+/-8 ml kg(-1) min(-1)). Males had higher absolute MIP values than females at all time intervals (P<0.05). Immediately following exercise, MIP was significantly reduced in both genders (M=83+/-16%; F=78+/-15% of baseline) but HG values were not different than resting values. MIP values remained depressed for both males and females throughout the 15 min (P<0.05). Differences for MIP between males and females were not statistically significant at any measurement time (P>0.05). The findings in this study conclude that IMF, observed immediately following maximal exercise, demonstrated the same pattern of recovery for both genders.

  20. Inspiratory Muscle Training Improves Sleep and Mitigates Cardiovascular Dysfunction in Obstructive Sleep Apnea

    PubMed Central

    Vranish, Jennifer R.; Bailey, E. Fiona

    2016-01-01

    Study Objectives: New and effective strategies are needed to manage the autonomic and cardiovascular sequelae of obstructive sleep apnea (OSA). We assessed the effect of daily inspiratory muscle strength training (IMT) on sleep and cardiovascular function in adults unable to use continuous positive airway pressure (CPAP) therapy. Methods: This is a placebo-controlled, single-blind study conducted in twenty four adults with mild, moderate, and severe OSA. Subjects were randomly assigned to placebo or inspiratory muscle strength training. Subjects in each group performed 5 min of training each day for 6 w. All subjects underwent overnight polysomnography at intake and again at study close. Results: We evaluated the effects of placebo training or IMT on sleep, blood pressure, and plasma catecholamines. Relative to placebo-trained subjects with OSA, subjects with OSA who performed IMT manifested reductions in systolic and diastolic blood pressures (−12.3 ± 1.6 SBP and −5.0 ± 1.3 DBP mmHg; P < 0.01); plasma norepinephrine levels (536.3 ± 56.6 versus 380.6 ± 41.2 pg/mL; P = 0.01); and registered fewer nighttime arousals and reported improved sleep (Pittsburgh Sleep Quality Index scores: 9.1 ± 0.9 versus 5.1 ± 0.7; P = 0.001). These favorable outcomes were achieved without affecting apneahypopnea index. Conclusions: The results are consistent with our previously published findings in normotensive adults but further indicate that IMT can modulate blood pressure and plasma catecholamines in subjects with ongoing nighttime apnea and hypoxemia. Accordingly, we suggest IMT offers a low cost, nonpharmacologic means of improving sleep and blood pressure in patients who are intolerant of CPAP. Citation: Vranish JR, Bailey EF. Inspiratory muscle training improves sleep and mitigates cardiovascular dysfunction in obstructive sleep apnea. SLEEP 2016;39(6):1179–1185. PMID:27091540

  1. Delayed Onset Muscle Soreness After Inspiratory Threshold Loading in Healthy Adults

    PubMed Central

    Mathur, Sunita; Sheel, A. William; Road, Jeremy D.; Reid, W. Darlene

    2010-01-01

    Purpose: Skeletal muscle damage occurs following high-intensity or unaccustomed exercise; however, it is difficult to monitor damage to the respiratory muscles, particularly in humans. The aim of this study was to use clinical measures to investigate the presence of skeletal muscle damage in the inspiratory muscles. Methods: Ten healthy subjects underwent 60 minutes of voluntary inspiratory threshold loading (ITL) at 70% of maximal inspiratory pressure. Maximal inspiratory and expiratory mouth pressures, delayed onset muscle soreness on a visual analogue scale and plasma creatine kinase were measured prior to ITL, and at repeated time points after ITL (4, 24 and 48 hours post-ITL). Results: Delayed onset muscle soreness was present in all subjects 24 hours following ITL (intensity = 22 ± 6 mm; significantly higher than baseline p = 0.02). Muscle soreness was reported primarily in the anterior neck region, and was correlated to the amount of work done by the inspiratory muscles during ITL (r = 0.72, p = 0.02). However, no significant change was observed in maximal inspiratory or expiratory pressures or creatine kinase. Conclusions: These findings suggest that an intense bout of ITL results in muscle soreness primarily in the accessory muscles of inspiration, however, may be insufficient to cause significant muscle damage in healthy adults. PMID:20467514

  2. The role of inspiratory muscle training in the management of asthma and exercise-induced bronchoconstriction.

    PubMed

    Shei, Ren-Jay; Paris, Hunter L R; Wilhite, Daniel P; Chapman, Robert F; Mickleborough, Timothy D

    2016-11-01

    Asthma is a pathological condition comprising of a variety of symptoms which affect the ability to function in daily life. Due to the high prevalence of asthma and associated healthcare costs, it is important to identify low-cost alternatives to traditional pharmacotherapy. One of these low cost alternatives is the use of inspiratory muscle training (IMT), which is a technique aimed at increasing the strength and endurance of the diaphragm and accessory muscles of respiration. IMT typically consists of taking voluntary inspirations against a resistive load across the entire range of vital capacity while at rest. In healthy individuals, the most notable benefits of IMT are an increase in diaphragm thickness and strength, a decrease in exertional dyspnea, and a decrease in the oxygen cost of breathing. Due to the presence of expiratory flow limitation in asthma and exercise-induced bronchoconstriction, dynamic lung hyperinflation is common. As a result of varying operational lung volumes, due in part to hyperinflation, the respiratory muscles may operate far from the optimal portion of the length-tension curve, and thus may be forced to operate against a low pulmonary compliance. Therefore, the ability of these muscles to generate tension is reduced, and for any given level of ventilation, the work of breathing is increased as compared to non-asthmatics. Evidence that IMT is an effective treatment for asthma is inconclusive, due to limited data and a wide variation in study methodologies. However, IMT has been shown to decrease dyspnea, increase inspiratory muscle strength, and improve exercise capacity in asthmatic individuals. In order to develop more concrete recommendations regarding IMT as an effective low-cost adjunct in addition to traditional asthma treatments, we recommend that a standard treatment protocol be developed and tested in a placebo-controlled clinical trial with a large representative sample.

  3. Contribution of spindle reflexes to post-inspiratory activity in the canine external intercostal muscles

    PubMed Central

    Berdah, Stéphane V; De Troyer, André

    2001-01-01

    The external intercostal muscles have greater post-inspiratory activity than the parasternal intercostal muscles and are more abundantly supplied with muscle spindles. In the present study, the hypothesis was tested that spindle afferent inputs play a major role in determining this activity. The electrical activity of the external and parasternal intercostal muscles in the rostral interspaces was recorded in anaesthetized spontaneously breathing dogs, and the ribs were manipulated so as to alter their normal caudal displacement and the normal lengthening of the muscles in early expiration. Post-inspiratory activity in the external intercostal muscles showed a reflex decrease when the caudal motion of the ribs and the lengthening of the muscles was impeded, and it showed a reflex increase when the rate of caudal rib motion and muscle lengthening was increased. In contrast, the small post-inspiratory activity in the parasternal intercostal muscles remained unchanged. When the two ribs making up the interspace investigated were locked to keep muscle length constant, post-inspiratory activity in the external intercostal muscles was reduced and no longer responded to cranial rib manipulation. These observations confirm that afferent inputs from muscle receptors, presumably muscle spindles, are a primary determinant of post-inspiratory activity in the canine external intercostal muscles. In anaesthetized animals, the contribution of central control mechanisms to this activity is small. PMID:11483716

  4. Short-term effects of inspiratory muscle training in coronary artery bypass graft surgery: a randomized controlled trial.

    PubMed

    Savci, Sema; Degirmenci, Betul; Saglam, Melda; Arikan, Hulya; Inal-Ince, Deniz; Turan, Hatice Nur; Demircin, Metin

    2011-10-01

    To investigate the efficiency of inspiratory muscle training (IMT) on postoperative respiratory muscle strength, functional capacity, quality of life, and psychosocial status in patients with coronary artery bypass graft (CABG) surgery. Forty-three patients undergoing CABG surgery were randomly assigned to the one of two groups. All subjects received usual care. In addition, subjects in the intervention group received IMT training pre- and postoperatively. Pulmonary function testing, six minute walk test (6MWT), quality of life and psychosocial parameters were assessed preoperatively and the fifth day after the surgery. The mean inspiratory muscle strength increased from 82.64 cmH(2)O at baseline to 95.45 cmH(2)O five days postoperatively in the intervention group. The intervention group (319.55 ± 72.17 m before and 387.91 ± 65.69 m after surgery) covered further distance during the 6MWT than usual care (355.43 ± 56.08 m before and 357.69 ± 43.42 m after surgery). The improvement in quality of life was greater in the intervention group for the dimension of sleep. The anxiety scores were significantly lower in the intervention group than the usual care group. The length of intensive care unit stay was significantly shorter in the intervention group than the usual care group (p < 0.05). IMT results in faster recovery of inspiratory muscle strength, functional capacity, intensive care unit stay, quality of life and psychosocial status after CABG.

  5. The Role of Inspiratory Muscle Training in Sickle Cell Anemia Related Pulmonary Damage due to Recurrent Acute Chest Syndrome Attacks

    PubMed Central

    Camcıoğlu, Burcu; Boşnak-Güçlü, Meral; Karadallı, Müşerrefe Nur; Akı, Şahika Zeynep; Türköz-Sucak, Gülsan

    2015-01-01

    Background. The sickling of red blood cells causes a constellation of musculoskeletal, cardiovascular, and pulmonary manifestations. A 32-year-old gentleman with sickle cell anemia (SCA) had been suffering from recurrent acute chest syndrome (ACS). Aim. To examine the effects of inspiratory muscle training (IMT) on pulmonary functions, respiratory and peripheral muscle strength, functional exercise capacity, and quality of life in this patient with SCA. Methods. Functional exercise capacity was evaluated using six-minute walk test, respiratory muscle strength using mouth pressure device, hand grip strength using hand-held dynamometer, pain using Visual Analogue Scale, fatigue using Fatigue Severity Scale, dyspnea using Modified Medical Research Council Scale, and health related quality of life using European Organization for Research and Treatment of Cancer QOL measurement. Results. A significant improvement has been demonstrated in respiratory muscle strength, functional exercise capacity, pain, fatigue, dyspnea, and quality of life. There was no admission to emergency department due to acute chest syndrome in the following 12 months after commencing regular erythrocytapheresis. Conclusion. This is the first report demonstrating the beneficial effects of inspiratory muscle training on functional exercise capacity, respiratory muscle strength, pain, fatigue, dyspnea, and quality of life in a patient with recurrent ACS. PMID:26060589

  6. Respiratory Muscle Activity During Simultaneous Stationary Cycling and Inspiratory Muscle Training.

    PubMed

    Hellyer, Nathan J; Folsom, Ian A; Gaz, Dan V; Kakuk, Alynn C; Mack, Jessica L; Ver Mulm, Jacyln A

    2015-12-01

    Inspiratory muscle training (IMT) strengthens the muscles of respiration, improves breathing efficiency, and increases fitness. The IMT is generally performed independently of aerobic exercise; however, it is not clear whether there is added benefit of performing the IMT while simultaneously performing aerobic exercise in terms of activating and strengthening inspiratory muscles. The purpose of our study was to determine the effect of IMT on respiratory muscle electromyography (EMG) activity during stationary cycling in the upright and drops postures as compared with that when the IMT was performed alone. Diaphragm and sternocleidomastoid EMG activity was measured under different resting and cycling postures, with and without the use of the IMT at 40% maximal inspiratory pressure (n = 10; mean age 37). Cycling in an upright posture while simultaneously performing the IMT resulted in a significantly greater diaphragm EMG activity than while performing the IMT at rest in upright or drops postures (p ≤ 0.05). Cycling in drops postures while performing the IMT had a significantly greater diaphragm EMG activity than when performing the IMT at rest in either upright or drops postures (p ≤ 0.05). Sternocleidomastoid muscle activity increased with both cycling and IMT, although posture had little effect. These results support our hypothesis in that the IMT while cycling increases respiratory EMG activity to a significantly greater extent than when performing the IMT solely at rest, suggesting that the combination of IMT and cycling may provide an additive training effect.

  7. Benefits of combining inspiratory muscle with 'whole muscle' training in children with cystic fibrosis: a randomised controlled trial.

    PubMed

    Santana-Sosa, Elena; Gonzalez-Saiz, Laura; Groeneveld, Iris F; Villa-Asensi, José R; Barrio Gómez de Aguero, María I; Fleck, Steven J; López-Mojares, Luis M; Pérez, Margarita; Lucia, Alejandro

    2014-10-01

    The purpose of this study (randomised controlled trial) was to assess the effects of an 8-week combined 'whole muscle' (resistance+aerobic) and inspiratory muscle training (IMT) on lung volume, inspiratory muscle strength (PImax) and cardiorespiratory fitness (VO2 peak) (primary outcomes), and dynamic muscle strength, body composition and quality of life in paediatric outpatients with CF (cystic fibrosis, secondary outcomes). We also determined the effects of a detraining period. Participants were randomly allocated with a block on gender to a control (standard therapy) or intervention group (initial n=10 (6 boys) in each group; age 10±1 and 11±1 years). The latter group performed a combined programme (IMT (2 sessions/day) and aerobic+strength exercises (3 days/week, in-hospital)) that was followed by a 4-week detraining period. All participants were evaluated at baseline, post-training and detraining. Adherence to the training programme averaged 97.5%±1.7%. There was a significant interaction (group×time) effect for PImax, VO2peak and five-repetition maximum strength (leg-press, bench-press, seated-row) (all (p<0.001), and also for %fat (p<0.023) and %fat-free mass (p=0.001), with training exerting a significant beneficial effect only in the intervention group, which was maintained after detraining for PImax and leg-press. The relatively short-term (8-week) training programme used here induced significant benefits in important health phenotypes of paediatric patients with CF. IMT is an easily applicable intervention that could be included, together with supervised exercise training in the standard care of these patients. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  8. Spatial distribution of inspiratory drive to the parasternal intercostal muscles in humans

    PubMed Central

    Gandevia, Simon C; Hudson, Anna L; Gorman, Robert B; Butler, Jane E; De Troyer, André

    2006-01-01

    The human parasternal intercostal muscles are obligatory inspiratory muscles with a diminishing mechanical advantage from cranial to caudal interspaces. This study determined whether inspiratory neural drive to these muscles is graded, and whether this distribution matches regional differences in inspiratory mechanical advantage. To determine the neural drive, intramuscular EMG was recorded from the first to the fifth parasternal intercostals during resting breathing in six subjects. All interspaces showed phasic inspiratory activity but the onset of activity relative to inspiratory flow in the fourth and fifth spaces was delayed compared with that in cranial interspaces. Activity in the first, second and third interspaces commenced, on average, within the first 10% of inspiratory time, and sometimes preceded inspiratory airflow. In contrast, activity in the fourth and fifth interspaces began after an average 33% of inspiratory time. The peak inspiratory discharge frequency of motor units in the first interspace averaged 13.4 ± 1.0 Hz (mean ± s.e.m.) and was significantly greater than in all other interspaces, in particular in the fifth space (8.0 ± 1.0 Hz). Phasic inspiratory activity was sometimes superimposed on tonic activity. In the first interspace, only 3% of units had tonic firing, but this proportion increased to 34% in the fifth space. In five subjects, recordings were also made from the medial and lateral extent of the second parasternal intercostal. Both portions showed phasic inspiratory activity which began within the first 6% of inspiratory time. Motor units from the lateral and medial portions fired at the same peak discharge rate (10.4 ± 0.7 versus 10.7 ± 0.6 Hz). These observations indicate that the distribution of neural drive to the parasternal intercostals in humans has a rostrocaudal gradient, but that the drive is uniform along the mediolateral extent of the second interspace. The distribution of inspiratory neural drive to the

  9. Effects of swim training on lung volumes and inspiratory muscle conditioning.

    PubMed

    Clanton, T L; Dixon, G F; Drake, J; Gadek, J E

    1987-01-01

    Lung volumes and inspiratory muscle (IM) function tests were measured in 16 competitive female swimmers (age 19 +/- 1 yr) before and after 12 wk of swim training. Eight underwent additional IM training; the remaining eight were controls. Vital capacity (VC) increased 0.25 +/- 0.25 liters (P less than 0.01), functional residual capacity (FRC) increased 0.39 +/- 0.29 liters (P less than 0.001), and total lung capacity (TLC) increased 0.35 +/- 0.47 (P less than 0.025) in swimmers, irrespective of IM training. Residual volume (RV) did not change. Maximum inspiratory mouth pressure (PImax) measured at FRC changed -43 +/- 18 cmH2O (P less than 0.005) in swimmers undergoing IM conditioning and -29 +/- 25 (P less than 0.05) in controls. The time that 65% of prestudy PImax could be endured increased in IM trainers (P less than 0.001) and controls (P less than 0.05). All results were compared with similar IM training in normal females (age 21.1 +/- 0.8 yr) in which significant increases in PImax and endurance were observed in IM trainers only with no changes in VC, FRC, or TLC (Clanton et al., Chest 87: 62-66, 1985). We conclude that 1) swim training in mature females increases VC, TLC, and FRC with no effect on RV, and 2) swim training increases IM strength and endurance measured near FRC.

  10. Synchronization of presynaptic input to motor units of tongue, inspiratory intercostal, and diaphragm muscles.

    PubMed

    Rice, Amber; Fuglevand, Andrew J; Laine, Christopher M; Fregosi, Ralph F

    2011-05-01

    The respiratory central pattern generator distributes rhythmic excitatory input to phrenic, intercostal, and hypoglossal premotor neurons. The degree to which this input shapes motor neuron activity can vary across respiratory muscles and motor neuron pools. We evaluated the extent to which respiratory drive synchronizes the activation of motor unit pairs in tongue (genioglossus, hyoglossus) and chest-wall (diaphragm, external intercostals) muscles using coherence analysis. This is a frequency domain technique, which characterizes the frequency and relative strength of neural inputs that are common to each of the recorded motor units. We also examined coherence across the two tongue muscles, as our previous work shows that, despite being antagonists, they are strongly coactivated during the inspiratory phase, suggesting that excitatory input from the premotor neurons is distributed broadly throughout the hypoglossal motoneuron pool. All motor unit pairs showed highly correlated activity in the low-frequency range (1-8 Hz), reflecting the fundamental respiratory frequency and its harmonics. Coherence of motor unit pairs recorded either within or across the tongue muscles was similar, consistent with broadly distributed premotor input to the hypoglossal motoneuron pool. Interestingly, motor units from diaphragm and external intercostal muscles showed significantly higher coherence across the 10-20-Hz bandwidth than tongue-muscle units. We propose that the lower coherence in tongue-muscle motor units over this range reflects a larger constellation of presynaptic inputs, which collectively lead to a reduction in the coherence between hypoglossal motoneurons in this frequency band. This, in turn, may reflect the relative simplicity of the respiratory drive to the diaphragm and intercostal muscles, compared with the greater diversity of functions fulfilled by muscles of the tongue.

  11. Synchronization of presynaptic input to motor units of tongue, inspiratory intercostal, and diaphragm muscles

    PubMed Central

    Rice, Amber; Fuglevand, Andrew J.; Laine, Christopher M.

    2011-01-01

    The respiratory central pattern generator distributes rhythmic excitatory input to phrenic, intercostal, and hypoglossal premotor neurons. The degree to which this input shapes motor neuron activity can vary across respiratory muscles and motor neuron pools. We evaluated the extent to which respiratory drive synchronizes the activation of motor unit pairs in tongue (genioglossus, hyoglossus) and chest-wall (diaphragm, external intercostals) muscles using coherence analysis. This is a frequency domain technique, which characterizes the frequency and relative strength of neural inputs that are common to each of the recorded motor units. We also examined coherence across the two tongue muscles, as our previous work shows that, despite being antagonists, they are strongly coactivated during the inspiratory phase, suggesting that excitatory input from the premotor neurons is distributed broadly throughout the hypoglossal motoneuron pool. All motor unit pairs showed highly correlated activity in the low-frequency range (1–8 Hz), reflecting the fundamental respiratory frequency and its harmonics. Coherence of motor unit pairs recorded either within or across the tongue muscles was similar, consistent with broadly distributed premotor input to the hypoglossal motoneuron pool. Interestingly, motor units from diaphragm and external intercostal muscles showed significantly higher coherence across the 10–20-Hz bandwidth than tongue-muscle units. We propose that the lower coherence in tongue-muscle motor units over this range reflects a larger constellation of presynaptic inputs, which collectively lead to a reduction in the coherence between hypoglossal motoneurons in this frequency band. This, in turn, may reflect the relative simplicity of the respiratory drive to the diaphragm and intercostal muscles, compared with the greater diversity of functions fulfilled by muscles of the tongue. PMID:21307319

  12. Inspiratory Muscle Training Improves Sleep and Mitigates Cardiovascular Dysfunction in Obstructive Sleep Apnea.

    PubMed

    Vranish, Jennifer R; Bailey, E Fiona

    2016-06-01

    New and effective strategies are needed to manage the autonomic and cardiovascular sequelae of obstructive sleep apnea (OSA). We assessed the effect of daily inspiratory muscle strength training (IMT) on sleep and cardiovascular function in adults unable to use continuous positive airway pressure (CPAP) therapy. This is a placebo-controlled, single-blind study conducted in twenty four adults with mild, moderate, and severe OSA. Subjects were randomly assigned to placebo or inspiratory muscle strength training. Subjects in each group performed 5 min of training each day for 6 w. All subjects underwent overnight polysomnography at intake and again at study close. We evaluated the effects of placebo training or IMT on sleep, blood pressure, and plasma catecholamines. Relative to placebo-trained subjects with OSA, subjects with OSA who performed IMT manifested reductions in systolic and diastolic blood pressures (-12.3 ± 1.6 SBP and -5.0 ± 1.3 DBP mmHg; P < 0.01); plasma norepinephrine levels (536.3 ± 56.6 versus 380.6 ± 41.2 pg/mL; P = 0.01); and registered fewer nighttime arousals and reported improved sleep (Pittsburgh Sleep Quality Index scores: 9.1 ± 0.9 versus 5.1 ± 0.7; P = 0.001). These favorable outcomes were achieved without affecting apneahypopnea index. The results are consistent with our previously published findings in normotensive adults but further indicate that IMT can modulate blood pressure and plasma catecholamines in subjects with ongoing nighttime apnea and hypoxemia. Accordingly, we suggest IMT offers a low cost, nonpharmacologic means of improving sleep and blood pressure in patients who are intolerant of CPAP. © 2016 Associated Professional Sleep Societies, LLC.

  13. Inspiratory muscle performance relative to the ventilatory threshold in healthy subjects.

    PubMed

    Formanek, D; Wanke, T; Lahrmann, H; Rauscher, H; Popp, W; Zwick, H

    1993-10-01

    Inspiratory muscle performance, ventilation, and gas exchange were studied during exercise in healthy subjects to look for typical changes of pattern of contraction at the ventilatory threshold (VT). The steepening of the slope of carbon dioxide output (VCO2) vs oxygen uptake (VO2) at the VT was accompanied by a nonlinear increase of the mean rate of esophageal pressure development (Pes/TI) vs the esophageal pressure time index (PTIes) reflecting both the relative force (Pbreath/Pesmax) and duration (TI/TTOT) required for inspiration. The esophageal pressure time integral within one breath (Pbreath.dTI) was one of the best single predictors of the ventilatory equivalent for oxygen (VE/VO2) at the VT. Moreover, we presented inspiratory muscle load indices as a mirror image of breathing pattern, with the obvious advantage that the ventilation component can be compared with better established methods of presenting ventilatory output. Inspiratory muscle performance during exercise should link the increased metabolic rate to ventilatory output. We conclude that 1) there exists an inspiratory muscle threshold that is well correlated to commonly used gas exchange thresholds, and 2) the efficiency of ventilation and gas exchange during exercise could be linked to pressure and timing of inspiratory muscle contraction.

  14. A Cycle Ergometer Exercise Program Improves Exercise Capacity and Inspiratory Muscle Function in Hospitalized Patients Awaiting Heart Transplantation: a Pilot Study

    PubMed Central

    Forestieri, Patrícia; Guizilini, Solange; Peres, Monique; Bublitz, Caroline; Bolzan, Douglas W.; Rocco, Isadora S.; Santos, Vinícius B.; Moreira, Rita Simone L.; Breda, João R.; de Almeida, Dirceu R.; Carvalho, Antonio Carlos de C.; Arena, Ross; Gomes, Walter J.

    2016-01-01

    Objective The purpose of this study was to evaluate the effect of a cycle ergometer exercise program on exercise capacity and inspiratory muscle function in hospitalized patients with heart failure awaiting heart transplantation with intravenous inotropic support. Methods Patients awaiting heart transplantation were randomized and allocated prospectively into two groups: 1) Control Group (n=11) - conventional protocol; and 2) Intervention Group (n=7) - stationary cycle ergometer exercise training. Functional capacity was measured by the six-minute walk test and inspiratory muscle strength assessed by manovacuometry before and after the exercise protocols. Results Both groups demonstrated an increase in six-minute walk test distance after the experimental procedure compared to baseline; however, only the intervention group had a significant increase (P=0.08 and P=0.001 for the control and intervention groups, respectively). Intergroup comparison revealed a greater increase in the intervention group compared to the control (P<0.001). Regarding the inspiratory muscle strength evaluation, the intragroup analysis demonstrated increased strength after the protocols compared to baseline for both groups; statistical significance was only demonstrated for the intervention group, though (P=0.22 and P<0.01, respectively). Intergroup comparison showed a significant increase in the intervention group compared to the control (P<0.01). Conclusion Stationary cycle ergometer exercise training shows positive results on exercise capacity and inspiratory muscle strength in patients with heart failure awaiting cardiac transplantation while on intravenous inotropic support. PMID:27982348

  15. Common drive to the upper airway muscle genioglossus during inspiratory loading.

    PubMed

    Woods, Michael J; Nicholas, Christian L; Semmler, John G; Chan, Julia K M; Jordan, Amy S; Trinder, John

    2015-11-01

    Common drive is thought to constitute a central mechanism by which the efficiency of a motor neuron pool is increased. This study tested the hypothesis that common drive to the upper airway muscle genioglossus (GG) would increase with increased respiratory drive in response to an inspiratory load. Respiration, GG electromyographic (EMG) activity, single-motor unit activity, and coherence in the 0-5 Hz range between pairs of GG motor units were assessed for the 30 s before an inspiratory load, the first and second 30 s of the load, and the 30 s after the load. Twelve of twenty young, healthy male subjects provided usable data, yielding 77 pairs of motor units: 2 Inspiratory Phasic, 39 Inspiratory Tonic, 15 Expiratory Tonic, and 21 Tonic. Respiratory and GG inspiratory activity significantly increased during the loads and returned to preload levels during the postload periods (all showed significant quadratic functions over load trials, P < 0.05). As hypothesized, common drive increased during the load in inspiratory modulated motor units to a greater extent than in expiratory/tonic motor units (significant load × discharge pattern interaction, P < 0.05). Furthermore, this effect persisted during the postload period. In conclusion, common drive to inspiratory modulated motor units was elevated in response to increased respiratory drive. The postload elevation in common drive was suggestive of a poststimulus activation effect.

  16. Repeated-Sprint Cycling Does Not Induce Respiratory Muscle Fatigue in Active Adults: Measurements from The Powerbreathe® Inspiratory Muscle Trainer

    PubMed Central

    Minahan, Clare; Sheehan, Beth; Doutreband, Rachel; Kirkwood, Tom; Reeves, Daniel; Cross, Troy

    2015-01-01

    This study examined respiratory muscle strength using the POWERbreathe® inspiratory muscle trainer (i.e., ‘S-Index’) before and after repeated-sprint cycling for comparison with maximal inspiratory pressure (MIP) values obtained during a Mueller maneuver. The S-Index was measured during six trials across two sessions using the POWERbreathe® and MIP was measured during three trials in a single session using a custom-made manometer in seven recreationally active adults. Global respiratory muscle strength was measured using both devices before and after the performance of sixteen, 6-s sprints on a cycle ergometer. Intraclass correlation coefficients for the POWERbreathe® S-index indicated excellent (p < 0.05) trial-to-trial (r = 0.87) and day-to-day (r = 0.90) reliability yet there was no significant correlation (r = -0.35, p = 0.43) between the S-Index measured using the POWERbreathe® and MIP measured during a Mueller maneuver. Repeated-sprint cycling had no effect on respiratory muscle strength as measured by the POWERbreathe® (p > 0.99) and during the Mueller maneuver (p > 0.99). The POWERbreathe® S-Index is a moderately reliable, but not equivalent, measure of MIP determined during a Mueller maneuver. Furthermore, repeated-sprint cycling does not induce globalized respiratory muscle fatigue in recreationally-active adults. Key points The S-Index as measured by the POWERbreathe® is a reliable measure of respiratory muscle strength The S-Index does not accurately reflect maximal inspiratory pressure obtained from a Mueller maneuver Repeated-sprint cycling does not induce respiratory muscle fatigue as measured by the POWERbreathe® and the Manometer PMID:25729312

  17. Repeated-sprint cycling does not induce respiratory muscle fatigue in active adults: measurements from the powerbreathe® inspiratory muscle trainer.

    PubMed

    Minahan, Clare; Sheehan, Beth; Doutreband, Rachel; Kirkwood, Tom; Reeves, Daniel; Cross, Troy

    2015-03-01

    This study examined respiratory muscle strength using the POWERbreathe® inspiratory muscle trainer (i.e., 'S-Index') before and after repeated-sprint cycling for comparison with maximal inspiratory pressure (MIP) values obtained during a Mueller maneuver. The S-Index was measured during six trials across two sessions using the POWERbreathe® and MIP was measured during three trials in a single session using a custom-made manometer in seven recreationally active adults. Global respiratory muscle strength was measured using both devices before and after the performance of sixteen, 6-s sprints on a cycle ergometer. Intraclass correlation coefficients for the POWERbreathe® S-index indicated excellent (p < 0.05) trial-to-trial (r = 0.87) and day-to-day (r = 0.90) reliability yet there was no significant correlation (r = -0.35, p = 0.43) between the S-Index measured using the POWERbreathe® and MIP measured during a Mueller maneuver. Repeated-sprint cycling had no effect on respiratory muscle strength as measured by the POWERbreathe® (p > 0.99) and during the Mueller maneuver (p > 0.99). The POWERbreathe® S-Index is a moderately reliable, but not equivalent, measure of MIP determined during a Mueller maneuver. Furthermore, repeated-sprint cycling does not induce globalized respiratory muscle fatigue in recreationally-active adults. Key pointsThe S-Index as measured by the POWERbreathe® is a reliable measure of respiratory muscle strengthThe S-Index does not accurately reflect maximal inspiratory pressure obtained from a Mueller maneuverRepeated-sprint cycling does not induce respiratory muscle fatigue as measured by the POWERbreathe® and the Manometer.

  18. Effects of a 10-Week Inspiratory Muscle Training Program on Lower-Extremity Mobility in People with Multiple Sclerosis

    PubMed Central

    Fry, Donna

    2011-01-01

    Pulmonary muscle weakness is common in ambulatory people with multiple sclerosis (MS) and may lead to deficits in mobility function. The purpose of this study was to examine the effect of a 10-week home-based exercise program using an inspiratory muscle threshold trainer (IMT) on the results of four lower-extremity physical performance tests in people with MS. The study design was a two-group (experimental-control), pretest-posttest study. Outcome measures consisted of pulmonary function measures including maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), and maximal voluntary ventilation (MVV), and the following lower-extremity physical performance measures: the 6-Minute Walk (6MW) distance, gait velocity (GV), the Sit-to-Stand Test (SST), the Functional Stair Test (FST), and a balance test (BAL). A total of 46 ambulatory participants (Expanded Disability Status Scale [EDSS] score, 2.0–6.5) with MS were randomly assigned to an intervention group (mean EDSS score, 4.1) that received 10 weeks of home-based inspiratory muscle training or a nontreatment control group (mean EDSS score, 3.2). Of the original 46 participants, 20 intervention group participants and 19 control group participants completed the study. Compared with the control group, the intervention group made significantly greater gains in inspiratory muscle strength (P = .003) and timed balance scores (P = .008). A nonsignificant improvement in 6MW distance (P = .086) was also noted in the IMT-trained group as compared with the control group. This is the first study directly linking improvement in respiratory function to improvement in physical performance function in people with mild-to-moderate disability due to MS. PMID:24453703

  19. Inspiratory muscle training to facilitate weaning from mechanical ventilation: protocol for a systematic review

    PubMed Central

    2011-01-01

    Background In intensive care, weaning is the term used for the process of withdrawal of mechanical ventilation to enable spontaneous breathing to be re-established. Inspiratory muscle weakness and deconditioning are common in patients receiving mechanical ventilation, especially that of prolonged duration. Inspiratory muscle training could limit or reverse these unhelpful sequelae and facilitate more rapid and successful weaning. Methods This review will involve systematic searching of five electronic databases to allow the identification of randomised trials of inspiratory muscle training in intubated and ventilated patients. From these trials, we will extract available data for a list of pre-defined outcomes, including maximal inspiratory pressure, the duration of the weaning period, and hospital length of stay. We will also meta-analyse comparable results where possible, and report a summary of the available pool of evidence. Discussion The data generated by this review will be the most comprehensive answer available to the question of whether inspiratory muscle training is clinically useful in intensive care. As well as informing clinicians in the intensive care setting, it will also inform healthcare managers deciding whether health professionals with skills in respiratory therapy should be made available to provide this sort of intervention. Through the publication of this protocol, readers will ultimately be able to assess whether the review was conducted according to a pre-defined plan. Researchers will be aware that the review is underway, thereby avoid duplication, and be able to use it as a basis for planning similar reviews. PMID:21835031

  20. End-inspiratory airway occlusion: a method to assess the pressure developed by inspiratory muscles in patients with acute lung injury undergoing pressure support.

    PubMed

    Foti, G; Cereda, M; Banfi, G; Pelosi, P; Fumagalli, R; Pesenti, A

    1997-10-01

    We evaluated the end-inspiratory occlusion maneuver as a means to estimate the inspiratory effort during pressure support ventilation (PS). In nine nonobstructed acute lung injury (ALI) patients, we applied four levels of PS (0, 5, 10, 15 cm H2O) to modify the inspiratory effort. End inspiratory occlusions (2 to 3 s) were performed at the end of each experimental period by pushing the inspiratory hold button of the ventilator (Servo 900 C; Siemens, Berlin, Germany). We took the difference between the end-inspiratory occlusion plateau pressure and the airway pressure before the occlusion (PEEP + PS) as an estimate of the inspiratory effort and called it PMI (Pmusc,index). From the esophageal pressure tracing we obtained a reference measurement of the pressure developed by the inspiratory muscles at end inspiration (Pmusc,ei) and of the pressure-time product per breath (PTP/b) and per minute (PTP/min). In each patient, PMI was correlated with Pmusc,ei (p < 0.01) and PTP/b (p < 0.01). A PMI threshold of 6 cm H2O detected PTP/min < 125 cm H2O s/min with a sensitivity of 0.89 and a specificity of 0.89. We conclude that PMI is a good estimate of the pressure developed by the inspiratory muscles in ALI patients and may be used to titrate PS level. The major advantage of PMI is that it can be obtained from the ventilator display without any additional equipment.

  1. Comparison of incremental and constant load tests of inspiratory muscle endurance in COPD.

    PubMed

    Hill, K; Jenkins, S C; Philippe, D L; Shepherd, K L; Hillman, D R; Eastwood, P R

    2007-09-01

    The aim of the present study was to determine the relative value of incremental and constant load tests in detecting changes in inspiratory muscle endurance following high-intensity inspiratory muscle training (H-IMT) in chronic obstructive pulmonary disease. In total, 16 subjects (11 males; forced expiratory volume in one second (FEV(1)) 37.4+/-12.5%) underwent H-IMT. In addition, 17 subjects (11 males; FEV(1) 36.5+/-11.5%) underwent sham inspiratory muscle training (S-IMT). Training took place three times a week for 8 weeks. Baseline and post-training measurements were obtained of maximum threshold pressure sustained during an incremental load test (P(th,max)) and time breathing against a constant load (t(lim)). Breathing pattern was unconstrained. H-IMT increased P(th,max) and t(lim) relative to baseline and to any change seen following S-IMT. The effect size for P(th,max) was greater than for t(lim). Post-training tests were accompanied by changes in breathing pattern, including decreased duty cycle, which may have served to decrease inspiratory work and thereby contribute to the increase in P(th,max) and t(lim) in both groups. When assessing inspiratory muscle function in chronic obstructive pulmonary disease via tests in which the pattern of breathing is unconstrained, the current authors recommend incremental load tests be used in preference to constant load tests. However, to attribute changes in these tests to improvements in inspiratory muscle endurance, breathing pattern should be controlled.

  2. Ipsilateral inspiratory intercostal muscle activity after C2 spinal cord hemisection in rats.

    PubMed

    Beth Zimmer, M; Grant, Joshua S; Ayar, Angelo E; Goshgarian, Harry G

    2015-03-01

    Upper cervical spinal cord hemisection causes paralysis of the ipsilateral hemidiaphragm; however, the effect of C2 hemisection on the function of the intercostal muscles is not clear. We hypothesized that C2 hemisection would eliminate inspiratory intercostal activity ipsilateral to the injury and that some activity would return in a time-dependent manner. Female Sprague Dawley rats were anesthetized with urethane and inspiratory intercostal electromyogram (EMG) activity was recorded in control rats, acutely injured C2 hemisected rats, and at 1 and 16 weeks post C2 hemisection. Bilateral recordings of intercostal EMG activity showed that inspiratory activity was reduced immediately after injury and increased over time. EMG activity was observed first in rostral spaces followed by recovery occurring in caudal spaces. Theophylline increased respiratory drive and increased intercostal activity, inducing activity that was previously absent. These results suggest that there are crossed, initially latent, respiratory connections to neurons innervating the intercostal muscles similar to those innervating phrenic motor neurons.

  3. Inspiratory muscle warm-up attenuates muscle deoxygenation during cycling exercise in women athletes.

    PubMed

    Cheng, Ching-Feng; Tong, Tomas K; Kuo, Yu-Chi; Chen, Pin-Hui; Huang, Hsin-Wei; Lee, Chia-Lun

    2013-05-01

    This study examines the effects of inspiratory muscle warm-up (IMW) on performance and muscle oxygenation during cycling exercise. In a randomized crossover study of 10 female soccer players, the IMW, placebo (IMWP) and control (CON) trials were conducted before two 6-min submaximal cycling exercises (100 and 150W) followed by intermittent high-intensity sprint (IHIS, 6×10s with 60s recovery). The reduction in tissue saturation index (TSI) in legs in the IMW were significantly less than those in IMWP and CON (P<0.01) during submaximal cycling exercises. The average reduction in TSI during the IHIS test with IMW was significantly less than those in the IMWP and CON (P=0.023). Nevertheless, the IHIS performance with IMW did not differ from that in other trials. In conclusion, the leg TSI during continuous submaximal cycling exercise followed by intermittent sprinting was likely improved by specific IMW (40% maximal inspiratory mouth pressure), which did not enhance IHIS performance. Copyright © 2013 Elsevier B.V. All rights reserved.

  4. Molecular and physiological events in respiratory muscles and blood of rats exposed to inspiratory threshold loading.

    PubMed

    Domínguez-Álvarez, Marisol; Sabaté-Brescó, Marina; Vilà-Ubach, Mònica; Gáldiz, Juan B; Alvarez, Francisco J; Casadevall, Carme; Gea, Joaquim; Barreiro, Esther

    2014-05-01

    High-intensity exercise induces oxidative stress and inflammatory events in muscles. Tumor necrosis factor (TNF)-α may alter muscle protein metabolism or promote muscle regeneration. We hypothesized that a program of noninvasive chronic inspiratory loading of different intensities induces a differential pattern of physiological, molecular, and cellular events within rat diaphragms. Antioxidants and TNF-α blockade may influence those events. In the diaphragm, gastrocnemius, and blood of rats exposed to high-intensity inspiratory threshold loads (2 hour every 24 hours for 14 days), with and without treatment with N-acetyl cysteine or infliximab (anti-TNF-α antibody), inflammatory cells and cytokines, superoxide anion production, myogenesis markers, and muscle structure were explored. In all animals, maximum inspiratory pressure (MIP) and body weight were determined. High-intensity inspiratory loading for 2 weeks caused a decline in MIP and body weight, and in the diaphragm induced a reduction in fast-twitch fiber proportions and sizes, whereas inflammatory cells and cytokine levels, including TNF-α immunohistochemical expression, superoxide anion, internal nuclei counts, and markers of myogenesis were increased. Blockade of TNF-α improved respiratory muscle function and structure, and animal weight, and, in the diaphragm, reduced inflammatory cell numbers and superoxide anion production drastically while inducing larger increases in protein and messenger RNA levels and immunohistochemical expression of TNF-α, internal nuclei, and markers of muscle regeneration. Blunting of TNF-α also induced a reduction in blood inflammatory cytokines and superoxide anion production. We conclude that TNF-α synthesized by inflammatory cells or myofibers could have differential effects on muscle structure and function in response to chronic, noninvasive, high-intensity inspiratory threshold loading.

  5. Training the inspiratory muscles improves running performance when carrying a 25 kg thoracic load in a backpack.

    PubMed

    Faghy, Mark A; Brown, Peter I

    2016-08-01

    Load carriage (LC) exercise in physically demanding occupations is typically characterised by periods of low-intensity steady-state exercise and short duration, high-intensity exercise while carrying an external mass in a backpack; this form of exercise is also known as LC exercise. This induces inspiratory muscle fatigue and reduces whole-body performance. Accordingly we investigated the effect of inspiratory muscle training (IMT, 50% maximal inspiratory muscle pressure (PImax) twice daily for six week) upon running time-trial performance with thoracic LC. Nineteen healthy males formed a pressure threshold IMT (n = 10) or placebo control group (PLA; n = 9) and performed 60 min LC exercise (6.5 km h(-1)) followed by a 2.4 km running time trial (LCTT) either side of a double-blind six week intervention. Prior to the intervention, PImax was reduced relative to baseline, post-LC and post-LCTT in both groups (pooled data: 13 ± 7% and 16 ± 8%, respectively, p < .05) and similar changes were observed post-PLA. Post-IMT only, resting PImax increased +31% (p < .05) and relative to pre-IMT was greater post-LC (+19%) and post-LCTT (+18%, p < .05), however, the relative reduction in PImax at each time point was unchanged (13 ± 11% and 17 ± 9%, respectively, p > .05). In IMT only, heart rate and perceptual responses were reduced post-LC (p < .05). Time-trial performance was unchanged post-PLA and improved 8 ± 4% after IMT (p < .05). In summary, when wearing a 25 kg backpack, IMT attenuated the cardiovascular and perceptual responses to steady-state exercise and improved high-intensity time-trial performance which we attribute in part to reduced relative work intensity of the inspiratory muscles due to improved inspiratory muscle strength. These findings have real-world implications for occupational contexts.

  6. Impact of a Behavioral-Based Intervention on Inspiratory Muscle Training Prescription by a Multidisciplinary Team

    ERIC Educational Resources Information Center

    Simms, Alanna M.; Li, Linda C.; Geddes, E. Lynne; Brooks, Dina; Hoens, Alison M.; Reid, W. Darlene

    2012-01-01

    Introduction: Our goal was to compare behavioral- and information-based interventions aimed at increasing prescription of inspiratory muscle training (IMT) for people with chronic obstructive pulmonary disease (COPD) by interdisciplinary teams during pulmonary rehabilitation (PR). Methods: Six hospital PR programs were randomly assigned to a…

  7. Impact of a Behavioral-Based Intervention on Inspiratory Muscle Training Prescription by a Multidisciplinary Team

    ERIC Educational Resources Information Center

    Simms, Alanna M.; Li, Linda C.; Geddes, E. Lynne; Brooks, Dina; Hoens, Alison M.; Reid, W. Darlene

    2012-01-01

    Introduction: Our goal was to compare behavioral- and information-based interventions aimed at increasing prescription of inspiratory muscle training (IMT) for people with chronic obstructive pulmonary disease (COPD) by interdisciplinary teams during pulmonary rehabilitation (PR). Methods: Six hospital PR programs were randomly assigned to a…

  8. Effect of inspiratory muscle warm-up on submaximal rowing performance.

    PubMed

    Arend, Mati; Mäestu, Jarek; Kivastik, Jana; Rämson, Raul; Jürimäe, Jaak

    2015-01-01

    Performing inspiratory muscle warm-up might increase exercise performance. The aim of this study was to investigate the impact of inspiratory muscle warm-up to submaximal rowing performance and to find if there is an effect on lactic acid accumulation and breathing parameters. Ten competitive male rowers aged between 19 and 27 years (age, 23.1 ± 3.8 years; height, 188.1 ± 6.3 cm; body mass, 85.6 ± 6.6 kg) were tested 3 times. During the first visit, maximal inspiratory pressure (MIP) assessment and the incremental rowing test were performed to measure maximal oxygen consumption and maximal aerobic power (Pamax). A submaximal intensity (90% Pamax) rowing test was performed twice with the standard rowing warm-up as test 1 and with the standard rowing warm-up and specific inspiratory muscle warm-up as test 2. During the 2 experimental tests, distance, duration, heart rate, breathing frequency, ventilation, peak oxygen consumption, and blood lactate concentration were measured. The only value that showed a significant difference between the test 1 and test 2 was breathing frequency (52.2 ± 6.8 vs. 53.1 ± 6.8, respectively). Heart rate and ventilation showed a tendency to decrease and increase, respectively, after the inspiratory muscle warm-up (p < 0.1). Despite some changes in respiratory parameters, the use of 40% MIP intensity warm-up is not suggested if the mean intensity of the competition is at submaximal level (at approximately 90% maximal oxygen consumption). In conclusion, the warm-up protocol of the respiratory muscles used in this study does not have a significant influence on submaximal endurance performance in highly trained male rowers.

  9. Inspiratory muscle fatigue after race-paced swimming is not restricted to the front crawl stroke.

    PubMed

    Lomax, Mitch; Iggleden, Colin; Tourell, Alice; Castle, Sophie; Honey, Jo

    2012-10-01

    The occurrence of inspiratory muscle fatigue (IMF) has been documented after front crawl (FC) swimming of various distances. Whether IMF occurs after other competitive swimming strokes is not known. The aim of the present study was to assess the impact of all 4 competitive swimming strokes on the occurrence of IMF after race-paced swimming and to determine whether the magnitude of IMF was related to the breathing pattern adopted and hence breathing frequency (f(b)). Eleven, nationally ranked, youth swimmers completed four 200-m swims (one in each competitive stroke) on separate occasions. The order of the swims, which consisted of FC, backstroke (BK), breaststroke (BR), and butterfly (FLY), was randomized. Maximal inspiratory mouth pressure (MIP) was assessed before (after a swimming and inspiratory muscle warm-up) and after each swim with f(b) calculated post swim from recorded data. Inspiratory muscle fatigue was evident after each 200-m swim (p < 0.05) but did not differ between the 4 strokes (range 18-21%). No relationship (p > 0.05) was observed between f(b) and the change in MIP (FC: r = -0.456; BK: r = 0.218; BR: r = 0.218; and FLY: r = 0.312). These results demonstrate that IMF occurs in response to 200-m race-paced swimming in all strokes and that the magnitude of IMF is similar between strokes when breathing is ad libitum occurring no less than 1 breath (inhalation) every third stroke.

  10. Respiratory muscle strength and training in stroke and neurology: a systematic review.

    PubMed

    Pollock, Ross D; Rafferty, Ged F; Moxham, John; Kalra, Lalit

    2013-02-01

    We undertook two systematic reviews to determine the levels of respiratory muscle weakness and effects of respiratory muscle training in stroke patients. Two systematic reviews were conducted in June 2011 using a number of electronic databases. Review 1 compared respiratory muscle strength in stroke and healthy controls. Review 2 was expanded to include randomized controlled trials assessing the effects of respiratory muscle training on stroke and other neurological conditions. The primary outcomes of interest were maximum inspiratory and expiratory mouth pressure (maximum inspiratory pressure and maximum expiratory pressure, respectively). Meta-analysis of four studies revealed that the maximum inspiratory pressure and maximum expiratory pressure were significantly lower (P < 0·00001) in stroke patients compared with healthy individuals (weighted mean difference -41·39 and -54·62 cmH(2) O, respectively). Nine randomized controlled trials indicate a significantly (P = 0·0009) greater effect of respiratory muscle training on maximum inspiratory pressure in neurological patients compared with control subjects (weighted mean difference 6·94 cmH(2) O) while no effect on maximum expiratory pressure. Respiratory muscle strength appears to be impaired after stroke, possibly contributing to increased incidence of chest infection. Respiratory muscle training can improve inspiratory but not expiratory muscle strength in neurological conditions, although the paucity of studies in the area and considerable variability between them is a limiting factor. Respiratory muscle training may improve respiratory muscle function in neurological conditions, but its clinical benefit remains unknown.

  11. Distribution of inspiratory drive to the external intercostal muscles in humans

    PubMed Central

    De Troyer, André; Gorman, Robert B; Gandevia, Simon C

    2003-01-01

    The external intercostal muscles in humans show marked regional differences in respiratory effect, and this implies that their action on the lung during breathing is primarily determined by the spatial distribution of neural drive among them. To assess this distribution, monopolar electrodes were implanted under ultrasound guidance in different muscle areas in six healthy individuals and electromyographic recordings were made during resting breathing. The muscles in the dorsal portion of the third and fifth interspace showed phasic inspiratory activity with each breath in every subject. However, the muscle in the ventral portion of the third interspace showed inspiratory activity in only three subjects, and the muscle in the dorsal portion of the seventh interspace was almost invariably silent. Also, activity in the ventral portion of the third interspace, when present, and activity in the dorsal portion of the fifth interspace were delayed relative to the onset of activity in the dorsal portion of the third interspace. In addition, the discharge frequency of the motor units identified in the dorsal portion of the third interspace averaged (mean ± s.e.m.) 11.9 ± 0.3 Hz and was significantly greater than the discharge frequency of the motor units in both the ventral portion of the third interspace (6.0 ± 0.5 Hz) and the dorsal portion of the fifth interspace (6.7 ± 0.4 Hz). The muscle in the dorsal portion of the third interspace started firing simultaneously with the parasternal intercostal in the same interspace, and the discharge frequency of its motor units was even significantly greater (11.4 ± 0.3 vs. 8.9 ± 0.2 Hz). These observations indicate that the distribution of neural inspiratory drive to the external intercostals in humans takes place along dorsoventral and rostrocaudal gradients and mirrors the spatial distribution of inspiratory mechanical advantage. PMID:12563017

  12. [Measurement of the reserve function of inspiratory muscle and its clinical significance].

    PubMed

    Xiao, X; Luo, Y; Chen, W; Yuan, Y; He, T; Zeng, J

    1995-06-01

    The principles of measuring inspiratory muscle tension-time index (TTim) and the ratio of the works of inspiration over the maximal works of inspiration (Wi/Wi(max)) were investigated and their formulae were deduced, i.e. TTim = (Pi x Ti)/(MIP x Ttot) and Wi/Wi(max) = (Pi x VT)/(MIP x IC). The importance of the inspiratory pressure and the maximal inspiratory pressure (MIP) measured at function residual capacity (FRC) level was emphasized. Both TTim and Wi/Wi(max) were measured in 35 normal subjects and 89 patients with chronic obstructive pulmonary disease (COPD). The results showed that normal value of TTim was 0.0253 +/- 0.0055 which corresponds to the normal value of the diaphragm tension-time index (TTdi = 0.02-0.03) reported by Bellemare. Patients with COPD had a mean TTim much higher than that of normals (P < 0.01). The works of inspiration (Wi) in patients with COPD increased, while the maximal works of inspiration (Wi(max)) declined, so Wi/Wi(max) became significantly greater than that of normals (P < 0.01). The results also showed that there was a linear relationship between Pi/Pimax and TTim or Wi/Wimax (r = 0.7891, 0.9738, 0.6459, 0.9327, P < 0.01). Therefore, we suggest that both TTim and Wi/Wimax can be used as clinical indices to reflect the reserve function of inspiratory muscles.

  13. Effects of inspiratory muscle training on exercise capacity and spontaneous physical activity in elderly subjects: a randomized controlled pilot trial.

    PubMed

    Aznar-Lain, S; Webster, A L; Cañete, S; San Juan, A F; López Mojares, L M; Pérez, M; Lucia, A; Chicharro, J L

    2007-12-01

    Inspiratory muscle training (IMT) has been shown to improve exercise capacity in diseased populations. We chose to examine the effects of eight weeks of IMT on exercise capacity and spontaneous physical activity in elderly individuals. Eighteen moderately active elderly subjects (68.1 +/- 6.8 years [mean +/- SD]; range 58 - 78 years) were randomly assigned to either an experimental group (n = 9) or a control group (n = 9) in a double-blind manner. All subjects underwent inspiratory muscle testing, treadmill exercise testing and a four-day measurement period of spontaneous physical activity (using accelerometry) both pre- and post-intervention. The experimental group underwent eight weeks of incremental IMT using a pressure threshold device, while the control group underwent sham training using identical devices. After IMT training, inspiratory muscle strength (mean + 21.5 cm H (2)O; 95 % CI: 9.3, 33.7; p = 0.002), V.O (2peak) (+ 2.8 ml x min (-1) x kg (-1); 95 % CI: 0.5, 5.2; p = 0.022), time to exhaustion during a fixed workload treadmill test (+ 7.1 min; 95 % CI: 1.8, 2.4; p = 0.013) and time engaged in moderate-to-vigorous physical activity (+ 59 min; 95 % CI: 15, 78; p = 0.008) improved. Except for a decline in moderate-to-vigorous physical activity, no significant changes were seen in the control group. Therefore, IMT may be a useful technique for positively influencing exercise capacity and physical activity in elderly individuals.

  14. Effect of acute inflation on the mechanics of the inspiratory muscles.

    PubMed

    De Troyer, André; Wilson, Theodore A

    2009-07-01

    When the lung is inflated acutely, the capacity of the diaphragm to generate pressure, in particular pleural pressure (Ppl), is impaired because the muscle during contraction is shorter and generates less force. At very high lung volumes, the pressure-generating capacity of the diaphragm may be further reduced by an increase in the muscle radius of curvature. Lung inflation similarly impairs the pressure-generating capacity of the inspiratory intercostal muscles, both the parasternal intercostals and the external intercostals. In contrast to the diaphragm, however, this adverse effect is largely related to the orientation and motion of the ribs, rather than the ability of the muscles to generate force. During combined activation of the two sets of muscles, the change in Ppl is larger than during isolated diaphragm activation, and this added load on the diaphragm reduces the shortening of the muscle and increases muscle force. In addition, activation of the diaphragm suppresses the cranial displacement of the passive diaphragm that occurs during isolated intercostal contraction and increases the respiratory effect of the intercostals. As a result, the change in Ppl generated during combined diaphragm-intercostal activation is greater than the sum of the pressures generated during separate muscle activation. Although this synergistic interaction becomes particularly prominent at high lung volumes, lung inflation, either bilateral or unilateral, places a substantial stress on the inspiratory muscle pump.

  15. Activation of human inspiratory muscles in an upside-down posture.

    PubMed

    Hudson, Anna L; Joulia, Fabrice; Butler, Annie A; Fitzpatrick, Richard C; Gandevia, Simon C; Butler, Jane E

    2016-06-01

    During quiet breathing, activation of obligatory inspiratory muscles differs in timing and magnitude. To test the hypothesis that this coordinated activation can be modified, we determined the effect of the upside-down posture compared with standing and lying supine. Subjects (n=14) breathed through a pneumotachometer with calibrated inductance bands around the chest wall and abdomen. Surface electromyographic activity (EMG) was recorded from the scalene muscles. Crural diaphragmatic EMG and oesophageal and gastric pressures were measured in a subset of six subjects. Quiet breathing and standard lung function manoeuvres were performed. The upside-down posture reduced end-expiratory lung volume. During quiet breathing, for the same inspiratory airflow and tidal volume, ribcage contribution decreased, abdominal contribution increased and transdiaphragmatic pressure swing doubled in the upside-down posture compared to standing (p<0.05). Despite this, crural diaphragm EMG was unchanged, whereas scalene muscle EMG was reduced by ∼half (p<0.05). Thus, the mechanical effect of an upside-down posture differentially affects inspiratory muscle activation. Copyright © 2015 Elsevier B.V. All rights reserved.

  16. A comparison of the Acapella and a threshold inspiratory muscle trainer for sputum clearance in bronchiectasis-A pilot study.

    PubMed

    Naraparaju, Sushmitha; Vaishali, K; Venkatesan, Prem; Acharya, Vishak

    2010-08-01

    Inspiratory muscle training is used to specifically strengthen the respiratory muscles. Controversy exists regarding the use of inspiratory muscle training as a method of facilitating airways clearance. Acapella is already known to be effective in airway clearance. The objective of the study was to compare the effects of the Acapella and a threshold inspiratory muscle trainer as a method of airway clearance in subjects with bronchiectasis and to determine patient preference between the two techniques. Thirty patients (10 males, 20 females) mean age of 50.67+/-6.37 (mean+/-SD) with a history of expectoration of more than 30 ml sputum per day were recruited. The sequence of therapy was allocated by block randomization. Assessment and familiarization session was performed on day 1. Treatments employing the Acapella and inspiratory muscle trainer were done on days 2 and 3. Treatment order and allocation was determined by block randomization. Sputum volume was measured during and 2 hours after the treatment and patient treatment preference was recorded. A statistically significant difference was found in the sputum volume expectorated after treatment with the Acapella (7.16+/-1.12 ml) compared with the threshold inspiratory muscle trainer (6.46+/-1.08 ml). Patients preferred Acapella in terms of usefulness of clearing secretions. The present study demonstrated increased sputum clearance following the use of the Acapella when compared to the threshold inspiratory muscle trainer. In addition, the Acapella was preferred by patients who judged that it was more useful in clearing secretions.

  17. Maximal inspiratory mouth pressure in Japanese elite male athletes.

    PubMed

    Ohya, Toshiyuki; Hagiwara, Masahiro; Chino, Kentaro; Suzuki, Yasuhiro

    2016-08-01

    Maximal inspiratory mouth pressure (MIP) is a common measurement of inspiratory muscle strength, which is often used in a variety of exercises to evaluate the effects of inspiratory muscle training. An understanding of elite athletes' MIP characteristics is needed to guide sport-specific inspiratory muscle training programs. The purpose of this study was to investigate and better understand the MIP characteristics of elite athletes from a variety of sports. A total of 301 Japanese elite male athletes participated in this study. MIP was assessed using a portable autospirometer with a handheld mouth pressure meter. Athletes with higher body mass tended to have stronger MIP values, in absolute terms. In relative terms, however, athletes who regularly experienced exercise-induced inspiratory muscle fatigue tended to have stronger MIP values. Our findings suggest that athletes could benefit from prescribed, sport-specific, inspiratory muscle training or warm-ups. Copyright © 2016 Elsevier B.V. All rights reserved.

  18. Relation between hand grip strength, respiratory muscle strength and spirometric measures in male nursing home residents.

    PubMed

    Bahat, Gulistan; Tufan, Asli; Ozkaya, Hilal; Tufan, Fatih; Akpinar, Timur Selçuk; Akin, Sibel; Bahat, Zumrut; Kaya, Zuleyha; Kiyan, Esen; Erten, Nilgün; Karan, Mehmet Akif

    2014-09-01

    Adverse-outcomes related to sarcopenia are mostly mentioned as physical disability. As the other skeletal muscles, respiratory muscles may also be affected by sarcopenia. Respiratory muscle strength is known to affect pulmonary functions. Therefore, we aimed to investigate the relations between extremity muscle strength, respiratory muscle strengths and spirometric measures in a group of male nursing home residents. Among a total of 104 male residents, residents with obstructive measures were excluded and final study population was composed of 62 residents. Mean age was 70.5 ± 6.7 years, body mass index: 27.7 ± 5.3 kg/m2 and dominant hand grip strength: 29.7 ± 6.5 kg. Hand grip strength was positively correlated with maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) (r = 0.35, p < 0.01 and r = 0.26, p < 0.05, respectively). In regression analysis, the only factor related to MIP was hand grip strength; among spirometric measures only parameter significantly related to grip strength was peak cough flow (PCF). The association of PCF with grip strength disappeared when MIP alone or "MIP and MEP" were included in the regression analysis. In the latter case, PCF was significantly associated only with MIP. We found peripheric muscle strength be associated with MIP and PCF but not with MEP or any other spirometric parameters. The relation between peripheral muscle strength and PCF was mediated by MIP. Our findings suggest that sarcopenia may affect inspiratory muscle strength earlier or more than the expiratory muscle strength. Sarcopenia may cause decrease in PCF in the elderly, which may stand for some common adverse respiratory complications.

  19. Inspiratory muscle performance in endurance-trained elderly males during incremental exercise.

    PubMed

    Chlif, Mehdi; Keochkerian, David; Temfemo, Abdou; Choquet, Dominique; Ahmaidi, Said

    2016-07-01

    The aim of this study was to compare the inspiratory muscle performance during an incremental exercise of twelve fit old endurance-trained athletes (OT) with that of fit young athletes (YT) and healthy age-matched controls (OC). The tension-time index (TT0.1) was determined according to the equation TT0.1=P0.1/PImax×ti/ttot, where P0.1 is the mouth occlusion pressure, PImax the maximal inspiratory pressure and ti/ttot the duty cycle. For a given VCO2, OT group displayed P0.1, P0.1/PImax ratio, TT0.1 and effective impedance of the respiratory muscle values which were lower than OC group and higher than YT group. At maximal exercise, P0.1/PImax ratio and TT0.1 was still lower in the OT group than OC group and higher than YT group. This study showed lower inspiratory muscle performance attested by a higher (TT0.1) during exercise in the OT group than YT group, but appeared to be less marked in elderly men having performed lifelong endurance training compared with sedentary elderly subjects. Copyright © 2016 Elsevier B.V. All rights reserved.

  20. RESPIRATORY MUSCLE STRENGTH IN IDIOPATHIC SCOLIOSIS AFTER TRAINING PROGRAM.

    PubMed

    Alves, Vera Lúcia Dos Santos; Avanzi, Osmar

    2016-01-01

    To analyze the impact of a physiotherapy protocol in maximum inspiratory and expiratory pressure in patients with adolescent idiopathic scoliosis (AIS) by manovacuometry. AIS may change the respiratory dynamics and the performance of inspiratory and expiratory muscles, affecting ventilatory capacity. Patients with AIS aged 10 to 20 years old were randomly assigned to receive an aerobic exercise-training program or no treatment. They were evaluated for respiratory muscle strength before and after the treatment period by means of manovacuometry, thorax and spine radiographs. Physical therapy exercising protocol comprised three weekly sessions including stretching and aerobic exercises during four months. Forty five patients received physical therapy and 45 patients received no treatment (control group). The mean maximum inspiratory pressure (Pimax) was -52.13 cm H20 and the maximum expiratory pressure (Pemax) was 62.38 cm H20. There was a significant increase of Pimax and Pemax (p=0,000) in the group receiving physical therapy. There were no drop-outs and no adverse events in this study. Respiratory muscle strength, scoliosis and kyphosis degrees were not statistically correlated. Exercising is beneficial to patients with AIS, who have shown significant increases in respiratory muscle strength after physical therapy. There was no correlation between respiratory pressure and spine deformity. Level of Evidence I, High quality randomized trial.

  1. The Borg dyspnoea score: a relevant clinical marker of inspiratory muscle weakness in amyotrophic lateral sclerosis.

    PubMed

    Just, N; Bautin, N; Danel-Brunaud, V; Debroucker, V; Matran, R; Perez, T

    2010-02-01

    The aim of the study was to determine whether the Borg dyspnoea scale could be a useful and simple marker to predict respiratory muscle weakness in amyotrophic lateral sclerosis (ALS). From April 1997 to 2001, respiratory function was perfomed in 72 patients together with the Borg score in both the upright (uBorg) and supine (sBorg) positions. Mean upright vital capacity (VC) was 81+/-24% predicted, sniff nasal inspiratory pressure (SNIP) was 55+/-26% pred, maximal inspiratory pressure (P(I,max)) was 57+/-26% pred and arterial carbon dioxide tension (P(a,CO(2))) was 41+/-6 mmHg. The mean Borg scores in the upright and supine positions were 1.7+/-1.5 and 2.2+/-2, respectively. A significant relationship between SNIP and uBorg (r = 0.4; p = 0.0007) and SNIP and sBorg (r = 0.58; p<0.0001) was observed. Upright VC, DeltaVC (measured as the supine fall in VC as a percentage of seated VC), P(I,max) and P(a,CO(2)) were significantly correlated with SNIP. A cut-off value of 3 on the sBorg scale provided the best sensitivity (80%) and specificity (78%) (area under the curve 0.8) to predict a SNIP < or =40 cmH(2)O, indicating severe inspiratory muscle weakness. Patients with a sBorg score > or =3 also exhibited significantly lower VC, P(I,max) and twitch mouth pressure during cervical magnetic stimulation, and slightly higher P(a,CO(2)) (43.7+/-7 versus 39.2+/-5 mmHg; p = 0.05). The Borg dyspnoea scale is a valuable noninvasive test for the prediction of inspiratory muscle weakness in ALS patients.

  2. Inspiratory muscle training during pulmonary rehabilitation in chronic obstructive pulmonary disease: A randomized trial.

    PubMed

    Beaumont, M; Mialon, P; Le Ber-Moy, C; Lochon, C; Péran, L; Pichon, R; Gut-Gobert, C; Leroyer, C; Morelot-Panzini, C; Couturaud, F

    2015-11-01

    Although recommended by international guidelines, the benefit of inspiratory muscle training (IMT) in addition to rehabilitation remains uncertain. The objective was to demonstrate the effectiveness of IMT on dyspnea using Borg scale and multidimensional dyspnea profile questionnaire at the end of a 6-minute walk test (6MWT) in patients with chronic obstructive pulmonary disease (COPD) with preserved average maximum inspiratory pressure (PImax) of 85 cm H2O (95% of predicted (pred.) value) and admitted for a rehabilitation program in a dedicated center. In a randomized trial, comparing IMT versus no IMT in 32 COPD patients without inspiratory muscle weakness (PImax >60 cm H2O) who were admitted for pulmonary rehabilitation (PR) for 3 weeks, we evaluated the effect of IMT on dyspnea, using both Borg scale and multidimensional dyspnea profile (MDP) at the end of the 6MWT, and on functional parameters included inspiratory muscle function (PImax) and 6MWT. All testings were performed at the start and the end of PR. In unadjusted analysis, IMT was not found to be associated with an improvement of either dyspnea or PImax. After adjustment on confounders (initial Borg score) and variables of interaction (forced expiratory volume in 1 second (FEV1)), we found a trend toward an improvement of "dyspnea sensory intensity", items from MDP and a significant improvement on the variation in the 2 items of MDP ("tight or constricted" and "breathing a lot"). In the subgroup of patients with FEV1 < 50% pred., 5 items of MDP were significantly improved, whereas no benefit was observed in patients with FEV1 > 50% pred. IMT did not significantly improve dyspnea or functional parameter in COPD patients with PImax > 60 cm H2O. However, in the subgroup of patients with FEV1 < 50% pred., MDP was significantly improved.

  3. Effects of high-intensity inspiratory muscle training following a near-fatal gunshot wound.

    PubMed

    Hill, Kylie; Gain, Kevin R; McKay, Sean W; Nathan, Christine; Gabbay, Eli

    2011-09-01

    Severe injuries sustained during combat may classify individuals as undeployable for active service. It is imperative that every effort is made to optimize physical function following such injuries. A 38-year-old man sustained a gunshot wound during armed combat. The bullet entered via the left axilla and exited from the right side of the abdomen, resulting in severe thoracic and abdominal injuries. Five months later, he continued to describe severe dyspnea on exertion. During a cardiopulmonary exercise test on a cycle ergometer, he achieved a maximum rate of oxygen uptake of 2,898 mL·min(-1) (114% predicted) and maximum power of 230 W (114% predicted). His maximum forced inspiratory flow was 5.95 L·s(-1), and inspiratory reserve volume at test end was ∼80 mL. The test was terminated by the patient due to dyspnea that was too severe to tolerate. Video fluoroscopy demonstrated impaired right hemidiaphragm function. The main goals of therapy were to reduce dyspnea on exertion and to enable return to full work duties. A program of high-intensity, interval-based threshold inspiratory muscle training (IMT) was undertaken. An average of 5 sessions of IMT were completed each week for 10 weeks. During a repeat cardiopulmonary exercise test, the patient achieved a similar power and maximum rate of oxygen uptake. His maximum forced inspiratory flow increased by 48% to 8.83 L·s(-1), and he was limited by leg fatigue. High-intensity IMT was safe and well tolerated. It was associated with improvements in maximum forced inspiratory flow and changed the locus of symptom limitation during high-intensity exercise from dyspnea to leg fatigue.

  4. Effects of inspiratory muscle training upon recovery time during high intensity, repetitive sprint activity.

    PubMed

    Romer, L M; McConnell, A K; Jones, D A

    2002-07-01

    The present study examined the influence of specific inspiratory muscle training (IMT) upon recovery time during repetitive sprint activity, as well as the physiological and perceptual responses to fixed intensity shuttle running. Using a double-blind placebo-controlled design, 24 male repetitive sprint athletes were assigned randomly to either an IMT (n = 12) or placebo (n = 12) group. The self-selected recovery time during a repetitive sprint test and the physiological response to submaximal endurance exercise were determined. Following completion of baseline and pre-intervention measures, the IMT group performed 30 inspiratory efforts twice daily against a resistance equivalent to 50 % maximum inspiratory mouth pressure (MIP) for 6 wk. The placebo group performed 60 breaths once daily, for 6 wk, at a resistance equivalent to 15 % MIP, a load known to elicit negligible changes in respiratory muscle function. The IMT group improved total recovery time during the repetitive sprint test by 6.2 +/- 1.1 % (mean +/- SEM) above the changes noted for the placebo group (p = 0.006). Blood lactate and perceptual responses to submaximal exercise were also significantly attenuated following IMT (p

  5. Ipsilateral inspiratory intercostal muscle activity after C2 spinal cord hemisection in rats

    PubMed Central

    Beth Zimmer, M.; Grant, Joshua S.; Ayar, Angelo E.; Goshgarian, Harry G.

    2015-01-01

    Background Upper cervical spinal cord hemisection causes paralysis of the ipsilateral hemidiaphragm; however, the effect of C2 hemisection on the function of the intercostal muscles is not clear. We hypothesized that C2 hemisection would eliminate inspiratory intercostal activity ipsilateral to the injury and that some activity would return in a time-dependent manner. Methods Female Sprague Dawley rats were anesthetized with urethane and inspiratory intercostal electromyogram (EMG) activity was recorded in control rats, acutely injured C2 hemisected rats, and at 1 and 16 weeks post C2 hemisection. Results Bilateral recordings of intercostal EMG activity showed that inspiratory activity was reduced immediately after injury and increased over time. EMG activity was observed first in rostral spaces followed by recovery occurring in caudal spaces. Theophylline increased respiratory drive and increased intercostal activity, inducing activity that was previously absent. Conclusion These results suggest that there are crossed, initially latent, respiratory connections to neurons innervating the intercostal muscles similar to those innervating phrenic motor neurons. PMID:24969369

  6. Effects of concurrent inspiratory and expiratory muscle training on respiratory and exercise performance in competitive swimmers.

    PubMed

    Wells, Gregory D; Plyley, Michael; Thomas, Scott; Goodman, Len; Duffin, James

    2005-08-01

    The efficiency of the respiratory system presents significant limitations on the body's ability to perform exercise due to the effects of the increased work of breathing, respiratory muscle fatigue, and dyspnoea. Respiratory muscle training is an intervention that may be able to address these limitations, but the impact of respiratory muscle training on exercise performance remains controversial. Therefore, in this study we evaluated the effects of a 12-week (10 sessions week(-1)) concurrent inspiratory and expiratory muscle training (CRMT) program in 34 adolescent competitive swimmers. The CRMT program consisted of 6 weeks during which the experimental group (E, n = 17) performed CRMT and the sham group (S, n = 17) performed sham CRMT, followed by 6 weeks when the E and S groups performed CRMT of differing intensities. CRMT training resulted in a significant improvement in forced inspiratory volume in 1 s (FIV1.0) (P = 0.050) and forced expiratory volume in 1 s (FEV1.0) (P = 0.045) in the E group, which exceeded the S group's results. Significant improvements in pulmonary function, breathing power, and chemoreflex ventilation threshold were observed in both groups, and there was a trend toward an improvement in swimming critical speed after 12 weeks of training (P = 0.08). We concluded that although swim training results in attenuation of the ventilatory response to hypercapnia and in improvements in pulmonary function and sustainable breathing power, supplemental respiratory muscle training has no additional effect except on dynamic pulmonary function variables.

  7. [Effect of methylphenidatum on inspiratory muscles function in patients with chronic obstructive pulmonary disease and its mechanism].

    PubMed

    Wang, Y; Luo, Y; Chen, W; Yuan, Y; He, T; Zeng, J

    1997-03-01

    To have a better understanding of the effect of methylphenidatum on inspiratory muscles function, we studied the respiratory force parameters of 70 patients with chronic obstructive pulmonary disease by intravenous infusion methylphenidatum in a randomized controlled clinical trial. The indices of respiratory force parameter included maximal inspiratory mouth pressure (MIP), maximal midinspiratory flow (MMIF), forced inspiratory capacity (FIC), maximal works of inspiration (Wimax) and airway occlusion pressure (P0.1), etc. Aminophylline and Nikethamidi were chosen as controls. The results showed that MIP, MMIF, FIC, Wimax, P0.1 and minute ventilation (Vr) were significantly increased after administration of methylphenidatum and aminophylline. There were no significant differences in MIP, MMIF, FIC and Wimax after administration of Nikethamidi, but P0.1 was significantly increased and the increase was higher than that after administration of methylphenidatum and aminophylline groups. We conclude that methylphenidatum can significantly improve the function of inspiratory muscles as aminophylline can do.

  8. Function of the canine inspiratory muscle pump in pleural effusion: influence of body position.

    PubMed

    Leduc, Dimitri; De Troyer, André

    2013-04-01

    Pleural effusion, a complicating feature of many diseases of the lung and pleura, adversely affects the pressure-generating capacity of the diaphragm in supine dogs. The objective of the present study was to assess the impact of body position on this effect and to evaluate the adaptation to effusion of the inspiratory muscle pump during breathing. Two experiments were performed. In the first, progressively increasing effusion was induced in anesthetized animals, and the changes in pleural (ΔPpl) and abdominal (ΔPab) pressure were measured during isolated phrenic nerve stimulation while the animals were placed in both the supine and the 45° head-up posture. In the second experiment, graded pleural effusion was also performed, and ΔPpl, ΔPab, and the electromyogram of the parasternal intercostal muscles were measured while the vagotomized animals were breathing spontaneously in the same two postures. The data showed that with effusion 1) ΔPpl during phrenic nerve stimulation was substantially lower with the animals in the head-up than in the supine posture; 2) this postural effect was primarily the result of the decrease in muscle length in the head-up posture; 3) during spontaneous breathing, however, parasternal intercostal inspiratory activity increased and ΔPpl remained unaltered while ΔPab decreased; and 4) the decrease in ΔPab and in the ΔPab/ΔPpl ratio was much larger in the head-up than in the supine posture. It is concluded that in the presence of pleural effusion, the pressure contribution of the inspiratory intercostal muscles during breathing increases and compensates for the shortening of the diaphragm, particularly in the upright posture.

  9. Respiratory muscle training increases respiratory muscle strength and reduces respiratory complications after stroke: a systematic review.

    PubMed

    Menezes, Kênia Kp; Nascimento, Lucas R; Ada, Louise; Polese, Janaine C; Avelino, Patrick R; Teixeira-Salmela, Luci F

    2016-07-01

    After stroke, does respiratory muscle training increase respiratory muscle strength and/or endurance? Are any benefits carried over to activity and/or participation? Does it reduce respiratory complications? Systematic review of randomised or quasi-randomised trials. Adults with respiratory muscle weakness following stroke. Respiratory muscle training aimed at increasing inspiratory and/or expiratory muscle strength. Five outcomes were of interest: respiratory muscle strength, respiratory muscle endurance, activity, participation and respiratory complications. Five trials involving 263 participants were included. The mean PEDro score was 6.4 (range 3 to 8), showing moderate methodological quality. Random-effects meta-analyses showed that respiratory muscle training increased maximal inspiratory pressure by 7 cmH2O (95% CI 1 to 14) and maximal expiratory pressure by 13 cmH2O (95% CI 1 to 25); it also decreased the risk of respiratory complications (RR 0.38, 95% CI 0.15 to 0.96) compared with no/sham respiratory intervention. Whether these effects carry over to activity and participation remains uncertain. This systematic review provided evidence that respiratory muscle training is effective after stroke. Meta-analyses based on five trials indicated that 30minutes of respiratory muscle training, five times per week, for 5 weeks can be expected to increase respiratory muscle strength in very weak individuals after stroke. In addition, respiratory muscle training is expected to reduce the risk of respiratory complications after stroke. Further studies are warranted to investigate whether the benefits are carried over to activity and participation. PROSPERO (CRD42015020683). [Menezes KKP, Nascimento LR, Ada L, Polese JC, Avelino PR, Teixeira-Salmela LF (2016) Respiratory muscle training increases respiratory muscle strength and reduces respiratory complications after stroke: a systematic review.Journal of Physiotherapy62: 138-144]. Copyright © 2016 Australian

  10. The effect of inspiratory muscle training on high-intensity, intermittent running performance to exhaustion.

    PubMed

    Tong, Tom Kwokkeung; Fu, Frank Hokin; Chung, Pak Kwong; Eston, Roger; Lu, Kui; Quach, Binh; Nie, Jinlei; So, Raymond

    2008-08-01

    The effects of inspiratory muscle (IM) training on maximal 20 m shuttle run performance (Ex) during Yo-Yo intermittent recovery test and on the physiological and perceptual responses to the running test were examined. Thirty men were randomly allocated to 1 of 3 groups. The experimental group underwent a 6 week pressure threshold IM training program by performing 30 inspiratory efforts twice daily, 6 d/week, against a load equivalent to 50% maximal static inspiratory pressure. The placebo group performed the same training procedure but with a minimal inspiratory load. The control group received no training. In post-intervention assessments, IM function was enhanced by >30% in the experimental group. The Ex was improved by 16.3% +/- 3.9%, while the rate of increase in intensity of breathlessness (RPB/4i) was reduced by 11.0% +/- 6.2%. Further, the whole-body metabolic stress reflected by the accumulations of plasma ammonia, uric acid, and blood lactate during the Yo-Yo test at the same absolute intensity was attenuated. For the control and placebo groups, no significant change in these variables was observed. In comparison with previous observations that the reduced RPB/4i resulting from IM warm-up was the major reason for improved Ex, the reduced RPB/4i resulting from the IM training program was lower despite the greater enhancement of IM function, whereas improvement in Ex was similar. Such findings suggest that although both IM training and warm-up improve the tolerance of intense intermittent exercise, the underlying mechanisms may be different.

  11. Effect of specific inspiratory muscle warm-up on intense intermittent run to exhaustion.

    PubMed

    Tong, Tom K; Fu, Frank H

    2006-08-01

    The effects of inspiratory muscle (IM) warm-up on the maximum dynamic IM function and the maximum repetitions of 20-m shuttle run (Ex) in the Yo-Yo intermittent recovery test were examined. Ten men were recruited to perform identical IM function test and exercise test in three different trials randomly. The control trial was without IM warm-up while the placebo and experimental trials were with IM warm-up by performing two sets of 30 breaths with inspiratory pressure-threshold load equivalent to 15% (IMW(P)) and 40% (IMW) maximum inspiratory mouth pressure, respectively. In IMW, maximum dynamic IM functions including the maximal inspiratory pressure at zero flow (P0) and maximal rate of P0 development (MRPD) were increased compared with control values (P < 0.05). The Ex was also augmented [mean (SD)] [19.5% (12.6)] while the slope of the linear relationship of the increase in rating of perceived breathlessness for every 4th exercise interval (RPB/4i) was reduced (P < 0.05). In IMW(P), although increase in Ex and reduction in RPB/4i were occurred concomitantly in some subjects, the differences in Ex, RPB/4i and dynamic IM functions between control and IMW(P) trials were not statistically significant. For the changes (Delta) in parameters in IMW and IMW(P) (n = 20), negative correlations were found between Delta RPB/4i and Delta Ex (r = -0.92), DeltaP0 and Delta RPB/4i (r = -0.48), and Delta MRPD and Delta RPB/4i (r = -0.54). Such findings suggested that the specific IM warm-up in IMW may entail reduction in breathlessness sensation, partly attributable to the enhancement of dynamic IM functions, in subsequent exhaustive intermittent run and, in turn, improve the exercise tolerance.

  12. Inspiratory muscle performance relative to the anaerobic threshold in patients with COPD.

    PubMed

    Wanke, T; Formanek, D; Lahrmann, H; Merkle, M; Rauscher, H; Zwick, H

    1993-09-01

    Rehabilitation programmes in chronic obstructive pulmonary disease (COPD) require exercise training above the anaerobic threshold. However, not all COPD patients develop metabolic acidosis during exercise. The hypothesis of this study was that non-exercise variables, characterizing the mechanical load on the inspiratory muscles during breathing at rest, can be used to reliably predict which patients with COPD are not able to develop metabolic acidosis during exercise. Thirty participants with COPD performed a symptom-limited cycle ergometer test. The oesophageal pressure/time index (PTIoes: the product of pressure magnitude and duration), the mean rate of pressure development during inspiration (Poes/TI), and the mean airway resistance (Raw)/maximal oesophageal pressure (Poesmax) ratio served as indices for the mechanical load on the inspiratory muscles. The oxygen uptake (VO2) at which plasma standard bicarbonate was seen to decrease from its baseline value was taken as the anaerboic threshold (AT). Mean Raw was significantly higher in those patients in whom the AT could not be detected. No other lung function parameters measured at rest allowed the accurate selection of those patients who did or did not develop exercise metabolic acidosis. On the other hand, Raw/Poesmax, PTIoes and Poes/TI were significantly different in the two patient groups. Additionally, whereas in the patient group with identifiable AT exercise hyperpnoea produced a non-linear increase of Poes/TI with respect to PTIoes above the AT, in the patient group without identifiable AT there was a linear relationship between Poes/TI and PTIoes throughout exercise. We conclude that the determination of inspiratory muscle load indices at rest may be useful in pulmonary rehabilitation programmes, for identifying those patients with COPD who do not develop exercise induced metabolic acidosis.(ABSTRACT TRUNCATED AT 250 WORDS)

  13. Short-term inspiratory muscle training potentiates the benefits of aerobic and resistance training in patients undergoing CABG in phase II cardiac rehabilitation program.

    PubMed

    Hermes, Bárbara Maria; Cardoso, Dannuey Machado; Gomes, Tiago José Nardi; Santos, Tamires Daros dos; Vicente, Marília Severo; Pereira, Sérgio Nunes; Barbosa, Viviane Acunha; Albuquerque, Isabella Martins de

    2015-01-01

    To investigate the efficiency of short-term inspiratory muscle training program associated with combined aerobic and resistance exercise on respiratory muscle strength, functional capacity and quality of life in patients who underwent coronary artery bypass and are in the phase II cardiac rehabilitation program. A prospective, quasi-experimental study with 24 patients who underwent coronary artery bypass and were randomly assigned to two groups in the Phase II cardiac rehabilitation program: inspiratory muscle training program associated with combined training (aerobic and resistance) group (GCR + IMT, n=12) and combined training with respiratory exercises group (GCR, n=12), over a period of 12 weeks, with two sessions per week. Before and after intervention, the following measurements were obtained: maximal inspiratory and expiratory pressures (PImax and PEmax), peak oxygen consumption (peak VO2) and quality of life scores. Data were compared between pre- and post-intervention at baseline and the variation between the pre- and post-phase II cardiac rehabilitation program using the Student's t-test, except the categorical variables, which were compared using the Chi-square test. Values of P<0.05 were considered statistically significant. Compared to GCR, the GCR + IMT group showed larger increments in PImax (P<0.001), PEmax (P<0.001), peak VO2 (P<0.001) and quality of life scores (P<0.001). The present study demonstrated that the addition of inspiratory muscle training, even when applied for a short period, may potentiate the effects of combined aerobic and resistance training, becoming a simple and inexpensive strategy for patients who underwent coronary artery bypass and are in phase II cardiac rehabilitation.

  14. Short-term inspiratory muscle training potentiates the benefits of aerobic and resistance training in patients undergoing CABG in phase II cardiac rehabilitation program

    PubMed Central

    Hermes, Bárbara Maria; Cardoso, Dannuey Machado; Gomes, Tiago José Nardi; dos Santos, Tamires Daros; Vicente, Marília Severo; Pereira, Sérgio Nunes; Barbosa, Viviane Acunha; de Albuquerque, Isabella Martins

    2015-01-01

    Objective To investigate the efficiency of short-term inspiratory muscle training program associated with combined aerobic and resistance exercise on respiratory muscle strength, functional capacity and quality of life in patients who underwent coronary artery bypass and are in the phase II cardiac rehabilitation program. Methods A prospective, quasi-experimental study with 24 patients who underwent coronary artery bypass and were randomly assigned to two groups in the Phase II cardiac rehabilitation program: inspiratory muscle training program associated with combined training (aerobic and resistance) group (GCR + IMT, n=12) and combined training with respiratory exercises group (GCR, n=12), over a period of 12 weeks, with two sessions per week. Before and after intervention, the following measurements were obtained: maximal inspiratory and expiratory pressures (PImax and PEmax), peak oxygen consumption (peak VO2) and quality of life scores. Data were compared between pre- and post-intervention at baseline and the variation between the pre- and post-phase II cardiac rehabilitation program using the Student's t-test, except the categorical variables, which were compared using the Chi-square test. Values of P<0.05 were considered statistically significant. Results Compared to GCR, the GCR + IMT group showed larger increments in PImax (P<0.001), PEmax (P<0.001), peak VO2 (P<0.001) and quality of life scores (P<0.001). Conclusion The present study demonstrated that the addition of inspiratory muscle training, even when applied for a short period, may potentiate the effects of combined aerobic and resistance training, becoming a simple and inexpensive strategy for patients who underwent coronary artery bypass and are in phase II cardiac rehabilitation. PMID:27163422

  15. Effects of Respiratory Muscle Strength Training in Classically Trained Singers.

    PubMed

    Ray, Christin; Trudeau, Michael D; McCoy, Scott

    2017-09-25

    Many voice pedagogy practices revolve around the notion of controlling airflow and lung volumes and focus heavily on the concepts of breath support and breath control. Despite this emphasis, the effects of increased respiratory muscle strength on airflow and phonation patterns in trained singers remain unknown. This study addressed whether singers could increase respiratory muscle strength with progressive threshold training and whether respiratory muscle strength increases had measurable effect on voice outcomes. A single-subject design was used to answer the research questions. Improved breath support was hypothesized to manifest in differences in airflow and phonetogram characteristics. Six graduate-level singing students were recruited to complete the protocol, which consisted of a baseline phase followed by either inspiratory muscle strength training followed by expiratory muscle strength training or vice versa. Results showed that these singers had increased respiratory muscle strength after completing the training program. Consistent changes in measures of aerodynamics and voice were not present among subjects, although some individual changes were noted. Future research may focus on the effects of respiratory muscle strength training in less advanced singers. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  16. Protocol: inspiratory muscle training for promoting recovery and outcomes in ventilated patients (IMPROVe): a randomised controlled trial

    PubMed Central

    Leditschke, I Anne; Paratz, Jennifer D; Boots, Robert J

    2012-01-01

    Introduction Inspiratory muscle weakness is a known consequence of mechanical ventilation and a potential contributor to difficulty in weaning from ventilatory support. Inspiratory muscle training (IMT) reduces the weaning period and increases the likelihood of successful weaning in some patients. However, it is not known how this training affects the residual inspiratory muscle fatigability following successful weaning nor patients' quality of life or functional outcomes. Methods and analysis This dual centre study includes two concurrent randomised controlled trials of IMT in adult patients who are either currently ventilator-dependent (>7 days) (n=70) or have been recently weaned from mechanical ventilation (>7 days) in the past week (n=70). Subjects will be stable, alert and able to actively participate and provide consent. There will be concealed allocation to either treatment (IMT) or usual physiotherapy (including deep breathing exercises without a resistance device). Primary outcomes are inspiratory muscle fatigue resistance and maximum inspiratory pressures. Secondary outcomes are quality of life (Short Form-36v2, EQ-5D), functional status (Acute Care Index of Function), rate of perceived exertion (Borg Scale), intensive care length of stay (days), post intensive care length of stay (days), rate of reintubation (%) and duration of ventilation (days). Ethics and dissemination Ethics approval has been obtained from relevant institutions, and results will be published with a view to influencing physiotherapy practice in the management of long-term ventilator-dependent patients to accelerate weaning and optimise rehabilitation outcomes. Trial registration number ACTRN12610001089022. PMID:22389363

  17. Muscle Strength and Poststroke Hemiplegia: A Systematic Review of Muscle Strength Assessment and Muscle Strength Impairment.

    PubMed

    Kristensen, Otto H; Stenager, Egon; Dalgas, Ulrik

    2017-02-01

    To systematically review (1) psychometric properties of criterion isokinetic dynamometry testing of muscle strength in persons with poststroke hemiplegia (PPSH); and (2) literature that compares muscle strength in patients poststroke with that in healthy controls assessed by criterion isokinetic dynamometry. A systematic literature search of 7 databases was performed. Included studies (1) enrolled participants with definite poststroke hemiplegia according to defined criteria; (2) assessed muscle strength or power by criterion isokinetic dynamometry; (3) had undergone peer review; and (4) were available in English or Danish. The psychometric properties of isokinetic dynamometry were reviewed with respect to reliability, validity, and responsiveness. Furthermore, comparisons of strength between paretic, nonparetic, and comparable healthy muscles were reviewed. Twenty studies covering 316 PPSH were included. High intraclass correlation coefficient (ICC) inter- and intrasession reliability was reported for isokinetic dynamometry, which was independent of the tested muscle group, contraction mode, and contraction velocity. Slightly higher ICC values were found for the nonparetic extremity. Standard error of the mean (SEM) values showed that a change of 7% to 20% was required for a real group change to take place for most muscle groups, with the knee extensors showing the smallest SEM% values. The muscle strength of paretic muscles showed deficits when compared with both healthy and nonparetic muscles, independent of muscle group, contraction mode, and contraction velocity. Nonparetic muscles only showed minor strength impairments when compared with healthy muscles. Criterion isokinetic dynamometry is a reliable test in persons with stroke, generally showing marked reductions in muscle strength of paretic and, to a lesser degree, nonparetic muscles when compared with healthy controls, independent of muscle group, contraction mode, and contraction velocity. Copyright

  18. Inspiratory Muscle Function and Exercise Capacity in Patients With Heart Failure With Preserved Ejection Fraction.

    PubMed

    Palau, Patricia; Domínguez, Eloy; Núñez, Eduardo; Ramón, Jose María; López, Laura; Melero, Joana; Bellver, Alejandro; Chorro, Francisco J; Bodí, Vicent; Bayés-Genis, Antoni; Sanchis, Juan; Núñez, Julio

    2017-06-01

    Heart failure with preserved ejection fraction (HFpEF) is a clinical syndrome characterized by impaired exercise capacity resulting from dyspnea and fatigue. The pathophysiological mechanisms underlying the exercise intolerance in HFpEF are not well established. We sought to evaluate the effects of inspiratory muscle function on exercise tolerance in symptomatic patients with HFpEF. A total of 74 stable symptomatic patients with HFpEF and New York Heart Association class II-III underwent a cardiopulmonary exercise test between June 2012 and May 2016. Inspiratory muscle weakness was defined as maximum inspiratory pressure (MIP)  <70% of normal predicted values. Pearson correlation coefficient and multivariate linear regression analysis were used to assess the association between percent of predicted MIP (pp-MIP) and maximal exercise capacity [measured by peak oxygen uptake (peak VO2) and percent of predicted peak VO2 (pp-peak VO2)]. Thirty-one patients (42%) displayed inspiratory muscle weakness. Mean (standard deviation) age was 72.5 ± 9.1 years, 53% were women, and 35.1% displayed New York Heart Association class III. Mean peak VO2 and pp-peak VO2 were 10 ± 2.8 mL•min•kg and 57.3 ± 13.8%, respectively. The median (interquartile range) of pp-MIP was 72% (58%-90%). pp-MIP was not correlated with peak VO2 (r = -0.047, P = .689) nor pp-peak VO2 (r = -0.078, P = .509). Furthermore, in multivariable analysis, pp-MIP showed no association with peak VO2 (β coefficient = 0.01, 95% confidence interval -0.01 to 0.03, P = .241) and pp-peak VO2 (β coefficient = -0.00, 95% confidence interval -0.10 to 0.10, P = .975). In symptomatic elderly patients with HFpEF, we found that pp-MIP was not associated with either peak VO2 or pp-peak VO2. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. The correlation of respiratory muscle strength and cough capacity in stroke patients.

    PubMed

    Jo, Myeong-Rae; Kim, Nan-Soo

    2016-10-01

    [Purpose] The purpose of this study was to investigate the correlation between respiratory muscle strength and cough capacity in stroke patients. [Subjects and Methods] Forty-two stroke patients were assigned to 2 different groups (intervention group=21, control group=21). Both groups participated in a conventional stroke rehabilitation program, with the intervention group also receiving respiratory muscle training for 20 to 30 minutes a day, 3 times a week for 8 weeks. Respiratory muscle strength (maximal inspiratory pressure, maximal expiratory pressure), forced vital capacity, and cough capacity were measured. [Results] The intervention group showed significant increases in maximal inspiratory pressure, maximal expiratory pressure, forced vital capacity, and cough capacity. The change in maximal inspiratory pressure, maximal expiratory pressure, and forced vital capacity showed a significant correlation with cough capacity, with maximal expiratory pressure showing the highest correlation. [Conclusion] The present study showed that the increase in maximal expiratory pressure plays an important role in improving the cough capacity of stroke patients.

  20. Influence of Inspiratory Muscle Training on Ventilatory Efficiency and Cycling Performance in Normoxia and Hypoxia

    PubMed Central

    Salazar-Martínez, Eduardo; Gatterer, Hannes; Burtscher, Martin; Naranjo Orellana, José; Santalla, Alfredo

    2017-01-01

    The aim of this study was to analyse the influence of inspiratory muscle training (IMT) on ventilatory efficiency, in normoxia and hypoxia, and to investigate the relationship between ventilatory efficiency and cycling performance. Sixteen sport students (23.05 ± 4.7 years; 175.11 ± 7.1 cm; 67.0 ± 19.4 kg; 46.4 ± 8.7 ml·kg−1·min−1) were randomly assigned to an inspiratory muscle training group (IMTG) and a control group (CG). The IMTG performed two training sessions/day [30 inspiratory breaths, 50% peak inspiratory pressure (Pimax), 5 days/week, 6-weeks]. Before and after the training period subjects carried out an incremental exercise test to exhaustion with gas analysis, lung function testing, and a cycling time trial test in hypoxia and normoxia. Simulated hypoxia (FiO2 = 16.45%), significantly altered the ventilatory efficiency response in all subjects (p < 0.05). Pimax increased significantly in the IMTG whereas no changes occurred in the CG (time × group, p < 0.05). Within group analyses showed that the IMTG improved ventilatory efficiency (VE/VCO2 slope; EqCO2VT2) in hypoxia (p < 0.05) and cycling time trial performance [WTTmax (W); WTTmean (W); PTF(W)] (p < 0.05) in hypoxia and normoxia. Significant correlations were not found in hypoxia nor normoxia found between ventilatory efficiency parameters (VE/VCO2 slope; LEqCO2; EqCO2VT2) and time trial performance. On the contrary the oxygen uptake efficiency slope (OUES) was highly correlated with cycling time trial performance (r = 0.89; r = 0.82; p < 0.001) under both conditions. Even though no interaction effect was found, the within group analysis may suggest that IMT reduces the negative effects of hypoxia on ventilatory efficiency. In addition, the data suggest that OUES plays an important role in submaximal cycling performance. PMID:28337149

  1. Inspiratory muscle warm-up does not improve cycling time-trial performance.

    PubMed

    Johnson, M A; Gregson, I R; Mills, D E; Gonzalez, J T; Sharpe, G R

    2014-09-01

    This study examined the effects of an active cycling warm-up, with and without the addition of an inspiratory muscle warm-up (IMW), on 10-km cycling time-trial performance. Ten cyclists (VO₂ = 65 ± 9 mL kg(-1) min(-1)) performed a habituation 10-km cycling time-trial and three further time-trials preceded by either no warm-up (CONT), a cycling-specific warm-up (CYC) comprising three consecutive 5-min bouts at powers corresponding to 70, 80, and 90% of the gas exchange threshold, or a cycling-specific warm-up preceded by an IMW (CYC + IMW) comprising two sets of 30 inspiratory efforts against a pressure-threshold load of 40% maximal inspiratory pressure (MIP). The cycling warm-up was followed by 2-min rest before the start of the time-trial. Time-trial performance times during CYC (14.75 ± 0.79 min) and CYC + IMW (14.70 ± 0.75 min) were not different, although both were faster than CONT (14.99 ± 0.90 min) (P < 0.05). Throughout the time-trial, physiological (minute ventilation, breathing pattern, pulmonary gas exchange, heart rate, blood lactate concentration and pH) and perceptual (limb discomfort and dyspnoea) responses were not different between CYC and CYC + IMW. Baseline MIP during CONT and CYC was 151 ± 31 and 156 ± 39 cmH₂O, respectively, and was unchanged following the time-trial. MIP increased by 8% after IMW (152 ± 27 vs. 164 ± 27 cmH2O, P < 0.05) and returned to baseline after the time-trial. Improvements in 10-km cycling time-trial performance following an active cycling warm-up were not magnified by the addition of an IMW. Therefore, an appropriately designed active whole-body warm-up does adequately prepare the inspiratory muscles for cycling time-trials lasting approximately 15 min.

  2. Influence of Inspiratory Muscle Training on Ventilatory Efficiency and Cycling Performance in Normoxia and Hypoxia.

    PubMed

    Salazar-Martínez, Eduardo; Gatterer, Hannes; Burtscher, Martin; Naranjo Orellana, José; Santalla, Alfredo

    2017-01-01

    The aim of this study was to analyse the influence of inspiratory muscle training (IMT) on ventilatory efficiency, in normoxia and hypoxia, and to investigate the relationship between ventilatory efficiency and cycling performance. Sixteen sport students (23.05 ± 4.7 years; 175.11 ± 7.1 cm; 67.0 ± 19.4 kg; 46.4 ± 8.7 ml·kg(-1)·min(-1)) were randomly assigned to an inspiratory muscle training group (IMTG) and a control group (CG). The IMTG performed two training sessions/day [30 inspiratory breaths, 50% peak inspiratory pressure (Pimax), 5 days/week, 6-weeks]. Before and after the training period subjects carried out an incremental exercise test to exhaustion with gas analysis, lung function testing, and a cycling time trial test in hypoxia and normoxia. Simulated hypoxia (FiO2 = 16.45%), significantly altered the ventilatory efficiency response in all subjects (p < 0.05). Pimax increased significantly in the IMTG whereas no changes occurred in the CG (time × group, p < 0.05). Within group analyses showed that the IMTG improved ventilatory efficiency (VE/VCO2 slope; EqCO2VT2) in hypoxia (p < 0.05) and cycling time trial performance [WTTmax (W); WTTmean (W); PTF(W)] (p < 0.05) in hypoxia and normoxia. Significant correlations were not found in hypoxia nor normoxia found between ventilatory efficiency parameters (VE/VCO2 slope; LEqCO2; EqCO2VT2) and time trial performance. On the contrary the oxygen uptake efficiency slope (OUES) was highly correlated with cycling time trial performance (r = 0.89; r = 0.82; p < 0.001) under both conditions. Even though no interaction effect was found, the within group analysis may suggest that IMT reduces the negative effects of hypoxia on ventilatory efficiency. In addition, the data suggest that OUES plays an important role in submaximal cycling performance.

  3. Pulmonary Function, Muscle Strength, and Incident Mobility Disability in Elders

    PubMed Central

    Buchman, Aron S.; Boyle, Patricia A.; Leurgans, Sue E.; Evans, Denis A.; Bennett, David A.

    2009-01-01

    Muscle strength, including leg strength and respiratory muscle strength, are relatively independently associated with mobility disability in elders. However, the factors linking muscle strength with mobility disability are unknown. To test the hypothesis that pulmonary function mediates the association of muscle strength with the development of mobility disability in elders, we used data from a longitudinal cohort study of 844 ambulatory elders without dementia participating in the Rush Memory and Aging Project with a mean follow-up of 4.0 years (SD = 1.39). A composite measure of pulmonary function was based on spirometric measures of forced vital capacity, forced expiratory volume, and peak expiratory flow. Respiratory muscle strength was based on maximal inspiratory pressure and expiratory pressure and leg strength based on hand-held dynamometry. Mobility disability was defined as a gait speed less than or equal to 0.55 m/s based on annual assessment of timed walk. Secondary analyses considered time to loss of the ability to ambulate. In separate proportional hazards models which controlled for age, sex, and education, composite measures of pulmonary function, respiratory muscle strength, and leg strength were each associated with incident mobility disability (all P values < 0.001). Further, all three were related to the development of incident mobility disability when considered together in a single model (pulmonary function: hazard ratio [HR], 0.721; 95% confidence interval [CI], 0.577, 0.902; respiratory muscle strength: HR, 0.732; 95% CI, 0.593, 0.905; leg strength: HR, 0.791; 95% CI, 0.640, 0.976). Secondary analyses examining incident loss of the ability to ambulate revealed similar findings. Overall, these findings suggest that lower levels of pulmonary function and muscle strength are relatively independently associated with the development of mobility disability in the elderly. PMID:19934353

  4. Transdiaphragmatic pressure and neural respiratory drive measured during inspiratory muscle training in stable patients with chronic obstructive pulmonary disease.

    PubMed

    Wu, Weiliang; Zhang, Xianming; Lin, Lin; Ou, Yonger; Li, Xiaoying; Guan, Lili; Guo, Bingpeng; Zhou, Luqian; Chen, Rongchang

    2017-01-01

    Inspiratory muscle training (IMT) is a rehabilitation therapy for stable patients with COPD. However, its therapeutic effect remains undefined due to the unclear nature of diaphragmatic mobilization during IMT. Diaphragmatic mobilization, represented by transdiaphragmatic pressure (Pdi), and neural respiratory drive, expressed as the corrected root mean square (RMS) of the diaphragmatic electromyogram (EMGdi), both provide vital information to select the proper IMT device and loads in COPD, therefore contributing to the curative effect of IMT. Pdi and RMS of EMGdi (RMSdi%) were measured and compared during inspiratory resistive training and threshold load training in stable patients with COPD. Pdi and neural respiratory drive were measured continuously during inspiratory resistive training and threshold load training in 12 stable patients with COPD (forced expiratory volume in 1 s ± SD was 26.1%±10.2% predicted). Pdi was significantly higher during high-intensity threshold load training (91.46±17.24 cmH2O) than during inspiratory resistive training (27.24±6.13 cmH2O) in stable patients with COPD, with P<0.01 for each. Significant difference was also found in RMSdi% between high-intensity threshold load training and inspiratory resistive training (69.98%±16.78% vs 17.26%±14.65%, P<0.01). We concluded that threshold load training shows greater mobilization of Pdi and neural respiratory drive than inspiratory resistive training in stable patients with COPD.

  5. Inspiratory muscle conditioning exercise and diaphragm gene therapy in Pompe disease: Clinical evidence of respiratory plasticity.

    PubMed

    Smith, Barbara K; Martin, A Daniel; Lawson, Lee Ann; Vernot, Valerie; Marcus, Jordan; Islam, Saleem; Shafi, Nadeem; Corti, Manuela; Collins, Shelley W; Byrne, Barry J

    2017-01-01

    Pompe disease is an inherited disorder due to a mutation in the gene that encodes acid α-glucosidase (GAA). Children with infantile-onset Pompe disease develop progressive hypotonic weakness and cardiopulmonary insufficiency that may eventually require mechanical ventilation (MV). Our team conducted a first in human trial of diaphragmatic gene therapy (AAV1-CMV-GAA) to treat respiratory neural dysfunction in infantile-onset Pompe. Subjects (aged 2-15years, full-time MV: n=5, partial/no MV: n=4) underwent a period of preoperative inspiratory muscle conditioning exercise. The change in respiratory function after exercise alone was compared to the change in function after intramuscular delivery of AAV1-CMV-GAA to the diaphragm with continued exercise. Since AAV-mediated gene therapy can reach phrenic motoneurons via retrograde transduction, we hypothesized that AAV1-CMV-GAA would improve dynamic respiratory motor function to a greater degree than exercise alone. Dependent measures were maximal inspiratory pressure (MIP), respiratory responses to inspiratory threshold loads (load compensation: LC), and physical evidence of diaphragm activity (descent on MRI, EMG activity). Exercise alone did not change function. After AAV1-CMV-GAA, MIP was unchanged. Flow and volume LC responses increased after dosing (p<0.05 to p<0.005), but only in the subjects with partial/no MV use. Changes in LC tended to occur on or after 180days. At Day 180, the four subjects with MRI evidence of diaphragm descent had greater maximal voluntary ventilation (p<0.05) and tended to be younger, stronger, and use fewer hours of daily MV. In conclusion, combined AAV1-CMV-GAA and exercise training conferred benefits to dynamic motor function of the diaphragm. Children with a higher baseline neuromuscular function may have greater potential for functional gains. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Effects of inspiratory muscle training on respiratory function and repetitive sprint performance in wheelchair basketball players.

    PubMed

    Goosey-Tolfrey, V; Foden, E; Perret, C; Degens, H

    2010-07-01

    There is considerable evidence that respiratory muscle training improves pulmonary function, quality of life and exercise performance in healthy athletic populations. The benefits for wheelchair athletes are less well understood. Therefore, in the present study, influence of inspiratory muscle training (IMT) on respiratory function and repetitive propulsive sprint performance in wheelchair basketball players was examined. Using a placebo-controlled design, 16 wheelchair athletes were divided to an experimental (IMT; n=8) or placebo (sham-IMT; n=8) group based on selective grouping criteria. 30 dynamic breaths were performed by the IMT group twice daily at a resistance equivalent to 50% maximum inspiratory pressure (MIP), and 60 slow breaths were performed by the sham-IMT group once a day at 15% MIP for a period of 6 weeks. In the IMT group, both MIP and maximum expiratory pressure (17% and 23%, respectively; p< or =0.03) were improved. Similar improvements were noted for the sham-IMT group with 23% and 33% from baseline for MIP and maximum expiratory pressure, respectively (p< or =0.03). There were no significant changes in pulmonary function at rest and any of the performance parameters associated with the repetitive sprint test (sprint and recovery times, peak heart rate and peak blood lactate concentration). Reported experiences of using the IMT training device suggested "less breathlessness" and "less tightness in the chest during the training". Although there was no improvement in sprint performance, an improved respiratory muscle function and quality of life were reported by participants in both the IMT and sham-IMT groups.

  7. Diaphragmatic amplitude and accessory inspiratory muscle activity in nasal and mouth-breathing adults: a cross-sectional study.

    PubMed

    Trevisan, Maria Elaine; Boufleur, Jalusa; Soares, Juliana Corrêa; Haygert, Carlos Jesus Pereira; Ries, Lilian Gerdi Kittel; Corrêa, Eliane Castilhos Rodrigues

    2015-06-01

    The purpose of this study was to evaluate the electromyographic activity of the accessory inspiratory muscles and the diaphragmatic amplitude (DA) in nasal and mouth-breathing adults. The study evaluated 38 mouth-breathing (MB group) and 38 nasal-breathing (NB group) adults, from 18 to 30years old and both sexes. Surface electromyography (sEMG) was used to evaluate the amplitude and symmetry (POC%) of the sternocleidomastoid (SCM) and upper trapezius (UT) muscles at rest, during nasal slow inspiration at Lung Total Capacity (LTC) and, during rapid and abrupt inspiration: Sniff, Peak Nasal Inspiratory Flow (PNIF) and Maximum Inspiratory Pressure (MIP). M-mode ultrasonography assessed the right diaphragm muscle amplitude in three different nasal inspirations: at tidal volume (TV), Sniff and inspiration at LTC. The SCM activity was significantly lower in the MB group during Sniff, PNIF (p<0.01, Mann-Whitney test) and MIP (p<0.01, t-test). The groups did not differ during rest and inspiration at LTC, regarding sEMG amplitude and POC%. DA was significantly lower in the MB group at TV (p<0.01, Mann-Whitney) and TLC (p=0.03, t-test). Mouth breathing reflected on lower recruitment of the accessory inspiratory muscles during fast inspiration and lower diaphragmatic amplitude, compared to nasal breathing. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. An experimental study on the impacts of inspiratory and expiratory muscles activities during mechanical ventilation in ARDS animal model

    PubMed Central

    Zhang, Xianming; Du, Juan; Wu, Weiliang; Zhu, Yongcheng; Jiang, Ying; Chen, Rongchang

    2017-01-01

    In spite of intensive investigations, the role of spontaneous breathing (SB) activity in ARDS has not been well defined yet and little has been known about the different contribution of inspiratory or expiratory muscles activities during mechanical ventilation in patients with ARDS. In present study, oleic acid-induced beagle dogs’ ARDS models were employed and ventilated with the same level of mean airway pressure. Respiratory mechanics, lung volume, gas exchange and inflammatory cytokines were measured during mechanical ventilation, and lung injury was determined histologically. As a result, for the comparable ventilator setting, preserved inspiratory muscles activity groups resulted in higher end-expiratory lung volume (EELV) and oxygenation index. In addition, less lung damage scores and lower levels of system inflammatory cytokines were revealed after 8 h of ventilation. In comparison, preserved expiratory muscles activity groups resulted in lower EELV and oxygenation index. Moreover, higher lung injury scores and inflammatory cytokines levels were observed after 8 h of ventilation. Our findings suggest that the activity of inspiratory muscles has beneficial effects, whereas that of expiratory muscles exerts adverse effects during mechanical ventilation in ARDS animal model. Therefore, for mechanically ventilated patients with ARDS, the demands for deep sedation or paralysis might be replaced by the strategy of expiratory muscles paralysis through epidural anesthesia. PMID:28230150

  9. Exercise-induced inspiratory muscle fatigue during swimming: the effect of race distance.

    PubMed

    Brown, Sarah; Kilding, Andrew E

    2011-05-01

    Exercise-induced inspiratory muscle fatigue (IMF) has been quantified for several sports. However, it is not yet known if, or to what extent, IMF is determined by the competition distance. The aim of the present study was to assess the influence of 3 different competitive front-crawl swimming race distances on the magnitude of IMF. Ten well-trained swimmers from a local swim team participated in the study and on separate days completed maximal 100-, 200-, and 400-m time trials (TTs). Before and after each trial, maximal inspiratory pressure (MIP) was measured and %IMF determined from pre- and post-time-trial differences in MIP. The heart rate (HR) and rate of perceived dyspnea (RPD) was also assessed. For all distances, posttrial MIP was lower than pretrial MIP, though this was only significant for 100 m (p < 0.05). There were no differences between distances for absolute posttrial MIP. The %IMF after the 100-m TT (8.2 ± 4.1%) was, however, significantly greater than the 400 m (4.9 ± 3.8%) TT (p < 0.05) but not 200-m TT. There were no differences between trials for HR or RPD (p > 0.05). There were no relationships between %IMF and mean pretrial MIP (r = -0.28, p > 0.05) or between %IMF and time for any TT (100 m, r = 0.25; 200 m, r = 0.34; 400 m r = 0.18; p > 0.05). The lack of difference between trials for posttrial absolute MIP suggests that race distance during swimming does not substantially influence the degree of IMF.

  10. Inspiratory muscle training, altitude, and arterial oxygen desaturation: a preliminary investigation.

    PubMed

    Lomax, Mitch

    2010-05-01

    Specific inspiratory muscle training (IMT) has been shown to significantly attenuate the fall in arterial oxygen saturation (SpO2) during exhaustive exercise while breathing a hypoxic gas mixture of 14% oxygen. The aim of the current study was to assess the impact of IMT on resting SpO2 over a range of altitudes in healthy individuals. Resting SpO2 and the Borg Score were examined at altitudes of 0 or 400 m (0-400 m; 0-1312.3 ft), 1400 m, 4880 m, and 5550 m (4593 ft, 16,011 ft, and 18,209 ft) in 14 military personnel who were part of a climbing expedition to the Nepali Himalaya. Volunteer participants were randomly assigned to either a control (N = 7) or IMT (N = 7) group: IMT consisted of 1 set of 30 breaths twice daily at 50% maximal inspiratory mouth pressure (MIP) for 4 wk prior to departure. MIP was similar between groups pre-IMT but increased significantly by 15% post-IMT. Baseline maximal expiratory mouth pressure was not different between groups. The Borg Score increased significantly from 1400 m, but was not different between groups at any altitude. Resting SpO2 declined significantly at ascending altitudes in both groups and was similar between groups at altitudes of 0-400 m and 1400 m. However, at altitudes of 4880 m and 5550 m, SpO2 was significantly higher (6%) in the IMT group. IMT can attenuate the fall in resting SpO2, but only at altitudes of 4880 m and above. Conversely, IMT had no effect on resting levels of dyspnea as measured by the Borg Score.

  11. Reference Values for Inspiratory Muscle Endurance in Healthy Children and Adolescents

    PubMed Central

    Woszezenki, Cristhiele Taís; Heinzmann-Filho, João Paulo; Vendrusculo, Fernanda Maria; Piva, Taila Cristina; Levices, Isadora; Donadio, Márcio Vinícius Fagundes

    2017-01-01

    Aims To generate reference values for two inspiratory muscle endurance (IME) protocols in healthy children and adolescents. Materials and methods This is an observational, cross-sectional study, in healthy children and adolescents from 4 to 18 years of age. Weight, height, maximal inspiratory pressure (MIP) and IME were measured using two protocols. A fixed load of 30% of MIP with a 10% increment every 2 minutes was used in the incremental threshold loading protocol. As for the maximal loading protocol, a fixed load of 70% of MIP was used and the time limit (Tlim) achieved until fatigue was measured. Results A total of 462 participants were included, 281 corresponding to the incremental loading protocol and 181 to maximal loading. There were moderate and positive correlations between IME and age, MIP, weight and height in the incremental threshold loading. However, the regression model demonstrated that MIP and age were the best variables to predict the IME. Otherwise, weak and positive correlations with age, weight and height were found in the maximal loading. Only age and height influenced endurance in the regression model. The predictive power (r2) of the incremental threshold loading protocol was 0.65, while the maximal loading was 0.15. The reproducibility measured by the intraclass correlation coefficient (ICC) was higher in the incremental loading (0.96) compared to the maximal loading test (0.69). Conclusion IME in healthy children and adolescents can be explained by age, height and MIP. The incremental threshold loading protocol showed more reliable results and should be the model of choice to evaluate IME in the pediatric age group. PMID:28122012

  12. The 400- and 800-m Track Running Induces Inspiratory Muscle Fatigue in Trained Female Middle-Distance Runners.

    PubMed

    Ohya, Toshiyuki; Yamanaka, Ryo; Hagiwara, Masahiro; Oriishi, Marie; Suzuki, Yasuhiro

    2016-05-01

    Inspiratory muscle fatigue (IMF) may limit exercise performance. A few studies have reported that IMF occurs after short-duration swimming exercise, but whether short-duration running can induce IMF remains unclear. Intra-abdominal pressure is increased during running through diaphragmatic activation to stabilize the spine during movements of the upper limbs. This occurs along with the increased inspiratory muscle effort associated with increased respirations during exercise; thus, we hypothesized that short-duration running exercise would induce IMF. To test this hypothesis, we measured maximal inspiratory pressure (MIP) before and after 400- and 800-m track running sessions. Eight female middle-distance (400, 800 m) runners performed a 400- and 800-m running test. Maximal inspiratory pressure was measured before and after each test using a portable autospirometer. The mean MIPs were significantly lower after running than before running; values obtained were 107 ± 25 vs. 97 ± 27 cmH2O (p = 0.01, effect size [ES] = 0.65) and 108 ± 26 vs. 92 ± 27 cmH2O (p = 0.01, ES = 0.74) before vs. after the 400- and 800-m tests, respectively. The mean MIP after the 800-m test was significantly lower than after the 400-m test (p = 0.04, ES = 0.48). There was no correlation between IMF value and running time (r = 0.53 and r = -0.28 for either the 400- and 800-m tests, respectively; p > 0.05). In conclusion, IMF occurs after short-duration running exercise. Coaches could consider prescribing inspiratory muscle training or warm-up in an effort to reduce the inevitable IMF associated with maximal effort running.

  13. Response of the canine inspiratory intercostal muscles to chest wall vibration.

    PubMed

    Leduc, D; Brunko, E; De Troyer, A

    2000-02-01

    High-frequency mechanical vibration of the rib cage reduces dyspnea, but the effect of this procedure on the respiratory muscles is largely unknown. In the present studies, we have initially assessed the electrical and mechanical response to vibration (40 Hz) of the canine parasternal and external intercostal muscles (third interspace) during hyperventilation-induced apnea. When the vibrator was applied to the segment investigated, prominent external intercostal activity was recorded in the seven animals studied, whereas low-amplitude parasternal intercostal activity was recorded in only four animals. Similarly, when the vibrator was applied to more rostral and more caudal interspaces, activity was recorded commonly from the external intercostal but only occasionally from the parasternal. The two muscles, however, showed similar changes in length. We next examined the response to vibration of the muscles in seven spontaneously breathing animals. Vibrating the rib cage during inspiration (in-phase) had no effect on parasternal intercostal inspiratory activity but induced a marked increase in neural drive to the external intercostals. For the animal group, peak external intercostal activity during the control, nonvibrated breaths averaged (mean +/- SE) 43.1 +/- 3.7% of the activity recorded during the vibrated breaths (p < 0.001). External intercostal activity during vibration also occurred earlier at the onset of inspiration and commonly carried on after the cessation of parasternal intercostal activity. Yet tidal volume was unchanged. Vibrating the rib cage during expiration (out-of-phase) did not elicit any parasternal or external intercostal activity in six animals. These observations thus indicate that the external intercostals, with their larger spindle density, are much more sensitive to chest wall vibration than the parasternal intercostals. They also suggest that the impact of this procedure on the mechanical behavior of the respiratory system is relatively

  14. Transdiaphragmatic pressure and neural respiratory drive measured during inspiratory muscle training in stable patients with chronic obstructive pulmonary disease

    PubMed Central

    Wu, Weiliang; Zhang, Xianming; Lin, Lin; Ou, Yonger; Li, Xiaoying; Guan, Lili; Guo, Bingpeng; Zhou, Luqian; Chen, Rongchang

    2017-01-01

    Purpose Inspiratory muscle training (IMT) is a rehabilitation therapy for stable patients with COPD. However, its therapeutic effect remains undefined due to the unclear nature of diaphragmatic mobilization during IMT. Diaphragmatic mobilization, represented by transdiaphragmatic pressure (Pdi), and neural respiratory drive, expressed as the corrected root mean square (RMS) of the diaphragmatic electromyogram (EMGdi), both provide vital information to select the proper IMT device and loads in COPD, therefore contributing to the curative effect of IMT. Pdi and RMS of EMGdi (RMSdi%) were measured and compared during inspiratory resistive training and threshold load training in stable patients with COPD. Patients and methods Pdi and neural respiratory drive were measured continuously during inspiratory resistive training and threshold load training in 12 stable patients with COPD (forced expiratory volume in 1 s ± SD was 26.1%±10.2% predicted). Results Pdi was significantly higher during high-intensity threshold load training (91.46±17.24 cmH2O) than during inspiratory resistive training (27.24±6.13 cmH2O) in stable patients with COPD, with P<0.01 for each. Significant difference was also found in RMSdi% between high-intensity threshold load training and inspiratory resistive training (69.98%±16.78% vs 17.26%±14.65%, P<0.01). Conclusion We concluded that threshold load training shows greater mobilization of Pdi and neural respiratory drive than inspiratory resistive training in stable patients with COPD. PMID:28280321

  15. Short-latency inhibitory reflex responses to inspiratory loading of the scalene muscles are impaired in spinal cord injury.

    PubMed

    McBain, Rachel A; Hudson, Anna L; Gandevia, Simon C; Butler, Jane E

    2015-02-01

    What is the central question of this study? The aim was to determine whether the reflex inhibition in the electromyographic activity of scalene muscles in response to inspiratory muscle loading is present in individuals with cervical spinal cord injury and to examine whether the intercostal muscle afferents are critical for genesis of the reflex. What is the main finding and its importance? The lack of reflex inhibition in response to inspiratory loading in individuals with complete cervical spinal cord injury suggests that the reflex critically requires input from intercostal afferents and/or an intact intersegmental neural network. In healthy individuals, transient loading of inspiratory muscles with a brief inspiratory occlusion produces a short-latency inhibitory response (IR) in the electromyographic activity of scalene muscles at ∼40 ms, followed by an excitatory response (ER). It has been argued that this reflex plays a protective role in neuromuscular control of the inspiratory muscles and that it is co-ordinated by spinal segmental or supraspinal circuits. In this study, the reflex response to airway occlusion was recorded bilaterally from scalene muscles in 14 subjects and from the right costal diaphragm in seven subjects with spinal cord injury [SCI, C4-C6; American Spinal Injury Association (ASIA) Impairment Scale (AIS) A]. The incidence, latency and size of the reflex were compared with previously published data from able-bodied subjects. Only two subjects with SCI showed an IR, and six subjects had an ER. Latencies to the onset and peak of the IR and ER were 5-50 ms longer than in able-bodied subjects. However, when reflexes were identified, their size in individuals with SCI was similar to that of control subjects. We conclude that afferents from the scalene muscles and diaphragm are insufficient in most subjects with SCI to evoke the usual inhibition to airway occlusion and that input from chest wall afferents below the spinal cord lesion may be

  16. [Tolerance test to an inspiratory resistive load and resistive training of respiratory muscles. Preliminary critical study in kyphoscoliotic patients].

    PubMed

    Vandevenne, A; Ducolone, A

    1988-01-01

    Is increased tolerance to an additional inspiratory load after resistive training always due to respiratory muscle endurance? To answer this question, 5 kyphoscoliotic subjects were subjected to ventilation through a Y-shaped tube 3.2 cm in diameter during 10 minutes three times a day for 3 months. The subjects were divided into 3 groups. Group 1 (n = 3) trained with a non-linear resistance placed in the inspiratory branch of the tube during the first and third months and without additional load during the second month. Group 2 (n = 2) trained without inspiratory resistance during the first and third months and with an additional load during the second month. The load selected for the initial tolerance test (R1) was an inspiratory orifice with a diameter 0.5 mm wider than that of the orifice not tolerated during 3 min (R2). In each subject, ventilatory mode and time of tolerance on R1 were determined. This time was 10.8 +/- 6.8 min for the whole group. The tolerance test was repeated after each month of resistive or placebo training on R1 and R2. By grouping together the results of tolerance tests at 2 months after placebo training (4 measurements) and after resistive training (5 measurements), we found that the gain in endurance was similar without concomitant changes in volumes, air flows, VO2 max and time of endurance at 70% of VO2 max.(ABSTRACT TRUNCATED AT 250 WORDS)

  17. Effect of inspiratory muscle training on respiratory capacity and walking ability with subacute stroke patients: a randomized controlled pilot trial

    PubMed Central

    Jung, Kyeong-Man; Bang, Dae-Hyouk

    2017-01-01

    [Purpose] To investigate the effects of inspiratory muscle training on respiratory capacity and walking ability in subacute stroke patients. [Subjects and Methods] The subjects were randomly assigned to an experimental group (n=6) or a control group (n=6). Patients in the experimental group received inspiratory muscle training for 30 minutes (six sets of five-minutes) and traditional physical therapy once a day, five days a week, for four weeks. The control group received aerobic exercise for 30 minutes and traditional physical therapy for 30 minutes a day, five days a week, for four weeks. [Results] After the intervention, both groups showed significant improvements in the forced vital capacity, forced expiratory volume in one second, 10-meter walking test, and six-minute walking test over the baseline results. There were significant between-group differences for the forced vital capacity, forced expiratory volume in one second, and six-minute walking test. No statistically significant differences were observed for measures of saturation pulse oximetry oxygen and 10-meter walking test between the groups. [Conclusion] These findings gave some indications that inspiratory muscle training may benefit in patients with subacute stroke, and it is feasible to be included in rehabilitation program with this population. PMID:28265169

  18. Effect of inspiratory muscle training on respiratory capacity and walking ability with subacute stroke patients: a randomized controlled pilot trial.

    PubMed

    Jung, Kyeong-Man; Bang, Dae-Hyouk

    2017-02-01

    [Purpose] To investigate the effects of inspiratory muscle training on respiratory capacity and walking ability in subacute stroke patients. [Subjects and Methods] The subjects were randomly assigned to an experimental group (n=6) or a control group (n=6). Patients in the experimental group received inspiratory muscle training for 30 minutes (six sets of five-minutes) and traditional physical therapy once a day, five days a week, for four weeks. The control group received aerobic exercise for 30 minutes and traditional physical therapy for 30 minutes a day, five days a week, for four weeks. [Results] After the intervention, both groups showed significant improvements in the forced vital capacity, forced expiratory volume in one second, 10-meter walking test, and six-minute walking test over the baseline results. There were significant between-group differences for the forced vital capacity, forced expiratory volume in one second, and six-minute walking test. No statistically significant differences were observed for measures of saturation pulse oximetry oxygen and 10-meter walking test between the groups. [Conclusion] These findings gave some indications that inspiratory muscle training may benefit in patients with subacute stroke, and it is feasible to be included in rehabilitation program with this population.

  19. Medicinal clays improve the endurance of loaded inspiratory muscles in COPD: a randomized clinical trial of nonpharmacological treatment

    PubMed Central

    Baldi, Simonetta; Pinna, Gian Domenico; Bruschi, Claudio; Caldara, Fabrizio; Maestri, Roberto; Dacosto, Elena; Rezzani, Antonella; Popovich, Ermanno; Bellinzona, Ezio; Crotti, Paola; Montemartini, Silvia; Fracchia, Claudio

    2015-01-01

    Background Inspiratory resistive breathing (IRB) challenges affect respiratory muscle endurance in healthy individuals, which is considered to be an interleukin 6 (IL-6)–dependent mechanism. Whether nonpharmacological thermal therapies promote the endurance of loaded inspiratory muscles in chronic obstructive pulmonary disease (COPD) is unclear. The objectives of this study were to compare the effects of two thermal interventions on endurance time (ET) and plasma IL-6 concentration following an IRB challenge. Methods This study was a randomized, parallel-group, unblinded clinical trial in a single-center setting. Forty-two patients (aged 42–76 years) suffering from mild to severe COPD participated in this study. Both groups completed 12 sessions of the mud bath therapy (MBT) (n=22) or leisure thermal activity (LTA) (n=19) in a thermal spa center in Italy. Pre- and postintervention spirometry, maximum inspiratory pressure, and plasma mediators were obtained and ET and endurance oxygen expenditure (VO2Endur) were measured following IRB challenge at 40% of maximum inspiratory pressure. Results There was no difference in ΔIL-6 between the intervention groups. But, IRB challenge increased cytokine IL-6 plasma levels systematically. The effect size was small. A statistically significant treatment by IRB challenge effect existed in ET, which significantly increased in the MBT group (P=0.003). In analysis of covariance treatment by IRB challenge analysis with LnVO2Endur as the dependent variable, ΔIL-6 after intervention predicted LnVO2Endur in the MBT group, but not in the LTA group. Adverse events occurred in two individuals in the MBT group, but they were mainly transient. One patient in the LTA group dropped out. Conclusion MBT model improves ET upon a moderate IRB challenge, indicating the occurrence of a training effect. The LnVO2Endur/ΔIL-6 suggests a physiologic adaptive mechanism in respiratory muscles of COPD patients allocated to treatment. Both thermal

  20. Medicinal clays improve the endurance of loaded inspiratory muscles in COPD: a randomized clinical trial of nonpharmacological treatment.

    PubMed

    Baldi, Simonetta; Pinna, Gian Domenico; Bruschi, Claudio; Caldara, Fabrizio; Maestri, Roberto; Dacosto, Elena; Rezzani, Antonella; Popovich, Ermanno; Bellinzona, Ezio; Crotti, Paola; Montemartini, Silvia; Fracchia, Claudio

    2015-01-01

    Inspiratory resistive breathing (IRB) challenges affect respiratory muscle endurance in healthy individuals, which is considered to be an interleukin 6 (IL-6)-dependent mechanism. Whether nonpharmacological thermal therapies promote the endurance of loaded inspiratory muscles in chronic obstructive pulmonary disease (COPD) is unclear. The objectives of this study were to compare the effects of two thermal interventions on endurance time (ET) and plasma IL-6 concentration following an IRB challenge. This study was a randomized, parallel-group, unblinded clinical trial in a single-center setting. Forty-two patients (aged 42-76 years) suffering from mild to severe COPD participated in this study. Both groups completed 12 sessions of the mud bath therapy (MBT) (n=22) or leisure thermal activity (LTA) (n=19) in a thermal spa center in Italy. Pre- and postintervention spirometry, maximum inspiratory pressure, and plasma mediators were obtained and ET and endurance oxygen expenditure (VO2Endur) were measured following IRB challenge at 40% of maximum inspiratory pressure. There was no difference in ΔIL-6 between the intervention groups. But, IRB challenge increased cytokine IL-6 plasma levels systematically. The effect size was small. A statistically significant treatment by IRB challenge effect existed in ET, which significantly increased in the MBT group (P=0.003). In analysis of covariance treatment by IRB challenge analysis with LnVO2Endur as the dependent variable, ΔIL-6 after intervention predicted LnVO2Endur in the MBT group, but not in the LTA group. Adverse events occurred in two individuals in the MBT group, but they were mainly transient. One patient in the LTA group dropped out. MBT model improves ET upon a moderate IRB challenge, indicating the occurrence of a training effect. The LnVO2Endur/ΔIL-6 suggests a physiologic adaptive mechanism in respiratory muscles of COPD patients allocated to treatment. Both thermal interventions are safe.

  1. Inspiratory muscle training enhances pulmonary O(2) uptake kinetics and high-intensity exercise tolerance in humans.

    PubMed

    Bailey, Stephen J; Romer, Lee M; Kelly, James; Wilkerson, Daryl P; DiMenna, Fred J; Jones, Andrew M

    2010-08-01

    Fatigue of the respiratory muscles during intense exercise might compromise leg blood flow, thereby constraining oxygen uptake (Vo(2)) and limiting exercise tolerance. We tested the hypothesis that inspiratory muscle training (IMT) would reduce inspiratory muscle fatigue, speed Vo(2) kinetics and enhance exercise tolerance. Sixteen recreationally active subjects (mean + or - SD, age 22 + or - 4 yr) were randomly assigned to receive 4 wk of either pressure threshold IMT [30 breaths twice daily at approximately 50% of maximum inspiratory pressure (MIP)] or sham treatment (60 breaths once daily at approximately 15% of MIP). The subjects completed moderate-, severe- and maximal-intensity "step" exercise transitions on a cycle ergometer before (Pre) and after (Post) the 4-wk intervention period for determination of Vo(2) kinetics and exercise tolerance. There were no significant changes in the physiological variables of interest after Sham. After IMT, baseline MIP was significantly increased (Pre vs. Post: 155 + or - 22 vs. 181 + or - 21 cmH(2)O; P < 0.001), and the degree of inspiratory muscle fatigue was reduced after severe- and maximal-intensity exercise. During severe exercise, the Vo(2) slow component was reduced (Pre vs. Post: 0.60 + or - 0.20 vs. 0.53 + or - 0.24 l/min; P < 0.05) and exercise tolerance was enhanced (Pre vs. Post: 765 + or - 249 vs. 1,061 + or - 304 s; P < 0.01). Similarly, during maximal exercise, the Vo(2) slow component was reduced (Pre vs. Post: 0.28 + or - 0.14 vs. 0.18 + or - 0.07 l/min; P < 0.05) and exercise tolerance was enhanced (Pre vs. Post: 177 + or - 24 vs. 208 + or - 37 s; P < 0.01). Four weeks of IMT, which reduced inspiratory muscle fatigue, resulted in a reduced Vo(2) slow-component amplitude and an improved exercise tolerance during severe- and maximal-intensity exercise. The results indicate that the enhanced exercise tolerance observed after IMT might be related, at least in part, to improved Vo(2) dynamics, presumably as a

  2. Inspiratory muscle training improves aerobic capacity and pulmonary function in patients with ankylosing spondylitis: a randomized controlled study.

    PubMed

    Drăgoi, Răzvan-Gabriel; Amaricai, Elena; Drăgoi, Mihai; Popoviciu, Horatiu; Avram, Claudiu

    2016-04-01

    To evaluate the impact of inspiratory muscle training on aerobic capacity and pulmonary function in patients with ankylosing spondylitis. Randomized controlled study. Rheumatic Rehabilitation Centre. A total of 54 ankylosing spondylitis patients, all males, were randomized to a conventional exercise training associated with an inspiratory muscle training group, or to a conventional exercise training group. Group 1 (27 patients) performed eight weeks of conventional exercise training (supervised weekly group sessions followed by a home-based exercise programme) associated with inspiratory muscle training sessions. Group 2 (27 patients) received eight weeks of conventional exercise training only. Resting pulmonary function (forced vital capacity - FVC, forced expiratory volume in one second - FEV1); effort ventilatory efficiency (lowest ventilatory equivalent ratio for oxygen and carbon dioxide - VE/VO2 and VE/VCO2) and aerobic capacity (peak oxygen uptake - VO2peak) were assessed at baseline and after eight weeks of exercise-based intervention. After eight weeks follow-up, patients in Group 1 had a significant increased chest expansion and VO2peak compared with Group 2 (3.6 ±0.8 cm vs. 3.2 ±0.5 cm, P = 0.032; 2.0 ±0.5 l/min vs. 1.8 ±0.3 l/min, P = 0.033). There were no significant differences of spirometric measurements, except FVC which significantly improved in patients who performed inspiratory muscle training (82.7 ±5.1% vs. 79.5 ±3.5%, P = 0.014). VE/VCO2 also improved significantly in Group 1 (26.6 ±3.6 vs. 29.2 ±4.7, P = 0.040). Ankylosing spondylitis patients who performed eight weeks of inspiratory muscle training associated to conventional exercise training had an increased chest expansion, a better aerobic capacity, resting pulmonary function and ventilatory efficiency than those who performed conventional exercise training only. © The Author(s) 2015.

  3. Nutritional status is related to fat-free mass, exercise capacity and inspiratory strength in severe chronic obstructive pulmonary disease patients.

    PubMed

    Sabino, Pollyane Galinari; Silva, Bruno Moreira; Brunetto, Antonio Fernando

    2010-06-01

    Being overweight or obese is associated with a higher rate of survival in patients with advanced chronic obstructive pulmonary disease (COPD). This paradoxical relationship indicates that the influence of nutritional status on functional parameters should be further investigated. To investigate the impact of nutritional status on body composition, exercise capacity and respiratory muscle strength in severe chronic obstructive pulmonary disease patients. Thirty-two patients (nine women) were divided into three groups according to their body mass indices (BMI): overweight/obese (25 < or = BMI < or = 34.9 kg/m(2), n=8), normal weight (18.5 < or = BMI < or = 24.9 kg/m(2), n=17) and underweight (BMI <18.5 kg/m(2), n=7). Spirometry, bioelectrical impedance, a six-minute walking distance test and maximal inspiratory and expiratory pressures were assessed. Airway obstruction was similar among the groups (p=0.30); however, overweight/obese patients had a higher fat-free mass (FFM) index [FFMI=FFM/body weight(2) (mean+/-SEM: 17+/-0.3 vs. 15+/-0.3 vs. 14+/-0.5 m/kg(2), p<0.01)], exercise capacity (90+/-8 vs. 79+/-6 vs. 57+/-8 m, p=0.02) and maximal inspiratory pressure (63+/-7 vs. 57+/-5 vs. 35+/-8 % predicted, p=0.03) in comparison to normal weight and underweight patients, respectively. In addition, on backward multiple regression analysis, FFMI was the unique independent predictor of exercise capacity (partial r=0.52, p<0.01). Severe chronic obstructive pulmonary disease (COPD) patients who were overweight or obese had a greater FFM, exercise capacity and inspiratory muscle strength than patients with the same degree of airflow obstruction who were of normal weight or underweight, and higher FFM was independently associated with higher exercise capacity. These characteristics of overweight or obese patients might counteract the drawbacks of excess weight and lead to an improved prognosis in COPD.

  4. Mechanical ventilation weaning in inclusion body myositis: feasibility of isokinetic inspiratory muscle training as an adjunct therapy.

    PubMed

    Cordeiro de Souza, Leonardo; Campos, Josué Felipe; Daher, Leandro Possidente; Furtado da Silva, Priscila; Ventura, Alex; do Prado, Pollyana Zamborlini; Brasil, Daniele; Mendonça, Debora; Lugon, Jocemir Ronaldo

    2014-01-01

    Inclusion body myositis is a rare myopathy associated with a high rate of respiratory complications. This condition usually requires prolonged mechanical ventilation and prolonged intensive care stay. The unsuccessful weaning is mainly related to respiratory muscle weakness that does not promptly respond to immunosuppressive therapy. We are reporting a case of a patient in whom the use of an inspiratory muscle-training program which started after a two-week period of mechanical ventilation was associated with a successful weaning in one week and hospital discharge after 2 subsequent weeks.

  5. Mechanical Ventilation Weaning in Inclusion Body Myositis: Feasibility of Isokinetic Inspiratory Muscle Training as an Adjunct Therapy

    PubMed Central

    Campos, Josué Felipe; Daher, Leandro Possidente; Ventura, Alex; do Prado, Pollyana Zamborlini; Brasil, Daniele; Mendonça, Debora; Lugon, Jocemir Ronaldo

    2014-01-01

    Inclusion body myositis is a rare myopathy associated with a high rate of respiratory complications. This condition usually requires prolonged mechanical ventilation and prolonged intensive care stay. The unsuccessful weaning is mainly related to respiratory muscle weakness that does not promptly respond to immunosuppressive therapy. We are reporting a case of a patient in whom the use of an inspiratory muscle-training program which started after a two-week period of mechanical ventilation was associated with a successful weaning in one week and hospital discharge after 2 subsequent weeks. PMID:25147743

  6. Effects of fast expiration exercises without pressure on the respiratory muscle strength of healthy subjects

    PubMed Central

    Ishida, Hiroshi; Kuramoto, Yuri; Ikeda, Daiki; Watanabe, Susumu

    2016-01-01

    [Purpose] The aim of this investigation was to determine the effects of 4 weeks of fast expiration exercises performed without pressure on respiratory muscle strength. [Subjects and Methods] Respiratory muscle strength of the training group that performed fast expiration exercises (n=12) was compared with that of a control group that performed no exercises (n=12). The fast expiration exercises were performed using a peak expiratory flow meter device and consisted of 20 fast expiration exercises performed 3 times per week for 4 weeks. Maximal expiratory and inspiratory pressures were evaluated as respiratory muscle strength using a spirometer pre- and post- intervention. [Results] There were significant increases in maximal expiratory pressure from 76.9 ± 29.1 to 96.1 ± 37.5 cmH2O and maximal inspiratory pressure from 80.8 ± 36.6 to 95.3 ± 37.6 cmH2O in the training group, but there was no significant difference in respiratory muscle strength between pre- and post-intervention in the control group. [Conclusion] Fast expiration exercises may be beneficial for increasing respiratory muscle strength. The findings of this study should be considered when prescribing a variation of the expiratory muscle strength training, as part of a pulmonary rehabilitation program. PMID:27821930

  7. The effects of chest expansion resistance exercise on chest expansion and maximal respiratory pressure in elderly with inspiratory muscle weakness

    PubMed Central

    Kim, Chang-Beom; Yang, Jin-Mo; Choi, Jong-Duk

    2015-01-01

    [Purpose] The aim of this study was to examine the effect of chest expansion resistance exercises (CERE) on chest expansion, maximal inspiratory pressure (MIP), and maximal expiratory pressure (MEP) in elderly people with inspiratory muscle weakness. [Subjects] Thirty elderly people with inspiratory muscle weakness (MIP < 80% of the predicted value) were randomly and equally assigned to a chest expansion resistance exercise (CERE) group, core conditioning exercise (CCE) group, and control group. [Methods] The intervention was applied to the CERE group and CCE group five times per week, 30 minutes each time, for six weeks. A tapeline was used to measure upper and lower chest expansion. MIP and MEP before and after the intervention were measured and compared. [Results] There was significant improvement in upper and lower chest expansion and MIP after the intervention in both the CERE group and the CCE group, whereas the control group did not show any significant difference. MEP did not significantly change in any of the three groups after the intervention. [Conclusion] The CERE group underwent greater changes than the CCE group, which proves that the CERE is more effective for improving elderly people’s chest expansion capacity and MIP in elderly people. Therefore, application of the CERE by therapists is recommended if the environment and conditions are appropriate for enhancement of chest expansion capacity and MIP in elderly people. PMID:25995570

  8. Lung Function, Respiratory Muscle Strength, and Thoracoabdominal Mobility in Women With Fibromyalgia Syndrome.

    PubMed

    Forti, Meire; Zamunér, Antonio R; Andrade, Carolina P; Silva, Ester

    2016-10-01

    Fibromyalgia syndrome (FMS) is associated with a variety of symptoms, such as fatigue and dyspnea, which may be related to changes in the respiratory system. The objective of this work was to evaluate pulmonary function, respiratory muscle strength, and thoracoabdominal mobility in women with FMS and its association with clinical manifestations. The study included 23 women with FMS and 23 healthy women (control group). Pulmonary function, respiratory muscle strength, and thoracoabdominal mobility were assessed in all participants. Clinical manifestations such as number of active tender points, pain, fatigue, well-being, and general pressure pain threshold and pressure pain threshold in regions involved in respiratory function were also assessed. For data analysis, the Mann-Whitney test and Spearman correlation coefficient were used. The FMS group showed lower values of maximum voluntary ventilation (P = .030), maximal inspiratory pressure (P = .003), and cirtometry at the axillary and xiphoid levels (P < .001 and P < .001, respectively) as well as higher cirtometry at the abdominal level (P = .005) compared with the control group. However, there was no significant difference between groups for maximum expiratory pressure. In predicted percentage, maximal inspiratory pressure showed significant positive correlation with axillary cirtometry (r = 0.41, P = .049) and negative correlation with the number of active tender points (r = -0.44, P = .031) and fatigue (r = -0.41, P = .049). Subjects with FMS had lower respiratory muscle endurance, inspiratory muscle strength, and thoracic mobility than healthy subjects. In addition, inspiratory muscle strength was associated with the number of active tender points, fatigue, and axillary mobility. Copyright © 2016 by Daedalus Enterprises.

  9. Impact of a behavioral-based intervention on inspiratory muscle training prescription by a multidisciplinary team.

    PubMed

    Simms, Alanna M; Li, Linda C; Geddes, E Lynne; Brooks, Dina; Hoens, Alison M; Reid, W Darlene

    2012-01-01

    Our goal was to compare behavioral- and information-based interventions aimed at increasing prescription of inspiratory muscle training (IMT) for people with chronic obstructive pulmonary disease (COPD) by interdisciplinary teams during pulmonary rehabilitation (PR). Six hospital PR programs were randomly assigned to a behavioral- or information-based intervention. Both interventions provided evidence supporting IMT and its prescription details. However, the behavioral-based intervention focused on barriers and challenges to IMT prescription informed by a nationwide survey and the theory of planned behavior (TPB). It included hands-on practice and content, in part, was driven by learners' questions. In contrast, the information-based intervention delivered information in a typical didactic education session followed by a demonstration and question period. It was supplemented with evidence-based research articles. The primary outcome was the change in prescription rate of IMT for COPD patients by determining the difference during the 6 months preceding compared to the 6 months during the interventions. Sixty-one health professionals and 488 COPD outpatients within 6 PR programs participated. No COPD patients were prescribed IMT at any of the sites during the 6-month preintervention phase. The behavioral-based intervention resulted in an IMT prescription rate of 10.2% to people with COPD, whereas the information-based intervention resulted in no IMT prescriptions. A behavioral-based intervention that is based on TPB and addresses challenges identified by health professionals is more effective than a traditional lecture approach to increase health professionals' prescription of IMT for patients with COPD. Copyright © 2012 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on CME, Association for Hospital Medical Education.

  10. Noninvasive assessment of respiratory muscle strength and activity in Myotonic dystrophy

    PubMed Central

    Evangelista, Morgana de Araújo; Dias, Fernando Augusto Lavezzo; Dourado Júnior, Mário Emílio Teixeira; do Nascimento, George Carlos; Gualdi, Lucien Peroni; Aliverti, Andrea; Resqueti, Vanessa; Fregonezi, Guilherme Augusto de Freitas

    2017-01-01

    Objective To evaluate sensitivity/specificity of the maximum relaxation rate (MRR) of inspiratory muscles, amplitude of electromyographic activity of the sternocleidomastoid (SCM), scalene (SCA), parasternal (2ndIS) and rectus abdominis (RA) muscles; lung function and respiratory muscle strength in subjects with Myotonic dystrophy type 1 (DM1) compared with healthy subjects. Design and methods Quasi-experimental observational study with control group. MRR of inspiratory muscles, lung function and amplitude of the electromyographic activity of SCM, SCA, 2ndIS and RA muscles during maximum inspiratory pressure (PImax), maximum expiratory pressure (PEmax) and sniff nasal inspiratory pressure (SNIP) tests were assessed in eighteen DM1 subjects and eleven healthy. Results MRR was lower in DM1 group compared to healthy (P = 0.001) and was considered sensitive and specific to identify disease in DM1 and discard it in controls, as well as SNIP% (P = 0.0026), PImax% (P = 0.0077) and PEmax% (P = 0.0002). Contraction time of SCM and SCA was higher in DM1 compared to controls, respectively, during PImax (P = 0.023 and P = 0.017) and SNIP (P = 0.015 and P = .0004). The DM1 group showed lower PImax (P = .0006), PEmax (P = 0.0002), SNIP (P = 0.0014), and higher electromyographic activity of the SCM (P = 0.002) and SCA (P = 0.004) at rest; of 2ndIS (P = 0.003) during PEmax and of SCM (P = 0.02) and SCA (P = 0.03) during SNIP test. Conclusions MD1 subjects presented restrictive pattern, reduced respiratory muscle strength, muscular electrical activity and MRR when compared to higher compared to controls. In addition, the lower MRR found in MD1 subjects showed to be reliable to sensitivity and specificity in identifying the delayed relaxation of respiratory muscles. PMID:28594857

  11. Noninvasive assessment of respiratory muscle strength and activity in Myotonic dystrophy.

    PubMed

    Evangelista, Morgana de Araújo; Dias, Fernando Augusto Lavezzo; Dourado Júnior, Mário Emílio Teixeira; do Nascimento, George Carlos; Sarmento, Antonio; Gualdi, Lucien Peroni; Aliverti, Andrea; Resqueti, Vanessa; Fregonezi, Guilherme Augusto de Freitas

    2017-01-01

    To evaluate sensitivity/specificity of the maximum relaxation rate (MRR) of inspiratory muscles, amplitude of electromyographic activity of the sternocleidomastoid (SCM), scalene (SCA), parasternal (2ndIS) and rectus abdominis (RA) muscles; lung function and respiratory muscle strength in subjects with Myotonic dystrophy type 1 (DM1) compared with healthy subjects. Quasi-experimental observational study with control group. MRR of inspiratory muscles, lung function and amplitude of the electromyographic activity of SCM, SCA, 2ndIS and RA muscles during maximum inspiratory pressure (PImax), maximum expiratory pressure (PEmax) and sniff nasal inspiratory pressure (SNIP) tests were assessed in eighteen DM1 subjects and eleven healthy. MRR was lower in DM1 group compared to healthy (P = 0.001) and was considered sensitive and specific to identify disease in DM1 and discard it in controls, as well as SNIP% (P = 0.0026), PImax% (P = 0.0077) and PEmax% (P = 0.0002). Contraction time of SCM and SCA was higher in DM1 compared to controls, respectively, during PImax (P = 0.023 and P = 0.017) and SNIP (P = 0.015 and P = .0004). The DM1 group showed lower PImax (P = .0006), PEmax (P = 0.0002), SNIP (P = 0.0014), and higher electromyographic activity of the SCM (P = 0.002) and SCA (P = 0.004) at rest; of 2ndIS (P = 0.003) during PEmax and of SCM (P = 0.02) and SCA (P = 0.03) during SNIP test. MD1 subjects presented restrictive pattern, reduced respiratory muscle strength, muscular electrical activity and MRR when compared to higher compared to controls. In addition, the lower MRR found in MD1 subjects showed to be reliable to sensitivity and specificity in identifying the delayed relaxation of respiratory muscles.

  12. Effect of inspiratory muscle fatigue on exercise performance taking into account the fatigue-induced excess respiratory drive.

    PubMed

    Wüthrich, Thomas U; Notter, Dominic A; Spengler, Christina M

    2013-12-01

    Inspiratory muscle fatigue (IMF) is suggested to compromise exercise performance, possibly via a respiratory muscle metaboreflex that impairs blood flow to working muscles, thereby accelerating the development of fatigue in these muscles. Cycling with IMF has also been associated with an excess ventilatory response, which could per se impair performance. Therefore, the present study investigated whether prior-induced IMF would affect subsequent cycling performance via increased quadriceps muscle fatigue alone and whether fatigue-induced excess ventilation would contribute to this impairment. Fourteen healthy male subjects (peak oxygen uptake, 57.0 ± 5.5 ml min(-1) kg(-1)) cycled to exhaustion at 85% of their maximal work output with prior-induced IMF (PF-EX) and without prior-induced IMF (C-EX). Subjects then cycled twice for the duration of PF-EX but without prior IMF, once with spontaneous breathing (C-ISO) and once with breathing coached to match PF-EX ventilation (MATCH-ISO). Inspiratory muscle (P(tw)) and quadriceps muscle contractility (Q(tw)) was assessed via magnetic nerve stimulation before and after exercise. The time to exhaustion in the PF-EX conditions was significantly reduced by 14% compared with C-EX. The reduction in P(tw) and Q(tw) was greater after PF-EX (P(tw), 17.3 ± 9.7%; Q(tw), 32.0 ± 10.8%) than after MATCH-ISO (P(tw), 10.8 ± 10.3%; Q(tw), 23.3 ± 15.2%; P < 0.05), which may explain the increased perception of exertion and earlier task failure with prior-induced IMF. The augmented ventilatory drive had no effect on reductions in P(tw) and Q(tw) after MATCH-ISO compared with C-ISO. Thus, prior-induced IMF reduces exercise performance, probably as a result of the increased quadriceps muscle fatigue and thus greater perception of exertion independent of the excess respiratory drive when cycling with fatigued inspiratory muscles.

  13. Pilates: Build Strength in Your Core Muscles

    MedlinePlus

    ... MB, et al. The Pilates Method increases respiratory muscle strength and performance as well as abdominal muscle thickness. ... 20:258. Kloubec JA. Pilates for improvement of muscle endurance, flexibility, balance, and posture. Journal of Strength and Conditioning Research. 2010;24:661. 2008 Physical ...

  14. Effect of high-intensity home-based respiratory muscle training on strength of respiratory muscles following a stroke: a protocol for a randomized controlled trial.

    PubMed

    Menezes, Kênia Kiefer Parreiras De; Nascimento, Lucas Rodrigues; Polese, Janaine Cunha; Ada, Louise; Teixeira-Salmela, Luci Fuscaldi

    2017-07-03

    Respiratory muscle training has shown to increase strength of the respiratory muscles following a stroke. However, low duration and/or intensity of training may be responsible for the small effect size seen and/or absence of carry-over effects to an activity, e.g., walking. Therefore, an investigation of the effects of long-duration, high-intensity respiratory muscle training is warranted. This proposed protocol for a randomized clinical trial will examine the efficacy of high-intensity respiratory muscle training to increase strength and improve activity following a stroke. This study will be a two-arm, prospectively registered, randomized controlled trial, with blinded assessors. Thirty-eight individuals who have suffered a stroke will participate. The experimental group will undertake a 40-min of respiratory muscle training program, seven days/week, for eight weeks in their homes. Training loads will be increased weekly. The control group will undertake a sham respiratory muscle training program with equivalent duration and scheduling of training. The primary outcome will be the strength of the inspiratory muscles, measured as maximal inspiratory pressure. Secondary outcomes will include expiratory muscle strength, inspiratory muscle endurance, dyspnea, respiratory complications, and walking capacity. Outcomes will be collected by a researcher blinded to group allocation at baseline (Week 0), after intervention (Week 8), and one month beyond intervention (Week 12). High-intensity respiratory muscle training may have the potential to optimize the strength of the respiratory muscles following a stroke. If benefits are carried over to activity, the findings may have broader implications, since walking capacity has been shown to predict physical activity and community participation on this population. Copyright © 2017 Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia. Publicado por Elsevier Editora Ltda. All rights reserved.

  15. Inspiratory muscle fatigue affects latissimus dorsi but not pectoralis major activity during arms only front crawl sprinting.

    PubMed

    Lomax, Mitch; Tasker, Louise; Bostanci, Ozgur

    2014-08-01

    The purpose of this study was to determine whether inspiratory muscle fatigue (IMF) affects the muscle activity of the latissimus dorsi and pectoralis major during maximal arms only front crawl swimming. Eight collegiate swimmers were recruited to perform 2 maximal 20-second arms only front crawl sprints in a swimming flume. Both sprints were performed on the same day, and IMF was induced 30 minutes after the first (control) sprint. Maximal inspiratory and expiratory mouth pressures (PImax and PEmax, respectively) were measured before and after each sprint. The median frequency (MDF) of the electromyographic signal burst was recorded from the latissimus dorsi and pectoralis major during each 20-second sprint along with stroke rate and breathing frequency. Median frequency was assessed in absolute units (Hz) and then referenced to the start of the control sprint for normalization. After IMF inducement, stroke rate increased from 56 ± 4 to 59 ± 5 cycles per minute, and latissimus dorsi MDF fell from 67 ± 11 Hz at the start of the sprint to 61 ± 9 Hz at the end. No change was observed in the MDF of the latissimus dorsi during the control sprint. Conversely, the MDF of the pectoralis major shifted to lower frequencies during both sprints but was unaffected by IMF. As the latter induced fatigue in the latissimus dorsi, which was not otherwise apparent during maximal arms only control sprinting, the presence of IMF affects the activity of the latissimus dorsi during front crawl sprinting.

  16. Asymmetry of Muscle Strength in Elite Athletes

    ERIC Educational Resources Information Center

    Drid, Patrik; Drapsin, Miodrag; Trivic, Tatjana; Lukac, Damir; Obadov, Slavko; Milosevic, Zoran

    2009-01-01

    "Study aim": To determine muscle strength variables in elite judoists and wrestlers since thigh muscle strength and bilaterally balanced flexor-to-extensor ratio minimise injury risk and are desirable for achieving sport successes. "Material and methods": Judoists, wrestlers and untrained subjects, 10 each, were subjected to isokinetic strength…

  17. Quadriceps muscle strength in scoliosis.

    PubMed

    Swallow, E B; Barreiro, E; Gosker, H; Sathyapala, S A; Sanchez, F; Hopkinson, N S; Moxham, J; Schols, A; Gea, J; Polkey, M I

    2009-12-01

    Quadriceps muscle weakness is an important component of chronic obstructive pulmonary disease (COPD). We hypothesised that quadriceps weakness would also be a feature of restrictive lung disease due to scoliosis. We studied 10 patients with severe scoliosis (median (interquartile range (IQR)) forced expiratory volume in 1 s (FEV(1))() 35.3 (11)% predicted), 10 patients with severe COPD (FEV(1) 26.5 (9.0)% pred) and 10 healthy age-matched adults. We measured quadriceps strength, exercise capacity and analysed quadriceps muscle biopsies for myosin heavy-chain (MyHC) isoform expression and the presence of oxidative stress. Both groups exhibited quadriceps weakness with median (IQR) maximal voluntary contraction force being 46.0 (17.0) kg, 21.5 (21.0) kg and 31.5 (11.0) kg, respectively (p = 0.02 and 0.04, respectively, for each patient group against controls). Oxidative stress was significantly greater in the quadriceps of both restrictive and COPD patients. The scoliosis patients exhibited a decrease in the proportion of MyHC type I compared with controls; median (IQR) 35.3 (18.5)% compared with 47.7 (9.3)%, p = 0.028. The scoliosis patients also showed an increase in MyHC IIx (26.3 (15.5)% compared with 11.3 (13.0)%, p = 0.01. Quadriceps weakness is a feature of severe scoliosis; the similarities between patients with scoliosis and patients with COPD suggest a common aetiology to quadriceps weakness in both conditions.

  18. Inspiratory muscle training improves exercise tolerance in recreational soccer players without concomitant gain in soccer-specific fitness.

    PubMed

    Guy, Joshua H; Edwards, Andrew M; Deakin, Glen B

    2014-02-01

    This study investigated whether the addition of inspiratory muscle training (IMT) to an existing program of preseason soccer training would augment performance indices such as exercise tolerance and sports-specific performance beyond the use of preseason training alone. Thirty-one men were randomized across 3 groups: experimental (EXP: n = 12), placebo (PLA: n = 9), and control (CON: n = 10). The EXP and PLA completed a 6-week preseason program (2× weekly sessions) in addition to concurrent IMT with either an IMT load (EXP) or negligible (PLA) inspiratory resistance. Control group did not use an IMT device or undertake soccer training. All participants performed the following tests before and after the 6-week period: standard spirometry; maximal inspiratory mouth pressure (MIP); multistage fitness test (MSFT); and a soccer-specific fitness test (SSFT). After 6-weeks training, EXP significantly improved: MIP (p = 0.002); MSFT distance covered (p = 0.02); and post-SSFT blood lactate (BLa) (p = 0.04). No other outcomes from the SSFT were changed. Pre- to posttraining performance outcomes for PLA and CON were unchanged. These findings suggest the addition of IMT to preseason soccer training improved exercise tolerance (MSFT distance covered) but had little effect on soccer-specific fitness indices beyond a slightly reduced posttraining SSFT BLa. In conclusion, there may be benefit for soccer players to incorporate IMT to their preseason training but the effect is not conclusive. It is likely that a greater preseason training stimulus would be particularly meaningful for this population if fitness gains are a priority and evoke a stronger IMT response.

  19. Preoperative inspiratory muscle training for postoperative pulmonary complications in adults undergoing cardiac and major abdominal surgery.

    PubMed

    Katsura, Morihiro; Kuriyama, Akira; Takeshima, Taro; Fukuhara, Shunichi; Furukawa, Toshi A

    2015-10-05

    Postoperative pulmonary complications (PPCs) have an impact on the recovery of adults after surgery. It is therefore important to establish whether preoperative respiratory rehabilitation can decrease the risk of PPCs and to identify adults who might benefit from respiratory rehabilitation. Our primary objective was to assess the effectiveness of preoperative inspiratory muscle training (IMT) on PPCs in adults undergoing cardiac or major abdominal surgery. We looked at all-cause mortality and adverse events. We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2014, Issue 10), MEDLINE (1966 to October 2014), EMBASE (1980 to October 2014), CINAHL (1982 to October 2014), LILACS (1982 to October 2014), and ISI Web of Science (1985 to October 2014). We did not impose any language restrictions. We included randomized controlled trials that compared preoperative IMT and usual preoperative care for adults undergoing cardiac or major abdominal surgery. Two or more review authors independently identified studies, assessed trial quality, and extracted data. We extracted the following information: study characteristics, participant characteristics, intervention details, and outcome measures. We contacted study authors for additional information in order to identify any unpublished data. We included 12 trials with 695 participants; five trials included participants awaiting elective cardiac surgery and seven trials included participants awaiting elective major abdominal surgery. All trials contained at least one domain judged to be at high or unclear risk of bias. Of greatest concern was the risk of bias associated with inadequate blinding, as it was impossible to blind participants due to the nature of the study designs. We could pool postoperative atelectasis in seven trials (443 participants) and postoperative pneumonia in 11 trials (675 participants) in a meta-analysis. Preoperative IMT was associated with a reduction of postoperative atelectasis and

  20. Muscle training for bone strength.

    PubMed

    Suominen, Harri

    2006-04-01

    The main function of bone is to provide the mechanical integrity for locomotion and protection; accordingly, bone mass and architecture are adjusted to control the strains produced by mechanical load and muscular activity. Age-related patterns involve peak bone mass during growth, a plateau in adulthood, and bone loss during aging. The decline in bone mass and structural integrity results in increased risk of fractures, particularly in post-menopausal women. Athletes competing in strength and power events, such as weight-lifting and jumping, have superior bone mass and structure compared with their untrained counterparts in all age groups. Exercise seems to be most effective during rapid growth, the average gain in bone mineral content (BMC) and density (BMD) in controlled trials being of the order of 2-5% per year. The net gain of BMD after exercise interventions among older people is modest, at a level of 1-3% per year, but it is not clear whether positive effects can be maintained over a longer time. Although aerobic exercise is important in maintaining overall health, the resistance type of muscle training may be more applicable to the basic rules of bone adaptation and site-specific effects of exercise, have more favorable effects in maintaining or improving bone mass and architecture, and be safe and feasible for older people. It has been suggested that there is an opportunity for resistance training, for improved effects on BMD in postmenopausal women in bones which have less daily loading. In addition to BMC and BMD, bone geometry and mass distribution may also change as a result of training and other treatment, such as hormonal replacement therapy, thereby further improving bone strength and reducing fracture risk. Appropriate training regimens may reduce the risk of falls and the severity of fall-related injuries, and also constitute potential therapy to improve functional ability and the quality of life in osteoporotic patients. However, further research

  1. Effect of acute inspiratory muscle exercise on blood flow of resting and exercising limbs and glucose levels in type 2 diabetes.

    PubMed

    Corrêa, Ana Paula dos Santos; Antunes, Cristiano Fetter; Figueira, Franciele Ramos; de Castro, Marina Axmann; Ribeiro, Jorge Pinto; Schaan, Beatriz D'Agord

    2015-01-01

    To evaluate the effects of inspiratory loading on blood flow of resting and exercising limbs in patients with diabetic autonomic neuropathy. Ten diabetic patients without cardiovascular autonomic neuropathy (DM), 10 patients with cardiovascular autonomic neuropathy (DM-CAN) and 10 healthy controls (C) were randomly assigned to inspiratory muscle load of 60% or 2% of maximal inspiratory pressure (PImax) for approximately 5 min, while resting calf blood flow (CBF) and exercising forearm blood flow (FBF) were measured. Reactive hyperemia was also evaluated. From the 20 diabetic patients initially allocated, 6 wore a continuous glucose monitoring system to evaluate the glucose levels during these two sessions (2%, placebo or 60%, inspiratory muscle metaboreflex). Mean age was 58 ± 8 years, and mean HbA1c, 7.8% (62 mmol/mol) (DM and DM-CAN). A PImax of 60% caused reduction of CBF in DM-CAN and DM (P<0.001), but not in C, whereas calf vascular resistance (CVR) increased in DM-CAN and DM (P<0.001), but not in C. The increase in FBF during forearm exercise was blunted during 60% of PImax in DM-CAN and DM, and augmented in C (P<0.001). Glucose levels decreased by 40 ± 18.8% (P<0.001) at 60%, but not at 2%, of PImax. A negative correlation was observed between reactive hyperemia and changes in CVR (Beta coefficient = -0.44, P = 0.034). Inspiratory muscle loading caused an exacerbation of the inspiratory muscle metaboreflex in patients with diabetes, regardless of the presence of neuropathy, but influenced by endothelial dysfunction. High-intensity exercise that recruits the diaphragm can abruptly reduce glucose levels.

  2. Respiratory muscle strength in the physically active elderly.

    PubMed

    Summerhill, Eleanor M; Angov, Nadia; Garber, Carol; McCool, F Dennis

    2007-12-01

    Advancing age is associated with a decline in the strength of the skeletal muscles, including those of respiration. Respiratory muscles can be strengthened with nonrespiratory activities. We therefore hypothesized that regular exercise in the elderly would attenuate this age-related decline in respiratory muscle strength. Twenty-four healthy subjects older than 65 years were recruited (11 males and 13 females). A comprehensive physical activity survey was administered, and subjects were categorized as active (n = 12) or inactive (n = 12). Each subject underwent testing of maximum inspiratory and expiratory pressures (PI(max) and PE(max)). Diaphragmatic thickness (tdi) was measured via two-dimensional B-mode ultrasound. There were no significant differences between the active and inactive groups with respect to age (75 vs. 73 years) or body weight (69.1vs. 69.9 kg). There were more women (9) than men (3) in the inactive group. Diaphragm thickness was greater in the active group (0.31 +/- 0.06 cm vs. 0.25 +/- 0.04 cm; p = 0.011). PE(max) and PI(max) were also greater in the active group (130 +/- 44 cm H(2)O vs. 80 +/- 24 cm H(2)O; p = 0.002; and 99 +/- 32 cm H(2)O vs. 75 +/- 14 cm H(2)O; p = 0.03). There was a positive association between PI(max )and tdi (r = 0.43, p = 0.03). Regular exercise was positively associated with diaphragm muscle thickness in this cohort. As PE(max) was higher in the active group, we postulate that recruitment of the diaphragm and abdominal muscles during nonrespiratory activities may be the source of this training effect.

  3. Maximal inspiratory mouth pressure in Japanese elite female athletes.

    PubMed

    Ohya, Toshiyuki; Hagiwara, Masahiro; Chino, Kentaro; Suzuki, Yasuhiro

    2017-04-01

    Maximal inspiratory mouth pressure (MIP) is a common measurement of inspiratory muscle strength, which is often used in a variety of exercises to evaluate the effects of inspiratory muscle training. The characteristics of MIP in elite female athletes remain unclear. This study aimed to determine the characteristics of MIP at rest in a variety of sport-specific elite female athletes. We also aimed to clarify if there is a sex difference of MIP in elite athletes. We studied 169 Japanese elite female athletes and 301 Japanese elite male athletes. MIP was assessed using a portable autospirometer with a handheld mouth pressure meter. Female athletes who regularly experienced exercise-induced inspiratory muscle fatigue tended to have higher MIP values. The mean absolute MIP value in females was significantly lower than that in males. However, when this value was expressed relative to body mass, this difference disappeared. Our findings provide essential information for prescribed, sport-specific, inspiratory muscle training in elite female athletes. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. Personality Typology in Relation to Muscle Strength

    PubMed Central

    Terracciano, Antonio; Milaneschi, Yuri; Metter, E. Jeffrey; Ferrucci, Luigi

    2011-01-01

    Background Physical inactivity plays a central role in the age-related decline in muscle strength, an important component in the process leading to disability. Personality, a significant determinant of health behaviors including physical activity, could therefore impact muscle strength throughout adulthood and affect the rate of muscle strength decline with aging. Personality typologies combining “high neuroticism” (N≥55), “low extraversion” (E<45), and “low conscientiousness” (C<45) have been associated with multiple risky health behaviors but have not been investigated with regards to muscle strength. Purpose The purpose of this study is to investigate associations between individual and combined typologies consisting of high N, low E, and low C and muscle strength, and whether physical activity and body mass index act as mediators. Method This cross-sectional study includes 1,220 participants from the Baltimore Longitudinal Study of Aging. Results High N was found among 18%, low E among 31%, and low C among 26% of the sample. High levels of N, particularly when combined with either low E or low C, were associated with lower muscle strength compared with having only one or none of these personality types. Facet analyses suggest an important role for the N components of depression and hostility. Physical activity level appears to partly explain some of these associations. Conclusion Findings provide support for the notion that the typological approach to personality may be useful in identifying specific personality types at risk of low muscle strength and offer the possibility for more targeted prevention and intervention programs. PMID:21614452

  5. Effect of abdominal muscle training on respiratory muscle strength and forced expiratory flows in sedentary, healthy adolescents.

    PubMed

    Rodríguez-Núñez, Iván; Navarro, Ximena; Gatica, Darwin; Manterola, Carlos

    2016-10-01

    Respiratory muscle training is the most commonly used method to revert respiratory muscle weakness; however, the effect of protocols based on non-respiratory maneuvers has not been adequately studied in the pediatric population. The objective of this study was to establish the effect of abdominal muscle training on respiratory muscle strength and forced expiratory flows in healthy adolescents. This was a quasi-experiment. The sample was made up of healthy adolescents divided into two groups: an experimental group who completed eight weeks of active abdominal muscle training, and an equivalent control group. The following indicators were measured: abdominal muscle strength, maximal inspiratory pressure, maximal expiratory pressure (MEP), peak expiratory flow, and peak cough flow, before and after protocol completion. A value of p < 0.05 was considered significant. All studied outcome measures increased significantly in the experimental group but only MEP increased in the control group. In addition, a higher MEP was observed in the experimental group compared to the control group at the end of the protocol, together with a greater increase in MEP and peak expiratory flow. Finally, the increase in MEP was associated with an increase in cough peak flow in the experimental group but not in the control group. After eight weeks of abdominal muscle training, MEP and peak expiratory flow increased in healthy (sedentary) adolescents. Such effects were associated with intervention-induced increases in cough peak flow. Sociedad Argentina de Pediatría.

  6. [How I investigate...respiratory muscle disorders].

    PubMed

    Lehance, C; Close, P; Bury, Th

    2004-01-01

    As for other skeletal muscles, ventilatory muscle performance can be described in terms of strength and endurance. Ventilatory muscle strength is measured, for example, as the maximum inspiratory and expiratory mouth pressures. It is now a routine procedure in many pulmonary function laboratories. Measurements of ventilatory muscle endurance are more difficult but two general types of tests are used: maximum voluntary ventilation and inspiratory threshold loading.

  7. Chronic and acute inspiratory muscle loading augment the effect of a 6-week interval program on tolerance of high-intensity intermittent bouts of running.

    PubMed

    Tong, Tom K; Fu, Frank H; Eston, Roger; Chung, Pak-Kwong; Quach, Binh; Lu, Kui

    2010-11-01

    This study examined the hypothesis that chronic (training) and acute (warm-up) loaded ventilatory activities applied to the inspiratory muscles (IM) in an integrated manner would augment the training volume of an interval running program. This in turn would result in additional improvement in the maximum performance of the Yo-Yo intermittent recovery test in comparison with interval training alone. Eighteen male nonprofessional athletes were allocated to either an inspiratory muscle loading (IML) group or control group. Both groups participated in a 6-week interval running program consisting of 3-4 workouts (1-3 sets of various repetitions of selected distance [100-2,400 m] per workout) per week. For the IML group, 4-week IM training (30 inspiratory efforts at 50% maximal static inspiratory pressure [P0] per set, 2 sets·d-1, 6 d·wk-1) was applied before the interval program. Specific IM warm-up (2 sets of 30 inspiratory efforts at 40% P0) was performed before each workout of the program. For the control group, neither IML was applied. In comparison with the control group, the interval training volume as indicated by the repeatability of running bouts at high intensity was approximately 27% greater in the IML group. Greater increase in the maximum performance of the Yo-Yo test (control: 16.9 ± 5.5%; IML: 30.7 ± 4.7% baseline value) was also observed after training. The enhanced exercise performance was partly attributable to the greater reductions in the sensation of breathlessness and whole-body metabolic stress during the Yo-Yo test. These findings show that the combination of chronic and acute IML into a high-intensity interval running program is a beneficial training strategy for enhancing the tolerance to high-intensity intermittent bouts of running.

  8. Benefits of physical training on exercise capacity, inspiratory muscle function, and quality of life in patients with ventricular assist devices long-term postimplantation.

    PubMed

    Laoutaris, Ioannis D; Dritsas, Athanasios; Adamopoulos, Stamatis; Manginas, Athanassios; Gouziouta, Aggeliki; Kallistratos, Manolis S; Koulopoulou, Maria; Voudris, Vasilis; Cokkinos, Dennis V; Sfirakis, Petros

    2011-02-01

    Capacity to exercise may not be fully restored in patients with heart failure even in the long term after ventricular assist device (VAD) implantation. The benefits of exercise training in patients with VAD are unknown. Fifteen patients, aged 38.3 ± 15.9 years, bridged to heart transplantation with left ventricular assist device or biventricular assist device were randomized at a ratio of 2 : 1 to a training group (TG, n = 10) or a control group (n = 5), 6.3 ± 4 months after implantation. Both the groups were advised to walk 30–45 min/day. TG also underwent moderate-intensity aerobic exercise using a bike or treadmill for 45 min, three to five times a week, combined with high-intensity inspiratory muscle training using a computer-designed software to respiratory exhaustion, two to three times a week for 10 weeks. The patients were tested using cardiopulmonary exercise testing, 6-min walk test, spirometry and electronic pressure manometer for inspiratory muscle strength (Pimax) and endurance (sustained Pimax) measurement. Quality of life was assessed with the Minnesota Living with Heart Failure questionnaire. TG improved peak oxygen consumption (19.3 ± 4.5 vs. 16.8 ± 3.7 ml/kg per min, P = 0.008) and VO2 at ventilatory threshold (15.1 ± 4.2 vs. 12 ± 5.6 ml/kg per min, P = 0.01), whereas the ventilation/carbon dioxide slope decreased (35.9 ± 5.6 vs. 40 ± 6.5, P = 0.009). The 6-min walk test distance increased (527 ± 76 vs. 462 ± 88 m, P = 0.005) and quality of life was improved (38.2 ± 11.6 vs. 48.9 ± 12.8, P = 0.005), as well as Pimax (131.8 ± 33 vs. 95.5 ± 28cmH2O, P = 0.005), sustained Pimax (484 ± 195 vs. 340 ± 193cmH2O/s/103, P = 0.005), and inspiratory lung capacity (2.4 ± 0.9 vs. 1.7 ± 0.7 L, P = 0.008) were improved. No significant changes were noted in the control group. Our findings indicate that exercise

  9. Effects of Respiratory Muscle Training on Respiratory Function, Respiratory Muscle Strength, and Exercise Tolerance in Patients Poststroke: A Systematic Review With Meta-Analysis.

    PubMed

    Gomes-Neto, Mansueto; Saquetto, Micheli Bernardone; Silva, Cassio Magalhães; Carvalho, Vitor Oliveira; Ribeiro, Nildo; Conceição, Cristiano Sena

    2016-11-01

    To examine the effects of respiratory muscle training on respiratory function, respiratory muscle strength, and exercise tolerance in patients poststroke. We searched MEDLINE, Cochrane Library, Embase, SciELO, Physiotherapy Evidence Database (PEDro), and CINAHL (from the earliest date available to November 2015) for trials. Randomized controlled trials (RCTs) that examined the effects of respiratory muscle training versus nonrespiratory muscle training in patients poststroke. Two reviewers selected studies independently. Extracted data from the published RCTs. Study quality was evaluated using the PEDro Scale. Weighted mean differences (WMDs), standard mean differences (SMDs), and 95% confidence intervals (CIs) were calculated. Eight studies met the study criteria. Respiratory muscle training improved maximal inspiratory pressure WMDs (7.5; 95% CI, 2.7-12.4), forced vital capacity SMDs (2.0; 95% CI, 0.6-3.4), forced expiratory volume at 1 second SMDs (1.2; 95% CI, 0.6-1.9), and exercise tolerance SMDs (0.7; 95% CI, 0.2-1.2). No serious adverse events were reported. Respiratory muscle training should be considered an effective method of improving respiratory function, inspiratory muscle strength, and exercise tolerance in patients poststroke. Further research is needed to determine optimum dosages and duration of effect. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  10. Respiratory muscle activity and patient–ventilator asynchrony during different settings of noninvasive ventilation in stable hypercapnic COPD: does high inspiratory pressure lead to respiratory muscle unloading?

    PubMed Central

    Duiverman, Marieke L; Huberts, Anouk S; van Eykern, Leo A; Bladder, Gerrie; Wijkstra, Peter J

    2017-01-01

    Introduction High-intensity noninvasive ventilation (NIV) has been shown to improve outcomes in stable chronic obstructive pulmonary disease patients. However, there is insufficient knowledge about whether with this more controlled ventilatory mode optimal respiratory muscle unloading is provided without an increase in patient–ventilator asynchrony (PVA). Patients and methods Ten chronic obstructive pulmonary disease patients on home mechanical ventilation were included. Four different ventilatory settings were investigated in each patient in random order, each for 15 min, varying the inspiratory positive airway pressure and backup breathing frequency. With surface electromyography (EMG), activities of the intercostal muscles, diaphragm, and scalene muscles were determined. Furthermore, pressure tracings were derived simultaneously in order to assess PVA. Results Compared to spontaneous breathing, the most pronounced decrease in EMG activity was achieved with the high-pressure settings. Adding a high breathing frequency did reduce EMG activity per breath, while the decrease in EMG activity over 1 min was comparable with the high-pressure, low-frequency setting. With high backup breathing frequencies less breaths were pressure supported (25% vs 97%). PVAs occurred more frequently with the low-frequency settings (P=0.017). Conclusion High-intensity NIV might provide optimal unloading of respiratory muscles, without undue increases in PVA. PMID:28138234

  11. Relationship between chest expansion and respiratory muscle strength in patients with primary fibromyalgia.

    PubMed

    Ozgocmen, S; Cimen, O B; Ardicoglu, O

    2002-02-01

    In this paper the assessment of the relationship between chest expansion with maximal inspiratory (MIP) and expiratory pressures (MEP) in primary fibromyalgia (FM) syndrome is discussed. Chest expansion (CE) measurements, spirometric values, and MIP and MEP values in 30 female patients with primary FM are compared with 29 healthy age-matched female controls. Patients with FM had lower CE, MEP and MIP values than controls. CE correlated significantly with MIP and MEP values. There was no significant difference between groups in spirometric values. Our results indicate that patients with FM have impaired respiratory muscle strength, and measurement of CE may be a useful clinical parameter. Despite its limitations CE may reflect respiratory muscle strength. It is worth following up these data in a wider and controlled series, with ancillary tests in addition to the MIP and MEP.

  12. Respiratory Muscle Strength as a Predictive Biomarker for Survival in Amyotrophic Lateral Sclerosis.

    PubMed

    Polkey, Michael I; Lyall, Rebecca A; Yang, Ke; Johnson, Erin; Leigh, P Nigel; Moxham, John

    2017-01-01

    Biomarkers for survival in amyotrophic lateral sclerosis (ALS) would facilitate the development of novel drugs. Although respiratory muscle weakness is a known predictor of poor prognosis, a comprehensive comparison of different tests is lacking. To compare the predictive power of invasive and noninvasive respiratory muscle strength assessments for survival or ventilator-free survival, up to 3 years. From a previously published report respiratory muscle strength measurements were available for 78 patients with ALS. Time to death and/or ventilation were ascertained. Receiver operating characteristic analysis was used to determine the cutoff point of each parameter. Each respiratory muscle strength assessment individually achieved statistical significance for prediction of survival or ventilator-free survival. In multivariate analysis sniff trans-diaphragmatic and esophageal pressure, twitch trans-diaphragmatic pressure (Tw Pdi), age, and maximal static expiratory mouth pressure were significant predictors of ventilation-free survival and Tw Pdi and maximal static expiratory mouth pressure for absolute survival. Although all measures had good specificity, there were differing sensitivities. All cutoff points for the VC were greater than 80% of normal, except for prediction of 3-month outcomes. Sequential data showed a linear decline for direct measures of respiratory muscle strength, whereas VC showed little to no decline until 12 months before death/ventilation. The most powerful biomarker for mortality stratification was Tw Pdi, but the predictive power of sniff nasal inspiratory pressure was also excellent. A VC within normal range suggested a good prognosis at 3 months but was of little other value.

  13. Human jaw muscle strength and size in relation to limb muscle strength and size.

    PubMed

    Raadsheer, M C; Van Eijden, T M G J; Van Ginkel, F C; Prahl-Andersen, B

    2004-10-01

    The aim of the present study was to investigate to what extent general factors (e.g. genotype, hormones) and factors at the craniofacial level (e.g. craniofacial size, jaw muscle architecture) contribute to the size and strength of the jaw muscles. A strong relationship of jaw muscle size and strength with that of other muscles would argue for general influences, whereas a weak relationship would argue for craniofacial influences. In 121 adult individuals, moments of maximal bite force, arm flexion force and leg extension force were measured. In addition, thicknesses of jaw muscles, arm flexor muscles and leg extensor muscles were measured using ultrasound. Relationships were assessed by using a principal component analysis. In females, one component was found in which all force moments were represented. Bite force moment, however, loaded very low. In males, two components were found. One component loaded for arm flexion and leg extension moments, the other loaded for bite force moments. In both females and males, only one component was found for the muscle thicknesses in which all muscle groups loaded similarly. It was concluded that the size of the jaw muscles was significantly related to the size of the limb muscles, suggesting that they were both subject to the same general influences. Maximal voluntary bite force moments were not significantly related to the moments of the arm flexion and leg extension forces, suggesting that besides the general influence on the muscle size, variation in bite force moment was also influenced by local variables, such as craniofacial morphology.

  14. Association between respiratory muscle strength and reduction of arterial blood pressure levels after aerobic training in hypertensive subjects

    PubMed Central

    Galdino, Giovane; Silva, Andreia Maria; Bogão, José Angelo; Braz de Oliveira, Marcos Paulo; Araújo, Hayslenne Andressa Gonçalves de Oliveira; Oliveira, Maísa Sodoco; Maldonado, Ana Clara Desiderio; Ulisses de Oliveira, Herick; Borges, Juliana Bassalobre Carvalho

    2016-01-01

    [Purpose] The purpose of present study was associate the increase of respiratory muscle strength with blood pressure levels in hypertensive subjects who underwent an aerobic exercise program. [Subjects and Methods] 90 hypertensive subjects were divided in two groups: intervention and control. All participants had an interview with a physiotherapist and were evaluated by 6-minute walk test, maximal inspiratory pressure, maximal expiratory pressure, heart rate, systolic blood pressure and diastolic blood pressure, before and after the 8 weeks. In the intervention group, the subjects underwent aerobic exercise program, 2 times a week for 8 weeks [Results] After the program, the levels of blood pressure were significantly reduced and the distance walked in the 6-minute walk test and the respiratory muscle strength were increased, compared to pre intervention and control group values. However, there was no correlation between the results provided by 6-minute walk test, maximal inspiratory pressure and maximal expiratory pressure with systolic arterial blood pressure levels. Nonetheless, the distance walked correlated with respiratory muscle strength values, in the intervention group. [Conclusion] The present study demonstrated that the aerobic training was effective in reducing the arterial blood pressure in hypertensive subjects associated with an improvement of physical conditioning and respiratory muscle strength. PMID:28174465

  15. Single- and multiple-set resistance training improves skeletal and respiratory muscle strength in elderly women.

    PubMed

    Abrahin, Odilon; Rodrigues, Rejane P; Nascimento, Vanderson C; Da Silva-Grigoletto, Marzo E; Sousa, Evitom C; Marçal, Anderson C

    2014-01-01

    Aging involves a progressive reduction of respiratory muscle strength as well as muscle strength. Compare the effects of resistance training volume on the maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP), functional performance, and muscle strength in elderly women. Thirty elderly women were randomly assigned to a group performing either single sets (1-SET) or three sets (3-SET) of exercises. The sit-to-stand test, MIP, MEP, and muscle strength were assessed before and after 24 training sessions. Progressive resistance training was performed two times per week for a total of 8-12 repetitions, using the main muscle groups of the upper and lower limbs. The main results showed that the participants significantly increased their MEP (P<0.05; 1-SET: 34.6%; 3-SET: 35.8%) and MIP (P<0.05; 1-SET: 13.7%; 3-SET: 11.2%). Both groups also improved in the sit-to-stand test (P<0.05; 1-SET: 10.6%; 3-SET: 17.1%). After 24 training sessions, muscle strength also significantly increased (P<0.0001; 40%-80%) in both groups. An intergroup comparison did not show any statistically significant differences between the groups in any of the parameters analyzed. Single- and multiple-set resistance training programs increased MIP, MEP, muscle strength, and sit-to-stand test performance in elderly women after 24 sessions of training. In conclusion, our results suggested that elderly women who are not in the habit of physical activity may start with single-set resistance training programs as a short-term strategy for the maintenance of health.

  16. Single- and multiple-set resistance training improves skeletal and respiratory muscle strength in elderly women

    PubMed Central

    Abrahin, Odilon; Rodrigues, Rejane P; Nascimento, Vanderson C; Da Silva-Grigoletto, Marzo E; Sousa, Evitom C; Marçal, Anderson C

    2014-01-01

    Introduction Aging involves a progressive reduction of respiratory muscle strength as well as muscle strength. Purpose Compare the effects of resistance training volume on the maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP), functional performance, and muscle strength in elderly women. Methods Thirty elderly women were randomly assigned to a group performing either single sets (1-SET) or three sets (3-SET) of exercises. The sit-to-stand test, MIP, MEP, and muscle strength were assessed before and after 24 training sessions. Progressive resistance training was performed two times per week for a total of 8–12 repetitions, using the main muscle groups of the upper and lower limbs. Results The main results showed that the participants significantly increased their MEP (P<0.05; 1-SET: 34.6%; 3-SET: 35.8%) and MIP (P<0.05; 1-SET: 13.7%; 3-SET: 11.2%). Both groups also improved in the sit-to-stand test (P<0.05; 1-SET: 10.6%; 3-SET: 17.1%). After 24 training sessions, muscle strength also significantly increased (P<0.0001; 40%–80%) in both groups. An intergroup comparison did not show any statistically significant differences between the groups in any of the parameters analyzed. Conclusion Single- and multiple-set resistance training programs increased MIP, MEP, muscle strength, and sit-to-stand test performance in elderly women after 24 sessions of training. In conclusion, our results suggested that elderly women who are not in the habit of physical activity may start with single-set resistance training programs as a short-term strategy for the maintenance of health. PMID:25342896

  17. Respiratory muscle strength in healthy infants and those with surgically correctable anomalies.

    PubMed

    Kassim, Zainab; Moxham, John; Davenport, Mark; Nicolaides, Kypros; Greenough, Anne; Rafferty, Gerrard F

    2015-01-01

    Assessment of respiratory muscle strength provides important diagnostic and prognostic information. Normative data in healthy, term infants is, however, limited. Surgically correctable birth defects, congenital diaphragmatic hernia (CDH) and abdominal wall defects (AWD), commonly have impaired diaphragm function. The study aims were to obtain normative data for respiratory muscle strength in healthy, term born infants at birth and at 6 weeks postnatal age (PNA) and to investigate the influence of growth and maturation on inspiratory muscle strength in CDH/AWD infants. Maximal inspiratory (cPimax) and expiratory (cPemax) pressures during crying were measured at birth in 67 healthy, term born infants (mean (SD) gestational age (GA) 39.4 (1.7) weeks) and reassessed in 27 at 6 weeks PNA. cPimax and functional residual capacity (FRC) (22.3 (4.2) ml/kg) were also measured in 23 infants with AWD/CDH (mean (SD) GA 36.9 (2.1) weeks) and reassessed in 16 at median (range) 6.5 (1.5-15) months PNA. In healthy infants, mean (SD) cPimax was 88.8 (19.33) cmH2 O and cPemax 61.8 (13.5) cmH2 O at birth, increasing significantly at followup to 100.9 (15.2) cmH2 O (P < 0.05) and 82.6 (19.4) cmH2 O (P < 0.001) respectively. Mean (SD) cPimax was significantly lower (47.5 (22.4) cmH2 O, P < 0.0001) in AWD/CDH infants compared to healthy infants at birth but had increased significantly to 88.1 (27.6) cmH2 O (P < 0.0001) at followup which correlated significantly with increases in FRC (r(2)  = 0.33, P = 0.0263). Infants with AWD and CDH have significantly reduced inspiratory muscle strength compared to healthy term born infants but strength increases markedly in early life.

  18. The kinanthropometric and pulmonary determinants of global respiratory muscle strength and endurance indices in an athletic population.

    PubMed

    Kroff, Jacolene; Terblanche, Elmarie

    2010-09-01

    The morphological determinants of respiratory muscle (RM) strength and endurance in non-athletic populations are well documented, but are lacking in athletic populations. The purpose of this study was to determine the kinanthropometric and pulmonary predictors of RM strength and endurance. 160 athletes (103 men) were recruited from eight different sports to participate in the study. All subjects underwent a series of kinanthropometric and RM function assessments during a single visit to the laboratory. RM function assessments included the flow-volume curve test to assess pulmonary function, maximum voluntary ventilation (MVV) to assess RM endurance and maximum inspiratory mouth pressure (MIP) and maximum expiratory mouth pressure (MEP) to assess RM strength. Multiple regression analyses revealed that gender, mesomorphy and exercise sessions per week predicted 35% (SEE = 26.6 cmH(2)O) of the variance in inspiratory muscle strength (MIP). Gender and mesomorphy predicted 24% (SEE = 28.3 cmH(2)O) of the variance in expiratory muscle strength (MEP), while gender, relative sitting height, forced expiratory volume in 1 s (FEV(1)) and peak expiratory flow rate (PEFR) predicted 78% (SEE = 18.2 L min(-1)) of the variance in RM endurance (MVV). Although the reference equations are still not adequate to predict MIP and MEP in an athletic population, they provide more suitable reference values than previously reported. The predicted values derived from the equation for MVV can be applied as adequate reference values for athletic populations.

  19. Exercise capacity, muscle strength, and fatigue in sarcoidosis: a follow-up study.

    PubMed

    Marcellis, Rik G J; Lenssen, Antoine F; Kleynen, Stephan; De Vries, Jolanda; Drent, Marjolein

    2013-06-01

    The purpose of this study was to examine changes in the prevalence of exercise intolerance, reduced muscle strength, and fatigue and the changes in these parameters in individual patients during a 2-year follow-up study. Ninety sarcoidosis patients (62 males and 28 females; mean age: 46.0 ± 10.2 years) participated in a 2-year follow-up study. At the baseline and follow-up measurements, patients performed a 6-min walk test and elbow flexor muscle strength, quadriceps peak torque, and hamstrings peak torque tests. Maximal inspiratory pressure was recorded. All patients completed the Fatigue Assessment Scale. Both at baseline and follow-up, a substantial proportion of the patients showed a reduced 6-minute walk test (41.6 and 34.8 %, respectively), elbow flexor muscle strength (6.7 and 14.6 %), quadriceps peak torque (21.3 and 18 %), hamstrings peak torque (13.5 and 12.4 %), and maximal inspiratory pressure (45.9 and 48.6 %). The majority of the patients reported fatigue (86 and 77 %). These physical impairments remained stable during the follow-up period. The prevalence of these physical impairments in patients diagnosed with sarcoidosis <2 years before inclusion in this study was similar to that in patients with a longer history of the disease. Exercise intolerance, muscle weakness, and fatigue are frequent problems in symptomatic sarcoidosis patients with a stable and persistent character. This study highlights that beyond medical treatment a rehabilitation program should be considered as adjunct therapy in the multidisciplinary management of sarcoidosis patients even though the achieved benefit needs future studies.

  20. The effect of inspiratory muscle training on respiratory variables in a patient with ankylosing spondylitis: A case report.

    PubMed

    Wong, Marlon L; Anderson, Rachael G; Garcia, Kelsey; Housmann, Elissa M; McHale, Erin; Goldberger, Gregory S; Cahalin, Lawrence P

    2017-10-01

    Ankylosing Spondylitis (AS) presents with both musculoskeletal and cardiorespiratory pathophysiological manifestations. Inspiratory muscle training (IMT) may be a useful intervention to address deficits in respiratory and functional status. A 25-year-old male with AS initially sought treatment for low back and right hip pain, but 7 weeks of IMT was also provided due to abnormal respiratory performance. At baseline, the patient presented with a resting respiratory rate (RR) of 14.5 breaths/minute, tidal volume (TV) of 0.76 L, minute ventilation (VE) of 10.87 L/min, and end tidal CO2 (PetCO2) of 30.56 mmHg. Baseline exercise test results revealed a VO2max of 44 ml/kg/min and VE to CO2 output (VE/VCO2) slope of 30. Baseline MIP, SMIP, and MEP were 54 cm H2O, 507 PTU, and 87 cm H2O, respectively, and increased to 176 cm H2O, 807 PTU, and 151 cm H2O, respectively, after IMT. The VO2max increased to 51 ml/kg/min with decreases in the VE/VCO2 slope (29), resting RR (12 breaths/minute), resting TV (0.52 L), and resting VE (6.83 L/min) after IMT. Improvements during postural challenges were also observed. This case demonstrates the clinical utility of respiratory gas analysis and respiratory performance measures to identify functional deficits and manage a patient with AS. The improvements in respiratory performance at rest, during postural challenges, and during maximal exercise after a relatively short period of IMT highlights the role IMT may have to improve functional status in patients with AS. Further investigation of IMT in patients with AS is warranted.

  1. Sniff nasal inspiratory pressure. Reference values in Caucasian children.

    PubMed

    Stefanutti, D; Fitting, J W

    1999-01-01

    Like in adults, normal values of maximal inspiratory pressure (PImax) and maximal expiratory pressure (PEmax) span a large range in children, making interpretation of low values difficult. Recently, sniff nasal inspiratory pressure (Pnsn) was developed as a new noninvasive test of inspiratory muscle strength. In healthy adults, Pnsn is most often higher than PImax. The aim of this study was to establish reference values of Pnsn in children and to compare them with PImax. A group of 180 unselected healthy children age 6 to 17 yr was studied in a school setting. All had a forced vital capacity (FVC) > 80% of predicted and a ratio of forced expiratory volume in one second/forced vital capacity (FEV1/ FVC) > 85% of predicted. All maneuvers were performed in the sitting position. The Pnsn was measured using a catheter occluding one nostril during maximal sniffs performed through the contralateral nostril from FRC. The PImax was measured from FRC and residual volume, and PEmax from FRC and total lung capacity. All children were able to perform the Pnsn maneuver easily. Pnsn was 104 +/- 26 cm H2O in boys and 93 +/- 23 cm H2O in girls (p < 0.005). These values were similar to those previously measured in healthy adults. Pnsn correlated with age, weight, and height in boys, but not in girls. In both sexes, Pnsn was higher than PImax measured at the same lung volume (FRC) (p < 0. 0001). Pnsn was >= PImaxFRC in 73 of 93 boys and 79 of 87 girls. We conclude that Pnsn can be easily used to assess inspiratory muscle strength in children age 6 yr or more, providing values higher than PImax. Normal values are independent of age in girls, and can be predicted from age by a first-degree equation in boys. Being easy and noninvasive, Pnsn may prove useful to assess inspiratory muscle strength in children with neuromuscular disorders.

  2. Inspiratory muscle pacing in spinal cord injury: case report and clinical commentary.

    PubMed

    DiMarco, Anthony F; Onders, Raymond P; Ignagni, Anthony; Kowalski, Krzysztof E

    2006-01-01

    A significant fraction of patients with cervical spinal cord injury suffer from respiratory muscle paralysis and dependence on chronic mechanical ventilation. In selected patients, diaphragm pacing (DP) through electrical stimulation of the phrenic nerves provides an alternative to mechanical ventilation with significant advantages in life quality. A case report of an individual who successfully underwent DP using intramuscular diaphragm electrodes. A brief review of the state of the art of DP including the clinical benefits of DP, patient selection and evaluation, description of equipment, methods of transition from mechanical ventilation to DP, potential complications and side effects, long-term outcome, and potential future developments in this field is included. Several available DP systems are available, including conventional ones in which electrodes are positioned directly on the phrenic nerves through thoracotomy and less invasive systems in which electrodes are placed within the diaphragm through laparoscopy. For patients with only unilateral phrenic nerve function, a combined intercostal and unilateral diaphragm pacing system is under development. In patients with ventilator-dependent tetraplegia, there are alternative methods of ventilatory support, which offer substantial benefits compared to mechanical ventilation.

  3. Importance and challenges of measuring intrinsic foot muscle strength

    PubMed Central

    2012-01-01

    Background Intrinsic foot muscle weakness has been implicated in a range of foot deformities and disorders. However, to establish a relationship between intrinsic muscle weakness and foot pathology, an objective measure of intrinsic muscle strength is needed. The aim of this review was to provide an overview of the anatomy and role of intrinsic foot muscles, implications of intrinsic weakness and evaluate the different methods used to measure intrinsic foot muscle strength. Method Literature was sourced from database searches of MEDLINE, PubMed, SCOPUS, Cochrane Library, PEDro and CINAHL up to June 2012. Results There is no widely accepted method of measuring intrinsic foot muscle strength. Methods to estimate toe flexor muscle strength include the paper grip test, plantar pressure, toe dynamometry, and the intrinsic positive test. Hand-held dynamometry has excellent interrater and intrarater reliability and limits toe curling, which is an action hypothesised to activate extrinsic toe flexor muscles. However, it is unclear whether any method can actually isolate intrinsic muscle strength. Also most methods measure only toe flexor strength and other actions such as toe extension and abduction have not been adequately assessed. Indirect methods to investigate intrinsic muscle structure and performance include CT, ultrasonography, MRI, EMG, and muscle biopsy. Indirect methods often discriminate between intrinsic and extrinsic muscles, but lack the ability to measure muscle force. Conclusions There are many challenges to accurately measure intrinsic muscle strength in isolation. Most studies have measured toe flexor strength as a surrogate measure of intrinsic muscle strength. Hand-held dynamometry appears to be a promising method of estimating intrinsic muscle strength. However, the contribution of extrinsic muscles cannot be excluded from toe flexor strength measurement. Future research should clarify the relative contribution of intrinsic and extrinsic muscles

  4. Correlation of single-breath count test and neck flexor muscle strength with spirometry in myasthenia gravis

    PubMed Central

    Elsheikh, Bakri; Arnold, W. David; Gharibshahi, Shahram; Reynolds, Jerold; Freimer, Miriam; Kissel, John T.

    2015-01-01

    Introduction Although formal spirometry is the gold standard for monitoring respiratory function in patients with myasthenia gravis (MG), such testing is often delayed or unavailable. There is a need for a simple bedside test that can accurately measure respiratory function. Method We conducted a prospective, cross-sectional, single-blind study in adults with acetylcholine receptor antibody positive MG. Participants performed the single breath count test (SBCT) and underwent manual muscle strength testing, while a respiratory therapist performed spirometry blinded to SBCT and strength results. Results Thirty-one patients, aged 57 ±19 years participated. SBCT showed significant correlations with forced vital capacity (FVC), negative inspiratory force (NIF), and neck flexor strength (P<0.01). FVC showed significant correlation with neck flexor strength (P=0.02) but no correlation with shoulder abductor strength. Discussion These data suggest that the SBCT and neck flexor strength testing are valuable tools for bedside assessment of respiratory function in MG patients. PMID:26437790

  5. The effects of inspiratory diaphragm breathing exercise and expiratory pursed-lip breathing exercise on chronic stroke patients' respiratory muscle activation.

    PubMed

    Seo, KyoChul; Hwan, Park Seung; Park, KwangYong

    2017-03-01

    [Purpose] The purpose of this study is to examine the effects of inspiratory diaphragm breathing exercise and expiratory pursed-lip breathing exercise on chronic stroke patients' respiratory muscle activation. [Subjects and Methods] All experimental subjects performed exercises five times per week for four weeks. Thirty chronic stroke patients were randomly assign to an experimental group of 15 patients and a control group of 15 patients. The experimental group underwent exercises consisting of basic exercise treatment for 15 minutes and inspiratory diaphragm breathing exercise and expiratory pursed-lip breathing exercise for 15 minutes and the control group underwent exercises consisting of basic exercise treatment for 15 minutes and auto-med exercise for 15 minutes. The activation levels of respiratory muscles were measured before and after the experiment using MP 150WSW to obtain the results of the experiment. [Results] In the present study, when the pulmonary functions of the experimental group and the control group before and after the experiment were compared, whereas the experimental group showed significant differences in all sections. In the verification of intergroup differences between the experimental group and the control group before and after the experiment. [Conclusion] The respiratory rehabilitation exercise is considered to be capable of inducing positive effects on stroke patients' respiratory muscles through diaphragm breathing exercise and lip puckering breathing exercise.

  6. The effects of inspiratory diaphragm breathing exercise and expiratory pursed-lip breathing exercise on chronic stroke patients’ respiratory muscle activation

    PubMed Central

    Seo, KyoChul; Hwan, Park Seung; Park, KwangYong

    2017-01-01

    [Purpose] The purpose of this study is to examine the effects of inspiratory diaphragm breathing exercise and expiratory pursed-lip breathing exercise on chronic stroke patients’ respiratory muscle activation. [Subjects and Methods] All experimental subjects performed exercises five times per week for four weeks. Thirty chronic stroke patients were randomly assign to an experimental group of 15 patients and a control group of 15 patients. The experimental group underwent exercises consisting of basic exercise treatment for 15 minutes and inspiratory diaphragm breathing exercise and expiratory pursed-lip breathing exercise for 15 minutes and the control group underwent exercises consisting of basic exercise treatment for 15 minutes and auto-med exercise for 15 minutes. The activation levels of respiratory muscles were measured before and after the experiment using MP 150WSW to obtain the results of the experiment. [Results] In the present study, when the pulmonary functions of the experimental group and the control group before and after the experiment were compared, whereas the experimental group showed significant differences in all sections. In the verification of intergroup differences between the experimental group and the control group before and after the experiment. [Conclusion] The respiratory rehabilitation exercise is considered to be capable of inducing positive effects on stroke patients’ respiratory muscles through diaphragm breathing exercise and lip puckering breathing exercise. PMID:28356632

  7. Respiratory muscle strength test: is it realistic in young children?

    PubMed Central

    Heinzmann-Filho, João Paulo; Donadio, Márcio Vinícius Fagundes

    2015-01-01

    Objective: To determine the success rate of the manovacuometry test in children between 4 and 12 years of age. Methods: Cross-sectional study involving children and adolescents from 4 to 12 years of age, enrolled in three basic education schools. All subjects had the anthropometric and respiratory muscle strength (maximum inspiratory pressure and maximum expiratory pressure) data measured. Students whose parents did not authorize participation or who did not want to undergo the test were excluded. The test was considered successful when the subject reached acceptability (no air leaks) and reproducibility (variation <10% between the two major maneuvers) criteria established by guidelines. Failure was defined when subjects did not meet the above criteria. Data were expressed as mean and standard deviation and the categorical variables in absolute and relative frequency. The comparison between proportions was performed using the chi-square test. Results: We included 196 children and adolescents, mean age of 8.4±2.5 years, 53.1% female. The success rate of the manovacuometry test in children and adolescents evaluated was 92.3%. When comparing the differences between the success rates of preschool children with those children and adolescents of school age, there was a significantly lower success rate in the pre-school (85.1%) group compared to the school group (94.6%) (p=0.032). However, no significant differences (p=0.575) were found when gender comparisons were performed. Conclusions: The manovacuometry test showed a high success rate in both preschool and school population assessed. Furthermore, the rate of success appears to be related to aging. PMID:26137867

  8. [Respiratory muscle strength test: is it realistic in young children?].

    PubMed

    Heinzmann-Filho, João Paulo; Donadio, Márcio Vinícius Fagundes

    2015-01-01

    To determine the success rate of the manovacuometry test in children between 4 and 12 years of age. Cross-sectional study involving children and adolescents from 4 to 12 years of age, enrolled in three basic education schools. All subjects had the anthropometric and respiratory muscle strength (maximum inspiratory pressure and maximum expiratory pressure) data measured. Students whose parents did not authorize participation or who did not want to undergo the test were excluded. The test was considered successful when the subject reached acceptability (no air leaks) and reproducibility (variation <10% between the two major maneuvers) criteria established by guidelines. Failure was defined when subjects did not meet the above criteria. Data were expressed as mean and standard deviation and in absolute and relative frequency. The comparison between proportions was performed using the chi-square test. We included 196 children and adolescents, mean age of 8.4±2.5 years, 53.1% female. The success rate of the manovacuometry test in children and adolescents evaluated was 92.3%. When comparing the differences between the success rates of preschool children with those children and adolescents of school age, there was a significantly lower success rate in the pre-school (85.1%) group compared to the school group (94.6%) (p=0.032). However, no significant differences (p=0.575) were found when gender comparisons were performed. The manovacuometry test showed a high success rate in both preschool and school population assessed. Furthermore, the rate of success appears to be related to aging. Copyright © 2015 Sociedade de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.

  9. Correlation among proprioception, muscle strength, and balance.

    PubMed

    Wang, Huihui; Ji, Zhongqiu; Jiang, Guiping; Liu, Weitong; Jiao, Xibian

    2016-12-01

    [Purpose] To study the correlation among proprioception, muscle strength, and balance. [Subjects and Methods] A balance testing system (Biodex Balance System, BBS) and an isokinetic testing system (Biodex System 4, BS4) were used to test related indexes in 24 healthy young females. [Results] With the knee joint at 15 degree flexion, proprioception was significantly correlated with Limits of Stability-Time values, and was highly significantly correlated with Limits of Stability-Overall and Athlete Single Leg Medial/Lateral values. The sense of force was significantly correlated with Limits of Stability-Overall and Athlete Single Leg-Overall values. Quadriceps strength was significantly associated with Limits of Stability-Overall, Athlete Single Leg Medial/Lateral, and Athlete Double Leg-Overall values. The ratio of Quadriceps to Hamstring strength was significantly correlated with Athlete Single Leg Medial/Lateral, and Athlete Single Leg-Overall values. With the knee joint at 45°, proprioception was highly significantly correlated with dynamic balance, and was significantly correlated with double foot support under static balance; force sense had a high correlation with Limits of Stability-Overall, but no correlation with other indexes. Quadriceps strength had a significant correlation with dynamic and static balance; the ratio of Quadriceps/Hamstring had a highly significant correlation with Limits of Stability-Overall, Athlete Single Leg-Anterior/Posterior and Athlete Single Leg-Overall. [Conclusion] At different knee angles, the correlation differs among proprioception, force sense, quadriceps strength, the Quadriceps/Hamstring ratio, and balance.

  10. Effect of upper extremity proprioceptive neuromuscular facilitation combined with elastic resistance bands on respiratory muscle strength: a randomized controlled trial

    PubMed Central

    Areas, Guilherme P. T.; Borghi-Silva, Audrey; Lobato, Arianne N.; Silva, Alessandra A.; Freire, Renato C.; Areas, Fernando Z. S.

    2013-01-01

    Background Elastic resistance bands (ERB) combined with proprioceptive neuromuscular facilitation (PNF) are often used in resistance muscle training programs, which have potential effects on peripheral muscle strength. However, the effects of the combination of ERB and PNF on respiratory muscle strength warrant further investigation. Objectives The assessment of the effects of PNF combined with ERB on respiratory muscle strength. Method Twenty healthy, right-handed females were included. Subjects were randomized to either the resistance training program group (TG, n=10) or the control group (CG, n=10). Maximal expiratory pressure (MEP) and inspiratory pressure (MIP) were measured before and after four weeks of an upper extremity resistance training program. The training protocol consisted of upper extremity PNF combined with ERB, with resistance selected from 1 repetition maximum protocol. Results PNF combined with ERB showed significant increases in MIP and MEP (p<0.05). In addition, there were significant differences between the TG and CG regarding ∆MIP (p=0.01) and ∆MEP (p=0.04). Conclusions PNF combined with ERB can have a positive impact on respiratory muscle strength. These results may be useful with respect to cardiopulmonary chronic diseases that are associated with reduced respiratory muscle strength. PMID:24346292

  11. Inspiratory Muscle Training and Functional Electrical Stimulation for Treatment of Heart Failure With Preserved Ejection Fraction: Rationale and Study Design of a Prospective Randomized Controlled Trial.

    PubMed

    Palau, Patricia; Domínguez, Eloy; López, Laura; Heredia, Raquel; González, Jessika; Ramón, Jose María; Serra, Pilar; Santas, Enrique; Bodi, Vicente; Sanchis, Juan; Chorro, Francisco J; Núñez, Julio

    2016-08-01

    Heart failure with preserved ejection fraction (HFpEF) has become the most prevalent form of heart failure in developed countries. Regrettably, there is no evidence-based effective therapy for HFpEF. We seek to evaluate whether inspiratory muscle training, functional electrical stimulation, or a combination of both can improve exercise capacity as well as left ventricular diastolic function, biomarker profile, quality of life (QoL), and prognosis in patients with HFpEF. A total of 60 stable symptomatic patients with HFpEF (New York Heart Association class II-III/IV) will be randomized (1:1:1:1) to receive a 12-week program of inspiratory muscle training, functional electrical stimulation, a combination of both, or standard care alone. The primary endpoint of the study is change in peak exercise oxygen uptake; secondary endpoints are changes in QoL, echocardiogram parameters, and prognostic biomarkers. As of March 21, 2016, thirty patients have been enrolled. Searching for novel therapies that improve QoL and autonomy in the elderly with HFpEF has become a health care priority. We believe that this study will add important knowledge about the potential utility of 2 simple and feasible physical interventions for the treatment of advanced HFpEF.

  12. Mechanisms behind Estrogens’ Beneficial Effect on Muscle Strength in Females

    PubMed Central

    Lowe, Dawn A.; Baltgalvis, Kristen A.; Greising, Sarah M.

    2010-01-01

    Muscle weakness ensues when serum testosterone declines with age in men. Testosterone’s female counterpart, estrogen, has also been implicated in age-related strength loss but these results are less conclusive. Our working hypothesis is that estrogens do benefit muscle strength, and that the underlying mechanism involves estrogen receptors to improve muscle quality more so than quantity. PMID:20335737

  13. Flexible bronchoscopy may decrease respiratory muscle strength: premedicational midazolam in focus

    PubMed Central

    2012-01-01

    Background Flexible bronchoscopy (FB) is a procedure accepted to be safe in general, with low complication rates reported. On the other hand, it is known that patients with pre-existing respiratory failure have developed hypoventilation following FB. In this study the effects of FB on respiratory muscle strength were investigated by measuring maximum respiratory pressures. Methods One hundred and forty patients, aged between 25 and 90 years, who had undergone diagnostic bronchoscopy between February 2012 and May 2012, were recruited to the study. Pre- and post-procedure maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) were measured. A correlation between the MIP and MEP changes and patient characteristics and FB variables were investigated. Results Significant decreases in both MIP and MEP values were observed following FB (p < 0.001 for both). Decreases were attributed to the midazolam used for sedation. Significant decreases in respiratory muscle strengths were observed especially in the high-dose midazolam group, compared to both low-dose and non-midazolam groups. Conclusions It was determined that respiratory muscle weakness may arise post-procedure in patients who have undergone FB, and this is constitutively related to midazolam premedication. Respiratory muscle weakness might play a role in potential hypoventilation in critical patients who undergo FB. PMID:23009348

  14. Sniff Nasal Inspiratory Pressure Does Not Decrease in Elderly Subjects

    PubMed Central

    Huang, Chien-Hui; Yang, Gee-Gwo; Chen, Tung-Wei

    2014-01-01

    [Purpose] Measurements of inspiratory strength are critical for detecting inspiratory muscle weakness. Sniff nasal inspiratory pressure (SNIP) is a quick, noninvasive measurement of global inspiratory strength; however, it is not clear how many trials are needed for reliable measurements. [Subjects and Methods] One hundred and nineteen subjects (age 39.9±16.5, range 18–69 yrs) completed the study. They were divided into subgroups of different ages and gender. Subjects were asked to take 20 maximal sniffs after normal expiration, with 30 seconds rest in-between. The highest values among the first 10 and last 10 SNIP maneuvers were recorded as SNIP1-10, and SNIP11-20, respectively. The paired t-test was used to compare the differences. Two-way measures ANOVA was used to compare the effects of age and gender on SNIP. [Results] SNIP 11–20 was significantly greater than SNIP1–10, suggesting that 10 trials is not enough to eliminate learning effects. Age did not affect SNIP in either gender, suggesting SNIP is preserved. In stepwise multiple linear regression analysis, the SNIP values were positively related with body mass index in women and positively related with weight in men. [Conclusion] The results suggest that twenty trials are needed for reliable SNIP measurements. The mean value and lower limits of normal SNIP are provided for clinical comparison. PMID:25276047

  15. Correlation among proprioception, muscle strength, and balance

    PubMed Central

    Wang, Huihui; Ji, Zhongqiu; Jiang, Guiping; Liu, Weitong; Jiao, Xibian

    2016-01-01

    [Purpose] To study the correlation among proprioception, muscle strength, and balance. [Subjects and Methods] A balance testing system (Biodex Balance System, BBS) and an isokinetic testing system (Biodex System 4, BS4) were used to test related indexes in 24 healthy young females. [Results] With the knee joint at 15 degree flexion, proprioception was significantly correlated with Limits of Stability-Time values, and was highly significantly correlated with Limits of Stability-Overall and Athlete Single Leg Medial/Lateral values. The sense of force was significantly correlated with Limits of Stability-Overall and Athlete Single Leg-Overall values. Quadriceps strength was significantly associated with Limits of Stability-Overall, Athlete Single Leg Medial/Lateral, and Athlete Double Leg-Overall values. The ratio of Quadriceps to Hamstring strength was significantly correlated with Athlete Single Leg Medial/Lateral, and Athlete Single Leg-Overall values. With the knee joint at 45°, proprioception was highly significantly correlated with dynamic balance, and was significantly correlated with double foot support under static balance; force sense had a high correlation with Limits of Stability-Overall, but no correlation with other indexes. Quadriceps strength had a significant correlation with dynamic and static balance; the ratio of Quadriceps/Hamstring had a highly significant correlation with Limits of Stability-Overall, Athlete Single Leg-Anterior/Posterior and Athlete Single Leg-Overall. [Conclusion] At different knee angles, the correlation differs among proprioception, force sense, quadriceps strength, the Quadriceps/Hamstring ratio, and balance. PMID:28174475

  16. Autism Severity and Muscle Strength: A Correlation Analysis

    ERIC Educational Resources Information Center

    Kern, Janet K.; Geier, David A.; Adams, James B.; Troutman, Melissa R.; Davis, Georgia; King, Paul G.; Young, John L.; Geier, Mark R.

    2011-01-01

    The current study examined the relationship between muscle strength, as measured by hand grip strength, and autism severity, as measured by the Childhood Autism Rating Scale (CARS). Thirty-seven (37) children with a diagnosis of autism spectrum disorder (ASD) were evaluated using the CARS and then tested for hand muscle strength using a hand grip…

  17. Autism Severity and Muscle Strength: A Correlation Analysis

    ERIC Educational Resources Information Center

    Kern, Janet K.; Geier, David A.; Adams, James B.; Troutman, Melissa R.; Davis, Georgia; King, Paul G.; Young, John L.; Geier, Mark R.

    2011-01-01

    The current study examined the relationship between muscle strength, as measured by hand grip strength, and autism severity, as measured by the Childhood Autism Rating Scale (CARS). Thirty-seven (37) children with a diagnosis of autism spectrum disorder (ASD) were evaluated using the CARS and then tested for hand muscle strength using a hand grip…

  18. Respiratory and skeletal muscle strength in COPD: Impact on exercise capacity and lower extremity function

    PubMed Central

    Singer, Jonathan; Yelin, Edward H.; Katz, Patricia P.; Sanchez, Gabriela; Iribarren, Carlos; Eisner, Mark D.; Blanc, Paul D.

    2011-01-01

    PURPOSE We sought to quantify the impact of respiratory muscle and lower extremity strength on exercise capacity and lower extremity function in patients with chronic obstructive pulmonary disease (COPD). METHODS In 828 persons with COPD, we assessed the impact of reduced respiratory (maximum inspiratory pressure, MIP) and lower extremity muscle strength (quadriceps, QS) on exercise capacity (6 Minute Walk Distance, 6MWT) and lower extremity function (LEF, Short Physical Performance Battery). Multiple regression analyses taking into account key covariates, including lung function and smoking, tested the associations between muscle strength and exercise and functional capacity. RESULTS For each ½ standard deviation (0.5 SD) decrement in QS, men walked 18.3 meters less during 6MWT (95% CI −24.1 to −12.4); women 25.1 meters less (95% CI −31.1 to −12.4). For each 0.5 SD decrement in MIP, men walked 9.4 meters less during 6MWT (95% CI – 15.2 to −3.6); women 8.7 meters less (95% CI −14.1 to −3.4). For each 0.5 SD decrease in QS, men had a 1.32 higher odds (95% CI: 1.11 to 1.15) of poor LEF; women, 1.87 higher odds (95% CI: 1.54 to 2.27). Lower MIP (per 0.5 SD) was associated with increased odds of poor LEF in women (OR 1.18, 95% CI: 1.00 to 1.39), but not in men (OR 1.10, 95% CI: 0.93 to 1.31). CONCLUSION In COPD, reduced respiratory and lower extremity muscle strength are associated with decreased exercise and functional capacity. Muscle weakness is likely an important component of impairment and disability in patients with COPD. PMID:21240003

  19. Aerobic exercise and respiratory muscle strength in patients with cystic fibrosis.

    PubMed

    Dassios, Theodore; Katelari, Anna; Doudounakis, Stavros; Dimitriou, Gabriel

    2013-05-01

    The beneficial role of exercise in maintaining health in patients with cystic fibrosis (CF) is well described. Few data exist on the effect of exercise on respiratory muscle function in patients with CF. Our objective was to compare respiratory muscle function indices in CF patients that regularly exercise with those CF patients that do not. This cross-sectional study assessed nutrition, pulmonary function and respiratory muscle function in 37 CF patients that undertook regular aerobic exercise and in a control group matched for age and gender which consisted of 44 CF patients that did not undertake regular exercise. Respiratory muscle function in CF was assessed by maximal inspiratory pressure (Pimax), maximal expiratory pressure (Pemax) and pressure-time index of the respiratory muscles (PTImus). Median Pimax and Pemax were significantly higher in the exercise group compared to the control group (92 vs. 63 cm H2O and 94 vs. 64 cm H2O respectively). PTImus was significantly lower in the exercise group compared to the control group (0.089 vs. 0.121). Upper arm muscle area (UAMA) and mid-arm muscle circumference were significantly increased in the exercise group compared to the control group (2608 vs. 2178 mm2 and 23 vs. 21 cm respectively). UAMA was significantly related to Pimax in the exercising group. These results suggest that CF patients that undertake regular aerobic exercise maintain higher indices of respiratory muscle strength and lower PTImus values, while increased UAMA values in exercising patients highlight the importance of muscular competence in respiratory muscle function in this population. Copyright © 2013 Elsevier Ltd. All rights reserved.

  20. Differences in muscle strength after ACL reconstruction do not influence cardiorespiratory responses to isometabolic exercise

    PubMed Central

    Andrade, Marília S.; Lira, Claudio A. B.; Vancini, Rodrigo L.; Nakamoto, Fernanda P.; Cohen, Moisés; Silva, Antonio C.

    2014-01-01

    Objectives To investigate whether the muscle strength decrease that follows anterior cruciate ligament (ACL) reconstruction would lead to different cardiorespiratory adjustments during dynamic exercise. Method Eighteen active male subjects were submitted to isokinetic evaluation of knee flexor and extensor muscles four months after ACL surgery. Thigh circumference was also measured and an incremental unilateral cardiopulmonary exercise test was performed separately for both involved and uninvolved lower limbs in order to compare heart rate, oxygen consumption, minute ventilation, and ventilatory pattern (breath rate, tidal volume, inspiratory time, expiratory time, tidal volume/inspiratory time) at three different workloads (moderate, anaerobic threshold, and maximal). Results There was a significant difference between isokinetic extensor peak torque measured in the involved (116.5±29.1 Nm) and uninvolved (220.8±40.4 Nm) limbs, p=0.000. Isokinetic flexor peak torque was also lower in the involved limb than in the uninvolved limb (107.8±15.4 and 132.5±26.3 Nm, p=0.004, respectively). Lower values were also found in involved thigh circumference as compared with uninvolved limb (46.9±4.3 and 48.5±3.9 cm, p=0.005, respectively). No differences were found between the lower limbs in any of the variables of the incremental cardiopulmonary tests at all exercise intensities. Conclusions Our findings indicate that, four months after ACL surgery, there is a significant deficit in isokinetic strength in the involved limb, but these differences in muscle strength requirement do not produce differences in the cardiorespiratory adjustments to exercise. Based on the hypotheses from the literature which explain the differences in the physiological responses to exercise for different muscle masses, we can deduce that, after 4 months of a rehabilitation program after an ACL reconstruction, individuals probably do not present differences in muscle oxidative and peripheral

  1. Effects of muscle extension strength exercise on trunk muscle strength and stability of patients with lumbar herniated nucleus pulposus

    PubMed Central

    Jeon, Kyoungkyu; Kim, Taeyoung; Lee, Sang-Ho

    2016-01-01

    [Purpose] The purpose of this study was to provide the data for constructing an integrated exercise program to help restore muscle strength and stability through extension strength exercise in adult females with lumbar disc herniation. [Subjects and Methods] An 8-week exercise program for lumbar muscle extension strength and stabilization was performed by 26 females older than 20 with lumbar disc herniation findings. [Results] Significant differences were found in lumbar extension muscle strength at every angle of lumbar flexion after participation in the 8-week stabilization exercise program; but there was no significant difference in the weight distribution index. [Conclusion] An integrated exercise program aiming to strengthen lumbar spine muscles, reduce pain and stabilize the trunk can help to maintain muscle strength and balance. In addition, improvement in extension strength is expected to be helpful in daily life by securing the range of joint motion and improving the strength and stability. PMID:27313342

  2. Sensible manual muscle strength testing to evaluate and monitor strength of the intrinsic muscles of the hand: a commentary.

    PubMed

    Brandsma, J W; Schreuders, T A

    2001-01-01

    Hand therapists often assess, evaluate, and monitor the status of, and changes in the strength of, the intrinsic muscles of the hand. Some common indications are peripheral and central neuropathies and nerve lacerations and repairs. The therapist will often use a muscle chart that lists all the muscles innervated by the ulnar and median nerves, and all muscles will be tested. Not all muscles in the hand can be sufficiently isolated to grade their strength, nor is it always necessary to test all muscles innervated by a particular nerve to evaluate the presence or extent of motor function impairment or monitor changes. This paper discusses the tests by which changes in strength of the ulnar and median innervated intrinsic muscles can be assessed and the reasons that certain muscles cannot or need not be tested. Information about the reliability of muscle testing is also given.

  3. Muscle strength testing: use of normalisation for body size.

    PubMed

    Jaric, Slobodan

    2002-01-01

    Assessment of muscle strength tests has been a popular form of testing muscle function in sports and exercises, as well as in other movement-related sciences for several decades. Although the relationship between muscle strength and body size has attracted considerable attention from researchers, this relationship has been often either neglected or incorrectly taken into account when presenting the results from muscle strength tests. Two specific problems have been identified. First, most of the studies have presented strength data either non-normalised for body size, or normalised using inappropriate methods, or even several different normalisations have been applied on the same sets of data. Second, the role of body size in various movement performances has been neglected when functional movement performance was assessed by muscle strength. As a consequence, muscle function, athletic profiles, or functional movement performance assessed by tested muscle strength have been often confounded by the effect of body size. Differences in the normalisation methods applied also do not allow for comparison of the data obtained in different studies. Using the following allometric formula for obtaining index of muscle strength, S, independent of body size (assessed by body mass, m) should be recommended in routine strength testing procedures: The allometric parameter should be either b = 0.67 for muscle force (recorded by a dynamometer), or b = 1 for muscle torque (recorded by an isokinetic apparatus). We also recommend using body-size-independent indices of both muscle strength and movement performance when assessing functional performance from recorded muscle strength or vice versa.

  4. Inspiratory resistive loading improves cycling capacity: a placebo controlled trial

    PubMed Central

    Gething, A; Williams, M; Davies, B

    2004-01-01

    Background: Respiratory muscle training has been shown to improve both its strength and endurance. The effect of these improvements on whole-body exercise performance remains controversial. Objective: To assess the effect of a 10 week inspiratory resistive loading (IRL) intervention on respiratory muscle performance and whole-body exercise endurance. Methods: Fifteen apparently healthy subjects (10 men, 5 women) were randomly allocated to one of three groups. One group underwent IRL set at 80% of maximum inspiratory pressure with ever decreasing work/rest ratios until task failure, for three days a week for 10 weeks (IRL group). A second placebo group performed the same training procedure but with a minimal resistance (PLA group). IRL and placebo training were performed at rest. The remaining five control subjects performed no IRL during the 10 week study period (CON group). Cycling endurance capacity at 75% V·O2peak was measured before and after the intervention. Results: After the 10 week IRL intervention, respiratory muscle strength (maximum inspiratory pressure) and endurance (sum of sustained maximum inspiratory pressure) had significantly improved (by 34% and 38% respectively). An increase in diaphragm thickness was also observed. These improvements translated into a 36% increase in cycling time to exhaustion at 75% V·O2peak. During cycling trials, heart rate, ventilation, and rating of perceived exertion were attenuated in the IRL group. No changes were observed for the PLA or CON group either in the time to exhaustion or cardiorespiratory response to the same intensity of exercise. Conclusion: Ten weeks of IRL attenuated the heart rate, ventilatory, and perceptual response to constant workload exercise, and improved the cycling time to exhaustion. Familiarisation was not a factor and the placebo effect was minimal. PMID:15562168

  5. Upper limb muscle strength & endurance in chronic obstructive pulmonary disease.

    PubMed

    Shah, Swati; Nahar, Pradeep; Vaidya, Savita; Salvi, Sundeep

    2013-10-01

    There are very few studies that have investigated the muscle strength and endurance of upper limbs (UL) in chronic obstructive pulmonary disease (COPD). We undertook this study to measure and compare the skeletal muscle strength and endurance of UL in COPD patients and age matched healthy controls and to study the association between lung function parameters and UL muscle strength and endurance. Forty one COPD patients and 45 height and weight matched healthy subjects of the same age group were studied. UL skeletal muscle strength and endurance were measured using the hand grip dynamometer test. Forced vital capacity (FVC), forced expiratory volume in 1 sec (FEV₁), forced expiratory flow during 25-75% FVC (FEF (25-75%)) and peak expiratory flow rate (PEFR) were measured. The handgrip muscle strength and endurance between the two groups were compared and correlations between FVC and FEV 1 with muscle strength and endurance were analyzed. The mean handgrip strength and mean muscle endurance in COPD patients were significantly lesser than the normal subjects in both males and females (P<0.001). There was significant positive correlation between muscle strength and FVC in males (r² =0.32, P<0.05); and between muscle strength and FEV₁ in females (r² =0.20, P<0.05). The study showed that the handgrip muscle strength decreases as the FVC and FEV₁ decrease in patients with COPD. Identifying those patients who have reduced strength and endurance will allow early interventions targeted at improving the quality of life of the patient.

  6. Respiratory Muscle Strength Predicts Decline in Mobility in Older Persons

    PubMed Central

    Buchman, A.S.; Boyle, P.A.; Wilson, R.S.; Leurgans, S.; Shah, R.C.; Bennett, D.A.

    2008-01-01

    Objectives To test the hypothesis that respiratory muscle strength is associated with the rate of change in mobility even after controlling for leg strength and physical activity. Methods Prospective study of 890 ambulatory older persons without dementia who underwent annual clinical evaluations to examine change in the rate of mobility over time. Results In a linear mixed-effect model adjusted for age, sex, and education, mobility declined about 0.12 unit/year, and higher levels of respiratory muscle strength were associated with a slower rate of mobility decline (estimate 0.043, SE 0.012, p < 0.001). Respiratory muscle strength remained associated with the rate of change in mobility even after controlling for lower extremity strength (estimate 0.036, SE 0.012, p = 0.004). In a model that included terms for respiratory muscle strength, lower extremity strength and physical activity together, all three were independent predictors of mobility decline in older persons. These associations remained significant even after controlling for body composition, global cognition, the development of dementia, parkinsonian signs, possible pulmonary disease, smoking, joint pain and chronic diseases. Conclusion Respiratory muscle strength is associated with mobility decline in older persons independent of lower extremity strength and physical activity. Clinical interventions to improve respiratory muscle strength may decrease the burden of mobility impairment in the elderly. PMID:18784416

  7. Rib motion modulates inspiratory intercostal activity in dogs.

    PubMed Central

    De Troyer, A

    1996-01-01

    1. A test was performed of the hypothesis that the motion of the ribs during inspiration modulates, via changes in spindle afferent activity, the activation of the inspiratory intercostal muscles. The electrical activity of the parasternal intercostal, external intercostal, and levator costae muscles in anaesthetized spontaneously breathing dogs was thus recorded during manipulation of the inspiratory displacement of the ribs over a wide range of rib motion. 2. In agreement with the hypothesis, the external intercostal and levator costae muscles lengthened and showed increased inspiratory activities when the normal inspiratory cranial motion of the lower rib was reduced or reversed into an inspiratory caudal motion. Conversely, the inspiratory activities decreased when the inspiratory cranial motion of the rib and the inspiratory shortening of the muscles was augmented. The inspiratory activity of the parasternal intercostal remained unchanged throughout. 3. However, when the two ribs making up the interspace were linked together so that the external intercostal muscle was constant in length, the relationship of muscle activity to rib motion was maintained. 4. In addition, when the upper rather than the lower rib of the interspace was manipulated, the relationship between the change in muscle length and inspiratory activity was reversed, so that activity decreased when the muscle was lengthened and increased when the muscle was shortened. The relationship of muscle activity to lower rib motion, however, was still maintained. 5. These observations thus indicate that rib motion triggers proprioceptive reflexes which, regardless of the changes in length of the individual muscles, make the external intercostal inspiratory activity exquisitely sensitive to the direction of rib displacement. PMID:8730601

  8. Effects of wheelchair sports on respiratory muscle strength and thoracic mobility of individuals with spinal cord injury.

    PubMed

    Moreno, Marlene Aparecida; Zamunér, Antonio Roberto; Paris, Juliana Viana; Teodori, Rosana Macher; Barros, Ricardo M L

    2012-06-01

    The aim of this study was to evaluate the effects of wheelchair sports on respiratory muscle strength and the thoracic mobility of individuals with spinal cord injury. Thirty male subjects with chronic spinal cord injury (American Spinal Injury Association Impairment Scale grade A) took part in the study and were divided into four groups: sedentary subjects with quadriplegia (S-QUAD, n = 7), wheelchair rugby athletes with quadriplegia (A-QUAD, n = 8), sedentary subjects with paraplegia (S-PARA, n = 6), and wheelchair basketball athletes with paraplegia (A-PARA, n = 9). The main outcome measures were maximal inspiratory and expiratory pressure and the respiratory coefficients at the axillary and xiphoid levels. A-QUAD group presented values significantly higher for all respiratory variables studied compared with the S-QUAD group. No significant differences in any of the respiratory variables were observed between S-PARA and A-PARA groups. There was a negative correlation between spinal cord injury level and respiratory variables for the S-QUAD and S-PARA groups. There were positive correlations in the A-QUAD group between time of training and maximal inspiratory pressure (adjusted R = 0.84; P = 0.001) and respiratory coefficients at the axillary level (adjusted R = 0.80; P = 0.002). Physical training seems to have a positive influence on respiratory muscle strength and thoracic mobility, especially in subjects with quadriplegia.

  9. Objective Evaluation of Muscle Strength in Infants with Hypotonia and Muscle Weakness

    ERIC Educational Resources Information Center

    Reus, Linda; van Vlimmeren, Leo A.; Staal, J. Bart; Janssen, Anjo J. W. M.; Otten, Barto J.; Pelzer, Ben J.; Nijhuis-van der Sanden, Maria W. G.

    2013-01-01

    The clinical evaluation of an infant with motor delay, muscle weakness, and/or hypotonia would improve considerably if muscle strength could be measured objectively and normal reference values were available. The authors developed a method to measure muscle strength in infants and tested 81 typically developing infants, 6-36 months of age, and 17…

  10. Objective Evaluation of Muscle Strength in Infants with Hypotonia and Muscle Weakness

    ERIC Educational Resources Information Center

    Reus, Linda; van Vlimmeren, Leo A.; Staal, J. Bart; Janssen, Anjo J. W. M.; Otten, Barto J.; Pelzer, Ben J.; Nijhuis-van der Sanden, Maria W. G.

    2013-01-01

    The clinical evaluation of an infant with motor delay, muscle weakness, and/or hypotonia would improve considerably if muscle strength could be measured objectively and normal reference values were available. The authors developed a method to measure muscle strength in infants and tested 81 typically developing infants, 6-36 months of age, and 17…

  11. Generalization of Muscle Strength Capacities as Assessed From Different Variables, Tests, and Muscle Groups.

    PubMed

    Cuk, Ivan; Prebeg, Goran; Sreckovic, Sreten; Mirkov, Dragan M; Jaric, Slobodan

    2017-02-01

    Cuk, I, Prebeg, G, Sreckovic, S, Mirkov, DM, and Jaric, S. Generalization of muscle strength capacities as assessed from different variables, tests, and muscle groups. J Strength Cond Res 31(2): 305-312, 2017-The muscle strength capacities to exert force under various movement conditions have been indiscriminately assessed from various strength tests and variables applied on different muscles. We tested the hypotheses that the distinctive strength capacities would be revealed (H1) through different strength tests, and (H2) through different strength variables. Alternatively, (H3) all strength variables independent of the selected test could depict the same strength capacity of the tested muscle. Sixty subjects performed both the standard strength test and the test of alternating contractions of 6 pairs of antagonistic muscles acting in different leg and arm joints. The dependent variables obtained from each test and muscle were the maximum isometric force and the rate of force development. A confirmatory principle component analysis set to 2 factors explained 31.9% of the total variance. The factor loadings discerned between the tested arm and leg muscles, but not between the strength tests and variables. An exploratory analysis applied on the same data revealed 6 factors that explained 60.1% of the total variance. Again, the individual factors were mainly loaded by different tests and variables obtained from the same pair of antagonistic muscles. Therefore, a comprehensive assessment of the muscle strength capacity of the tested individual should be based on a single strength test and variable obtained from a number of different muscles, than on a single muscle tested through different tests and variables. The selected muscles should act in different limbs and joints, while the maximum isometric force should be the variable of choice.

  12. Muscle power predicts bone strength in Division II athletes.

    PubMed

    Yingling, Vanessa R; Webb, Shannon; Inouye, Cathy; O, Jenny; Sherwood, Jennifer J

    2017-08-29

    The relationship between muscle fitness measures and tibial bone strength in collegiate level athletes was investigated. Eighty-six Division II collegiate athletes (age: (18-29 years), height: 1.71 m (.09): mass: 66.7 kg (10.5) 56 female: 30 male) participated in this cross-sectional study. Maximum grip strength (GS), 1 repetition maximum leg press (1RM) and vertical jump peak power (PP) tests were measured. Cortical area (Ct.Ar), cortical bone mineral density (cBMD), moment of inertia (J) and bone strength (polar strength-strain index, SSIp) were measured using peripheral quantitative computed tomography (pQCT) at 50% tibia length. For each bone strength parameter, a hierarchical multiple regression (HMR) analysis was performed to examine the contribution of sex and the 3 muscle fitness parameters (muscle power, relative 1 repetition leg extensor strength and relative grip strength) to bone parameters. Vertical jump peak power explained 54-59% of the variance in bone strength parameters, and relative leg extensor and grip strength were not predictive of bone strength parameters. Muscle power correlated with bone mass and architecture variables but not cBMD values. Cortical bone mineral density (cBMD) was also not predicted by relative leg extensor strength or relative grip strength. Muscular fitness assessment, specifically peak power calculated from vertical jump height assessments provides a simple, objective, valid and reliable measure to identify and monitor bone strength in collegiate athletes.

  13. Ventilatory muscle strength, diaphragm thickness and pulmonary function in world-class powerlifters.

    PubMed

    Brown, Peter I; Venables, Heather K; Liu, Hymsuen; de-Witt, Julie T; Brown, Michelle R; Faghy, Mark A

    2013-11-01

    Resistance training activates the ventilatory muscles providing a stimulus similar to ventilatory muscle training. We examined the effects of elite powerlifting training upon ventilatory muscle strength, pulmonary function and diaphragm thickness in world-class powerlifters (POWER) and a control group (CON) with no history of endurance or resistance training, matched for age, height and body mass. Body composition was assessed using single-frequency bioelectrical impedance. Maximal static volitional inspiratory (P(I,max)) and expiratory (P(E,max)) mouth pressures, diaphragm thickness (T(di)) derived from ultrasound measurements and pulmonary function from maximal flow volume loops were measured. There were no differences in physical characteristics or pulmonary function between groups. P(I,max) (22 %, P < 0.05, effect size d = 1.13), P(E,max) (16 %, P = 0.07, effect size d = 0.86) and T(di) (27 %, P < 0.01, effect size d = 1.59) were greater in POWER than CON. Correlations were observed between both T(di) and P(I,max) (r = 0.518, P < 0.05), T(di) and P(E,max) (r = 0.671, P < 0.01) and T(di) and body mass (r = 0.502, P < 0.05). We conclude that manoeuvres performed by world-class powerlifters improve ventilatory muscle strength and increases diaphragm size. Whole-body resistance training may be an appropriate training mode to attenuate the effects of ventilatory muscle weakness experienced with ageing and some disease states.

  14. Muscle Strength and Muscle Mass in Older Patients during Hospitalization: The EMPOWER Study.

    PubMed

    Van Ancum, Jeanine M; Scheerman, Kira; Pierik, Vincent D; Numans, Siger T; Verlaan, Sjors; Smeenk, Hanne E; Slee-Valentijn, Monique; Kruizinga, Roeliene C; Meskers, Carel G M; Maier, Andrea B

    2017-08-18

    Low muscle strength and muscle mass are associated with an increased length of hospital stay and higher mortality rate in inpatients. To what extent hospitalization affects muscle strength and muscle mass is unclear. We aimed to assess muscle strength and muscle mass at admission and during hospitalization in older patients and its relation with being at risk of geriatric conditions. The EMPOWER study included patients aged 70 years and older, admitted to 4 wards of the VU University Medical Center in the Netherlands between April and December 2015. At admission, patients were screened for being at risk of 4 geriatric conditions: delirium, falls, malnutrition, and functional disability. At admission and at discharge, muscle strength and muscle mass were assessed. A total of 373 patients (mean age, standard deviation [SD]: 79.6, 6.38 years) were included at admission, and 224 patients (mean age, SD: 80.1, 6.32 years) at discharge. At admission, lower muscle strength in both female and male patients and low muscle mass in male patients were associated with being at risk of a higher cumulative number of geriatric conditions. Muscle strength increased during hospitalization, but no change in muscle mass was observed. Changes in muscle measures were not associated with being at risk of geriatric conditions. Older patients with lower muscle strength and muscle mass at admission were at risk of a higher cumulative number of geriatric conditions. However, being at risk of geriatric conditions did not forecast further decrease in muscle strength and muscle mass during hospitalization. © 2017 The Author(s) Published by S. Karger AG, Basel.

  15. Progressive resistance muscle strength training of hospitalized frail elderly.

    PubMed

    Sullivan, D H; Wall, P T; Bariola, J R; Bopp, M M; Frost, Y M

    2001-07-01

    To determine whether frail elderly patients recuperating from acute illnesses could safely participate in and gain appreciable improvement in muscle strength from progressive resistance muscle strength training. Muscle strength (one repetition maximum), functional abilities (sit-to-stand maneuver and 20-sec maximal safe gait speed), and body composition were measured before and at the conclusion of a 10-wk program of lower limb progressive resistance muscle strength training. The nonrandomized study was conducted in a 30-bed geriatric rehabilitation unit of a university-affiliated Veterans Affairs hospital and a 28-bed transitional care unit of a community nursing home. Participants included 19 recuperating elderly subjects (14 male, 5 female; 13 ambulatory, 6 nonambulatory) >64 yr (mean age, 82.8+/-7.9 yr). The one repetition maximum increased an average of 74%+/-49% (median, 70%; interquartile range, 38%-95%, and an average of 20+/-13 kg (P = 0.0001). Sit-to-stand maneuver times improved in 15 of 19 cases (79%). Maximum safe gait speeds improved in 10 of 19 cases (53%). Four of the six nonambulatory subjects progressed to ambulatory status. No subject experienced a complication. A carefully monitored program of progressive resistance muscle strength training to regain muscle strength is a safe and possibly effective method for frail elderly recuperating from acute illnesses. A randomized control study is needed to examine the degree to which progressive resistance muscle strength training offers advantages, if any, over routine posthospital care that includes traditional low-intensity physical therapy.

  16. Comparative effects of plasma exchange and pyridostigmine on respiratory muscle strength and breathing pattern in patients with myasthenia gravis.

    PubMed Central

    Goti, P.; Spinelli, A.; Marconi, G.; Duranti, R.; Gigliotti, F.; Pizzi, A.; Scano, G.

    1995-01-01

    BACKGROUND--Pyridostigmine, an acetylcholinesterase antagonist, is useful in improving respiratory function in patients with myasthenia gravis. More recently, plasma exchange has been employed in myasthenia gravis because it acts presumably by removal of circulating antibodies against acetylcholine receptors. Surprisingly, comparative data on the effects of pyridostigmine and plasma exchange on lung volumes, respiratory muscle strength, and ventilatory control system in patients with myasthenia gravis are lacking. METHODS--Nine consecutive patients with grade IIb myasthenia gravis were studied under control conditions and after a therapeutic dose of pyridostigmine. In a second study the patients were re-evaluated a few days after a cycle of plasma exchange, before taking pyridostigmine. In each subject pulmonary volumes, inspiratory (MIP) and expiratory (MEP) muscle force, and respiratory muscle strength, calculated as average MIP and MEP as percentages of their predicted values, were measured. The ventilatory control system was evaluated in terms of volume (tidal volume, VT) and time (inspiratory time, TI, and total time, TTOT) components of the respiratory cycle. Mean inspiratory flow (VT/TI)--that is, the "driving"--and TI/TTOT--that is, the "timing"--components of ventilation were also measured. RESULTS--In each patient treatment relieved weakness and tiredness, and dyspnoea grade was reduced with plasma exchange. Following treatment, vital capacity (VC) increased on average by 9.7% with pyridostigmine and by 14% with plasma exchange, and MIP increased by 18% and 26%, respectively. In addition, with plasma exchange but not with pyridostigmine forced expiratory volume in one second (FEV1) increased by 16% and MEP increased by 24.5%, while functional residual capacity (FRC) decreased a little (6.8%). The change in respiratory muscle strength was related to change in VC (r2 = 0.48). With plasma exchange, VT increased by 18.6% and VT/TI increased by 13.5%, while

  17. Respiratory muscle function and exercise intolerance in heart failure.

    PubMed

    Ribeiro, Jorge P; Chiappa, Gaspar R; Neder, J Alberto; Frankenstein, Lutz

    2009-06-01

    Inspiratory muscle weakness (IMW) is prevalent in patients with chronic heart failure (CHF) caused by left ventricular systolic dysfunction, which contributes to reduced exercise capacity and the presence of dyspnea during daily activities. Inspiratory muscle strength (estimated by maximal inspiratory pressure) has independent prognostic value in CHF. Overall, the results of trials with inspiratory muscle training (IMT) indicate that this intervention improves exercise capacity and quality of life, particularly in patients with CHF and IMW. Some benefit from IMT may be accounted for by the attenuation of the inspiratory muscle metaboreflex. Moreover, IMT results in improved cardiovascular responses to exercise and to those obtained with standard aerobic training. These findings suggest that routine screening for IMW is advisable in patients with CHF, and specific IMT and/or aerobic training are of practical value in the management of these patients.

  18. [Progress on cervical muscle strength and soft tissue stiffness testing].

    PubMed

    Ma, Ming; Zhang, Shi-min

    2015-08-01

    Biomechanical evaluation of neck muscles has important significance in the diagnosis and treatment for cervical spondylosis, the neck muscle strength and soft tissue stiffness test is two aspects of biomechanical testing. Isometric muscle testing operation is relatively simple, the cost is lower, which can evaluate the muscle force below grade 3. However, isokinetic muscle strength testing can assess the muscle strength of joint motion in any position. It is hard to distinguish stiffness difference in different soft tissues when the load-displacement curve is used to evaluate the local soft tissue stiffness. Elasticity imaging technique can not only show the elastic differences of different tissues by images, but also quantify the elastic modulus of subcutaneous tissues and muscles respectively. Nevertheless, it is difficult to observe the flexibility of the cervical spine by means of the analysis of the whole neck stiffness. In a word, a variety of test method will conduce not only the biomechanical evaluation of neck muscles, but also making an effective biomechanics mathematical model of neck muscles. Besides, isokinetic muscle testing and the elasticity imaging technology still need further validation and optimization before they are better applied to neck muscles biomechanical testing.

  19. Evaluation of rotator cuff muscle strength in healthy individuals

    PubMed Central

    Cortez, Paulo José Oliveira; Tomazini, José Elias

    2015-01-01

    OBJECTIVE: To compare the strength generated by the rotator muscles of the shoulder joint between the right upper limb and left upper limb among healthy individuals. METHODS: To evaluate the muscle strength of upper limbs from isometric contractions in the horizontal direction (rotation) an isometric dynamometer was used, equipped with transducers, signal conditioning, a data acquisition board, and finally, a computer. Study participants were 22 male military subjects, aged between 18 and 19 years old, body mass between 57.7 and 93.0 kg (71.8 ± 9.45 kg) and height between 1.67 and 1.90 m (1.75 ± 0.06 m), healthy and without clinical diseases or any type of orthopedic injury in the muscle skeletal system. RESULTS: The internal rotation in the right upper limb (RUL) was higher than the average strength of internal rotation in the left upper limb (LUL) (p = 0.723). The external rotation strength in RUL was lower than the average strength of external rotation in the LUL (p=0.788). No statistical difference was observed by comparing the strength values of all isometric strength tests. CONCLUSION: For the sample and methodology used to assess muscle strength, there was no statistical difference between the strength generated by the muscles of the rotator cuff of the right and left upper limbs. Experimental Study. PMID:26207091

  20. Muscle strength, muscle mass, and physical disability in women with systemic lupus erythematosus.

    PubMed

    Andrews, James S; Trupin, Laura; Schmajuk, Gabriela; Barton, Jennifer; Margaretten, Mary; Yazdany, Jinoos; Yelin, Edward H; Katz, Patricia P

    2015-01-01

    Data describing relationships between muscle strength, muscle mass, and physical disability among individuals with systemic lupus erythematosus (SLE) are limited. The present study examines the relationship of muscle strength and muscle mass with physical disability among adult women with SLE. A total of 146 women from a longitudinal SLE cohort participated in the study. All measures were collected during an in-person research visit. Lower extremity muscle strength was assessed by peak knee torque of extension and flexion and by chair-stand time. Total lean body mass, appendicular lean mass, and fat mass (kg/m(2) ) were measured by whole-body dual x-ray absorptiometry. Self-reported physical disability was assessed using the Short Form 36 health survey (SF-36) physical functioning subscale, and the Valued Life Activities (VLA) disability scale. Spearman's rank correlation coefficients tested the correlations between muscle strength, muscle mass, and disability scores. Regression analyses modeled the effect of lower extremity muscle strength and mass on SF-36 and VLA disability scores controlling for age, SLE duration, SLE disease activity measured with the Systemic Lupus Activity Questionnaire, physical activity level, prednisone use, body composition, and depression. On all measures, reduced lower extremity muscle strength was associated with poorer SF-36 and VLA disability scores. Trends persisted after adjustment for covariates. Muscle mass was moderately correlated with muscle strength, but did not contribute significantly to adjusted regression models. Lower extremity muscle strength, but not muscle mass, was strongly associated with physical disability scores. While further studies are needed, these findings suggest that improving muscle strength may reduce physical disability among women with SLE. Copyright © 2015 by the American College of Rheumatology.

  1. Muscle Strength, Muscle Mass, and Physical Disability in Women with Systemic Lupus Erythematosus

    PubMed Central

    Andrews, James S.; Trupin, Laura; Schmajuk, Gabriela; Barton, Jennifer; Margaretten, Mary; Yazdany, Jinoos; Yelin, Edward H.; Katz, Patricia P.

    2014-01-01

    Objective Limited data exist describing relationships between muscle strength, muscle mass, and physical disability among individuals with systemic lupus erythematosus (SLE). The present study examines the relationship of muscle strength and muscle mass with physical disability among adult women with SLE. Methods One hundred forty-six women from a longitudinal SLE cohort participated in the study. All measures were collected during an in-person research visit. Lower extremity muscle strength was assessed by peak knee torque of extension and flexion and by chair-stand time. Total lean body mass, appendicular lean mass, and fat mass (kg/m2) were measured by whole-body dual energy absorptiometry. Self-reported physical disability was assessed using the SF-36 Physical Functioning subscale and Valued Life Activities (VLA) Disability scale. Spearman’s rank correlation coefficients tested the correlations between muscle strength, muscle mass, and disability scores. Regression analyses modeled the effect of lower extremity muscle strength and mass on SF-36 and VLA disability scores controlling for age, SLE duration, SLE disease activity measured with the Systemic Lupus Activity Questionnaire (SLAQ), physical activity level, prednisone use, body composition, and depression. Results On all measures, reduced lower extremity muscle strength was associated with poorer SF-36 and VLA disability scores. Trends persisted after adjustment for covariates. Muscle mass was moderately correlated with muscle strength, but did not contribute significantly to adjusted regression models. Conclusions Lower extremity muscle strength, but not muscle mass, was strongly associated with physical disability scores. While further studies are needed, these findings suggest that improving muscle strength may reduce physical disability among women with SLE. PMID:25049114

  2. The effects of inspiratory muscle training on plasma interleukin-6 concentration during cycling exercise and a volitional mimic of the exercise hyperpnea.

    PubMed

    Mills, Dean E; Johnson, Michael A; McPhilimey, Martin J; Williams, Neil C; Gonzalez, Javier T; Barnett, Yvonne A; Sharpe, Graham R

    2013-10-15

    It is unknown whether the respiratory muscles contribute to exercise-induced increases in plasma interleukin-6 (IL-6) concentration, if this is related to diaphragm fatigue, and whether inspiratory muscle training (IMT) attenuates the plasma IL-6 response to whole body exercise and/or a volitional mimic of the exercise hyperpnea. Twelve healthy males were divided equally into an IMT or placebo (PLA) group, and before and after a 6-wk intervention they undertook, on separate days, 1 h of 1) passive rest, 2) cycling exercise at estimated maximal lactate steady state power (EX), and 3) volitional hyperpnea at rest, which mimicked the breathing and respiratory muscle recruitment patterns achieved during EX (HYPEX). Plasma IL-6 concentration remained unchanged during passive rest. The plasma IL-6 response to EX was reduced following IMT (main effect of intervention, P = 0.039) but not PLA (P = 0.272). Plasma IL-6 concentration increased during HYPEX (main effect of time, P < 0.01) and was unchanged postintervention. There was no evidence of diaphragm fatigue (measured by phrenic nerve stimulation) following each trial. In conclusion, plasma IL-6 concentration is increased during EX and HYPEX and this occurred in the absence of diaphragm fatigue. Furthermore, IMT reduced the plasma IL-6 response to EX but not HYPEX. These findings suggest that the respiratory muscles contribute to exercise-induced increases in plasma IL-6 concentration in the absence of diaphragm fatigue and that IMT can reduce the magnitude of the response to exercise but not a volitional mimic of the exercise hyperpnea.

  3. Tai Chi, arterial compliance, and muscle strength in older adults.

    PubMed

    Lu, Xi; Hui-Chan, Christina W Y; Tsang, William W N

    2013-08-01

    Aerobic exercise can alleviate the declines in arterial compliance common in older adults. However, when combined with strength training, aerobic exercise may not reduce arterial compliance. Tai Chi practice has been found to improve muscle strength and cardiopulmonary function in older subjects, but whether or not it improves arterial compliance is not known. The primary aim of this study was to investigate whether Tai Chi practitioners have better arterial compliance and muscle strength. Twenty-nine older Tai Chi practitioners (73.7 ± 4.5 years) and 36 healthy control subjects (71.4 ± 6.6 years) participated in this cross-sectional study. The participants were independent in their daily living activities. They were screened for apparent cardiovascular disease and underwent arterial compliance testing and isokinetic knee muscle strength testing at 30°/s. Tai Chi practitioners showed significantly better haemodynamic parameters than the controls as indexed by larger and small artery compliance. They also demonstrated greater eccentric muscle strength in both knee extensors and flexors. The findings of better muscle strength without jeopardizing arterial compliance suggests that Tai Chi could be a suitable exercise for older persons to improve both cardiovascular function and muscle strength.

  4. [Development of Muscle Strength Evaluating System Based on Mobile Platform].

    PubMed

    Xu, Xiulin; Yao, Xiaoming; Xu, Xijiao; Hu, Xiaohui

    2015-08-01

    The development of muscle strength evaluating system based on Android system was developed in this research. The system consists of a lower unit and an intelligent mobile terminal. The pressure sensor of the lower unit was used to collect muscle strength parameters. And the parameters were sent to the Android device through the wireless Bluetooth serial port. Then the Android device would send the parameters to the doctor monitored platform through the Internet. The system realized analyzing the muscle strength parameters and real-time displaying them. After it ran on the Android mobile phones, it showed an effective result which proved that the system combined with mobile platform could make more convenient for the patients to assess their own muscle strength. It also provided reliable data references for doctors to know the patients' rehabilitation condition and to make the next rehabilitation plan.

  5. Reduction of cervical and respiratory muscle strength in patients with chronic nonspecific neck pain and having moderate to severe disability.

    PubMed

    López-de-Uralde-Villanueva, Ibai; Sollano-Vallez, Ernesto; Del Corral, Tamara

    2017-06-11

    To investigate whether patients with chronic nonspecific neck pain and having moderate to severe disability have a greater cervical motor function impairment and respiratory disturbances compared with patients with chronic nonspecific neck pain having mild disability and asymptomatic subjects; and the association between these outcomes in patients with chronic nonspecific neck pain and healthy controls. Cross-sectional study, 44 patients with chronic nonspecific neck pain and 31 healthy subjects participated. The neck disability index was used to divide the patients into 2 groups: 1) mild disability group (scores between 5 and 14 points); and 2) moderate to severe disability group (scores >14 points). Cervical motor function was measured by cervical range of motion, forward head posture, neck flexor, and extensor muscle strength. Respiratory function and maximum respiratory pressures were also measured. Statistically differences were found between the patients with chronic nonspecific neck pain having a moderate to severe disability and the asymptomatic subjects for cervical and respiratory muscle strength. Comparisons between chronic nonspecific neck pain and the asymptomatic groups showed differences for all the variables, except for forward head posture. The regression model determined that strength of cervical flexion explained 36.4 and 45.6% of the variance of maximum inspiratory pressures and maximum expiratory pressures, respectively. Only the chronic nonspecific neck pain group with moderate to severe disability showed differences compared with the healthy subjects. Neck muscle strength could be a good predictor of respiratory muscle function. Implications for rehabilitation Neck pain severity could be closely associated with decreased respiratory pressure in patients with chronic nonspecific neck pain. These findings suggest a new therapeutic approach for patients with moderate to severe disability, such as respiratory muscle training. The regression

  6. Comparative Associations of Muscle Mass and Muscle Strength with Mortality in Dialysis Patients

    PubMed Central

    Isoyama, Naohito; Qureshi, Abdul Rashid; Avesani, Carla Maria; Lindholm, Bengt; Bàràny, Peter; Heimbürger, Olof; Cederholm, Tommy; Stenvinkel, Peter

    2014-01-01

    Background and objectives Reduced muscle mass and strength are prevalent conditions in dialysis patients. However, muscle strength and muscle mass are not congruent; muscle strength can diminish even though muscle mass is maintained or increased. This study addresses phenotype and mortality associations of these muscle dysfunction entities alone or in combination (i.e., concurrent loss of muscle mass and strength/mobility, here defined as sarcopenia). Design, setting, participants, & measurements This study included 330 incident dialysis patients (203 men, mean age 53±13 years, and mean GFR 7±2 ml/min per 1.73 m2) recruited between 1994 and 2010 and followed prospectively for up to 5 years. Low muscle mass (by dual-energy x-ray absorptiometry appendicular mass index) and low muscle strength (by handgrip) were defined against young reference populations according to the European Working Group on Sarcopenia in Older People. Results Whereas 20% of patients had sarcopenia, low muscle mass and low muscle strength alone were observed in a further 24% and 15% of patients, respectively. Old age, comorbidities, protein-energy wasting, physical inactivity, low albumin, and inflammation associated with low muscle strength, but not with low muscle mass (multivariate ANOVA interactions). During follow-up, 95 patients (29%) died and both conditions associated with mortality as separate entities. When combined, individuals with low muscle mass alone were not at increased risk of mortality (adjusted hazard ratio [HR], 1.23; 95% confidence interval [95% CI], 0.56 to 2.67). Individuals with low muscle strength were at increased risk, irrespective of their muscle stores being appropriate (HR, 1.98; 95% CI, 1.01 to 3.87) or low (HR, 1.93; 95% CI, 1.01 to 3.71). Conclusions Low muscle strength was more strongly associated with aging, protein-energy wasting, physical inactivity, inflammation, and mortality than low muscle mass. Assessment of muscle functionality may provide additional

  7. Muscle Power Predicts Adolescent Bone Strength: Iowa Bone Development Study.

    PubMed

    Janz, Kathleen F; Letuchy, Elena M; Burns, Trudy L; Francis, Shelby L; Levy, Steven M

    2015-10-01

    To assess association between lower body muscle power and bone strength as well as the mediating effect of muscle cross-sectional area (MCSA) on that association. Participants (141 males and 162 females) were approximately 17 yr. Muscle power was predicted using vertical jump and the Sayers equation. Using peripheral quantitative computed tomography (pQCT), bone strength indices were obtained at two locations of the tibia, corresponding to primary stressors acting upon each site: bone strength index for compression (BSI) at the distal 4% site; density-weighted polar section modulus strength-strain index (SSIp) and cortical bone area (CoA) at the 66% midshaft site for torsion. Muscle cross-sectional area was measured at the 66% site. Pearson bivariate and partial correlation coefficients were estimated to quantify the strength of the associations among variables. Direct and indirect mediation model effects were estimated, and 95% bootstrap confidence intervals were constructed to test the causal hypothesis. Height and maturity were examined as covariates. Pearson correlation coefficients among muscle power, MCSA, and bone strength were statistically significant (P < 0.01) and ranged from r = 0.54 to r = 0.78. After adjustment for covariates, associations were reduced (r = 0.37 to 0.69) (P < 0.01). Mediation models for males for BSI, SSIp, and CoA accounted for 38%, 66%, and 54% of the variance in bone strength, respectively. Models for females for BSI, SSIp, and CoA accounted for 46%, 77%, and 66% of the variance, respectively. We found strong and consistent associations as well as direct and indirect pathways, among muscle power, MCSA, and tibia strength. These results support the use of muscle power as a component of health-related fitness in bone health interventions for older adolescents.

  8. Muscle Power Predicts Adolescent Bone Strength: Iowa Bone Development Study

    PubMed Central

    Janz, Kathleen F.; Letuchy, Elena M.; Burns, Trudy L.; Francis, Shelby L.; Levy, Steven M.

    2015-01-01

    Purpose To assess association between lower body muscle power and bone strength, as well as the mediating effect of muscle cross-sectional area (MCSA) on that association. Methods Participants (N=141 males; 162 females) were approximately 17 years. Muscle power was predicted using vertical jump and the Sayers equation. Using peripheral quantitative computed tomography (pQCT), bone strength indices were obtained at two locations of the tibia, corresponding to primary stressors acting upon each site: bone strength index for compression (BSI) at the distal 4% site; density-weighted polar section modulus strength-strain index [SSIp] and cortical bone area (CoA) at the 66% mid-shaft site for torsion. Muscle cross-sectional area (MCSA) was measured at the 66% site. Pearson bivariate and partial correlation coefficients were estimated to quantify the strength of the associations among variables. Direct and indirect mediation model effects were estimated and 95% bootstrap confidence intervals were constructed to test the causal hypothesis. Height and maturity were examined as covariates. Results Pearson correlation coefficients among muscle power, MCSA, and bone strength were statistically significant (p<0.01) and ranged from r=0.54 to 0.78. After adjustment for covariates, associations were reduced (r=0.37 to 0.69) (p<0.01). Mediation models for males for BSI, SSIp, and CoA accounted for 38%, 66%, and 54% of the variance in bone strength, respectively. Models for females for BSI, SSIp, and CoA accounted for 46%, 77%, and 66% of the variance, respectively. Conclusions We found strong and consistent associations, as well as direct and indirect pathways, among muscle power, MCSA, and tibia strength. These results support the use of muscle power as a component of health-related fitness in bone health interventions for older adolescents. PMID:25751769

  9. Examination of Strength Training and Detraining Effects in Expiratory Muscles

    ERIC Educational Resources Information Center

    Baker, Susan; Davenport, Paul; Sapienza, Christine

    2005-01-01

    Purpose: The purpose of this study was to determine strength gains following expiratory muscle strength training (EMST) and to determine detraining effects when the training stimulus is removed. Method: Thirty-two healthy participants were enrolled in an EMST program. Sixteen participants trained for 4 weeks (Group 1) and 16 participants trained…

  10. Examination of Strength Training and Detraining Effects in Expiratory Muscles

    ERIC Educational Resources Information Center

    Baker, Susan; Davenport, Paul; Sapienza, Christine

    2005-01-01

    Purpose: The purpose of this study was to determine strength gains following expiratory muscle strength training (EMST) and to determine detraining effects when the training stimulus is removed. Method: Thirty-two healthy participants were enrolled in an EMST program. Sixteen participants trained for 4 weeks (Group 1) and 16 participants trained…

  11. The effect of Nordic hamstring strength training on muscle architecture, stiffness, and strength.

    PubMed

    Seymore, Kayla D; Domire, Zachary J; DeVita, Paul; Rider, Patrick M; Kulas, Anthony S

    2017-05-01

    Hamstring strain injury is a frequent and serious injury in competitive and recreational sports. While Nordic hamstring (NH) eccentric strength training is an effective hamstring injury-prevention method, the protective mechanism of this exercise is not understood. Strength training increases muscle strength, but also alters muscle architecture and stiffness; all three factors may be associated with reducing muscle injuries. The purpose of this study was to examine the effects of NH eccentric strength training on hamstring muscle architecture, stiffness, and strength. Twenty healthy participants were randomly assigned to an eccentric training group or control group. Control participants performed static stretching, while experimental participants performed static stretching and NH training for 6 weeks. Pre- and post-intervention measurements included: hamstring muscle architecture and stiffness using ultrasound imaging and elastography, and maximal hamstring strength measured on a dynamometer. The experimental group, but not the control group, increased volume (131.5 vs. 145.2 cm(3), p < 0.001) and physiological cross-sectional area (16.1 vs. 18.1 cm(2), p = 0.032). There were no significant changes to muscle fascicle length, stiffness, or eccentric hamstring strength. The NH intervention was an effective training method for muscle hypertrophy, but, contrary to common literature findings for other modes of eccentric training, did not increase fascicle length. The data suggest that the mechanism behind NH eccentric strength training mitigating hamstring injury risk could be increasing volume rather than increasing muscle length. Future research is, therefore, warranted to determine if muscle hypertrophy induced by NH training lowers future hamstring strain injury risk.

  12. Muscle Strength And Golf Performance: A Critical Review

    PubMed Central

    Torres-Ronda, Lorena; Sánchez-Medina, Luis; González-Badillo, Juan J.

    2011-01-01

    Golf has become an increasingly popular sport and a growing body of research trying to identify its main physical requirements is being published. The aim of this review was twofold: first, to examine the existing scientific literature regarding strength training and golf in healthy, non-injured, subjects; and second, to reach conclusions that could provide information on how to design more effective strength training programs to improve golf performance as well as directions for future research. Studies which analyzed the relationship between muscle strength, swing performance variables (club head speed, driving distance, ball speed) and skill (handicap, score) were reviewed. Changes in swing performance following different strength training programs were also investigated. Finally, a critical analysis about the methodologies used was carried out. The results of the reviewed studies seem to indicate that: 1) a positive relationship exists between handicap and swing performance (even though few studies have investigated this issue); 2) there is a positive correlation between skill (handicap and/or score) and muscle strength; and 3) there is a relationship between driving distance, swing speed, ball speed and muscle strength. Results suggest that training leg-hip and trunk power as well as grip strength is especially relevant for golf performance improvement. Studies that analyzed variations in swing performance following resistance-only training programs are scarce, thus it is difficult to prove whether the observed improvements are attributable to changes in strength levels. Many of the studies reviewed presented some methodological errors in their design and not all strength assessment protocols seemed appropriate. Further studies should determine muscle strength needs in relation to final swing performance, using well designed experiments and strict isoinertial assessment protocols which adequately relate to specific golf motion, age and skill level. More

  13. Maximal inspiratory pressure is influenced by intensity of the warm-up protocol.

    PubMed

    Arend, Mati; Kivastik, Jana; Mäestu, Jarek

    2016-08-01

    The aim of the study was to compare the effect of inspiratory muscle warm-up protocols with different intensities and breathing repetitions on maximal inspiratory pressure (MIP). Ten healthy and recreationally active men (183.3±5.5cm, 83.7±7.8kg, 26.4±4.1years) completed four different inspiratory muscle (IM) warm-up protocols (2×30 inspirations at 40% MIP, 2×12 inspirations at 60% MIP, 2×6 inspirations at 80% MIP, 2×30 inspirations at 15% MIP) on separate, randomly assigned visits. Pre-post values of MIP using MicroRPM (Micro Medical, Kent, UK) showed a significant increase in the mean values after the IM warm-up (POWERbreathe(®) K1, Warwickshire, UK) with 40% MIP and 60% MIP warm-up protocols, when MIP increased by 7cm H2O (95% CI: 0.10…13.89) (p=0.047) and by 6.4cm H2O (95% CI: 2.98…13.83) (p=0.027), respectively. In conclusion, a higher intensity inspiratory muscle warm-up protocol (2×12 breaths at 60% of MIP) can increase IM strength.

  14. The Relation of Respiratory Muscle Strength to Disease Severity and Abnormal Ventilation During Exercise in Chronic Heart Failure Patients.

    PubMed

    Kasahara, Yusuke; Izawa, Kazuhiro P; Watanabe, Satoshi; Osada, Naohiko; Omiya, Kazuto

    2015-11-01

    Breathlessness is a common problem in chronic heart failure (CHF) patients, and respiratory muscle strength has been proposed to play an important role in causing breathlessness in these patients. The aim of this study was to investigate the relation between respiratory muscle strength and the severity of CHF, and the influence of respiratory muscle strength on abnormal ventilation during exercise in CHF patients. In this case series study, we assessed clinically stable CHF outpatients (N = 66, age: 57.7 ± 14.6 years). The peak oxygen consumption (peak VO2), the slope relating minute ventilation to carbon dioxide production (VE/VCO2 slope), and the slope relating tidal volume to respiratory rate (TV/RR slope) were measured during cardiopulmonary exercise testing. Respiratory muscle strength was assessed by measuring the maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP). The MIP and MEP decreased significantly as the New York Heart Association functional class increased (MIP, P = 0.021; MEP, P < 0.01). The MIP correlated with the TV/RR slope (r = 0.57, P < 0.001) and the VE/VCO2 slope (r = -0.44, P < 0.001), and the MEP also correlated with the TV/RR slope (r = 0.53, P < 0.001) and the VE/VCO2 slope (r = -0.25, P < 0.040). Stepwise multiple regression analysis revealed that age and MIP were statistically significant predictors of the TV/RR and VE/VCO2 slopes (both P < 0.05). Respiratory muscle strength is related to the severity of CHF, and associated with rapid and shallow ventilation or excessive ventilation during exercise.

  15. Development of a Theory-Based Intervention to Increase Prescription of Inspiratory Muscle Training by Health Professionals in the Management of People with Chronic Obstructive Pulmonary Disease

    PubMed Central

    Li, Linda C.; Reid, W. Darlene

    2011-01-01

    ABSTRACT Purpose: The purpose of this paper is twofold: (1) to provide an overview of the literature on barriers to evidence-based practice (EBP) and the effectiveness of implementation interventions in health care; and (2) to outline the development of an implementation intervention for improving the prescription of inspiratory muscle training (IMT) by physical therapists and other health professionals for people with chronic obstructive pulmonary disease (COPD). Summary of Key Points: Individuals, organizations, and the research itself present barriers to EBP in physical therapy. Despite the evidence supporting the use of IMT, this treatment continues to be under-used in managing COPD. Current health services research shows that traditional information-based approaches to implementation, such as didactic lectures, do not adequately address the challenges health professionals face when trying to make changes in practice. We propose the development of a theory-based intervention to improve health professionals' use of IMT in the management of COPD. It is postulated that a behavioural intervention, based on the theory of planned behaviour (TPB), may be more effective than an information-based strategy in increasing the prescription of IMT by health professionals. Conclusion: TPB may be used to understand the antecedents of health professionals' behaviour and to guide the development of implementation interventions. Further research is needed to evaluate the effectiveness of this proposed intervention in the management of people with COPD. PMID:22654237

  16. Development of a theory-based intervention to increase prescription of inspiratory muscle training by health professionals in the management of people with chronic obstructive pulmonary disease.

    PubMed

    Simms, Alanna M; Li, Linda C; Reid, W Darlene

    2011-01-01

    The purpose of this paper is twofold: (1) to provide an overview of the literature on barriers to evidence-based practice (EBP) and the effectiveness of implementation interventions in health care; and (2) to outline the development of an implementation intervention for improving the prescription of inspiratory muscle training (IMT) by physical therapists and other health professionals for people with chronic obstructive pulmonary disease (COPD). Individuals, organizations, and the research itself present barriers to EBP in physical therapy. Despite the evidence supporting the use of IMT, this treatment continues to be under-used in managing COPD. Current health services research shows that traditional information-based approaches to implementation, such as didactic lectures, do not adequately address the challenges health professionals face when trying to make changes in practice. We propose the development of a theory-based intervention to improve health professionals' use of IMT in the management of COPD. It is postulated that a behavioural intervention, based on the theory of planned behaviour (TPB), may be more effective than an information-based strategy in increasing the prescription of IMT by health professionals. TPB may be used to understand the antecedents of health professionals' behaviour and to guide the development of implementation interventions. Further research is needed to evaluate the effectiveness of this proposed intervention in the management of people with COPD.

  17. Twitch mouth pressure for detecting respiratory muscle weakness in suspicion of neuromuscular disorder.

    PubMed

    Santos, Dante Brasil; Desmarais, Gilbert; Falaize, Line; Ogna, Adam; Cognet, Sandrine; Louis, Bruno; Orlikowski, David; Prigent, Hélène; Lofaso, Frédéric

    2017-02-02

    Twitch mouth pressure using magnetic stimulation of the phrenic nerves and an automated inspiratory trigger is a noninvasive, non-volitional assessment of diaphragmatic strength. Our aims were to validate this method in patients with suspected neuromuscular disease, to determine the best inspiratory-trigger pressure threshold, and to evaluate whether twitch mouth pressure decreased the overdiagnosis of muscle weakness frequently observed with noninvasive volitional tests. Maximal inspiratory pressure, sniff nasal pressure, and twitch mouth pressure were measured in 112 patients with restrictive disease and suspected neuromuscular disorder. Esophageal and transdiaphragmatic pressures were measured in 64 of these patients to confirm or infirm inspiratory muscle weakness. Magnetic stimulation was triggered by inspiratory pressures of -1 and -5 cmH2O. The -5 cmH2O trigger produced the best correlation between twitch mouth pressure and twitch esophageal pressure (R(2) = 0.86; P <0.0001). The best association of noninvasive tests to predict inspiratory muscle weakness was sniff nasal pressure and twitch mouth pressure. Below-normal maximal inspiratory pressure and sniff nasal pressure values suggesting inspiratory muscle weakness were found in 63/112 patients. Only 52 of these 63 patients also had abnormal twitch mouth pressure. In conclusion twitch mouth pressure measurement is a simple, noninvasive, nonvolitional technique which may help to select patients with suspected neuromuscular disorder for invasive inspiratory-muscle investigation.

  18. Abdominal muscle and quadriceps strength in chronic obstructive pulmonary disease

    PubMed Central

    Man, W; Hopkinson, N; Harraf, F; Nikoletou, D; Polkey, M; Moxham, J

    2005-01-01

    Background: Quadriceps muscle weakness is common in chronic obstructive pulmonary disease (COPD) but is not observed in a small hand muscle (adductor pollicis). Although this could be explained by reduced activity in the quadriceps, the observation could also be explained by anatomical location of the muscle or fibre type composition. However, the abdominal muscles are of a similar anatomical and fibre type distribution to the quadriceps, although they remain active in COPD. Cough gastric pressure is a recently described technique that assesses abdominal muscle (and hence expiratory muscle) strength more accurately than traditional techniques. A study was undertaken to test the hypothesis that more severe weakness exists in the quadriceps than in the abdominal muscles of patients with COPD compared with healthy elderly controls. Methods: Maximum cough gastric pressure and quadriceps isometric strength were measured in 43 patients with stable COPD and 25 healthy elderly volunteers matched for anthropometric variables. Results: Despite a significant reduction in mean quadriceps strength (29.9 kg v 41.2 kg; 95% CI –17.9 to –4.6; p = 0.001), cough gastric pressure was preserved in patients with COPD (227.3 cm H2O v 204.8 cm H2O; 95% CI –5.4 to 50.6; p = 0.11). Conclusions: Abdominal muscle strength is preserved in stable COPD outpatients in the presence of quadriceps weakness. This suggests that anatomical location and fibre type cannot explain quadriceps weakness in COPD. By inference, we conclude that disuse and consequent deconditioning are important factors in the development of quadriceps muscle weakness in COPD patients, or that activity protects the abdominal muscles from possible systemic myopathic processes. PMID:15923239

  19. The association between hip muscle cross-sectional area, muscle strength, and bone mineral density.

    PubMed

    Ahedi, Harbeer; Aitken, Dawn; Scott, David; Blizzard, Leigh; Cicuttini, Flavia; Jones, Graeme

    2014-07-01

    Studies examining the association between muscle size, muscle strength, and bone mineral density (BMD) are limited. Thus, this study aimed to describe the association between hip muscles cross-sectional area (CSA), muscle strength, and BMD of the hip and spine. A total of 321 subjects from the Tasmanian Older Adult Cohort study with a right hip MRI scan conducted between 2004 and 2006 were included. Hip muscles were measured on MR images by OsiriX (Geneva) software measuring maximum muscle CSA (cm(2)) of gluteus maximus, obturator externus, gemelli, quadratus femoris, piriformis, pectineus, sartorius, and iliopsoas. Dual-energy X-ray absorptiometry measured total hip, femoral neck, and spine BMD, and lower limb muscle strength was assessed by dynamometer. Muscle CSA of the hip flexors (pectineus, sartorius, and iliopsoas) and the hip rotators, obturator externus, and quadratus femoris were associated with both total hip and femoral neck BMD (all p < 0.05). The associations between CSA of pectineus and sartorius and BMD were stronger in women (p = 0.01-0.001) compared to men (p = 0.12-0.54). Additionally, only gemelli CSA was associated with BMD of the spine (p = 0.002). Gluteus maximus and piriformis showed no relationship with BMD. CSA of most hip muscles (except gluteus maximus and gemelli) were positively associated with leg strength (p = 0.02 to <0.001). Lastly, leg strength was weakly associated with BMD (p = 0.11-0.007). Hip muscle CSA, and to a lesser extent muscle strength, were positively associated with hip BMD. These data suggest that both higher muscle mass and strength may contribute to the maintenance of bone mass and prevention of disease progression in older adults.

  20. Muscle strength: A better index of low physical performance than muscle mass in older adults.

    PubMed

    Kim, Yeo Hyung; Kim, Kwang-Il; Paik, Nam-Jong; Kim, Ki-Woong; Jang, Hak Chul; Lim, Jae-Young

    2016-05-01

    The most appropriate muscle index for the definition of sarcopenia has not been agreed on. We aimed to investigate the associations of muscle mass and strength with 5-year mortality and low physical performance. We included 560 participants aged 65 years or older in the analysis. Muscle and fat mass were assessed by dual-energy X-ray absorptiometry. Leg muscle and grip strength were measured using dynamometers. The clinical outcomes were 5-year mortality and low physical performance (Short Physical Performance Battery score < 9) in 5 years. Associations between muscle indices and clinical outcomes were analyzed. A Cox proportional hazard model for mortality and a logistic regression model for physical performance were used. Decreases in leg muscle and grip strength were significantly associated with 5-year mortality and low physical performance in both sexes. Total muscle mass in men and appendicular skeletal mass in both sexes were associated with mortality, but not with low physical performance. Lower leg muscle strength (OR 0.107; P = 0.020) was an independent predictor of low physical performance in women after adjusting for age, fat, cognition, and depression. Lower leg muscle (OR 0.123; P = 0.031) and lower grip strength (OR 0.950; P = 0.012) were independent predictors of low physical performance in men. Muscle strength is a better indicator of 5-year adverse clinical outcomes of mortality and low physical performance than muscle mass. Muscle strength was an independent predictor of low physical performance in 5 years. Geriatr Gerontol Int 2016; 16: 577-585. © 2015 Japan Geriatrics Society.

  1. Peak or plateau maximal inspiratory mouth pressure: which is best?

    PubMed

    Windisch, W; Hennings, E; Sorichter, S; Hamm, H; Criée, C P

    2004-05-01

    There is no clear evidence as to how maximal inspiratory mouth pressure (PI,max) should be measured, although plateau pressures sustained for 1 s and measured at residual volume (RV) are usually recommended. Peak and plateau PI,max were measured at RV and at functional residual capacity (FRC) in 533 healthy subjects (aged 10-90 yrs) in order to comparably test all PI,max measurements for their predictors, reproducibility and normal values. Plateau pressures accounted for 82.0-86.3%, of peak pressures. Peak and plateau pressures measured at FRC accounted for 84.3-90.5% of pressures at RV, and were highly correlated. Age was negatively predictive and weight and body mass index positively predictive of PI,max, but regression parameters were low. All PI,max measurements were comparable when calculating regression parameters, between-subject variability and reproducibility. In conclusion, peak and plateau maximal inspiratory mouth pressure are comparably useful for the assessment of inspiratory muscle strength and can be reliably measured at functional residual capacity and at residual volume. Regression equations are of low impact in predicting normal values due to the weak influence of demographic and anthropometric factors and to the high unexplained between-subject-variability. Age-related 5th percentiles can indicate the lower limit of the normal range.

  2. Variation of neck muscle strength along the human cervical spine.

    PubMed

    Oi, Nelson; Pandy, Marcus G; Myers, Barry S; Nightingale, Roger W; Chancey, Valeta Carol

    2004-11-01

    The aim of this study was to describe and explain the variation of neck muscle strength along the cervical spine. A three-dimensional model of the head-neck complex was developed to test the hypothesis that the moment-generating capacity of the neck musculature is lower in the upper cervical spine than in the lower cervical spine. The model calculations suggest that the neck muscles can protect the lower cervical spine from injury during extension and lateral bending. The maximum flexor moment developed in the lower cervical spine was 2 times higher than that developed in the upper spine. The model also predicted that the neck musculature is 30% stronger in the lower cervical spine during lateral bending. Peak compressive forces (up to 3 times body weight) were higher in the lower cervical spine. These results are consistent with the clinical finding that extension loading of the neck often leads to injuries in the upper cervical spine. Analysis of the model results showed that neck flexor strength was greater in the lower cervical spine because of the relatively large size of the sternocleidomastoid muscle. The hyoid muscles developed significant flexor moments about the joints of the upper cervical spine, as these muscles had relatively large flexor moment arms; however, this effect was offset by the action of the sternocleidomastoid, which exerted a large extensor moment in the upper spine. Lateral bending strength of the neck muscles was governed by geometry (i.e., moment arms) rather than by muscle size.

  3. Muscle strength and knee range of motion after femoral lengthening

    PubMed Central

    Bhave, Anil; Shabtai, Lior; Woelber, Erik; Apelyan, Arman; Paley, Dror; Herzenberg, John E

    2017-01-01

    Background and purpose Femoral lengthening may result in decrease in knee range of motion (ROM) and quadriceps and hamstring muscle weakness. We evaluated preoperative and postoperative knee ROM, hamstring muscle strength, and quadriceps muscle strength in a diverse group of patients undergoing femoral lengthening. We hypothesized that lengthening would not result in a significant change in knee ROM or muscle strength. Patients and methods This prospective study of 48 patients (mean age 27 (9–60) years) compared ROM and muscle strength before and after femoral lengthening. Patient age, amount of lengthening, percent lengthening, level of osteotomy, fixation time, and method of lengthening were also evaluated regarding knee ROM and strength. The average length of follow-up was 2.9 (2.0–4.7) years. Results Mean amount of lengthening was 5.2 (2.4–11.0) cm. The difference between preoperative and final knee flexion ROM was 2° for the overall group. Congenital shortening cases lost an average of 5% or 6° of terminal knee flexion, developmental cases lost an average of 3% or 4°, and posttraumatic cases regained all motion. The difference in quadriceps strength at 45° preoperatively and after lengthening was not statistically or clinically significant (2.7 Nm; p = 0.06). Age, amount of lengthening, percent lengthening, osteotomy level, fixation time, and lengthening method had no statistically significant influence on knee ROM or quadriceps strength at final follow-up. Interpretation Most variables had no effect on ROM or strength, and higher age did not appear to be a limiting factor for femoral lengthening. Patients with congenital causes were most affected in terms of knee flexion. PMID:27892743

  4. Lower limb muscle strength is associated with functional performance and quality of life in patients with systemic sclerosis

    PubMed Central

    Lima, Tatiana R. L.; Guimarães, Fernando S.; Carvalho, Mara N.; Sousa, Thaís L. M.; Menezes, Sara L. S.; Lopes, Agnaldo J.

    2015-01-01

    Background: Complaints of peripheral muscle weakness are quite common in patients with systemic sclerosis (SSc). It is likely that the muscle impairments may reduce the patients' exercise performance, which in turn may decrease their functional capacity and exert a direct impact on their quality of life. Objectives: To assess the peripheral and respiratory muscle strength in individuals with SSc and to investigate their correlation with the 6-min walk distance (6MWD) and quality of life measurements. Moreover, we aimed to characterize their nutritional status, pulmonary function, functional capacity, and quality of life compared to the controls. Method: The present cross-sectional study included 20 patients with SSc and 20 control subjects. All of the participants were subjected to isometric dynamometry, surface electromyography, bioelectrical impedance analysis, pulmonary function testing, and the 6-min walk test. Patients with SSc also responded to the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) and the Health Assessment Questionnaire Disability Index (HAQ-DI). Results: The individuals with SSc exhibited a reduction in quadriceps strength (p=0.0001), increased quadriceps fatigability (p=0.034), impaired pulmonary function, and a reduced 6MWD (p=0.0001) compared to the controls. Quadriceps strength was significantly correlated with the 6MWD (Rho=0.719; p=0.0004) and the HAQ-DI (Rho=-0.622; p=0.003). We also found significant correlations between quadriceps fatigability and maximal inspiratory (Rho=0.684; p=0.0009) and maximal expiratory (Rho=0.472; p=0.035) pressure. Conclusions: Patients with SSc exhibited reduced respiratory muscle and quadriceps strength and an increase in its fatigability. In these individuals, there was a relationship between quadriceps strength, functional capacity, and quality of life. PMID:25789555

  5. Evaluation of Respiratory Muscle Strength in Mouth Breathers: Clinical Evidences

    PubMed Central

    Andrade da Cunha, Renata; Andrade da Cunha, Daniele; Assis, Roberta Borba; Bezerra, Luciana Ângelo; Justino da Silva, Hilton

    2013-01-01

    Introduction The child who chronically breathes through the mouth may develop a weakness of the respiratory muscles. Researchers and clinical are seeking for methods of instrumental evaluation to gather complementary data to clinical evaluations. With this in mind, it is important to evaluate breathing muscles in the child with Mouth Breathing. Objective To develop a review to investigate studies that used evaluation methods of respiratory muscle strength in mouth breathers. Data Synthesis  The authors were unanimous in relation to manovacuometry method as a way to evaluate respiratory pressures in Mouth Breathing children. Two of them performed with an analog manovacuometer and the other one, digital. The studies were not evaluated with regard to the method efficacy neither the used instruments. Conclusion There are few studies evaluating respiratory muscle strength in Mouth Breathing people through manovacuometry and the low methodological rigor of the analyzed studies hindered a reliable result to support or refuse the use of this technique. PMID:25992108

  6. Thigh muscle strength in senior athletes and healthy controls.

    PubMed

    McCrory, Jean L; Salacinski, Amanda J; Hunt, Sarah E; Greenspan, Susan L

    2009-12-01

    Exercise is commonly recommended to counteract aging-related muscle weakness. While numerous exercise intervention studies on the elderly have been performed, few have included elite senior athletes, such as those who participate in the National Senior Games. The extent to which participation in highly competitive exercise affects muscle strength is unknown, as well as the extent to which such participation mitigates any aging-related strength losses. The purpose of this study was to examine isometric thigh muscle strength in selected athletes of the National Senior Games and healthy noncompetitive controls of similar age, as well as to investigate strength changes with aging in both groups. In all, 95 athletes of the Games and 72 healthy controls participated. Of the senior athletes, 43 were runners, 12 cyclists, and 40 swimmers. Three trials of isometric knee flexion and extension strength were collected using a load cell affixed to a custom-designed chair. Strength data were normalized to dual-energy x-ray absorptiometry-obtained lean mass of the leg. A 3-factor multivariate analysis of variance (group x gender x age group) was performed, which included both the extension and flexion variables (alpha = 0.05). Athletes exhibited 38% more extension strength and 66% more flexion strength than the controls (p < 0.001). Strength did not decrease with advancing age in either the athletes or the controls (p = 0.345). In conclusion, senior athletes who participate in highly competitive exercise have greater strength than healthy aged-matched individuals who do not. Neither group displayed the expected strength losses with aging. Our subject cohorts, however, were not typical of those over age 65 years because individuals with existing health conditions were excluded from the study.

  7. Measurement of facial muscle strength in normal subjects.

    PubMed

    Neely, J Gail; Pomerantz, Rebecca G

    2002-09-01

    Muscle strength is a fundamental measure of function for neuromuscular systems; however, mimetic facial muscle strength has never been recorded. The objective of the present feasibility project was to measure facial muscle strength. The study design was a prospective experimental trial in 10 normal subjects. Descriptive statistics, tests, and analysis of variance were used to summarize and compare data. Subjects were selected by convenience following submission and approval of a prospectively designed protocol and consent form to the Human Studies Committee. Application of a force transducer to the central eyebrow and commissure during eyebrow raising, eyelid closing, smiling, and puckering was performed by two methods: surface adhesion method (n = 5) and direct probe application method (n = 5). Data were recorded in pounds. Three repetitions of each movement were made. Rank order of muscle strengths (in pounds) by the surface adhesion technique was as follows: brow, 0.758; eye, 0.549; pucker, 0.387; and smile, 0.307. By direct probe application the rank order of muscle strengths was as follows: eye, 0.880; brow, 0.773; and smile, 0.730. Objective measures of facial motion are crucial for quantitative investigations of preventative, therapeutic, reconstructive, and rehabilitative interventions for facial nerve and muscle lesions. Until the present, objective measures required cross-correlations with current standards that were subjective. This is the first time an actual physical measure of facial muscle function has been performed. The purpose of presenting this preliminary work is to stimulate advancement along this line of research.

  8. Assessment of respiratory muscle strength in children according to the classification of body mass index

    PubMed Central

    da Rosa, George Jung; Schivinski, Camila Isabel S.

    2014-01-01

    OBJECTIVE: To assess and compare the respiratory muscle strength among eutrophic, overweight and obese school children, as well as to identify anthropometric and respiratory variables related to the results. METHODS: Cross-sectional survey with healthy schoolchildren aged 7-9 years old, divided into three groups: Normal weight, Overweight and Obese. The International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire was applied. The body mass index (BMI) was evaluated, as well as the forced expiratory volume in one second (FEV1) with a portable digital device. The maximal inspiratory and expiratory pressures (MIP and MEP) were measured by a digital manometer. Comparisons between the groups were made by Kruskal-Wallis test. Spearman's correlation coefficient was used to analyze the correlations among the variables. RESULTS: MIP of eutrophic school children was higher than MIP found in overweight (p=0.043) and obese (p=0.013) children. MIP was correlated with BMI percentile and weight classification (r=-0.214 and r=-0.256) and MEP was correlated with height (r=0.328). Both pressures showed strong correlation with each other in all analyses (r≥0.773), and less correlation with FEV1 (MIP - r=0.362 and MEP - r=0.494). FEV1 correlated with MEP in all groups (r: 0.429 - 0.569) and with MIP in Obese Group (r=0.565). Age was correlated with FEV1 (r=0.578), MIP (r=0.281) and MEP (r=0.328). CONCLUSIONS: Overweight and obese children showed lower MIP values, compared to eutrophic ones. The findings point to the influence of anthropometric variables on respiratory muscle strength in children. PMID:25119758

  9. Postpoliomyelitis muscle weakness: a prospective study of quadriceps strength.

    PubMed

    Munin, M C; Jaweed, M M; Staas, W E; Satinsky, A R; Gutierez, G; Herbison, G J

    1991-09-01

    The objective of this study was to evaluate the presence of progressive postpoliomyelitis muscle weakness (PPMW) in affected individuals 20 to 40 years after the initial polio infection. Over a three-year period, the isometric and isokinetic strength of the quadriceps femoris muscle was studied in seven symptomatic patients with previous poliomyelitis (mean = 38.3 years from infection) to determine if quadriceps strength decreased during the three years. Each patient had a quadriceps affected by polio on one side and a clinically nonaffected quadriceps on the contralateral limb. The maximal isometric force and the peak isokinetic force of the affected quadriceps (AQ) and nonaffected quadriceps (NQ) muscles were tested on a computerized isokinetic dynamometer machine at six-month intervals. Isometric force increased significantly, by 29% per year (p less than .02) in the AQ and by 14% per year (p less than .05) in the NQ. Paired analysis to determine the change in strength between the affected and nonaffected muscles for the isometric data showed a mean nonsignificant increase in the AQ of 14% per year (p = .01). The change in peak isokinetic force demonstrated a significant increase in the AQ of 35% per year (p less than .05); whereas, the NQ peak isokinetic force increased 15% per year which was not statistically significant. Paired analysis to determine the change in strength between the affected and nonaffected muscles for the isokinetic data showed a nonsignificant relative increase in the AQ of 20% per year (p less than .06).(ABSTRACT TRUNCATED AT 250 WORDS)

  10. Impaired hip muscle strength in patients with femoroacetabular impingement syndrome.

    PubMed

    Kierkegaard, Signe; Mechlenburg, Inger; Lund, Bent; Søballe, Kjeld; Dalgas, Ulrik

    2017-05-25

    Patients with femoroacetabular impingement (FAI) experience hip pain as well as decreased function and lowered quality of life. The aim was to compare maximal isometric and isokinetic muscle strength (MVC) during hip flexion and extension and rate of force development (RFD) during extension between patients with FAI and a matched reference group. Secondary, the aim was to compare patient hips and subgroups defined by gender and age as well as to investigate associations between hip muscle strength and self-reported outcomes. Design Cross-sectional, comparative study Methods Sixty patients (36±9 years, 63% females) and 30 age and gender matched reference persons underwent MVC tests in an isokinetic dynamometer. During hip flexion and extension, patients' affected hip showed a strength deficit of 15-21% (p<0.001) and 10-25% (p<0.03) compared with reference MVC, respectively. The affected hip of the patients was significantly weaker than their contralateral hip. RFD was significantly decreased for both patient hips compared to the reference group (p<0.05). While age had less effect on MVC, female patients were more affected than male patients. Self-reported measures were associated with isometric hip muscle strength. Patients with FAI demonstrate decreased hip flexion and extension strength when compared to (1) reference persons and (2) their contralateral hip. There seems to be a gender specific affection which should be investigated further and addressed when planning training protocols. Furthermore, self-reported measures were associated with isometric muscle strength, which underlines the clinical importance of the reduced muscle strength. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  11. Inspiratory-resistive loading increases the ventilatory response to arousal but does not reduce genioglossus muscle activity on the return to sleep.

    PubMed

    Cori, Jennifer M; Nicholas, Christian L; Baptista, Shaira; Huynh, Ivan; Rochford, Peter D; O'Donoghue, Fergal J; Trinder, John A; Jordan, Amy S

    2012-09-01

    Arousals from sleep are thought to predispose to obstructive sleep apnea by causing hyperventilation and hypocapnia, which reduce airway dilator muscle activity on the return to sleep. However, prior studies of auditory arousals have not resulted in reduced genioglossus muscle activity [GG-electromyogram (EMG)], potentially because airway resistance prior to arousal was low, leading to a small ventilatory response to arousal and minimal hypocapnia. Thus we aimed to increase the ventilatory response to arousal by resistive loading prior to auditory arousal and determine whether reduced GG-EMG occurred on the return to sleep. Eighteen healthy young men and women were recruited. Subjects were instrumented with a nasal mask with a pneumotachograph, an epiglottic pressure catheter, and intramuscular GG-EMG electrodes. Mask CO(2) levels were monitored. Three- to 15-s arousals from sleep were induced with auditory tones after resting breathing (No-Load) or inspiratory-resistive loading (Load; average 8.4 cmH(2)O·l(-1)·s(-1)). Peak minute ventilation following arousal was greater after Load than No-Load (mean ± SE; 8.0 ± 0.6 vs. 7.4 ± 0.6 l/min, respectively). However, the nadir end tidal partial pressure of CO(2) did not differ between Load conditions (43.1 ± 0.6 and 42.8 ± 0.5 mmHg, respectively), and no period of reduced GG activity occurred following the return to sleep (GG-EMG baseline, minimum after Load and No-Load = 2.9 ± 1.2%, 3.1 ± 1.3%, and 3.0 ± 1.3% max, respectively). These findings indicate that the hyperventilation, which occurs following tone-induced arousal, is appropriate for the prevailing level of respiratory drive, because loading did not induce marked hypocapnia or lower GG muscle activity on the return to sleep. Whether similar findings occur following obstructive events in patients remains to be determined.

  12. Relationship of respiratory muscle strength, pulmonary function, and functional capacity with quality of life in patients with atrial fibrillation.

    PubMed

    Demir, Rengin; Zeren, Melih; Gurses, Hulya Nilgun; Yigit, Zerrin

    2017-01-01

    Objective To examine the relationship of pulmonary parameters and functional capacity with quality of life (QoL) in patients with atrial fibrillation (AF). Methods Thirty-six patients with chronic AF were included in this cross-sectional study. QoL was assessed with the Medical Outcomes Survey 36-item Short Form (SF-36) and Minnesota Living with Heart Failure Questionnaire (MLHFQ). Respiratory muscle strength and pulmonary function were also measured. Functional capacity was assessed with the 6-min walk test (6MWT). The Borg CR10 Scale was used to determine the resting dyspnea and fatigue levels. Results The SF-36 physical component summary score was correlated with the maximum inspiratory pressure (r = 0.517), maximum expiratory pressure (r = 0.391), 6MWT distance (r = 0.542), resting Borg dyspnea score (r = -0.692), and resting Borg fatigue score (r = -0.727). The MLHFQ total score was correlated with the maximum inspiratory pressure (r = -0.542), maximum expiratory pressure (r = -0.384), 6MWT distance (r = -0.535), resting Borg dyspnea score (r = 0.641), and resting Borg fatigue score (r = 0.703). The resting Borg fatigue score was the significant independent predictor of the SF-36 physical component score and the MLHFQ total score. Conclusion Respiratory muscle strength, functional capacity measured with the 6MWT, and resting symptoms including dyspnea and fatigue may have an impact on QoL in patients with AF.

  13. Muscle strength and endurance following lowerlimb suspension in man

    NASA Technical Reports Server (NTRS)

    Tesch, Per A.; Berg, Hans E.; Haggmark, Tom; Ohlsen, Hans; Dudley, Gary A.

    1991-01-01

    The effect of lower-limb suspension on the muscle strength and muscle endurance was investigated in six men subjected to four weeks of unilateral unloading of a lower limb (using of a harness attached to a modified shoe), followed by seven weeks of weight-bearing recovery. Results showed a decrease in the cross-sectional area (CSA) of the thigh muscle and in the average peak torque (APT) during three bouts of 30 concentric knee extensions. While the the thigh muscle CSA returned to normal after seven weeks of recovery, the APT recovery was still reduced by 11 percent, suggesting that muscle metabolic function was severely affected by unloading and was not restored by ambulation.

  14. Muscle strength and endurance following lowerlimb suspension in man

    NASA Technical Reports Server (NTRS)

    Tesch, Per A.; Berg, Hans E.; Haggmark, Tom; Ohlsen, Hans; Dudley, Gary A.

    1991-01-01

    The effect of lower-limb suspension on the muscle strength and muscle endurance was investigated in six men subjected to four weeks of unilateral unloading of a lower limb (using of a harness attached to a modified shoe), followed by seven weeks of weight-bearing recovery. Results showed a decrease in the cross-sectional area (CSA) of the thigh muscle and in the average peak torque (APT) during three bouts of 30 concentric knee extensions. While the the thigh muscle CSA returned to normal after seven weeks of recovery, the APT recovery was still reduced by 11 percent, suggesting that muscle metabolic function was severely affected by unloading and was not restored by ambulation.

  15. Age at spinal cord injury determines muscle strength

    PubMed Central

    Thomas, Christine K.; Grumbles, Robert M.

    2014-01-01

    As individuals with spinal cord injury (SCI) age they report noticeable deficits in muscle strength, endurance and functional capacity when performing everyday tasks. These changes begin at ~45 years. Here we present a cross-sectional analysis of paralyzed thenar muscle and motor unit contractile properties in two datasets obtained from different subjects who sustained a cervical SCI at different ages (≤46 years) in relation to data from uninjured age-matched individuals. First, completely paralyzed thenar muscles were weaker when C6 SCI occurred at an older age. Muscles were also significantly weaker if the injury was closer to the thenar motor pools (C6 vs. C4). More muscles were strong (>50% uninjured) in those injured at a younger (≤25 years) vs. young age (>25 years), irrespective of SCI level. There was a reduction in motor unit numbers in all muscles tested. In each C6 SCI, only ~30 units survived vs. 144 units in uninjured subjects. Since intact axons only sprout 4–6 fold, the limits for muscle reinnervation have largely been met in these young individuals. Thus, any further reduction in motor unit numbers with time after these injuries will likely result in chronic denervation, and may explain the late-onset muscle weakness routinely described by people with SCI. In a second dataset, paralyzed thenar motor units were more fatigable than uninjured units. This gap widened with age and will reduce functional reserve. Force declines were not due to electromyographic decrements in either group so the site of failure was beyond excitation of the muscle membrane. Together, these results suggest that age at SCI is an important determinant of long-term muscle strength, and fatigability, both of which influence functional capacity. PMID:24478643

  16. Predictive equations for respiratory muscle strength according to international and Brazilian guidelines.

    PubMed

    Pessoa, Isabela M B S; Houri Neto, Miguel; Montemezzo, Dayane; Silva, Luisa A M; Andrade, Armèle Dornelas De; Parreira, Verônica F

    2014-09-12

    Background: The maximum static respiratory pressures, namely the maximum inspiratory pressure (MIP) and maximum expiratory pressure (MEP), reflect the strength of the respiratory muscles. These measures are simple, non-invasive, and have established diagnostic and prognostic value. This study is the first to examine the maximum respiratory pressures within the Brazilian population according to the recommendations proposed by the American Thoracic Society and European Respiratory Society (ATS/ERS) and the Brazilian Thoracic Association (SBPT). Objective: To establish reference equations, mean values, and lower limits of normality for MIP and MEP for each age group and sex, as recommended by the ATS/ERS and SBPT. Method: We recruited 134 Brazilians living in Belo Horizonte, MG, Brazil, aged 20-89 years, with a normal pulmonary function test and a body mass index within the normal range. We used a digital manometer that operationalized the variable maximum average pressure (MIP/MEP). At least five tests were performed for both MIP and MEP to take into account a possible learning effect. Results: We evaluated 74 women and 60 men. The equations were as follows: MIP=63.27-0.55 (age)+17.96 (gender)+0.58 (weight), r2 of 34% and MEP= - 61.41+2.29 (age) - 0.03(age2)+33.72 (gender)+1.40 (waist), r2 of 49%. Conclusion: In clinical practice, these equations could be used to calculate the predicted values of MIP and MEP for the Brazilian population.

  17. Predictive equations for respiratory muscle strength according to international and Brazilian guidelines

    PubMed Central

    Pessoa, Isabela M. B. S.; Houri, Miguel; Montemezzo, Dayane; Silva, Luisa A. M.; Andrade, Armèle Dornelas De; Parreira, Verônica F.

    2014-01-01

    Background: The maximum static respiratory pressures, namely the maximum inspiratory pressure (MIP) and maximum expiratory pressure (MEP), reflect the strength of the respiratory muscles. These measures are simple, non-invasive, and have established diagnostic and prognostic value. This study is the first to examine the maximum respiratory pressures within the Brazilian population according to the recommendations proposed by the American Thoracic Society and European Respiratory Society (ATS/ERS) and the Brazilian Thoracic Association (SBPT). Objective: To establish reference equations, mean values, and lower limits of normality for MIP and MEP for each age group and sex, as recommended by the ATS/ERS and SBPT. Method: We recruited 134 Brazilians living in Belo Horizonte, MG, Brazil, aged 20-89 years, with a normal pulmonary function test and a body mass index within the normal range. We used a digital manometer that operationalized the variable maximum average pressure (MIP/MEP). At least five tests were performed for both MIP and MEP to take into account a possible learning effect. Results: We evaluated 74 women and 60 men. The equations were as follows: MIP=63.27-0.55 (age)+17.96 (gender)+0.58 (weight), r2 of 34% and MEP= - 61.41+2.29 (age) - 0.03(age2)+33.72 (gender)+1.40 (waist), r2 of 49%. Conclusion: In clinical practice, these equations could be used to calculate the predicted values of MIP and MEP for the Brazilian population. PMID:25372003

  18. Adiposity, muscle mass, and muscle strength in relation to functional decline in older persons.

    PubMed

    Schaap, Laura A; Koster, Annemarie; Visser, Marjolein

    2013-01-01

    Aging is associated with changes in body composition and muscle strength. This review aimed to determine the relation between different body composition measures and muscle strength measures and functional decline in older men and women. By use of relevant databases (PubMed, Embase, and CINAHL) and keywords in a search from 1976 to April 2012, 50 articles were reviewed that met the inclusion criteria (written in English, a prospective, longitudinal design, involving older persons aged 65 years or more, and at least one of the measures that follow: body mass index (BMI), waist circumference, waist/hip ratio, midarm circumference, fat mass, muscle fat infiltration, muscle mass, or strength as independent variables and a measure of functional decline as outcome measure). Meta-analyses were performed and revealed that BMI ≥30 and low muscle strength were associated with functional decline (pooled odds ratio (OR) = 1.60, 95% confidence interval (CI): 1.43, 1.80, for BMI ≥30 and OR = 1.86, 95% CI: 1.32, 2.64, for muscle strength). Low muscle mass was not significantly associated with functional decline (pooled OR = 1.19, 95% CI: 0.98, 1.45). Future intervention research should focus on positive changes in body composition to prevent onset or worsening of functional decline in old age.

  19. Inverse associations between muscle mass, strength, and the metabolic syndrome.

    PubMed

    Atlantis, Evan; Martin, Sean A; Haren, Matthew T; Taylor, Anne W; Wittert, Gary A

    2009-07-01

    The metabolic syndrome (MetS) is a clustering of individual cardiovascular disease risk factors, which doubles the risk of early mortality. The authors' aimed to determine the prevalence and population attributable risk (PAR%) of the MetS among men according to demographic, physical, and lifestyle risk factors. A cross-sectional study was conducted in 1195 men in the Florey Adelaide Male Ageing Study, a regionally representative cohort of Australian men aged 35 to 81 years conducted in 2002-2005 (response rate, 45.1%). Prevalent MetS was determined according to the Adult Treatment Panel III (ATPIII) and International Diabetes Federation (IDF) classifications; and an extensive list of demographic, physical (including muscle strength, body composition by dual-energy x-ray absorptiometry, sex hormones), and lifestyle factors was accounted for. Prevalence estimates were 37.7% and 41.8% for ATPIII and IDF classifications. Odds ratios for present MetS were determined using multiple-adjusted logistic regression. Odds for present ATPIII MetS decreased (in order of importance) for lower insulin and increased for lower muscle mass, lower strength, and 3+ medical conditions. Odds for present IDF MetS decreased for lower insulin and increased for lower muscle mass, strength, and sex hormone-binding globulin levels; older age; and being married. Significant PAR% due to lowest insulin, muscle mass, and strength quarters were -44%, 27%, and 17% for the ATPIII Met, and -48%, 31%, and 20% for the IDF MetS. A substantial proportion of MetS cases would have been theoretically prevented if prior exposure to low muscle mass and strength were eradicated (PAR% ranged from 14% to 24%). Findings indicate that insulin resistance is a central abnormality in the MetS and that muscle mass and strength are strong protective factors independent of insulin resistance and abdominal fat accumulation. If confirmed prospectively, increases in muscle mass and strength needed to prevent a substantial

  20. Myotonometry as a Surrogate Measure of Muscle Strength

    NASA Technical Reports Server (NTRS)

    Ang, B. S.; Feeback, D. L.; Leonard, C. T.; Sykes, J.; Kruger, E.; Clarke, M. S. F.

    2007-01-01

    Space flight-induced muscle atrophy/neuromuscular degradation and the consequent decrements in crew-member performance are of increasing concern as mission duration lengthens, and planetary exploration after extended space flight is planned. Pre- to post-flight strength measures have demonstrated that specific countermeasures, such as resistive exercise, are effective at countering microgravity-induced muscle atrophy and preventing decrements in muscle strength. However, in-flight assessment/monitoring of exercise countermeasure effectiveness will be essential during exploration class missions due to their duration. The ability to modify an exercise countermeasure prescription based on such real-time information will allow each individual crew member to perform the optimal amount and type of exercise countermeasure to maintain performance. In addition, such measures can be used to determine if a crew member is physically capable of performing a particular mission-related task during exploration class missions. The challenges faced in acquiring such data are those common to all space operations, namely the requirement for light-weight, low power, mechanically reliable technologies that make valid measurements in microgravity, in this case of muscle strength/neuromuscular function. Here we describe a simple, light-weight, low power, non-invasive device, known as the Myotonometer, that measures tissue stiffness as an indirect measure of muscle contractile state and muscle force production. Repeat myotonometer measurements made at the same location on the surface of the rectis femoris muscle (as determined using a 3D locator device, SEM plus or minus 0.34 mm) were shown to be reproducible over time at both maximal voluntary contraction (MVC) and at rest in a total of 17 sedentary subjects assessed three times over a period of seven days. In addition, graded voluntary isometric force production (i.e. 20%, 40%, 60%, 80% & 100% of MVC) during knee extension was shown to

  1. Myotonometry as a Surrogate Measure of Muscle Strength

    NASA Technical Reports Server (NTRS)

    Ang, B. S.; Feeback, D. L.; Leonard, C. T.; Sykes, J.; Kruger, E.; Clarke, M. S. F.

    2007-01-01

    Space flight-induced muscle atrophy/neuromuscular degradation and the consequent decrements in crew-member performance are of increasing concern as mission duration lengthens, and planetary exploration after extended space flight is planned. Pre- to post-flight strength measures have demonstrated that specific countermeasures, such as resistive exercise, are effective at countering microgravity-induced muscle atrophy and preventing decrements in muscle strength. However, in-flight assessment/monitoring of exercise countermeasure effectiveness will be essential during exploration class missions due to their duration. The ability to modify an exercise countermeasure prescription based on such real-time information will allow each individual crew member to perform the optimal amount and type of exercise countermeasure to maintain performance. In addition, such measures can be used to determine if a crew member is physically capable of performing a particular mission-related task during exploration class missions. The challenges faced in acquiring such data are those common to all space operations, namely the requirement for light-weight, low power, mechanically reliable technologies that make valid measurements in microgravity, in this case of muscle strength/neuromuscular function. Here we describe a simple, light-weight, low power, non-invasive device, known as the Myotonometer, that measures tissue stiffness as an indirect measure of muscle contractile state and muscle force production. Repeat myotonometer measurements made at the same location on the surface of the rectis femoris muscle (as determined using a 3D locator device, SEM plus or minus 0.34 mm) were shown to be reproducible over time at both maximal voluntary contraction (MVC) and at rest in a total of 17 sedentary subjects assessed three times over a period of seven days. In addition, graded voluntary isometric force production (i.e. 20%, 40%, 60%, 80% & 100% of MVC) during knee extension was shown to

  2. Levator plate upward lift and levator muscle strength

    PubMed Central

    Rostaminia, Ghazaleh; Peck, Jennifer; Quiroz, Lieschen; Shobeiri, S. Abbas

    2016-01-01

    Objective The aim of study was to compare digital palpation with the levator plate lift measured by endovaginal and transperineal dynamic ultrasound. Methods Dynamic transperineal and endovaginal ultrasound were performed as part of multicompartmental pelvic floor functional assessment. Patients were instructed to perform Kegels while a probe captured the video clip of the levator plate movement at rest and during contraction in 2D mid-sagittal posterior view. We measured the distance between the levator plate and the probe on endovaginal ultrasound as well as the distance between the levator plate and the gothic arch of the pubis in transperineal ultrasound. The change in diameter (lift) and a levator plate lift ratio (lift / rest) x 100) were calculated. Pelvic floor muscle strength was assessed by digital palpation and divided into functional and non-functional groups using the Modified Oxford Scale (MOS). Mean differences in levator plate upward lifts were compared by MOS score using student t-tests and analysis of variance (ANOVA). Results 74 women were available for analysis. The mean age was 55 (SD±11.9). When measured by vaginal dynamic ultrasound, mean values of the lift and lift/rest ratio increased with increasing MOS score (ANOVA p=0.09 and p=0.04, respectively). When MOS scores were categorized to represent non-functional (MOS 0-1) and functional (MOS 2-5) muscle strength groups, the mean values of the lift (3.2 mm vs. 4.6 mm, p=0.03) and lift/rest ratio (13% vs 20%, p=0.01) were significantly higher in women with functional muscle strength. All patients with ≥ 30% lift detected by vaginal ultrasound had functional muscle strength. Conclusions Greater levator plate lift ratio detected by dynamic endovaginal ultrasound was associated with higher muscle strength as determined by MOS. This novel measurement can be incorporated into ultrasound evaluation of the levator ani function. PMID:26333568

  3. Daily acute intermittent hypoxia elicits functional recovery of diaphragm and inspiratory intercostal muscle activity after acute cervical spinal injury.

    PubMed

    Navarrete-Opazo, A; Vinit, S; Dougherty, B J; Mitchell, G S

    2015-04-01

    A major cause of mortality after spinal cord injury is respiratory failure. In normal rats, acute intermittent hypoxia (AIH) induces respiratory motor plasticity, expressed as diaphragm (Dia) and second external intercostal (T2 EIC) long-term facilitation (LTF). Dia (not T2 EIC) LTF is enhanced by systemic adenosine 2A (A2A) receptor inhibition in normal rats. We investigated the respective contributions of Dia and T2 EIC to daily AIH-induced functional recovery of breathing capacity with/without A2A receptor antagonist (KW6002, i.p.) following C2 hemisection (C2HS). Rats received daily AIH (dAIH: 10, 5-min episodes, 10.5% O2; 5-min normoxic intervals; 7 successive days beginning 7days post-C2HS) or daily normoxia (dNx) with/without KW6002, followed by weekly (reminder) presentations for 8weeks. Ventilation and EMGs from bilateral diaphragm and T2 EIC muscles were measured with room air breathing (21% O2) and maximum chemoreceptor stimulation ( 7% CO2, 10.5% O2). dAIH increased tidal volume (VT) in C2HS rats breathing room air (dAIH+vehicle: 0.47±0.02, dNx+vehicle: 0.40±0.01ml/100g; p<0.05) and MCS (dAIH+vehicle: 0.83±0.01, dNx+vehicle: 0.73±0.01ml/100g; p<0.001); KW6002 had no significant effect. dAIH enhanced contralateral (uninjured) diaphragm EMG activity, an effect attenuated by KW6002, during room air breathing and MCS (p<0.05). Although dAIH enhanced contralateral T2 EIC EMG activity during room air breathing, KW6002 had no effect. dAIH had no statistically significant effects on diaphragm or T2 EIC EMG activity ipsilateral to injury. Thus, two weeks post-C2HS: 1) dAIH enhances breathing capacity by effects on contralateral diaphragm and T2 EIC activity; and 2) dAIH-induced recovery is A2A dependent in diaphragm, but not T2 EIC. Daily AIH may be a useful in promoting functional recovery of breathing capacity after cervical spinal injury, but A2A receptor antagonists (e.g. caffeine) may undermine its effectiveness shortly after injury. Copyright © 2015

  4. Daily acute intermittent hypoxia elicits functional recovery of diaphragm and inspiratory intercostal muscle activity after acute cervical spinal injury

    PubMed Central

    Navarrete-Opazo, A.; Vinit, S; Dougherty, B.J.; Mitchell, G.S.

    2015-01-01

    A major cause of mortality after spinal cord injury is respiratory failure. In normal rats, acute intermittent hypoxia (AIH) induces respiratory motor plasticity, expressed as diaphragm (Dia) and second external intercostal (T2 EIC) long-term facilitation (LTF). Dia (not T2 EIC) LTF is enhanced by systemic adenosine 2A (A2a) receptor inhibition in normal rats. We investigated the respective contributions of Dia and T2 EIC to daily AIH-induced functional recovery of breathing capacity with/without A2a receptor antagonist (KW6002, i.p.) following C2 hemisection (C2HS). Rats received daily AIH (dAIH: 10, 5-min episodes, 10.5% O2; 5-min normoxic intervals; 7 successive days beginning 7 days post-C2HS) or daily normoxia (dNx) with/without KW6002, followed by weekly (reminder) presentations for 8 weeks. Ventilation and EMGs from bilateral diaphragm and T2 EIC muscles were measured with room air breathing (21% O2) and maximum chemoreceptor stimulation (MCS: 7% CO2, 10.5% O2). dAIH increased tidal volume (Vt) in C2HS rats breathing room air (dAIH + vehicle: 0.47 ± 0.02, dNx + vehicle: 0.40 ± 0.01ml/100 g; p<0.05) and MCS (dAIH + vehicle: 0.83 ± 0.01, dNx + vehicle: 0.73 ± 0.01ml/100g; p<0.001); KW6002 had no significant effect. dAIH enhanced contralateral (uninjured) diaphragm EMG activity, an effect attenuated by KW6002, during room air breathing and MCS (p<0.05). Although dAIH enhanced contralateral T2 EIC EMG activity during room air breathing, KW6002 had no effect. dAIH had no statistically significant effects on diaphragm or T2 EIC EMG activity ipsilateral to injury. Thus, two weeks post-C2HS: 1) dAIH enhances breathing capacity by effects on contralateral diaphragm and T2 EIC activity; and 2) dAIH-induced recovery is A2a dependent in diaphragm, but not T2 EIC. Daily AIH may be a useful in promoting functional recovery of breathing capacity after cervical spinal injury, but A2a receptor antagonists (eg. caffeine) may undermine its effectiveness shortly after

  5. Intra- and inter-rater reliability of maximum inspiratory pressure measured using a portable capsule-sensing pressure gauge device in healthy adults

    PubMed Central

    Jalan, Nikita S; Daftari, Sonam S; Retharekar, Seemi S; Rairikar, Savita A; Shyam, Ashok M; Sancheti, Parag K

    2015-01-01

    BACKGROUND: Measurement of maximum inspiratory pressure is the most prevalent method used in clinical practice to assess the strength of the inspiratory muscles. Although there are many devices available for the assessment of inspiratory muscle strength, there is a dearth of literature describing the reliability of devices that can be used in clinical patient assessment. The capsule-sensing pressure gauge (CSPG-V) is a new tool that measures the strength of inspiratory muscles; it is easy to use, noninvasive, inexpensive and lightweight. OBJECTIVE: To test the intra- and inter-rater reliability of a CSPG-V device in healthy adults. METHODS: A cross-sectional study involving 80 adult subjects with a mean (± SD) age of 22±3 years was performed. Using simple randomization, 40 individuals (20 male, 20 female) were used for intrarater and 40 (20 male, 20 female) were used for inter-rater reliability testing of the CSPG-V device. The subjects performed three inspiratory efforts, which were sustained for at least 3 s; the best of the three readings was used for intra- and inter-rater comparison. The intra- and inter-rater reliability were calculated using intraclass correlation coefficients (ICCs). RESULTS: The intrarater reliability ICC was 0.962 and the inter-rater reliability ICC was 0.922. CONCLUSION: Results of the present study suggest that maximum inspiratory pressure measured using a CSPG-V device has excellent intraand inter-rater reliability, and can be used as a diagnostic and prognostic tool in patients with respiratory muscle impairment. PMID:26089737

  6. Mechanisms of genioglossus responses to inspiratory resistive load in rabbits.

    PubMed

    Aleksandrova, N P; Goloubeva, E V; Isaev, G G

    2002-07-01

    The purpose of the present study has been to determine whether pharyngeal dilator muscles participate in inspiratory load compensatory responses and if so, to elucidate role of upper airway mechanoreceptors in these responses. The experiments were performed on anaesthetized rabbits. Each animal was tested in three ways by the imposition of inspiratory resistive load: (1) at upper airways via face mask, (2) at the tracheostomic cannula placed below larynx (all upper airway receptors were 'bypassed') and (3) at the mouth after the section of the hypoglossus nerves (motor denervation of genioglossus muscle). The inspiratory load applied to the upper airways evoked significant increases in integrated genioglossus activity (to 129 +/- 14.7% of control) and its inspiratory duration (to 113 +/- 5% of control) already within the first loaded breath (P < 0.05). The increases in the inspiratory activity of musculius genioglossus were relatively greater than the simultaneous increases in the activity of the diaphragm. Motor denervation of the pharynx dilator muscles (including m. genioglossus) increased airway resistance to 184 +/- 19% of control (P < 0.05) and induced obstructive alterations in the breathing pattern during unloaded breathing: decrease in maximal inspiratory flow (-13%) and increase in the level of negative oesophageal pressure (+14%) and the peak diaphragm activity (+6%). After nervi hypoglossus sections additional increases in motor and pressure outputs were required in order to maintain unaltered ventilation at the same degree of loading as before denervation. The results indicate that the pharyngeal dilator muscles have a role in compensation of added inspiratory load. Activation of these muscles facilitate the load compensating function of 'pump' muscles by decreasing airway resistance. Tracheostomy did not reduce the genioglossus response to inspiratory loading, ruling out any role for upper airways receptors in the genioglossus response to inspiratory

  7. Muscle strength in breast cancer patients receiving different treatment regimes

    PubMed Central

    Klassen, Oliver; Schmidt, Martina E.; Ulrich, Cornelia M.; Schneeweiss, Andreas; Potthoff, Karin; Steindorf, Karen

    2016-01-01

    Abstract Background Muscle dysfunction and sarcopenia have been associated with poor performance status, an increased mortality risk, and greater side effects in oncologic patients. However, little is known about how performance is affected by cancer therapy. We investigated muscle strength in breast cancer patients in different adjuvant treatment settings and also compared it with data from healthy individuals. Methods Breast cancer patients (N = 255) from two randomized controlled exercise trials, staged 0–III and aged 54.4 ± 9.4 years, were categorized into four groups according to their treatment status. In a cross‐sectional design, muscle function was assessed bilaterally by isokinetic dynamometry (0°, 60°, 180°/s) as maximal voluntary isometric contraction (MVIC) and maximal isokinetic peak torque (MIPT) in shoulder rotators and knee flexors and extensors. Additionally, muscular fatigue index (FI%) and shoulder flexibility were evaluated. Healthy women (N = 26), aged 53.3 ± 9.8 years, were tested using the same method. Analysis of covariance was used to estimate the impact of different cancer treatments on skeletal muscle function with adjustment for various clinical and socio‐demographic factors. Results Consistently, lower muscle strength was measured in shoulder and knee strength in patients after chemotherapy. On average, patients had up to 25% lower strength in lower extremities and 12–16% in upper extremities in MVIC and MIPT during cancer treatment compared with healthy women. No substantial difference between patient groups in shoulder strength, but significantly lower shoulder flexibility in patients with radical mastectomy was measured. Chemotherapy‐treated patients had consistently higher FI%. No serious adverse events were reported. Conclusions Breast cancer patients showed markedly impaired muscle strength and joint dysfunctions before and after anticancer treatment. The significant differences between patients

  8. Effects of a pre-operative home-based inspiratory muscle training programme on perceived health-related quality of life in patients undergoing coronary artery bypass graft surgery.

    PubMed

    Valkenet, K; Trappenburg, J C A; Hulzebos, E H; van Meeteren, N L U; Backx, F J G

    2017-09-01

    Pre-operative inspiratory muscle training has been shown to decrease the incidence of postoperative pneumonia and length of hospital stay in patients undergoing coronary artery bypass graft surgery (CABG). This study investigated if this decrease acted as a mediator on the time course of quality of life. Complementary analyses of a published randomised controlled trial. The initial trial included patients awaiting CABG surgery at a Dutch university hospital. The secondary analyses used data from the initial trial for patients who had completed at least one quality-of-life questionnaire. Participants were allocated at random to the intervention group or the usual care group. The intervention group followed a home-based pre-operative inspiratory muscle training programme. Quality of life was measured at five time points. Between-group differences in quality-of-life scores were analysed using mixed linear modelling. The secondary analyses used data for 235 patients. In line with the initial trial, pneumonia and length of hospital stay were decreased significantly in the intervention group. The time courses for all patients showed significant improvements in quality of life after surgery compared with baseline. No significant differences in quality of life were observed over time between the two groups. Despite decreased incidence of pneumonia and length of hospital stay in the intervention group, this study did not find any improvements in quality of life due to the pre-operative home-based inspiratory muscle training programme. Clinical trial registration number ISRCTN17691887. Copyright © 2016 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

  9. Muscle Damage and Muscle Activity Induced by Strength Training Super-Sets in Physically Active Men.

    PubMed

    Brentano, Michel A; Umpierre, Daniel; Santos, Lucas P; Lopes, André L; Radaelli, Regis; Pinto, Ronei S; Kruel, Luiz F M

    2017-07-01

    Brentano, MA, Umpierre, D, Santos, LP, Lopes, AL, Radaelli, R, Pinto, RS, and Kruel, LFM. Muscle damage and muscle activity induced by strength training super-sets in physically active men. J Strength Cond Res 31(7): 1847-1858, 2017-In strength training, muscle activity is often analyzed by surface electromyography (EMG) and muscle damage through indirect markers, such as plasma concentrations of creatine kinase (CK) after exercise. However, there is little information about the influence of the strength exercises order on these parameters. The purpose of this study is to analyze the effect of strength exercises order (super-sets) in muscle activity and indirect markers of muscle damage. Twenty men were randomly assigned to one of the strength training sessions (TS). Each TS (5 sets × 8-10 repetition maximum) consisted of 2 exercises for the knee extensor muscles and 2 exercises for the horizontal shoulder flexors performed in a different order: exercises for the same muscle group grouped (grouped exercises [GE]: n = 10; 26.6 ± 3.4 years; 17.4 ± 3.4 body fat) or separated (separated exercises [SE]: n = 10; 24.9 ± 2.6 years; 15.4 ± 5.9 body fat). Muscle activity was analyzed by surface EMG (vastus lateralis [VL], vastus medialis [VM], rectus femoris [RF], pectoralis major [PM], and anterior deltoid [AD]), and the main indirect marker of muscle damage was the CK, evaluated immediately before and after the first 5 days of each TS. There was a higher EMG activity of GE in the RF (GE: 88.4% × SE: 73.6%) and AD (GE: 176.4% × SE: 100.0%), in addition to greater concentration of CK (GE: 632.4% × SE: 330.5%) after exercise. Our findings suggest that, in physically active men, implementing super-sets with GE promotes greater muscle effort and muscle damage, wherein 5 days are not enough to recover the trained muscle groups.

  10. Respiratory muscle strength in relation to sarcopenia in elderly cardiac patients.

    PubMed

    Izawa, Kazuhiro P; Watanabe, Satoshi; Oka, Koichiro; Kasahara, Yusuke; Morio, Yuji; Hiraki, Koji; Hirano, Yasuyuki; Omori, Yutaka; Suzuki, Norio; Kida, Keisuke; Suzuki, Kengo; Akashi, Yoshihiro J

    2016-12-01

    Little information exists on the relation between respiratory muscle strength such as maximum inspiratory muscle pressure (MIP) and sarcopenia in elderly cardiac patients. The present study aimed to determine the differences in MIP, and cutoff values for MIP according to sarcopenia in elderly cardiac patients. We enrolled 63 consecutive elderly male patients aged ≥65 years with cardiac disease in this cross-sectional study. Sarcopenia was defined based on the European Working Group on Sarcopenia in Older People algorithm, and, accordingly, the patients were divided into two groups: the sarcopenia group (n = 24) and non-sarcopenia group (n = 39). The prevalence of sarcopenia in cardiac patients and MIP in the patients with and without sarcopenia were assessed to determine cutoff values of MIP. After adjustment for body mass index, the MIP in the sarcopenia group was significantly lower than that in the non-sarcopenia group (54.7 ± 36.8 cmH2O; 95 % CI 42.5-72.6 vs. 80.7 ± 34.7 cmH2O; 95 % CI 69.5-92.0; F = 4.89, p = 0.029). A receiver-operating characteristic curve analysis of patients with and without sarcopenia identified a cutoff value for MIP of 55.6 cmH2O, with a sensitivity of 0.76, 1-specificity of 0.37, and AUC of 0.70 (95 % CI 0.56-0.83; p = 0.01) in the study patients. Compared with elderly cardiac patients without sarcopenia, MIP in those with sarcopenia may be negatively affected. The MIP cutoff value reported here may be a useful minimum target value for identifying elderly male cardiac patients with sarcopenia.

  11. Exercise, muscle, and the applied load-bone strength balance.

    PubMed

    Giangregorio, L; El-Kotob, R

    2017-01-01

    A fracture occurs when the applied load is greater than the bone can withstand. Clinical practice guidelines for the management of osteoporosis include recommendations for exercise; one of the few therapies where the proposed anti-fracture mechanisms that include effects on both bone strength and applied loads, where applied loads can come in the form of a fall, externally applied loads, body weight, or muscle forces. The aim of this review is to provide an overview of the clinical evidence pertaining to the potential efficacy of exercise for preventing fractures in older adults, including its direct effects on outcomes along the causal pathway to fractures (e.g., falls, posture, bone strength) and the indirect effects on muscle or the muscle-bone relationship. The evidence is examined as it pertains to application in clinical practice. Considerations for future research are discussed, such as the need for trials in individuals with low bone mass or students that evaluate whether changes in muscle mediate changes in bone. Future trials should also consider adequacy of calorie or protein intake, the confounding effect of exercise-induced weight loss, or the most appropriate therapeutic goal (e.g., strength, weight bearing, or hypertrophy) and outcome measures (e.g., fracture, disability, cost-effectiveness).

  12. Bone mineral density, muscle strength, and recreational exercise in men

    NASA Technical Reports Server (NTRS)

    Snow-Harter, C.; Whalen, R.; Myburgh, K.; Arnaud, S.; Marcus, R.

    1992-01-01

    Muscle strength has been shown to predict bone mineral density (BMD) in women. We examined this relationship in 50 healthy men who ranged in age from 28 to 51 years (average 38.3 years). BMD of the lumbar spine, proximal femur, whole body, and tibia were measured by dual-energy x-ray absorptiometry (Hologic QDR 1000W). Dynamic strength using one repetition maximum was assessed for the biceps, quadriceps, and back extensors and for the hip abductors, adductors, and flexors. Isometric grip strength was measured by dynamometry. Daily walking mileage was assessed by 9 week stepmeter records and kinematic analysis of video filming. Subjects were designated as exercisers and nonexercisers. Exercisers participated in recreational exercise at least two times each week. The results demonstrated that BMD at all sites correlated with back and biceps strength (p < 0.01 to p = 0.0001). Body weight correlated with tibia and whole-body BMD (p < 0.001); age negatively correlated with Ward's triangle BMD (p < 0.01). In stepwise multiple regressions, back strength was the only independent predictor of spine and femoral neck density (R2 = 0.27). Further, back strength was the most robust predictor of BMD at the trochanter, Ward's triangle, whole body, and tibia, although biceps strength, age, body weight, and leg strength contributed significantly to BMD at these skeletal sites, accounting for 35-52% of the variance in BMD. Exercisers and nonexercisers were similar for walking (3.97 versus 3.94 miles/day), age (37.8 versus 38.5) years, and weight (80.0 versus 77.7 kg). However, BMD and muscle strength were significantly greater in exercises than in nonexercisers.(ABSTRACT TRUNCATED AT 250 WORDS).

  13. Bone mineral density, muscle strength, and recreational exercise in men

    NASA Technical Reports Server (NTRS)

    Snow-Harter, C.; Whalen, R.; Myburgh, K.; Arnaud, S.; Marcus, R.

    1992-01-01

    Muscle strength has been shown to predict bone mineral density (BMD) in women. We examined this relationship in 50 healthy men who ranged in age from 28 to 51 years (average 38.3 years). BMD of the lumbar spine, proximal femur, whole body, and tibia were measured by dual-energy x-ray absorptiometry (Hologic QDR 1000W). Dynamic strength using one repetition maximum was assessed for the biceps, quadriceps, and back extensors and for the hip abductors, adductors, and flexors. Isometric grip strength was measured by dynamometry. Daily walking mileage was assessed by 9 week stepmeter records and kinematic analysis of video filming. Subjects were designated as exercisers and nonexercisers. Exercisers participated in recreational exercise at least two times each week. The results demonstrated that BMD at all sites correlated with back and biceps strength (p < 0.01 to p = 0.0001). Body weight correlated with tibia and whole-body BMD (p < 0.001); age negatively correlated with Ward's triangle BMD (p < 0.01). In stepwise multiple regressions, back strength was the only independent predictor of spine and femoral neck density (R2 = 0.27). Further, back strength was the most robust predictor of BMD at the trochanter, Ward's triangle, whole body, and tibia, although biceps strength, age, body weight, and leg strength contributed significantly to BMD at these skeletal sites, accounting for 35-52% of the variance in BMD. Exercisers and nonexercisers were similar for walking (3.97 versus 3.94 miles/day), age (37.8 versus 38.5) years, and weight (80.0 versus 77.7 kg). However, BMD and muscle strength were significantly greater in exercises than in nonexercisers.(ABSTRACT TRUNCATED AT 250 WORDS).

  14. Treadmill walking in water induces greater respiratory muscle fatigue than treadmill walking on land in healthy young men.

    PubMed

    Yamashina, Yoshihiro; Yokoyama, Hisayo; Naghavi, Nooshin; Hirasawa, Yoshikazu; Takeda, Ryosuke; Ota, Akemi; Imai, Daiki; Miyagawa, Toshiaki; Okazaki, Kazunobu

    2016-05-01

    The purpose of the present study was to investigate the effect of walking in water on respiratory muscle fatigue compared with that of walking on land at the same exercise intensity. Ten healthy males participated in 40-min treadmill walking trials on land and in water at an intensity of 60% of peak oxygen consumption. Respiratory function and respiratory muscle strength were evaluated before and after walking trials. Inspiratory muscle strength and forced expiratory volume in 1 s were significantly decreased immediately after walking in water, and expiratory muscle strength was significantly decreased immediately and 5 min after walking in water compared with the baseline. The decreases of inspiratory and expiratory muscle strength were significantly greater compared with that after walking on land. In conclusion, greater inspiratory and expiratory muscle fatigue was induced by walking in water than by walking on land at the same exercise intensity in healthy young men.

  15. Associations between personality traits, physical activity level, and muscle strength.

    PubMed

    Tolea, Magdalena I; Terracciano, Antonio; Simonsick, Eleanor M; Metter, E Jeffrey; Costa, Paul T; Ferrucci, Luigi

    2012-06-01

    Associations among personality as measured by the Five Factor Model, physical activity, and muscle strength were assessed using data from the Baltimore Longitudinal Study of Aging (N = 1220, age: mean = 58, SD = 16). General linear modeling with adjustment for age, sex, race, and body mass index, and bootstrapping for mediation were used. We found neuroticism and most of its facets to negatively correlate with strength. The extraversion domain and its facets of warmth, activity, and positive-emotions were positively correlated with strength, independent of covariates. Mediation analysis results suggest that these associations are partly explained by physical activity level. Findings extend the evidence of an association between personality and physical function to its strength component and indicate health behavior as an important pathway.

  16. Associations between personality traits, physical activity level, and muscle strength

    PubMed Central

    Tolea, Magdalena I.; Terracciano, Antonio; Simonsick, Eleanor M.; Metter, E. Jeffrey; Costa, Paul T.; Ferrucci, Luigi

    2013-01-01

    Associations among personality as measured by the Five Factor Model, physical activity, and muscle strength were assessed using data from the Baltimore Longitudinal Study of Aging (N = 1220, age: mean = 58, SD = 16). General linear modeling with adjustment for age, sex, race, and body mass index, and bootstrapping for mediation were used. We found neuroticism and most of its facets to negatively correlate with strength. The extraversion domain and its facets of warmth, activity, and positive-emotions were positively correlated with strength, independent of covariates. Mediation analysis results suggest that these associations are partly explained by physical activity level. Findings extend the evidence of an association between personality and physical function to its strength component and indicate health behavior as an important pathway. PMID:23966753

  17. Kinesthetic imagery training of forceful muscle contractions increases brain signal and muscle strength.

    PubMed

    Yao, Wan X; Ranganathan, Vinoth K; Allexandre, Didier; Siemionow, Vlodek; Yue, Guang H

    2013-01-01

    The purpose of this study was to compare the effect of training using internal imagery (IMI; also known as kinesthetic imagery or first person imagery) with that of external imagery (EMI; also known as third-person visual imagery) of strong muscle contractions on voluntary muscle strengthening. Eighteen young, healthy subjects were randomly assigned to one of three groups (6 in each group): internal motor imagery (IMI), external motor imagery (EMI), or a no-practice control (CTRL) group. Training lasted for 6 weeks (~15 min/day, 5 days/week). The participants' right arm elbow-flexion strength, muscle electrical activity, and movement-related cortical potential (MRCP) were evaluated before and after training. Only the IMI group showed significant strength gained (10.8%) while the EMI (4.8%) and CTRL (-3.3%) groups did not. Only the IMI group showed a significant elevation in MRCP on scalp locations over both the primary motor (M1) and supplementary motor cortices (EMI group over M1 only) and this increase was significantly greater than that of EMI and CTRL groups. These results suggest that training by IMI of forceful muscle contractions was effective in improving voluntary muscle strength without physical exercise. We suggest that the IMI training likely strengthened brain-to-muscle (BTM) command that may have improved motor unit recruitment and activation, and led to greater muscle output. Training by IMI of forceful muscle contractions may change the activity level of cortical motor control network, which may translate into greater descending command to the target muscle and increase its strength.

  18. Effects of Aerobic Exercise Applied Early After Coronary Artery Bypass Grafting on Pulmonary Function, Respiratory Muscle Strength, and Functional Capacity: A Randomized Controlled Trial.

    PubMed

    Borges, Daniel L; Silva, Mayara Gabrielle; Silva, Luan Nascimento; Fortes, João Vyctor; Costa, Erika Thalita; Assunção, Rebeca Pessoa; Lima, Carlos Magno; da Silva Nina, Vinícius José; Bernardo-Filho, Mário; Caputo, Danúbia Sá

    2016-09-01

    Physical activity is beneficial in several clinical situations and recommended for patients with ischemic heart disease, as well as for those undergoing cardiac surgery. In a randomized controlled trial, 34 patients underwent coronary artery bypass grafting. A randomized control group (n = 15) submitted to conventional physiotherapy. The intervention group (n = 19) received the same protocol plus additional aerobic exercise with cycle ergometer. Pulmonary function by spirometry, respiratory muscle strength by manovacuometry, and functional capacity through 6-minute walking test was assessed before surgery and at hospital discharge. There was significant reduction in pulmonary function in both groups. In both groups, inspiratory muscle strength was maintained while expiratory muscle strength significantly decreased. Functional capacity was maintained in the intervention group (364.5 [324.5 to 428] vs. 348 [300.7 to 413.7] meters, P = .06), but it decreased significantly in control group patients (320 [288.5 to 393.0] vs. 292 [237.0 to 336.0] meters, P = .01). A significant difference in functional capacity was also found in intergroup analyses at hospital discharge (P = .03). Aerobic exercise applied early on coronary artery bypass grafting patients may promote maintenance of functional capacity, with no impact on pulmonary function and respiratory muscle strength when compared with conventional physiotherapy.

  19. Bone mineral density and respiratory muscle strength in male individuals with mental retardation (with and without Down Syndrome).

    PubMed

    da Silva, Vinicius Zacarias Maldaner; de França Barros, Jônatas; de Azevedo, Monique; de Godoy, José Roberto Pimenta; Arena, Ross; Cipriano, Gerson

    2010-01-01

    The purpose of this study was to assess the respiratory muscle strength (RMS) in individuals with mental retardation (MR), with or without Down Syndrome (DS), and its association with bone mineral density (BMD). Forty-five male individuals (15 with DS, 15 with mental retardation (MR) and 15 apparently healthy controls), aged 20-35, participated in this study. Subject assessment included pulmonary function tests, RMS (maximal inspiratory pressure, MIP, and maximal expiratory pressure, MEP) and BMD of the second and fourth lumbar vertebrae. ANOVA was used to test differences amongst groups. Tukey post hoc test was utilized when significant differences were detected with ANOVA. Bivariate correlation for BMD and respiratory muscle strength was calculated with Pearson's coefficient of correlation. Individuals with MR, both with and without DS, have lower FEV1, FVC, MIP and MEP (p<0.001) compared to controls. Individuals with DS also had lower BMD, which was associated with lower MIP and MEP. Hypotonia, sedentary lifestyle and obesity are factors that may explain lower MIP and MEP in DS. Strategies to increase RMS could decrease the risk of osteoporosis in the DS population. Copyright © 2010 Elsevier Ltd. All rights reserved.

  20. Strength training and aerobic exercise training for muscle disease.

    PubMed

    Voet, Nicoline B M; van der Kooi, Elly L; Riphagen, Ingrid I; Lindeman, Eline; van Engelen, Baziel G M; Geurts, Alexander C H

    2013-07-09

    Strength training or aerobic exercise programmes might optimise muscle and cardiorespiratory function and prevent additional disuse atrophy and deconditioning in people with a muscle disease. This is an update of a review first published in 2004. To examine the safety and efficacy of strength training and aerobic exercise training in people with a muscle disease. We searched the Cochrane Neuromuscular Disease Group Specialized Register (July 2012), CENTRAL (2012 Issue 3 of 4), MEDLINE (January 1946 to July 2012), EMBASE (January 1974 to July 2012), EMBASE Classic (1947 to 1973) and CINAHL (January 1982 to July 2012). Randomised or quasi-randomised controlled trials comparing strength training or aerobic exercise programmes, or both, to no training, and lasting at least six weeks, in people with a well-described diagnosis of a muscle disease.We did not use the reporting of specific outcomes as a study selection criterion. Two authors independently assessed trial quality and extracted the data obtained from the full text-articles and from the original investigators. We collected adverse event data from included studies. We included five trials (170 participants). The first trial compared the effect of strength training versus no training in 36 people with myotonic dystrophy. The second trial compared aerobic exercise training versus no training in 14 people with polymyositis and dermatomyositis. The third trial compared strength training versus no training in a factorial trial that also compared albuterol with placebo, in 65 people with facioscapulohumeral muscular dystrophy (FSHD). The fourth trial compared combined strength training and aerobic exercise versus no training in 18 people with mitochondrial myopathy. The fifth trial compared combined strength training and aerobic exercise versus no training in 35 people with myotonic dystrophy type 1.In both myotonic dystrophy trials and the dermatomyositis and polymyositis trial there were no significant differences

  1. Circuit strength training improves muscle strength, functional performance and anthropometric indicators in sedentary elderly women.

    PubMed

    Mazini Filho, Mauro L; Aidar, Felipe J; Gama de Matos, Dihogo; Costa Moreira, Osvaldo; Patrocínio de Oliveira, Cláudia E; de Oliveira Venturini, Gabriela R; Magalhães Curty, Victor; Menezes Touguinha, Henrique; Caputo Ferreira, Maria E

    2017-04-26

    This study aimed to investigate the effects of circuit strength training on the muscle strength, functional autonomy and anthropometric indicators of the elderly. Were included 65 women divided in two groups: strength training (TG, n= 34) and control group (CG, n = 31). The strength-training group was subjected to a circuit shaped training program, three days per week, for a period of 12 weeks. In each training session, the circuit was repeated three times. In each circuit, all exercises wereperformed once, with 8 to 12 repetitions per exercise, with 30-seconds intervals between each exercise. TG showed significantly changes in body composition post 12 weeks, as decreases in body weight (Δ -1.5±1.8 kg) and BMI (Δ-0.57 ±0.74 kg/m²), and decreases in abdominal (Δ -3±1.61 cm), waist (Δ -1 ± 1.61 cm), hip (Δ -2.75±1.44 cm) and waist hip ratio circumference (Δ -0.02 ± 0.15 cm). For functional autonomy, TG showed increases post 12 weeks by 30-second chair stand (Δ 3.5±0.4 reps), six minute walk (Δ60.95±7.91 m), back scratch (Δ 3.2 ± 1.36 cm), and time up and go tests (Δ -1,62 ±0,15s). TG also showed increases in muscle strength post 12 weeks in both leg press (Δ 11±1,29 kg) and lat pulldown (Δ11 ±0,75 Kg). For CG, Body composition, functional autonomy and muscle strength did not improved in any moment. Hence, circuit strength training provides significant improvements inmuscle strength, functional performance and anthropometric indicators in sedentary elderly women.

  2. Effects of electrical muscle stimulation on body composition, muscle strength, and physical appearance.

    PubMed

    Porcari, John P; McLean, Karen Palmer; Foster, Carl; Kernozek, Thomas; Crenshaw, Ben; Swenson, Chad

    2002-05-01

    Electrical muscle stimulation devices (EMS) have been advertised to increase muscle strength, to decrease body weight and body fat, and to improve muscle firmness and tone in healthy individuals. This study sought to test those claims. Twenty-seven college-aged volunteers were assigned to either an EMS (n = 16) or control group (n = 11). The EMS group underwent stimulation 3 times per week following the manufacturer's recommendations, whereas the control group underwent concurrent sham stimulation sessions. Bilaterally, the muscles stimulated included the biceps femoris, quadriceps, biceps, triceps, and abdominals (rectus abdominus and obliques). An identical pre- and posttesting battery included measurements of body weight, body fat (via skinfolds), girths, isometric and isokinetic strength (biceps, triceps, quadriceps, hamstrings), and appearance (via photographs from the front, side, and back). EMS had no significant effect on the any of the measured parameters. Thus, claims relative to the effectiveness of EMS for the apparently healthy individual are not supported by the findings of this study.

  3. Muscle Strength and Flexibility without and with Visual Impairments Judoka's

    ERIC Educational Resources Information Center

    Karakoc, Onder

    2016-01-01

    The aim of this study was to examine muscle strength and flexibility of judoka with and without visual impairments. A total of 32 male national judoka volunteered to participate in this study. There were 20 male judoka without visual impairments (mean ± SD; age: 19.20 ± 5.76 years, body weight: 66.45 ± 11.09 kg, height: 169.60 ± 7.98 cm, sport…

  4. Should we abandon manual muscle strength testing in the ICU?

    PubMed

    Hermans, Greet; Gosselink, Rik

    2011-03-01

    Intensive-care-unit-acquired weakness is a major complication in critically ill patients. The paper by Hough and coworkers suggests that the current method of manual muscle strength testing with the Medical Research Council sum score is of limited value in the intensive care unit. However, their results raise a number of questions and provide important lessons for implementation of such evaluations in the intensive care unit.

  5. Does grip strength on the unaffected side of patients with hemiparetic stroke reflect the strength of other ipsilateral muscles?

    PubMed Central

    Takahashi, Jumpei; Nishiyama, Toru; Matsushima, Yoshimasa

    2017-01-01

    [Purpose] Grip strength is used as an indicator of overall body muscular strength. However, most studies on grip strength have been performed in healthy people, and no study has evaluated it in the unaffected side of patients with hemiparetic stroke. The purpose of this study was to determine if grip strength on the unaffected side of patients with hemiparetic stroke correlates with the strength of other ipsilateral musculature. [Subjects and Methods] The maximal strengths of the muscles on the unaffected side of 31 patients with hemiparetic stroke were measured, and correlation coefficients were calculated. [Results] The results revealed significant positive correlations between grip strength on the unaffected side and the strength of the other ipsilateral muscle groups, with relatively high correlations being observed for the upper extremity muscle groups. [Conclusion] This suggests that grip strength on the unaffected side of patients with hemiparetic stroke can be used as a simple way to estimate overall strength on that side. PMID:28210040

  6. Does grip strength on the unaffected side of patients with hemiparetic stroke reflect the strength of other ipsilateral muscles?

    PubMed

    Takahashi, Jumpei; Nishiyama, Toru; Matsushima, Yoshimasa

    2017-01-01

    [Purpose] Grip strength is used as an indicator of overall body muscular strength. However, most studies on grip strength have been performed in healthy people, and no study has evaluated it in the unaffected side of patients with hemiparetic stroke. The purpose of this study was to determine if grip strength on the unaffected side of patients with hemiparetic stroke correlates with the strength of other ipsilateral musculature. [Subjects and Methods] The maximal strengths of the muscles on the unaffected side of 31 patients with hemiparetic stroke were measured, and correlation coefficients were calculated. [Results] The results revealed significant positive correlations between grip strength on the unaffected side and the strength of the other ipsilateral muscle groups, with relatively high correlations being observed for the upper extremity muscle groups. [Conclusion] This suggests that grip strength on the unaffected side of patients with hemiparetic stroke can be used as a simple way to estimate overall strength on that side.

  7. Role of body size in the relation between muscle strength and movement performance.

    PubMed

    Jaric, Slobodan

    2003-01-01

    Body size relates differently on the outcome of various tests of muscle strength and movement performance. Thus the estimation of functional performance from tests of muscle strength, and vice versa, should be based on the normalization of both muscle strength and movement performance.

  8. A comparison of respiratory and peripheral muscle strength, functional exercise capacity, activities of daily living and physical fitness in patients with cystic fibrosis and healthy subjects.

    PubMed

    Arikan, Hulya; Yatar, İlker; Calik-Kutukcu, Ebru; Aribas, Zeynep; Saglam, Melda; Vardar-Yagli, Naciye; Savci, Sema; Inal-Ince, Deniz; Ozcelik, Ugur; Kiper, Nural

    2015-01-01

    There are limited reports that compare muscle strength, functional exercise capacity, activities of daily living (ADL) and parameters of physical fitness of cystic fibrosis (CF) patients with healthy peers in the literature. The purpose of this study was to assess and compare respiratory and peripheral muscle strength, functional exercise capacity, ADL and physical fitness in patients with CF and healthy subjects. Nineteen patients with CF (mean forced expiratory volume in one second-FEV1: 86.56±18.36%) and 20 healthy subjects were included in this study. Respiratory (maximal inspiratory pressure-MIP and maximal expiratory pressure-MEP) and peripheral muscle strength (quadriceps, shoulder abductors and hand grip strength) were evaluated. Functional exercise capacity was determined with 6min walk test (6MWT). ADL was assessed with Glittre ADL test and physical fitness was assessed with Munich fitness test (MFT). There were not any statistically significant difference in MIP, %MIP, MEP and %MEP values between two groups (p>0.05). %Peripheral muscle strength (% quadriceps and shoulder abductors strength), 6MWT distance and %6MWT distance were significantly lower in patients with CF than those of healthy subjects (p<0.05). Glittre ADL-test time was significantly longer in patients with CF than healthy subjects (p<0.05). According to Munich fitness test, the number of bouncing a ball, hanging score, distance of standing vertical jumping and standing vertical jumping score were significantly lower in patients with CF than those of healthy subjects (p<0.05). Peripheral muscle strength, functional exercise capacity, ADL performance and speed, coordination, endurance and power components of physical fitness are adversely affected in mild-severe patients with CF compared to healthy peers. Evaluations must be done in comprehensive manner in patients with CF with all stages.

  9. Effects of whole-body vibration after eccentric exercise on muscle soreness and muscle strength recovery.

    PubMed

    Timon, Rafael; Tejero, Javier; Brazo-Sayavera, Javier; Crespo, Carmen; Olcina, Guillermo

    2016-06-01

    [Purpose] The aim of this study was to investigate whether or not a single whole-body vibration treatment after eccentric exercise can reduce muscle soreness and enhance muscle recovery. [Subjects and Methods] Twenty untrained participants were randomly assigned to two groups: a vibration group (n=10) and control group (n=10). Participants performed eccentric quadriceps training of 4 sets of 5 repetitions at 120% 1RM, with 4 min rest between sets. After that, the vibration group received 3 sets of 1 min whole body vibration (12 Hz, 4 mm) with 30 s of passive recovery between sets. Serum creatine kinase, blood urea nitrogen, muscle soreness (visual analog scale) and muscle strength (peak isometric torque) were assessed. [Results] Creatine kinase was lower in the vibration group than in the control group at 24 h (200.2 ± 8.2 vs. 300.5 ± 26.1 U/L) and at 48 h (175.2 ± 12.5 vs. 285.2 ± 19.7 U/L) post-exercise. Muscle soreness decreased in vibration group compared to control group at 48 h post-exercise (34.1 ± 11.4 vs. 65.2 ± 13.2 mm). [Conclusion] Single whole-body vibration treatment after eccentric exercise reduced delayed onset muscle soreness but it did not affect muscle strength recovery.

  10. Effects of whole-body vibration after eccentric exercise on muscle soreness and muscle strength recovery

    PubMed Central

    Timon, Rafael; Tejero, Javier; Brazo-Sayavera, Javier; Crespo, Carmen; Olcina, Guillermo

    2016-01-01

    [Purpose] The aim of this study was to investigate whether or not a single whole-body vibration treatment after eccentric exercise can reduce muscle soreness and enhance muscle recovery. [Subjects and Methods] Twenty untrained participants were randomly assigned to two groups: a vibration group (n=10) and control group (n=10). Participants performed eccentric quadriceps training of 4 sets of 5 repetitions at 120% 1RM, with 4 min rest between sets. After that, the vibration group received 3 sets of 1 min whole body vibration (12 Hz, 4 mm) with 30 s of passive recovery between sets. Serum creatine kinase, blood urea nitrogen, muscle soreness (visual analog scale) and muscle strength (peak isometric torque) were assessed. [Results] Creatine kinase was lower in the vibration group than in the control group at 24 h (200.2 ± 8.2 vs. 300.5 ± 26.1 U/L) and at 48 h (175.2 ± 12.5 vs. 285.2 ± 19.7 U/L) post-exercise. Muscle soreness decreased in vibration group compared to control group at 48 h post-exercise (34.1 ± 11.4 vs. 65.2 ± 13.2 mm). [Conclusion] Single whole-body vibration treatment after eccentric exercise reduced delayed onset muscle soreness but it did not affect muscle strength recovery. PMID:27390415

  11. Improved skeletal muscle mass and strength after heavy strength training in very old individuals.

    PubMed

    Bechshøft, Rasmus Leidesdorff; Malmgaard-Clausen, Nikolaj Mølkjær; Gliese, Bjørn; Beyer, Nina; Mackey, Abigail L; Andersen, Jesper Løvind; Kjær, Michael; Holm, Lars

    2017-06-01

    Age-related loss of muscle mass and function represents personal and socioeconomic challenges. The purpose of this study was to determine the adaptation of skeletal musculature in very old individuals (83+ years) performing 12weeks of heavy resistance training (3×/week) (HRT) compared to a non-training control group (CON). Both groups received similar protein supplementations. We studied 26 participants (86.9±3.2 (SD) (83-94, range) years old) per-protocol. Quadriceps cross-sectional area (CSA) differed between groups at post-test (P<0.05) and increased 1.5±0.7cm(2) (3.4%) (P<0.05) in HRT only. The increase in CSA is correlated inversely with the baseline level of CSA (R(2)=0.43, P<0.02). Thigh muscle isometric strength, isokinetic peak torque and power increased significantly only in HRT by 10-15%, whereas knee extension one-repetition maximum (1 RM) improved by 91%. Physical functional tests, muscle fiber type distribution and size did not differ significantly between groups. We conclude that in protein supplemented very old individuals, heavy resistance training can increase muscle mass and strength, and that the relative improvement in mass is more pronounced when initial muscle mass is low. Copyright © 2017. Published by Elsevier Inc.

  12. Respiratory training improved ventilatory function and respiratory muscle strength in patients with multiple sclerosis and lateral amyotrophic sclerosis: systematic review and meta-analysis.

    PubMed

    Ferreira, Gustavo D; Costa, Ana Cecília C; Plentz, Rodrigo D M; Coronel, Christian C; Sbruzzi, Graciele

    2016-09-01

    Among neurodegenerative diseases, multiple sclerosis (MS) and amyotrophic lateral sclerosis (ALS) have a high rate of respiratory disability. To analyze the effects of respiratory muscle training (RMT) on ventilatory function, muscle strength and functional capacity in patients with MS or ALS. A systematic review and meta-analysis of randomized controlled trials (RCTs) was performed. The sources were MEDLINE, PEDro, Cochrane CENTRAL, EMBASE, and LILACS, from inception to January 2015. The following were included: RCTs of patients with neurodegenerative diseases (MS or lateral ALS) who used the intervention as RMT (inspiratory/expiratory), comparison with controls who had not received RMT full time or were receiving training without load, and evaluations of ventilatory function (forced vital capacity - FVC, forced expiratory volume in one second - FEV1, maximum voluntary ventilation - MVV), respiratory muscle strength (maximal expiratory pressure/maximum inspiratory pressure - MEP/MIP) and functional capacity (6-minute walk test - 6MWT). The review included nine papers, and a total of 194 patients. It was observed that RMT significantly increased at MIP (23.50cmH2O; 95% CI: 7.82 to 39.19), MEP (12.03cmH2O; 95% CI: 5.50 to 18.57) and FEV1 (0.27L; 95% CI: 0.12 to 0.42) compared to the control group, but did not differ in FVC (0.48L; 95% CI: -0.15 to 1.10) and distance in 6MWT (17.95m; 95% CI: -4.54 to 40.44). RMT can be an adjunctive therapy in the rehabilitation of neurodegenerative diseases improving ventilatory function and respiratory strength. Copyright © 2016 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

  13. CCL2 and CCR2 variants are associated with skeletal muscle strength and change in strength with resistance training

    PubMed Central

    Harmon, Brennan T.; Orkunoglu-Suer, E. Funda; Adham, Kasra; Larkin, Justin S.; Gordish-Dressman, Heather; Clarkson, Priscilla M.; Thompson, Paul D.; Angelopoulos, Theodore J.; Gordon, Paul M.; Moyna, Niall M.; Pescatello, Linda S.; Visich, Paul S.; Zoeller, Robert F.; Hubal, Monica J.; Tosi, Laura L.; Hoffman, Eric P.

    2010-01-01

    Baseline muscle size and muscle adaptation to exercise are traits with high variability across individuals. Recent research has implicated several chemokines and their receptors in the pathogenesis of many conditions that are influenced by inflammatory processes, including muscle damage and repair. One specific chemokine, chemokine (C-C motif) ligand 2 (CCL2), is expressed by macrophages and muscle satellite cells, increases expression dramatically following muscle damage, and increases expression further with repeated bouts of exercise, suggesting that CCL2 plays a key role in muscle adaptation. The present study hypothesizes that genetic variations in CCL2 and its receptor (CCR2) may help explain muscle trait variability. College-aged subjects [n = 874, Functional Single-Nucleotide Polymorphisms Associated With Muscle Size and Strength (FAMUSS) cohort] underwent a 12-wk supervised strength-training program for the upper arm muscles. Muscle size (via MR imaging) and elbow flexion strength (1 repetition maximum and isometric) measurements were taken before and after training. The study participants were then genotyped for 11 genetic variants in CCL2 and five variants in CCR2. Variants in the CCL2 and CCR2 genes show strong associations with several pretraining muscle strength traits, indicating that inflammatory genes in skeletal muscle contribute to the polygenic system that determines muscle phenotypes. These associations extend across both sexes, and several of these genetic variants have been shown to influence gene regulation. PMID:20947712

  14. Isokinetic muscle strength and hiking performance in elite sailors.

    PubMed

    Aagaard, P; Beyer, N; Simonsen, E B; Larsson, B; Magnusson, S P; Kjaer, M

    1998-06-01

    The aim of the present study was to describe the isokinetic strength profile and its relation to hiking performance in male (SM, n = 15) and female (SF, n = 6) elite sailors compared to a group of male control subjects (CM, n = 8) similar in age, anthropometry and level of fitness. Eccentric knee extension strength was higher in SM compared to CM (P < 0.01). Furthermore, SM were stronger during trunk extension (P < 0.05), but not during trunk flexion compared to CM. Overall muscle strength was lower in SF compared to SM (P < 0.01) and CM (P < 0.05), except for eccentric knee extension strength, where SF and CM did not differ (P > 0.05). Hiking performance correlated to maximal eccentric and isometric knee extensor strength in SF (rs = 0.83-0.88, P < 0.05) and in CM (rs = 0.73-0.77, P < 0.05) and to maximal eccentric knee extensor strength at high velocity in SM (rs = 0.46-0.54, P < 0.05). For a subgroup of hikers in SM (n = 8), hiking performance correlated to maximal isometric-eccentric knee extensor strength (rs = 0.67-0.74, P < 0.05), whereas no correlations emerged for the non-hikers (n = 7). Few correlations were observed between hiking performance and maximal concentric trunk flexor strength (rs = 0.69-0.92, P < 0.05). Unexpectedly, in SM correlations also were observed between hiking performance and maximal strength of the trunk extensors (rs = 0.46-0.53, hiker subgroup: rs = 0.64-0.67, P < 0.05). In conclusion, notably high levels of maximal eccentric knee extensor strength were observed for the male and female elite sailors examined in the present study. Furthermore, the present results suggest that hiking performance depends in part on maximal isometric-eccentric knee extensor strength. The maximal strength of the trunk extensors, which potentially stabilizes the lower back and spine, also seems to have some importance for the hiking performance of top-level sailors.

  15. Comparison of isokinetic muscle strength and muscle power by types of warm-up.

    PubMed

    Sim, Young-Je; Byun, Yong-Hyun; Yoo, Jaehyun

    2015-05-01

    [Purpose] The purpose of this study was to clarify the influence of static stretching at warm-up on the isokinetic muscle torque (at 60°/sec) and muscle power (at 180°/sec) of the flexor muscle and extensor muscle of the knee joint. [Subjects and Methods] The subjects of this study were 10 healthy students with no medically specific findings. The warm-up group and warm-up with stretching group performed their respective warm-up prior to the isokinetic muscle torque evaluation of the knee joint. One-way ANOVA was performed by randomized block design for each variable. [Results] The results were as follows: First, the flexor peak torque and extensor peak torque of the knee joint tended to decrease at 60°/sec in the warm-up with stretching group compared with the control group and warm-up group, but without statistical significance. Second, extensor power at 180°/sec was also not statistically significant. However, it was found that flexor power increased significantly in the warm-up with stretching group at 180°/sec compared with the control group and warm-up group in which stretching was not performed. [Conclusion] Therefore, it is considered that in healthy adults, warm-up including two sets of stretching for 20 seconds per muscle group does not decrease muscle strength and muscle power.

  16. Comparison of isokinetic muscle strength and muscle power by types of warm-up

    PubMed Central

    Sim, Young-Je; Byun, Yong-Hyun; Yoo, Jaehyun

    2015-01-01

    [Purpose] The purpose of this study was to clarify the influence of static stretching at warm-up on the isokinetic muscle torque (at 60°/sec) and muscle power (at 180°/sec) of the flexor muscle and extensor muscle of the knee joint. [Subjects and Methods] The subjects of this study were 10 healthy students with no medically specific findings. The warm-up group and warm-up with stretching group performed their respective warm-up prior to the isokinetic muscle torque evaluation of the knee joint. One-way ANOVA was performed by randomized block design for each variable. [Results] The results were as follows: First, the flexor peak torque and extensor peak torque of the knee joint tended to decrease at 60°/sec in the warm-up with stretching group compared with the control group and warm-up group, but without statistical significance. Second, extensor power at 180°/sec was also not statistically significant. However, it was found that flexor power increased significantly in the warm-up with stretching group at 180°/sec compared with the control group and warm-up group in which stretching was not performed. [Conclusion] Therefore, it is considered that in healthy adults, warm-up including two sets of stretching for 20 seconds per muscle group does not decrease muscle strength and muscle power. PMID:26157247

  17. Measurement of peripheral muscle strength in individuals with chronic obstructive pulmonary disease: a systematic review.

    PubMed

    Robles, Priscila Games; Mathur, Sunita; Janaudis-Fereira, Tania; Dolmage, Thomas E; Goldstein, Roger S; Brooks, Dina

    2011-01-01

    Reduced maximal, peripheral muscle strength is associated with exercise intolerance in patients with chronic obstructive pulmonary disease (COPD). Therefore, it is important to accurately evaluate muscle strength to identify patients with muscle weakness and to prescribe adequate loads for resistance training. The objective here was to systematically identify and summarize the literature on measurement of peripheral muscle strength in individuals with COPD and to make recommendations for strength testing in clinical and research settings. A literature search was conducted of electronic databases between 1999 and 2009 of all English language articles utilizing muscle strength measurements. The search resulted in retrieval of 178 articles, of which 66 were reviewed. Isometric muscle strength was measured using handgrip (n = 30), strain gauge (n = 15), computerized dynamometer (n = 13), magnetic stimulation (n = 8), handheld dynamometer (n = 6), or manual testing (n = 3). Isotonic muscle strength was measured using a hydraulic system (n = 3) or 1-repetition maximum (n = 9), and isokinetic muscle strength was measured using computerized dynamometer (n = 16). Methodological issues such as limb position, number of trials, subject familiarization, test instructions, rest periods, and muscle group tested were all identified as important variables to consider when developing a strength-testing protocol. Muscle strength has been measured in people with COPD using similar methods as in other clinical populations. Each method presents advantages and disadvantages that need to be considered when selecting the most relevant measure. Standardization of the test procedures is essential in both clinical and research settings to obtain valid and reliable measurements of muscle strength.

  18. Effect of Gender, Disease Duration and Treatment on Muscle Strength in Myasthenia Gravis

    PubMed Central

    Citirak, Gülsenay; Cejvanovic, Sanja; Andersen, Henning; Vissing, John

    2016-01-01

    Introduction The aim of this observational, cross-sectional study was to quantify the potential presence of muscle weakness among patients with generalized myasthenia gravis (gMG). The influence of gender, treatment intensity and disease duration on muscle strength and disease progression was also assessed. Methods Muscle strength was tested in 8 muscle groups by manual muscle testing and by hand-held dynamometry in 107 patients with gMG and 89 healthy age- and gender-matched controls. Disease duration, severity and treatment history were reviewed and compared with muscle strength. Results Patients had reduced strength in all tested muscle group compared to control subjects (p<0.05). Women with gMG were stronger than men (decrease in strength 22.6% vs. 32.7% in men, P<0.05). Regional differences in muscle weakness were also evident, with proximal muscles being more affected. Interestingly, muscle strength did not correlate with disease duration and treatment intensity. Conclusions The results of this study show that in patients with gMG; 1) there is significant muscle weakness, 2) muscle weakness is more pronounced in men than women, 3) shoulder abductors, hip flexors, and neck muscles are the most affected muscle groups and 4) disease duration or treatment intensity alone are not predictors of loss of muscle strength in gMG. PMID:27741232

  19. Muscle strength rather than muscle mass is associated with standing balance in elderly outpatients.

    PubMed

    Bijlsma, Astrid Y; Pasma, Jantsje H; Lambers, Dorine; Stijntjes, Marjon; Blauw, Gerard Jan; Meskers, Carel G M; Maier, Andrea B

    2013-07-01

    Assessment of the association of muscle characteristics with standing balance is of special interest, as muscles are a target for potential intervention (ie, by strength training). Cross-sectional study. Geriatric outpatient clinic. The study included 197 community-dwelling elderly outpatients (78 men, 119 women; mean age 82 years). Muscle characteristics included handgrip and knee extension strength, appendicular lean mass divided by height squared (ALM/height(2)), and lean mass as percentage of body mass. Two aspects of standing balance were assessed: the ability to maintain balance, and the quality of balance measured by Center of Pressure (CoP) movement during 10 seconds of side-by-side, semitandem, and tandem stance, with both eyes open and eyes closed. Logistic and linear regression models were adjusted for age, and additionally for height, body mass, cognitive function, and multimorbidity. Handgrip and knee extension strength, adjusted for age, were positively related to the ability to maintain balance with eyes open in side-by-side (P = .011; P = .043), semitandem (P = .005; P = .021), and tandem stance (P = .012; P = .014), and with eyes closed in side-by-side (P = .004; P = .004) and semitandem stance (not significant; P = .046). Additional adjustments affected the results only slightly. ALM/height(2) and lean mass percentage were not associated with the ability to maintain standing balance, except for an association between ALM/height(2) and tandem stance with eyes open (P = .033) that disappeared after additional adjustments. Muscle characteristics were not associated with CoP movement. Muscle strength rather than muscle mass was positively associated with the ability to maintain standing balance in elderly outpatients. Assessment of CoP movement was not of additional value. Copyright © 2013 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.

  20. Cardiorespiratory fitness and muscle strength in pancreatic cancer patients.

    PubMed

    Clauss, Dorothea; Tjaden, Christine; Hackert, Thilo; Schneider, Lutz; Ulrich, Cornelia M; Wiskemann, Joachim; Steindorf, Karen

    2017-09-01

    Cancer patients frequently experience reduced physical fitness due to the disease itself as well as treatment-related side effects. However, studies on physical fitness in pancreatic cancer patients are missing. Therefore, we assessed cardiorespiratory fitness and muscle strength of pancreatic cancer patients. We included 65 pancreatic cancer patients, mostly after surgical resection. Cardiorespiratory fitness was assessed using cardiopulmonary exercise testing (CPET) and 6-min walk test (6MWT). Hand-held dynamometry was used to evaluate isometric muscle strength. Physical fitness values were compared to reference values of a healthy population. Associations between sociodemographic and clinical variables with patients' physical fitness were analyzed using multiple regression models. Cardiorespiratory fitness (VO2peak, 20.5 ± 6.9 ml/min/kg) was significantly lower (-24%) compared to healthy reference values. In the 6MWT pancreatic cancer patients nearly reached predicted values (555 vs. 562 m). Maximal voluntary isometric contraction (MVIC) of the upper (-4.3%) and lower extremities (-13.8%) were significantly lower compared to reference values. Overall differences were larger in men than those in women. Participating in regular exercise in the year before diagnosis was associated with greater VO2peak (p < .05) and MVIC of the knee extensors (p < .05). Pancreatic cancer patients had significantly impaired physical fitness with regard to both cardiorespiratory function and isometric muscle strength, already in the early treatment phase (median 95 days after surgical resection). Our findings underline the need to investigate exercise training in pancreatic cancer patients to counteract the loss of physical fitness.

  1. Balance and Muscle Strength in Elderly Women Who Dance Samba.

    PubMed

    Serra, Marcos Maurício; Alonso, Angelica Castilho; Peterson, Mark; Mochizuki, Luis; Greve, Júlia Maria D'Andréa; Garcez-Leme, Luiz Eugênio

    2016-01-01

    Considering the growth of the aging population, and the increasing risk for falls and related morbidity, it is vital to seek efficient, comprehensive, and culturally relevant prevention programs for elderly people to reduce risks for falls. The aim of the present study was to evaluate the postural balance and muscle strength among women participating in the "Wing of Baianas" in the carnival parades. One hundred and ten women, with an average age of 67.4±5.9 years, were divided into two groups: Baianas group-elderly participants of the carnival parades in the "Wing of Baianas", and a Control group of women who do not dance samba. Assessments included a physical activity questionnaire, isokinetic muscle strength testing for the knee extensors and flexors, and a postural balance assessment completed on a force platform. There were no differences between groups, for postural balance outcomes, during the eyes open condition; however, with eyes closed, there was a significant effect between groups (Baianas vs Control) in all variables. The Baianas group showed less medio-lateral displacement (p < 0.04); and anteroposterior displacement (p < 0.007); larger amplitudes of medio-lateral displacement (p < 0.001); and anteroposterior displacement (p < 0.001); increased mean velocity (p < 0.01); and elliptical area (p < 0.01) There were no differences in the isokinetic peak torque corrected by body weight, total work and flexor/extensor ratio. Participation in the Wing of Baianas is associated with better balance with closed eyes, but there were no differences between dancers and non-dancers for muscle strength.

  2. Balance and Muscle Strength in Elderly Women Who Dance Samba

    PubMed Central

    Serra, Marcos Maurício; Alonso, Angelica Castilho; Peterson, Mark; Mochizuki, Luis; Greve, Júlia Maria D'Andréa; Garcez-Leme, Luiz Eugênio

    2016-01-01

    Considering the growth of the aging population, and the increasing risk for falls and related morbidity, it is vital to seek efficient, comprehensive, and culturally relevant prevention programs for elderly people to reduce risks for falls. The aim of the present study was to evaluate the postural balance and muscle strength among women participating in the "Wing of Baianas" in the carnival parades. One hundred and ten women, with an average age of 67.4±5.9 years, were divided into two groups: Baianas group—elderly participants of the carnival parades in the “Wing of Baianas”, and a Control group of women who do not dance samba. Assessments included a physical activity questionnaire, isokinetic muscle strength testing for the knee extensors and flexors, and a postural balance assessment completed on a force platform. There were no differences between groups, for postural balance outcomes, during the eyes open condition; however, with eyes closed, there was a significant effect between groups (Baianas vs Control) in all variables. The Baianas group showed less medio-lateral displacement (p < 0.04); and anteroposterior displacement (p < 0.007); larger amplitudes of medio-lateral displacement (p < 0.001); and anteroposterior displacement (p < 0.001); increased mean velocity (p < 0.01); and elliptical area (p < 0.01) There were no differences in the isokinetic peak torque corrected by body weight, total work and flexor/extensor ratio. Participation in the Wing of Baianas is associated with better balance with closed eyes, but there were no differences between dancers and non-dancers for muscle strength. PMID:27906984

  3. Associations of Sarcopenia and Sarcopenic Obesity With Metabolic Syndrome Considering Both Muscle Mass and Muscle Strength

    PubMed Central

    2016-01-01

    Objectives: We investigated the associations of sarcopenia-defined both in terms of muscle mass and muscle strength-and sarcopenic obesity with metabolic syndrome. Methods: Secondary data pertaining to 309 subjects (85 men and 224 women) were collected from participants in exercise programs at a health center in a suburban area. Muscle mass was measured using bioelectrical impedance analysis, and muscle strength was measured via handgrip strength. Sarcopenia based on muscle mass alone was defined as a weight-adjusted skeletal muscle mass index more than two standard deviations below the mean of a sex-specific young reference group (class II sarcopenia). Two cut-off values for low handgrip strength were used: the first criteria were <26 kg for men and <18 kg for women, and the second criteria were the lowest quintile of handgrip strength among the study subjects. Sarcopenic obesity was defined as the combination of class II sarcopenia and being in the two highest quintiles of total body fat percentage among the subjects. The associations of sarcopenia and sarcopenic obesity with metabolic syndrome were evaluated using logistic regression models. Results: The age-adjusted risk ratios (RRs) of metabolic syndrome being compared in people with or without sarcopenia defined in terms of muscle mass were 1.25 (95% confidence interval [CI], 1.06 to 1.47, p=0.008) in men and 1.12 (95% CI, 1.06 to 1.19, p<0.001) in women, which were found to be statistically significant relationships. The RRs of metabolic syndrome being compared in people with or without sarcopenic obesity were 1.31 in men (95% CI, 1.10 to 1.56, p=0.003) and 1.17 in women (95% CI, 1.10 to 1.25, p<0.001), which were likewise found to be statistically significant relationships. Conclusions: The associations of sarcopenia defined in terms of muscle mass and sarcopenic obesity with metabolic syndrome were statistically significant in both men and women. Therefore, sarcopenia and sarcopenic obesity must be

  4. Relative appendicular skeletal muscle mass is associated with isokinetic muscle strength and balance in healthy collegiate men.

    PubMed

    Kim, Sung-Eun; Hong, Ju; Cha, Jun-Youl; Park, Jung-Min; Eun, Denny; Yoo, Jaehyun; Jee, Yong-Seok

    2016-11-01

    There are few studies on the relationship between skeletal muscle mass and balance in the young ages. We investigated the relationship between appendicular skeletal muscle mass, isokinetic muscle strength of lower extremity, and balance among healthy young men using relative skeletal muscle index. Thirty men were grouped according to relative appendicular skeletal muscle mass index: higher skeletal muscle group (n = 15) and lower skeletal muscle group (n = 15). Static and dynamic balance abilities were measured using the following: a test where participants stood on one leg with eyes closed, a modified Clinical Test of Sensory Interaction on Balance (mCTSIB) with eyes open and eyes closed, a stability test, and limits of stability test. The muscle strength of lower extremities was measured with an isokinetic analyser in hip, knee, and ankle joints. Participants with higher appendicular skeletal muscle mass were significantly more stable in maintaining dynamic balance than those with lower appendicular skeletal muscle mass. Moreover, appendicular skeletal muscle mass index was positively correlated with dynamic balance ability. Participants with higher appendicular skeletal muscle mass had stronger strength in the lower extremity, and there were significant differences in the isokinetic torque ratios between groups. From these results, it can be inferred that higher appendicular skeletal muscle mass relates to muscle strength and the alteration in the peak torque ratio of the lower extremity, contributing to the maintenance of balance.

  5. Dyspnea and respiratory muscle strength in end-stage liver disease

    PubMed Central

    Kaltsakas, Georgios; Antoniou, Efstathios; Palamidas, Anastasios F; Gennimata, Sofia-Antiopi; Paraskeva, Panorea; Smyrnis, Anastasios; Koutsoukou, Antonia; Milic-Emili, Joseph; Koulouris, Nickolaos G

    2013-01-01

    AIM: To investigate the prevalence of chronic dyspnea and its relationship to respiratory muscle function in end-stage liver disease. METHODS: Sixty-eight consecutive, ambulatory, Caucasian patients with end-stage liver disease, candidates for liver transplantation, were referred for preoperative respiratory function assessment. Forty of these (29 men) were included in this preliminary study after applying strict inclusion and exclusion criteria. Seventeen of 40 patients (42%) had ascites, but none of them was cachectic. Fifteen of 40 patients (38%) had a history of hepatic encephalopathy, though none of them was symptomatic at study time. All patients with a known history and/or presence of co-morbidities were excluded. Chronic dyspnea was rated according to the modified medical research council (mMRC) 6-point scale. Liver disease severity was assessed according to the Model for end-stage liver disease (MELD). Routine lung function tests, maximum static expiratory (Pemax) and inspiratory (Pimax) mouth pressures were measured. Respiratory muscle strength (RMS) was calculated from Pimax and Pemax values. In addition, arterial blood gases and pattern of breathing (VE: minute ventilation; VT: tidal volume; VT/TI: mean inspiratory flow; TI: duration of inspiration) were measured. RESULTS: Thirty-five (88%) of 40 patients aged (mean ± SD) 52 ± 10 years reported various degrees of chronic dyspnea (mMRC), ranging from 0 to 4, with a mean value of 2.0 ± 1.2. MELD score was 14 ± 6. Pemax, percent of predicted (%pred) was 105 ± 35, Pimax, %pred was 90 ± 29, and RMS, %pred was 97 ± 30. These pressures were below the normal limits in 12 (30%), 15 (38%), and 14 (35%) patients, respectively. Furthermore, comparing the subgroups of ascites to non-ascites patients, all respiratory muscle indices measured were found significantly decreased in ascites patients. Patients with ascites also had a significantly worse MELD score compared to non-ascites ones (P = 0

  6. The impact of obesity on skeletal muscle strength and structure through adolescence to old age.

    PubMed

    Tomlinson, D J; Erskine, R M; Morse, C I; Winwood, K; Onambélé-Pearson, Gladys

    2016-06-01

    Obesity is associated with functional limitations in muscle performance and increased likelihood of developing a functional disability such as mobility, strength, postural and dynamic balance limitations. The consensus is that obese individuals, regardless of age, have a greater absolute maximum muscle strength compared to non-obese persons, suggesting that increased adiposity acts as a chronic overload stimulus on the antigravity muscles (e.g., quadriceps and calf), thus increasing muscle size and strength. However, when maximum muscular strength is normalised to body mass, obese individuals appear weaker. This relative weakness may be caused by reduced mobility, neural adaptations and changes in muscle morphology. Discrepancies in the literature remain for maximal strength normalised to muscle mass (muscle quality) and can potentially be explained through accounting for the measurement protocol contributing to muscle strength capacity that need to be explored in more depth such as antagonist muscle co-activation, muscle architecture, a criterion valid measurement of muscle size and an accurate measurement of physical activity levels. Current evidence demonstrating the effect of obesity on muscle quality is limited. These factors not being recorded in some of the existing literature suggest a potential underestimation of muscle force either in terms of absolute force production or relative to muscle mass; thus the true effect of obesity upon skeletal muscle size, structure and function, including any interactions with ageing effects, remains to be elucidated.

  7. Muscle Strength and Speed Performance in Youth Soccer Players

    PubMed Central

    Peñailillo, Luis; Espíldora, Francisco; Jannas-Vela, Sebastián; Mujika, Iñigo

    2016-01-01

    Abstract This study aimed to examine the relationship between maximum leg extension strength and sprinting performance in youth elite male soccer players. Sixty-three youth players (12.5 ± 1.3 years) performed 5 m, flying 15 m and 20 m sprint tests and a zigzag agility test on a grass field using timing gates. Two days later, subjects performed a one-repetition maximum leg extension test (79.3 ± 26.9 kg). Weak to strong correlations were found between leg extension strength and the time to perform 5 m (r = -0.39, p = 0.001), flying 15 m (r = -0.72, p < 0.001) and 20 m (r = -0.67, p < 0.001) sprints; between body mass and 5 m (r = -0.43, p < 0.001), flying 15 m (r = -0.75, p < 0.001), 20 m (r = -0.65, p < 0.001) sprints and agility (r =-0.29, p < 0.001); and between height and 5 m (r = -0.33, p < 0.01) and flying 15 m (r = -0.74, p < 0.001) sprints. Our results show that leg muscle strength and anthropometric variables strongly correlate with sprinting ability. This suggests that anthropometric characteristics should be considered to compare among youth players, and that youth players should undergo strength training to improve running speed. PMID:28149358

  8. Muscle Strength and Speed Performance in Youth Soccer Players.

    PubMed

    Peñailillo, Luis; Espíldora, Francisco; Jannas-Vela, Sebastián; Mujika, Iñigo; Zbinden-Foncea, Hermann

    2016-04-01

    This study aimed to examine the relationship between maximum leg extension strength and sprinting performance in youth elite male soccer players. Sixty-three youth players (12.5 ± 1.3 years) performed 5 m, flying 15 m and 20 m sprint tests and a zigzag agility test on a grass field using timing gates. Two days later, subjects performed a one-repetition maximum leg extension test (79.3 ± 26.9 kg). Weak to strong correlations were found between leg extension strength and the time to perform 5 m (r = -0.39, p = 0.001), flying 15 m (r = -0.72, p < 0.001) and 20 m (r = -0.67, p < 0.001) sprints; between body mass and 5 m (r = -0.43, p < 0.001), flying 15 m (r = -0.75, p < 0.001), 20 m (r = -0.65, p < 0.001) sprints and agility (r =-0.29, p < 0.001); and between height and 5 m (r = -0.33, p < 0.01) and flying 15 m (r = -0.74, p < 0.001) sprints. Our results show that leg muscle strength and anthropometric variables strongly correlate with sprinting ability. This suggests that anthropometric characteristics should be considered to compare among youth players, and that youth players should undergo strength training to improve running speed.

  9. Force steadiness, muscle activity, and maximal muscle strength in subjects with subacromial impingement syndrome.

    PubMed

    Bandholm, Thomas; Rasmussen, Lars; Aagaard, Per; Jensen, Bente Rona; Diederichsen, Louise

    2006-11-01

    We investigated the effects of the subacromial impingement syndrome (SIS) on shoulder sensory-motor control and maximal shoulder muscle strength. It was hypothesized that both would be impaired due to chronic shoulder pain associated with the syndrome. Nine subjects with unilateral SIS who remained physically active in spite of shoulder pain and nine healthy matched controls were examined to determine isometric and isokinetic submaximal shoulder-abduction force steadiness at target forces corresponding to 20%, 27.5%, and 35% of the maximal shoulder abductor torque, and maximal shoulder muscle strength (MVC). Electromyographic (EMG) activity was assessed using surface and intramuscular recordings from eight shoulder muscles. Force steadiness was impaired in SIS subjects during concentric contractions at the highest target force level only, with muscle activity largely unaffected. No between-group differences in shoulder MVC were observed. The present data suggest that shoulder sensory-motor control is only mildly impaired in subjects with SIS who are able to continue with upper body physical activity in spite of shoulder pain. Thus, physical activity should be continued by patients with SIS, if possible, to avoid the loss in neural and muscle functions associated with inactivity.

  10. Reproducibility of Muscle Strength Testing for Children with Spina Bifida.

    PubMed

    Tan, Jia Ling; Thomas, Nicole Maree; Johnston, Leanne Marie

    2017-11-01

    Examine the inter-rater reliability of the Daniels and Worthingham (D&W) manual muscle test (MMT) protocol for children with spina bifida between experienced and novice physiotherapists. Thirteen children with spina bifida (two males) aged 6 to 18 years were recruited from a spina bifida service in a state-wide tertiary children's hospital. Each child had the muscle strength of 19, and lower limb muscles were measured bilaterally by one experienced and one novice physiotherapist using the D&W MMT protocol. Examiner and limb order were counterbalanced. Standard training and recording sheets were used. Agreement between raters was examined with quadratic weighted kappa (κw2), percentage exact agreement (%EA), and the Bland-Altmann Limits of Agreement (LoA). Minimal detectable change (MDC) was calculated. Inter-rater agreement between the experienced and novice raters was excellent (κw2 = 0.95; 95% confidence interval: 0.94-0.96); %EA was good (72.3%); and clinically appropriate LoA levels were -1.30-1.40. The MDC was 1.11 points on a six-point MMT scale. The D&W MMT protocol, when used after standard training and with standard recording sheets, was reproducible for children with spina bifida, aged 6-18 years.

  11. Respiratory muscle strength effect on linear and nonlinear heart rate variability parameters in COPD patients.

    PubMed

    Goulart, Cássia Da Luz; Simon, Julio Cristiano; Schneiders, Paloma De Borba; San Martin, Elisabete Antunes; Cabiddu, Ramona; Borghi-Silva, Audrey; Trimer, Renata; da Silva, Andréa Lúcia Gonçalves

    2016-01-01

    Chronic obstructive pulmonary disease (COPD) is recognized as a multisystemic inflammatory disease associated with extrapulmonary comorbidities, including respiratory muscle weakness and cardiovascular and cardiac autonomic regulation disorders. We investigated whether alterations in respiratory muscle strength (RMS) would affect cardiac autonomic modulation in COPD patients. This study was a cross-sectional study done in ten COPD patients affected by moderate to very severe disease. The heart rate variability (HRV) signal was recorded using a Polar cardiofrequencimeter at rest in the sitting position (10 minutes) and during a respiratory sinus arrhythmia maneuver (RSA-M; 4 minutes). Linear analysis in the time and frequency domains and nonlinear analysis were performed on the recorded signals. RMS was assessed using a digital manometer, which provided the maximum inspiratory pressure (PImax) and the maximum expiratory pressure (PEmax). During the RSA-M, patients presented an HRV power increase in the low-frequency band (LFnu) (46.9±23.7 vs 75.8±27.2; P=0.01) and a decrease in the high-frequency band (HFnu) (52.8±23.5 vs 24.0±27.0; P=0.01) when compared to the resting condition. Significant associations were found between RMS and HRV spectral indices: PImax and LFnu (r=-0.74; P=0.01); PImax and HFnu (r=0.74; P=0.01); PEmax and LFnu (r=-0.66; P=0.01); PEmax and HFnu (r=0.66; P=0.03); between PEmax and sample entropy (r=0.83; P<0.01) and between PEmax and approximate entropy (r=0.74; P=0.01). Using a linear regression model, we found that PImax explained 44% of LFnu behavior during the RSA-M. COPD patients with impaired RMS presented altered cardiac autonomic control, characterized by marked sympathetic modulation and a reduced parasympathetic response; reduced HRV complexity was observed during the RSA-M.

  12. Respiratory muscle strength effect on linear and nonlinear heart rate variability parameters in COPD patients

    PubMed Central

    Goulart, Cássia Da Luz; Simon, Julio Cristiano; Schneiders, Paloma De Borba; San Martin, Elisabete Antunes; Cabiddu, Ramona; Borghi-Silva, Audrey; Trimer, Renata; da Silva, Andréa Lúcia Gonçalves

    2016-01-01

    Introduction Chronic obstructive pulmonary disease (COPD) is recognized as a multisystemic inflammatory disease associated with extrapulmonary comorbidities, including respiratory muscle weakness and cardiovascular and cardiac autonomic regulation disorders. We investigated whether alterations in respiratory muscle strength (RMS) would affect cardiac autonomic modulation in COPD patients. Methods This study was a cross-sectional study done in ten COPD patients affected by moderate to very severe disease. The heart rate variability (HRV) signal was recorded using a Polar cardiofrequencimeter at rest in the sitting position (10 minutes) and during a respiratory sinus arrhythmia maneuver (RSA-M; 4 minutes). Linear analysis in the time and frequency domains and nonlinear analysis were performed on the recorded signals. RMS was assessed using a digital manometer, which provided the maximum inspiratory pressure (PImax) and the maximum expiratory pressure (PEmax). Results During the RSA-M, patients presented an HRV power increase in the low-frequency band (LFnu) (46.9±23.7 vs 75.8±27.2; P=0.01) and a decrease in the high-frequency band (HFnu) (52.8±23.5 vs 24.0±27.0; P=0.01) when compared to the resting condition. Significant associations were found between RMS and HRV spectral indices: PImax and LFnu (r=−0.74; P=0.01); PImax and HFnu (r=0.74; P=0.01); PEmax and LFnu (r=−0.66; P=0.01); PEmax and HFnu (r=0.66; P=0.03); between PEmax and sample entropy (r=0.83; P<0.01) and between PEmax and approximate entropy (r=0.74; P=0.01). Using a linear regression model, we found that PImax explained 44% of LFnu behavior during the RSA-M. Conclusion COPD patients with impaired RMS presented altered cardiac autonomic control, characterized by marked sympathetic modulation and a reduced parasympathetic response; reduced HRV complexity was observed during the RSA-M. PMID:27555757

  13. Diaphragmatic mobility: relationship with lung function, respiratory muscle strength, dyspnea, and physical activity in daily life in patients with COPD.

    PubMed

    Rocha, Flávia Roberta; Brüggemann, Ana Karla Vieira; Francisco, Davi de Souza; Medeiros, Caroline Semprebom de; Rosal, Danielle; Paulin, Elaine

    2017-01-01

    To evaluate diaphragmatic mobility in relation to lung function, respiratory muscle strength, dyspnea, and physical activity in daily life (PADL) in patients with COPD. We included 25 patients with COPD, classified according to the Global Initiative for Chronic Obstructive Lung Disease criteria, and 25 healthy individuals. For all of the participants, the following were evaluated: anthropometric variables, spirometric parameters, respiratory muscle strength, diaphragmatic mobility (by X-ray), PADL, and the perception of dyspnea. In the COPD group, diaphragmatic mobility was found to correlate with lung function variables, inspiratory muscle strength, and the perception of dyspnea, whereas it did not correlate with expiratory muscle strength or PADL. In patients with COPD, diaphragmatic mobility seems to be associated with airway obstruction and lung hyperinflation, as well as with ventilatory capacity and the perception of dyspnea, although not with PADL. Avaliar a relação da mobilidade diafragmática com a função pulmonar, força muscular respiratória, dispneia e atividade física de vida diária (AFVD) em pacientes com DPOC. Foram avaliados 25 pacientes com diagnóstico de DPOC, classificados de acordo com critérios da Global Initiative for Chronic Obstructive Lung Disease, e 25 indivíduos saudáveis. Todos foram submetidos às seguintes avaliações: mensuração antropométrica, espirometria, força muscular respiratória, mobilidade diafragmática (por radiografia), AFVD e percepção de dispneia. No grupo DPOC, houve correlações da mobilidade diafragmática com variáveis de função pulmonar, força muscular inspiratória e percepção de dispneia. Não houve correlações da mobilidade diafragmática com força muscular expiratória e AFVD. A mobilidade diafragmática parece estar associada tanto com a obstrução das vias aéreas quanto com a hiperinsuflação pulmonar em pacientes com DPOC, assim como com a capacidade ventilatória e percep

  14. Effects of strength training, detraining and retraining in muscle strength, hypertrophy and functional tasks in older female adults.

    PubMed

    Correa, Cleiton S; Cunha, Giovani; Marques, Nise; Oliveira-Reischak, Ãlvaro; Pinto, Ronei

    2016-07-01

    Previous studies presented different results regarding the maintenance time of muscular adaptations after strength training and the ability to resume the gains on muscular performance after resumption of the training programme. This study aimed to verify the effect of strength training on knee extensors and elbow flexor muscle strength, rectus femoris muscle volume and functional performance in older female adults after 12 weeks of strength training, 1 year of detraining and followed by 12 weeks of retraining. Twelve sedentary older women performed 12 weeks of strength training, 1 year of detraining and 12 weeks of retraining. The strength training was performed twice a week, and the assessment was made four times: at the baseline, after the strength training, after the detraining and after the retraining. The knee extensor and elbow flexor strength, rectus femoris muscle volume and functional task were assessed. Strength of knee extensor and elbow flexor muscles, rectus femoris muscle volume and 30-s sit-to-stand increased from baseline to post-training (respectively, 40%, 70%, 38% and 46%), decreased after detraining (respectively, -36%, -64%, -35% and -43%) and increased again these parameters after retraining (35%, 68%, 36% and 42%). Strength training induces gains on strength and hypertrophy, also increased the performance on functional tasks after the strength training. The stoppage of the strength caused strength loss and reduction of functional performance. The resumption of the strength training promoted the same gains of muscular performance in older female adults. © 2015 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

  15. Inspiratory high frequency airway oscillation attenuates resistive loaded dyspnea and modulates respiratory function in young healthy individuals.

    PubMed

    Morris, Theresa; Sumners, David Paul; Green, David Andrew

    2014-01-01

    Direct chest-wall percussion can reduce breathlessness in Chronic Obstructive Pulmonary Disease and respiratory function may be improved, in health and disease, by respiratory muscle training (RMT). We tested whether high-frequency airway oscillation (HFAO), a novel form of airflow oscillation generation can modulate induced dyspnoea and respiratory strength and/or patterns following 5 weeks of HFAO training (n = 20) compared to a SHAM-RMT (conventional flow-resistive RMT) device (n = 15) in healthy volunteers (13 males; aged 20-36 yrs). HFAO causes oscillations with peak-to-peak amplitude of 1 cm H2O, whereas the SHAM-RMT device was identical but created no pressure oscillation. Respiratory function, dyspnoea and ventilation during 3 minutes of spontaneous resting ventilation, 1 minute of maximal voluntary hyperventilation and 1 minute breathing against a moderate inspiratory resistance, were compared PRE and POST 5-weeks of training (2 × 30 breaths at 70% peak flow, 5 days a week). Training significantly reduced NRS dyspnoea scores during resistive loaded ventilation, both in the HFAO (p = 0.003) and SHAM-RMT (p = 0.005) groups. Maximum inspiratory static pressure (cm H2O) was significantly increased by HFAO training (vs. PRE; p<0.001). Maximum inspiratory dynamic pressure was increased by training in both the HFAO (vs. PRE; p<0.001) and SHAM-RMT (vs. PRE; p = 0.021) groups. Peak inspiratory flow rate (L.s(-1)) achieved during the maximum inspiratory dynamic pressure manoeuvre increased significantly POST (vs. PRE; p = 0.001) in the HFAO group only. HFAO reduced inspiratory resistive loading-induced dyspnoea and augments static and dynamic maximal respiratory manoeuvre performance in excess of flow-resistive IMT (SHAM-RMT) in healthy individuals without the respiratory discomfort associated with RMT.

  16. A method for comparing manual muscle strength measurements with joint moments during walking.

    PubMed

    Fosang, Adrienne; Baker, Richard

    2006-12-01

    This paper describes a protocol for dynamometer assisted manual muscle testing of the major muscle groups of the lower extremity and its application to 11 able-bodied children who also had conventional gait analysis to obtain joint kinetics. Data from the manual muscle testing was processed in such a way that the results for maximum muscle strength (grade 5) and resistance against gravity alone (grade 3) were presented in Nm/kg allowing direct comparison with conventional joint kinetics. The strength measurements of the hip muscles and the knee extensors were between two and three times the moments exerted during normal walking. Those of the knee flexors and dorsiflexors were about five times the joint moments. Measured plantarflexor strength was only just greater than the moment exerted during walking. These results, particularly those for the plantarflexors, question how valid it is to use measures of isometric muscle strength as indicators of muscle function during activity. The study also compares grade 3 muscle strength with both grade 5 strength and the maximum joint moments. For all muscle groups tested grade 3 muscle strength was less than the maximum moment exerted during normal walking. For the plantarflexors it was less than 1% of that moment. The study demonstrates that reliable isometric muscle testing is possible in able-bodied children but requires considerable care and is time consuming. More work is required to understand how measurements made in this way relate to how muscles function during activity.

  17. Inspiratory muscular activation during threshold therapy in elderly healthy and patients with COPD.

    PubMed

    de Andrade, A Dornelas; Silva, T N S; Vasconcelos, H; Marcelino, M; Rodrigues-Machado, M G; Filho, V C Galindo; Moraes, N H; Marinho, P E M; Amorim, C F

    2005-12-01

    Inspiratory muscles training in COPD is controversial not only in relation to the load level required to produce muscular conditioning effects but also in relation to the group of patients benefiting from the training. Consequently, inspiratory muscular response assessment during Threshold therapy may help optimizing training strategy. The objective of this study was to evaluate the participation of the diaphragm and the sternocleidomastoid (SMM) muscle to overcome with a 30% Threshold load using surface electromyography (sEMG) and to analyze the correlation between SMM activation, maximum strength level of inspiratory muscles (MIP) and obstruction degree in COPD patients (FEV1). We studied seven healthy elderly subjects, mean age of 68+/-4 years and seven COPD patients, FEV1 45+/-17% of the predicted value, with mean age 66+/-8 years. sEMG analysis of SMM muscles and diaphragm were obtained through RMS (root-mean-square) during three stages: pre-loading, loading and post-loading. In the COPD group, the RMS of the SMM increased 28% during load (p<0.05) while the RMS of the diaphragm remained constant. In the elderly there was a trend of a 11% increase in diaphragm activity and of 7% in SMM activity but, without reaching significance levels. SMM activity demonstrated good correlation with the obstruction level (r=-0.537). To overcome the load required by Threshold therapy, COPD patients demonstrated an increase of accessory muscles activity, represented by SMM. For the same relative load this increase seems to be proportional to the degree of pulmonary obstruction.

  18. Change in muscle strength and muscle mass in older hospitalized patients: A systematic review and meta-analysis.

    PubMed

    Van Ancum, Jeanine M; Scheerman, Kira; Jonkman, Nini H; Smeenk, Hanne E; Kruizinga, Roeliene C; Meskers, Carel G M; Maier, Andrea B

    2017-06-01

    Hospitalization may induce a decrease of muscle strength and muscle mass in older patients due to physical inactivity, malnutrition and diseases, negatively affecting health outcome. We aimed to examine the literature on change in muscle strength and muscle mass in older patients during hospitalization. A literature search was performed in major electronic databases from inception to March 2016. Studies including hospitalized patients with a mean age≥65years, describing change of hand grip strength and/or muscle mass were found eligible. Extracted data were divided in hand grip strength or muscle mass and stratified by elective or acute admission. Meta-analysis was conducted using Comprehensive Meta-analysis. Twenty-five studies were included, describing a total of 1789 patients with a mean age range of 65 to 85.8years and an overall median length of stay of 14.7days. Pooled hand grip strength and muscle mass were found to significantly decrease in electively admitted older patients during hospitalization (standardized mean difference (95% confidence interval): -0.42 (-0.66, -0.17) and -0.44 (-0.61, -0.27)), but not in acutely admitted older patients (standardized mean difference (95% confidence interval): 0.18 (-0.02, 0.37) and -0.25 (-0.58, 0.09)). In conclusion, decrease in muscle strength and muscle mass in older patients is dependent on the type of admission. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. A NEW CLINICAL MUSCLE FUNCTION TEST FOR ASSESSMENT OF HIP EXTERNAL ROTATION STRENGTH: AUGUSTSSON STRENGTH TEST

    PubMed Central

    2016-01-01

    ABSTRACT Introduction Dynamic clinical tests of hip strength applicable on patients, non–athletes and athletes alike, are lacking. The aim of this study was therefore to develop and evaluate the reliability of a dynamic muscle function test of hip external rotation strength, using a novel device. A second aim was to determine if gender differences exist in absolute and relative hip strength using the new test. Methods Fifty–three healthy sport science students (34 women and 19 men) were tested for hip external rotation strength using a device that consisted of a strap connected in series with an elastic resistance band loop, and a measuring tape connected in parallel with the elastic resistance band. The test was carried out with the subject side lying, positioned in 45 ° of hip flexion and the knees flexed to 90 ° with the device firmly fastened proximally across the knees. The subject then exerted maximal concentric hip external rotation force against the device thereby extending the elastic resistance band. The displacement achieved by the subject was documented by the tape measure and the corresponding force production was calculated. Both right and left hip strength was measured. Fifteen of the subjects were tested on repeated occasions to evaluate test–retest reliability. Results No significant test–retest differences were observed. Intra–class correlation coefficients ranged 0.93–0.94 and coefficients of variation 2.76–4.60%. In absolute values, men were significantly stronger in hip external rotation than women (right side 13.2 vs 11.0 kg, p = 0.001, left side 13.2 vs 11.5 kg, p = 0.002). There were no significant differences in hip external rotation strength normalized for body weight (BW) between men and women (right side 0.17 kg/BW vs 0.17 kg/BW, p = 0.675, left side 0.17 kg/BW vs 0.18 kg/BW, p = 0.156). Conclusions The new muscle function test showed high reliability and thus could be useful for measuring dynamic hip

  20. Combining strength training and botulinum neurotoxin intervention in children with cerebral palsy: the impact on muscle morphology and strength.

    PubMed

    Williams, Sîan A; Elliott, Catherine; Valentine, Jane; Gubbay, Anna; Shipman, Peter; Reid, Siobhan

    2013-04-01

    Investigate the combination effects of strength training and Botulinum Toxin Type-A (BoNT-A) on muscle strength and morphology in children with Cerebral Palsy (CP). Fifteen children receiving BoNT-A, classified as Spastic Diplegic CP, GMFCS I-II, and aged 5-12 years were recruited for this study. Randomly allocated to 10 weeks of strength training either before or after BoNT-A, children were assessed over 6 months. Eight of the 15 children also completed a control period. The Modified Ashworth Scale measured spasticity. The Goal Attainment Scale (GAS) assessed achievement of functional goals. Magnetic Resonance Imaging assessed muscle volume (MV). Instrumented dynamometry assessed strength. Spasticity was significantly reduced following BoNT-A injection (p = 0.033). Children made significant isokinetic strength gains (mean p = 0.022, ES = 0.57) in the intervention period compared to the control period (mean p = 0.15, ES = 0.56). Irrespective of timing, significant strength improvements were seen immediately (10 weeks) and over 6 months for all children. This was also the case for improvements in the GAS (immediately: mean p = 0.007, ES = 4.17, 6 months: mean p = 0.029, ES = 0.99), and improvements in MV in all assessed muscles. The simultaneous use of BoNT-A and strength training was successful in spasticity reduction, improving strength and achieving functional goals, over and above treatment with BoNT-A alone. Muscles targeted for BoNT-A injection should be included in strength training. Cerebral Palsy• Botulinum toxin type-A (BoNT-A) and strength training are available interventions that, on their own have found success in managing spasticity and muscle weakness (both significant motor impairments), respectively in children with Cerebral Palsy (CP). • This study has demonstrated that the concurrent treatment of BoNT-A and strength training can achieve positive outcomes in terms of strength, spasticity and for the achievement of set functional goals. • The

  1. Manual muscle testing: a method of measuring extremity muscle strength applied to critically ill patients.

    PubMed

    Ciesla, Nancy; Dinglas, Victor; Fan, Eddy; Kho, Michelle; Kuramoto, Jill; Needham, Dale

    2011-04-12

    Survivors of acute respiratory distress syndrome (ARDS) and other causes of critical illness often have generalized weakness, reduced exercise tolerance, and persistent nerve and muscle impairments after hospital discharge. Using an explicit protocol with a structured approach to training and quality assurance of research staff, manual muscle testing (MMT) is a highly reliable method for assessing strength, using a standardized clinical examination, for patients following ARDS, and can be completed with mechanically ventilated patients who can tolerate sitting upright in bed and are able to follow two-step commands. (7, 8) This video demonstrates a protocol for MMT, which has been taught to ≥ 43 research staff who have performed >800 assessments on >280 ARDS survivors. Modifications for the bedridden patient are included. Each muscle is tested with specific techniques for positioning, stabilization, resistance, and palpation for each score of the 6-point ordinal Medical Research Council scale. Three upper and three lower extremity muscles are graded in this protocol: shoulder abduction, elbow flexion, wrist extension, hip flexion, knee extension, and ankle dorsiflexion. These muscles were chosen based on the standard approach for evaluating patients for ICU-acquired weakness used in prior publications. (1,2).

  2. Isokinetic strength and endurance in proximal and distal muscles in patients with peripheral artery disease.

    PubMed

    Câmara, Lucas Caseri; Ritti-Dias, Raphael Mendes; Menêses, Annelise Lins; D'Andréa Greve, Júlia Maria; Filho, Wilson Jacob; Santarém, José Maria; Forjaz, Cláudia Lúcia de Moraes; Puech-Leão, Pedro; Wolosker, Nelson

    2012-11-01

    The objective of this study was to analyze the muscle strength and endurance of the proximal and distal lower-extremity muscles in peripheral artery disease (PAD) patients. Twenty patients with bilateral PAD with symptoms of intermittent claudication and nine control subjects without PAD were included in the study, comprising 40 and 18 legs, respectively. All subjects performed an isokinetic muscle test to evaluate the muscle strength and endurance of the proximal (knee extension and knee flexion movements) and distal (plantar flexion and dorsiflexion movements) muscle groups in the lower extremity. Compared with the control group, the PAD group presented lower muscle strength in knee flexion (-14.0%), dorsiflexion (-26.0%), and plantar flexion (-21.2%) movements (P < 0.05) but similar strength in knee extension movements (P > 0.05). The PAD patients presented a 13.5% lower knee flexion/extension strength ratio compared with the control subjects (P < 0.05), as well as lower muscle endurance in dorsiflexion (-28.1%) and plantar flexion (-17.0%) movements (P < 0.05). The muscle endurance in knee flexion and knee extension movements was similar between PAD patients and the control subjects (P > 0.05). PAD patients present lower proximal and distal muscle strength and lower distal muscle endurance than control patients. Therefore, interventions to improve muscle strength and endurance should be prescribed for PAD patients. Copyright © 2012 Annals of Vascular Surgery Inc. Published by Elsevier Inc. All rights reserved.

  3. Reflex inhibition of canine inspiratory intercostals by diaphragmatic tension receptors

    PubMed Central

    De Troyer, André; Brunko, Eric; Leduc, Dimitri; Jammes, Yves

    1999-01-01

    Electrical stimulation of phrenic afferent fibres in the dog elicits a reflex inhibition of efferent activity to the inspiratory intercostal muscles. However, electrical stimulation has a poor selectivity, so the sensory receptors responsible for this inhibition were not identified.In the present studies, cranial forces were applied during spontaneous inspiration to the abdominal surface of the central, tendinous portion of the canine diaphragm to activate tension mechanoreceptors in the muscle. Vagal afferent inputs were eliminated by vagotomy.The application of force to the central tendon caused a graded, reflex reduction in inspiratory intercostal activity, especially in external intercostal activity. This reduction was commonly associated with a decrease in inspiratory duration and was invariably attenuated after section of the cervical dorsal roots.In contrast, no change in inspiratory intercostal activity was seen when high frequency mechanical vibration was applied to the central tendon to stimulate diaphragmatic muscle spindles.These observations provide strong evidence that tension receptors in the diaphragm, but not muscle spindles, induce reflex inhibition of inspiratory intercostal activity. The expression of this reflex probably involves supraspinal structures. PMID:9831731

  4. Functional outcomes associated with expiratory muscle strength training: narrative review.

    PubMed

    Laciuga, Helena; Rosenbek, John C; Davenport, Paul W; Sapienza, Christine M

    2014-01-01

    This review presents the available evidence for the effects of expiratory muscle strength training (EMST) with the use of a pressure threshold device. The investigators used computerized database searches for studies reporting the outcomes of pressure threshold EMST published after 1994. A total of 24 selected articles presented outcomes related but not limited to respiratory function, such as speech, swallow, voice, and cough function in persons with neurologic conditions such as Parkinson disease, multiple sclerosis, and Lance-Adams syndrome; in persons with respiratory diseases, such as chronic obstructive pulmonary disease; and in healthy young adults and sedentary and active elderly. Several studies demonstrated promising outcomes of EMST as a non-task-specific training for airway protection in persons with dysphagia secondary to neuromuscular impairments; however, further research is needed to confirm and generalize the reported findings.

  5. Selective strength loss and decreased muscle activity in hamstring injury.

    PubMed

    Sole, Gisela; Milosavljevic, Stephan; Nicholson, Helen D; Sullivan, S John

    2011-05-01

    Cross-sectional, controlled laboratory study. To determine whether thigh muscle isokinetic torque patterns and activity, measured by electromyography (EMG), of individuals with hamstring injury differ from control individuals. Neuromuscular control during thigh muscle strength assessment following hamstring injuries has not been reported. Fifteen athletes with prior hamstring injury (hamstring-injured group [HG]) were compared to 15 uninjured athletes (control group [CG]). The injuries were incurred 6 weeks to 12 months prior to participation, and all injured athletes had returned to at least partial training. Participants performed 5 isokinetic concentric extensor, concentric flexor, and eccentric flexor torque tests at 60°/s in the seated position. Peak torque was determined for each contraction type, as well as average torque for each of 4 time-based movement quartiles. EMG root-mean-squares were calculated in these movement quartiles for the biceps femoris and medial hamstrings. No significant differences were found for peak torque for all contractions, when comparing HG injured and uninjured sides to CG bilateral averages. The HG injured limb eccentric flexor torque was significantly lower in the fourth quartile (approximately 25° to 5° knee flexion, hamstring lengthened range) compared to the CG bilateral average (P = .025). Eccentric flexor biceps femoris and hamstrings EMG root-mean-squares of the HG injured and the uninjured sides were significantly lower in the second to fourth quartiles (towards the lengthened range), compared to the CG bilateral averages (P<.05). Decreased strength and EMG activation in a lengthened hamstrings range for the athletes with prior hamstring injury suggested a change in neuromuscular control. Lengthened range assessment of isokinetic eccentric flexor torque may be useful for the assessment of athletes with a prior injury; however, results should be confirmed with prospective studies.

  6. Characteristics of locomotion, muscle strength, and muscle tissue in regenerating rat skeletal muscles.

    PubMed

    Iwata, Akira; Fuchioka, Satoshi; Hiraoka, Koichi; Masuhara, Mitsuhiko; Kami, Katsuya

    2010-05-01

    Although numerous studies have aimed to elucidate the mechanisms used to repair the structure and function of injured skeletal muscles, it remains unclear how and when movement recovers following damage. We performed a temporal analysis to characterize the changes in movement, muscle function, and muscle structure after muscle injury induced by the drop-mass technique. At each time-point, movement recovery was determined by ankle kinematic analysis of locomotion, and functional recovery was represented by isometric force. As a histological analysis, the cross-sectional area of myotubes was measured to examine structural regeneration. The dorsiflexion angle of the ankle, as assessed by kinematic analysis of locomotion, increased after injury and then returned to control levels by day 14 post-injury. The isometric force returned to normal levels by day 21 post-injury. However, the size of the myotubes did not reach normal levels, even at day 21 post-injury. These results indicate that recovery of locomotion occurs prior to recovery of isometric force and that functional recovery occurs earlier than structural regeneration. Thus, it is suggested that recovery of the movement and function of injured skeletal muscles might be insufficient as markers for estimating the degree of neuromuscular system reconstitution.

  7. Impact of exacerbations of cystic fibrosis on muscle strength

    PubMed Central

    2013-01-01

    Background Adult patients with cystic fibrosis have peripheral muscle weakness, which is related to exercise intolerance and poor prognosis. The influence of acute exacerbations on muscle strength has been poorly studied. This study aimed to investigate whether quadriceps force (QF), as assessed with an involuntary technique, changes during intravenous antibiotics therapy (IVAT) for an exacerbation. Methods QF was measured in 20 patients using twitch stimulation of the femoral nerve at the day of hospitalization (day 1) and at termination (day 14) of the IVAT. Physical activity was monitored during IVAT using a SenseWear armband. Ten stable patients served as control subjects. Results QF did not change during exacerbation (potentiated twitch force at day 1: 140 ± 42 N, at day 14: 140 ± 47 N), but a decrease was observed in individual patients. Changes in twitch force during exacerbation were correlated with time spent in activities of at least moderate intensity (r = 0.61, p = 0.007). Conclusions QF does not systematically decrease during exacerbations of cystic fibrosis. Individual changes in QF are well correlated with daily time spent in activities of at least moderate intensity. PMID:23601143

  8. Muscle strength after anterior shoulder stabilization: arthroscopic versus open Bankart repair.

    PubMed

    Rhee, Yong Girl; Lim, Chan Teak; Cho, Nam Su

    2007-11-01

    A number of reports have been made on the muscle strength at the last follow-up after arthroscopic or open Bankart repairs. Few have analyzed the change over time in muscle strength and compared the changes between different operative methods. Muscle strength recovers faster after arthroscopic Bankart repair than after open Bankart repair, and the final muscle strength is not different between the 2 procedures. Cohort study; Level of evidence, 2. Sixty patients with anterior shoulder instability and an isolated Bankart lesion were enrolled for this study. Thirty patients underwent open Bankart repair (open group), and 30 patients went through arthroscopic Bankart repair (arthroscopic group). The open group demonstrated markedly weaker muscle strength during forward elevation than did the arthroscopic group up to 3 months after surgery, but the difference narrowed to about 5% at 6 months (P = .074). At 6 months after surgery, the muscle strength of the open group measured 85.8% +/- 11.5% in forward elevation, 89.5% +/- 10.3% in external rotation, and 89.3% +/- 13.3% in internal rotation. The corresponding figures of the arthroscopic group were 90.6% +/- 8.6%, 92.1% +/- 9.1%, and 92.1% +/- 11.7%. As for external and internal rotations, the open group demonstrated markedly weaker muscle strength 6 weeks after surgery, but the differences were reduced to about 6% and 4%, respectively, at 3 months (P = .092 and .163, respectively). There was no statistically significant difference in final muscle strength 12 months after the operation between the 2 groups (P = .503, .468, and .659, respectively). Muscle strength recovered faster with an arthroscopic procedure than with an open procedure during the early postoperative periods, and strength was restored to the level of the unaffected side at 6 months postoperatively. In the group with open Bankart repairs, the muscle strength during forward elevation recovered slower than did external and internal rotation muscle

  9. Strength training for the intrinsic flexor muscles of the foot: effects on muscle strength, the foot arch, and dynamic parameters before and after the training.

    PubMed

    Hashimoto, Takayuki; Sakuraba, Keishoku

    2014-03-01

    [Purpose] The purpose of the present study was to verify the effects of intrinsic foot flexor strength training. [Subjects] The subjects were 12 healthy males without motor system disease. [Methods] A training method that involved flexion of all toe interphalangeal and metatarsophalangeal joints against a 3-kg load was implemented and was performed for 200 repetitions once per day, three times per week, for a period of eight weeks. [Results] Significant changes were observed for intrinsic foot flexor strength scores, foot arches, vertical jumping, 1-legged long jumping, and 50-m dash time. [Conclusion] This muscle strength training method significantly improved muscle strength scores, foot arch shape, and movement performance.

  10. Evaluation of Respiratory Muscle Strength and Pulmonary Function in Patients with Charcot-Marie-Tooth Disease Type 2.

    PubMed

    Garcez, Catarina Andrade; Neves, Eduardo Luis Aquino; Melo, Saulo Maia D''avila; Nunes, Paula Santos; Barreto, Lidiane Carine Lima; Costa, Iandra Maria Pinheiro; Souza, Cynthia Coelho; Rezende, Rejane Lenier; Araújo, Adriano Antunes de Souza

    2015-01-01

    The aim of this study was to evaluate the pulmonary condition in a large family with Charcot-Marie-Tooth disease type 2 (CMT2). Eighteen participants diagnosed with CMT2 and 20 healthy individuals were evaluated by spirometry and maximal expiratory and maximal inspiratory pressures (MEP and MIP, respectively). Clinical disability was measured with CMT neuropathy score (CMTNS; range 0-36). One control group (CG) comprising 20 individuals, matched for age, sex and body mass index, were used for comparison. Eight patients were female (44.5%) and 10 patients were male (55.5%); mean age was 31.8 years (range 11-79) and CMTNS range was 6-26. Differences between CMT2 and CG in the spirometry and respiratory muscle strength were statistically significant for all dimensions. There were significant correlations between CMTNS and MIP (Pearson = -0.581) and MEP (Pearson = -0.5090). The results of this study show that patients with CMT, in spite of not showing clinical signs of advanced respiratory impairment, may present subclinical respiratory changes. The respiratory comprise in the CMT disease can be silent and insidious without presenting characteristic clinical signals.

  11. Effects of Growth Hormone Administration on Muscle Strength in Men over 50 Years Old

    PubMed Central

    Tavares, A. B. W.; Micmacher, E.; Biesek, S.; Assumpção, R.; Redorat, R.; Veloso, U.; Vaisman, M.; Farinatti, P. T. V.; Conceição, F.

    2013-01-01

    Growth hormone (GH) use has been speculated to improve physical capacity in subjects without GH deficiency (GHD) through stimulation of collagen synthesis in the tendon and skeletal muscle, which leads to better exercise training and increased muscle strength. In this context, the use of GH in healthy elderly should be an option for increasing muscle strength. Our aim was to evaluate the effect of GH therapy on muscle strength in healthy men over 50 years old. Fourteen healthy men aged 50–70 years were evaluated at baseline for body composition and muscle strength (evaluated by leg press and bench press exercises, which focus primarily on quadriceps—lower body part and pectoralis major—upper body part—muscles, resp.). Subjects were randomised into 2 groups: GH therapy (7 subjects) and placebo (7 subjects) and reevaluated after 6 months of therapy. Thirteen subjects completed the study (6 subjects in the placebo group and 7 subjects in the GH group). Subjects of both groups were not different at baseline. After 6 months of therapy, muscle strength in the bench press responsive muscles did not increase in both groups and showed a statistically significant increase in the leg press responsive muscles in the GH group. Our study demonstrated an increase in muscle strength in the lower body part after GH therapy in healthy men. This finding must be considered and tested in frail older populations, whose physical incapacity is primarily caused by proximal muscle weakness. The trial was registered with NCT01853566. PMID:24382963

  12. Deviation in the recovery of the lower limb and respiratory muscles of patients with polymyositis: a preliminary clinical study

    PubMed Central

    Nishikawa, Yuichi; Hosomi, Naohisa; Ueno, Hiroki; Kurashige, Takashi; Ochi, Kazuhide; Takahashi, Tetsuya; Orita, Naoya; Ueda,, Kazuyuki; Maruyama, Hirofumi; Kimura, Hiroaki; Matsumoto, Masayasu

    2016-01-01

    [Purpose] The purposes of this study were to quantify the serial changes in lower limb and respiratory muscle strengths and to evaluate the acute effects of physiotherapy in polymyositis patients. [Subjects and Methods] Five patients (57.6 ± 9.0 years, 50 to 72; four females) received physiotherapy five days a week for four weeks. The lower limb and respiratory muscle strength, the % vital capacity, and the Barthel index were evaluated at baseline and after the intervention. [Results] The patient’s symptoms and creatine kinase values did not change, and after four weeks, all of the patients exhibited significantly increased outcomes compared with the baseline. However, the inspiratory muscle strength of the patients presented smaller improvements than the expiratory muscle strength. [Conclusion] Differential changes in inspiratory and expiratory muscle strength were observed following physiotherapy, and an unbalanced muscle distribution may explain the pathological and therapeutic effects. PMID:27799713

  13. Muscle Strength Predicts Changes in Physical Function in Women with Systemic Lupus Erythematosus

    PubMed Central

    Andrews, James S.; Trupin, Laura; Schmajuk, Gabriela; Barton, Jennifer; Margaretten, Mary; Yazdany, Jinoos; Yelin, Edward H.; Katz, Patricia P.

    2015-01-01

    Objective Cross-sectional studies have observed that muscle weakness is associated with worse physical function among women with systemic lupus erythematosus (SLE). The present study examines whether reduced upper and lower extremity muscle strength predict declines in function over time among adult women with SLE. Methods One hundred forty-six women from a longitudinal SLE cohort participated in the study. All measures were collected during in-person research visits approximately 2 years apart. Upper extremity muscle strength was assessed by grip strength. Lower extremity muscle strength was assessed by peak knee torque of extension and flexion. Physical function was assessed using the Short Physical Performance Battery (SPPB). Regression analyses modeled associations of baseline upper and lower extremity muscle strength with follow-up SPPB scores controlling for baseline SPPB, age, SLE duration, SLE disease activity (Systemic Lupus Activity Questionnaire [SLAQ]), physical activity level, prednisone use, body composition, and depression. Secondary analyses tested whether associations of baseline muscle strength with follow-up in SPPB scores differed between intervals of varying baseline muscle strength. Results Lower extremity muscle strength strongly predicted changes over 2 years in physical function even when controlling for covariates. The association of reduced lower extremity muscle strength with reduced future physical function was greatest among the weakest women. Conclusions Reduced lower extremity muscle strength predicted clinically significant declines in physical function, especially among the weakest women. Future studies should test whether therapies that promote preservation of lower extremity muscle strength may prevent declines in function among women with SLE. PMID:25623919

  14. The variation of the strength of neck extensor muscles and semispinalis capitis muscle size with head and neck position.

    PubMed

    Rezasoltani, A; Nasiri, R; Faizei, A M; Zaafari, G; Mirshahvelayati, A S; Bakhshidarabad, L

    2013-04-01

    Semispinalis capitis muscle (SECM) is a massive and long cervico-thoracic muscle which functions as a main head and neck extensor muscle. The aim of this study was to detect the effect of head and neck positions on the strength of neck extensor muscles and size of SECM in healthy subjects. Thirty healthy women students voluntarily participated in this study. An ultrasonography apparatus (Hitachi EUB 525) and a system of tension-meter were used to scan the right SECM at the level of third cervical spine and to measure the strength of neck extensor muscles at three head and neck positions. Neck extensor muscles were stronger in neutral than flexion or than extension positions while the size of SECM was larger in extension than neutral or than flexion position. The force generation capacity of the main neck extensor muscle was lower at two head and neck flexion and extension positions than neutral position.

  15. Loss of muscle strength prior to knee replacement: a question of anatomical cross-sectional area or specific-strength?

    PubMed

    Culvenor, Adam G; Hamler, Felix C; Kemnitz, Jana; Wirth, Wolfgang; Eckstein, Felix

    2017-10-09

    To elucidate whether loss in thigh muscle strength prior to knee replacement (KR) is caused by reductions of muscle anatomical cross sectional area (ACSA) or specific-strength. All 100 Osteoarthritis Initiative participants who received a KR (cases) and had thigh isometric muscle strength and MRI recorded (58 women, age 65±8 years, BMI 29±5 kg/m(2) ) were matched with a control (no KR) for age, sex, height, BMI, and radiographic severity. Thigh muscle ACSAs were determined from MRI at the visit before KR (T0 ), and two years before T0 (T-2 ). Specific-strength was calculated (strength÷ACSA) and the measures compared by conditional logistic regression (i.e., odds ratio [OR] per standard deviation). KR cases displayed significantly smaller extensor (but not flexor) ACSA than controls at T0 (women: pain-adjusted OR [ORadj ] 1.89; 95%CI 1.05-3.90; men: ORadj 2.22; 95%CI 1.04-4.76), whereas no significant differences were found at T-2 . Women with KR (but not men) displayed lower extensor specific-strength at T0 (OR 1.59 [1.02-2.50]), although this difference did not maintain significance after adjustment for pain (ORadj 1.22 [0.71-2.08]). Female cases lost significantly more extensor specific-strength between T-2 and T0 than controls (ORadj 3.76; 95%CI 1.04-13.60), whereas no significant differences were noted at T-2 , or in men CONCLUSION: In women, a significant reduction in knee extensor strength prior to KR appears to occur through two mechanisms: one driven by pain (loss in specific-strength) and one independent of pain (loss in muscle ACSA). Men with KR displayed significantly lower extensor ACSA, but not significantly lower strength or specific-strength. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  16. Impact on nutrition on muscle strength and performance in older adults

    USDA-ARS?s Scientific Manuscript database

    Muscle strength plays an important role in determining risk for falls, which result in fractures and other injuries. While bone loss has long been recognized as an inevitable consequence of aging, sarcopenia-the gradual loss of skeletal muscle mass and strength that occurs with advancing age-has rec...

  17. Soccer-specific fatigue and eccentric hamstrings muscle strength.

    PubMed

    Greig, Matt; Siegler, Jason C

    2009-01-01

    Epidemiologic findings of higher incidences of hamstrings muscle strains during the latter stages of soccer match play have been attributed to fatigue. To investigate the influence of soccer-specific fatigue on the peak eccentric torque of the knee flexor muscles. Descriptive laboratory study. Controlled laboratory environment. Ten male professional soccer players (age = 24.7 +/- 4.4 years, mass = 77.1 +/- 8.3 kg, Vo(2max) = 63.0 +/- 4.8 mL x kg(-1) x min(-1)). Participants completed an intermittent treadmill protocol replicating the activity profile of soccer match play, with a passive halftime interval. Before exercise and at 15-minute intervals, each player completed isokinetic dynamometer trials. Peak eccentric knee flexor torque was quantified at isokinetic speeds of 180 degrees x s(-1), 300 degrees x s(-1), and 60 degrees x s(-1), with 5 repetitions at each speed. Peak eccentric knee flexor torque at the end of the game (T(300eccH105) = 127 +/- 25 Nm) and at the end of the passive halftime interval (T(300eccH60) = 133 +/- 32 Nm) was reduced relative to T(300eccH00) (167 +/- 35 Nm, P < .01) and T(300eccH15) (161 +/- 35 Nm, P = .02). Eccentric hamstrings strength decreased as a function of time and after the halftime interval. This finding indicates a greater risk of injuries at these specific times, especially for explosive movements, in accordance with epidemiologic observations. Incorporating eccentric knee flexor exercises into resistance training sessions that follow soccer-specific conditioning is warranted to try to reduce the incidence or recurrence of hamstrings strains.

  18. Effects of daily vitamin D supplementation on respiratory muscle strength and physical performance in vitamin D-deficient COPD patients: a pilot trial.

    PubMed

    Rafiq, Rachida; Prins, Hendrik J; Boersma, Wim G; Daniels, Johannes Ma; den Heijer, Martin; Lips, Paul; de Jongh, Renate T

    2017-01-01

    Although vitamin D is well known for its function in calcium homeostasis and bone mineralization, several studies have shown positive effects on muscle strength and physical function. In addition, vitamin D has been associated with pulmonary function and the incidence of airway infections. As vitamin D deficiency is highly prevalent in chronic obstructive pulmonary disease (COPD) patients, supplementation might have a beneficial effect in these patients. To assess the effect of vitamin D supplementation on respiratory muscle strength and physical performance in vitamin D-deficient COPD patients. Secondary outcomes are pulmonary function, handgrip strength, exacerbation rate, and quality of life. We performed a randomized, double-blind, placebo-controlled pilot trial. Participants were randomly allocated to receive 1,200 IU vitamin D3 per day (n=24) or placebo (n=26) during 6 months. Study visits were conducted at baseline, and at 3 and 6 months after randomization. During the visits, blood was collected, respiratory muscle strength was measured (maximum inspiratory and expiratory pressure), physical performance and 6-minute walking tests were performed, and handgrip strength and pulmonary function were assessed. In addition, participants kept a diary card in which they registered respiratory symptoms. At baseline, the mean (standard deviation [SD]) serum 25-hydroxyvitamin D (25(OH)D) concentration (nmol/L) was 42.3 (15.2) in the vitamin D group and 40.6 (17.0) in the placebo group. Participants with vitamin D supplementation had a larger increase in serum 25(OH)D compared to the placebo group after 6 months (mean difference (SD): +52.8 (29.8) vs +12.3 (25.1), P<0.001). Primary outcomes, respiratory muscle strength and physical performance, did not differ between the groups after 6 months. In addition, no differences were found in the 6-minute walking test results, handgrip strength, pulmonary function, exacerbation rate, or quality of life. Vitamin D

  19. Relationship between muscle strength and motor function in Duchenne muscular dystrophy.

    PubMed

    Nunes, Milene F; Hukuda, Michele E; Favero, Francis M; Oliveira, Acary B; Voos, Mariana C; Caromano, Fátima A

    2016-07-01

    To investigate the relationship between muscle strength and motor function and between these variables and age. Muscle strength was measured by Medical Research Council (MRC) scale and motor function, by Motor Function Measure (MFM), in 40 non-ambulatory patients. Spearman tests investigated the relationships between muscle strength, motor function and age. Total MRC and MFM scores were strongly related to each other (r = 0.94; p < 0.001), but not to age (r = -0.19, r = -0.31, respectively; p > 0.05). Strong and moderate relationships between partial muscle strength and motor function scores were found. Higher correlation coefficients were found between total scores and Dimensions 2 (axial/ proximal control) and 3 (distal control) of MFM. Muscle strength and motor function are strongly correlated and seem to decrease proportionally in DMD.

  20. Effect of strength training on regional hypertrophy of the elbow flexor muscles.

    PubMed

    Drummond, Marcos D M; Szmuchrowski, Leszek A; Goulart, Karine N O; Couto, Bruno P

    2016-10-01

    Muscle hypertrophy is the main structural adaptation to strength training. We investigated the chronic effects of strength training on muscle hypertrophy in different regions of the elbow flexor muscles. Eleven untrained men (21.8 ± 1.62 years) underwent magnetic resonance imaging to determine the proximal, medial, distal, and mean cross-sectional areas (CSA) of the elbow flexors. The volunteers completed 12 weeks of strength training. The training protocol consisted of 4 sets of 8-10 maximum repetitions of unilateral elbow flexion. The interval between sets was 120 s. The training frequency was 3 sessions per week. The magnetic resonance images verified the presence of significant and similar hypertrophy in the distal, medial, and proximal portions of the elbow flexor muscles. Muscle hypertrophy may be assessed using only the medial CSA. We should not expect different degrees of hypertrophy among the regions of the elbow flexor muscles. Muscle Nerve 54: 750-755, 2016. © 2016 Wiley Periodicals, Inc.

  1. Do muscle mass, muscle density, strength and physical function similarly influence risk of hospitalization in older adults?

    PubMed Central

    Cawthon, Peggy Mannen; Fox, Kathleen M.; Gandra, Shravanthi. R.; Delmonico, Matthew J.; Chiou, Chiun-Fang; Anthony, Mary S.; Sewall, Ase; Goodpaster, Bret; Satterfield, Suzanne; Cummings, Steven R.; Harris, Tamara B.

    2012-01-01

    Objectives To examine the association between strength, function, lean mass, muscle density and risk of hospitalization. Design Prospective cohort stud Setting Two U.S. clinical centers Participants Adults aged 70 – 80 years (N=3,011) from the Health, Aging and Body Composition Study. Measurements Measures included grip strength; knee extension strength; lean mass; walking speed; chair stand pace. Thigh computed tomography scans assessed muscle area and density (a proxy for muscle fat infiltration). Hospitalizations were confirmed by local review of medical records. Negative binomial regression models estimated incident rate ratios (IRRs) of hospitalization for race/sex specific quartiles of each muscle/function parameter separately. Multivariate models adjusted for age, body mass index, health status and coexisting medical conditions. Results During an average 4.7 years of follow-up, 1,678 (55.7%) participants experienced ≥1 hospitalization. Participants in the lowest quartile of muscle density were more likely to be subsequently hospitalized (multivariate IRR: 1.47, 95% CI: 1.24, 1.73) compared to the highest quartile. Similarly, participants with the weakest grip strength were at increased risk of hospitalization (MIRR: 1.52, 95% CI: 1.30, 1.78, Q1 vs. Q4). Comparable results were seen for knee strength, walking pace and chair stands pace. Lean mass and muscle area were not associated with risk of hospitalization. Conclusion Weak strength, poor function and low muscle density, but not muscle size or lean mass, were associated with an increased risk of hospitalization. Interventions to reduce the disease burden associated with sarcopenia should focus on increasing muscle strength and improving physical function rather than simply increasing lean mass. PMID:19682143

  2. Effects of Age on Strength and Morphology of Toe Flexor Muscles.

    PubMed

    Mickle, Karen J; Angin, Salih; Crofts, Gillian; Nester, Christopher J

    2016-12-01

    Study Design Descriptive, cross-sectional. Background Age-related muscle atrophy is common in lower-limb muscles. We therefore speculated that foot muscles may also diminish with age. However, there is a paucity of literature characterizing foot muscle strength and morphology, and any relationship between these 2, in older people. Objective To compare the strength and size of the toe flexor muscles of older adults relative to their younger counterparts. Methods Seventeen young adults with a normal foot type were matched by sex and body mass index to 17 older adults with a normal foot type, from an available sample of 41 younger (18 to 50 years of age) and 44 older (60 or more years of age) adults. Among the matched groups (n = 34), muscle thickness and cross-sectional area for 5 intrinsic and 2 extrinsic toe flexor muscles were obtained using ultrasound. Toe strength was assessed using a pressure platform. Differences in toe flexor strength and muscle size between the young and older matched groups were determined using analysis of covariance (controlling for height). Correlations between strength and size of the toe flexor muscles of the pooled group (n = 34) were also calculated. Results Toe strength and the thickness and cross-sectional area of most foot muscles were significantly reduced in the older adults (P<.05). Hallux and toe flexor strength values were strongly correlated with the size of the intrinsic toe flexor muscles. Conclusion The smaller foot muscles appear to be affected by sarcopenia in older adults. This could contribute to reduced toe flexion force production and may affect the ability of older people to walk safely. Interventions aimed at reversing foot muscle atrophy in older people require further investigation. J Orthop Sports Phys Ther 2016;46(12):1065-1070. Epub 29 Oct 2016. doi:10.2519/jospt.2016.6597.

  3. Detraining outcomes with expiratory muscle strength training in Parkinson disease.

    PubMed

    Troche, Michelle S; Rosenbek, John C; Okun, Michael S; Sapienza, Christine M

    2014-01-01

    Expiratory muscle strength training (EMST) is efficacious for improving maximum expiratory pressure (MEP), cough function, and swallowing safety in Parkinson disease (PD). However, there are no published reports describing detraining effects following EMST in persons with PD. Moreover, there are no published reports describing detraining effects following any behavioral swallowing intervention. Ten participants with PD underwent 3 mo of detraining following EMST. Measures of MEP and swallowing safety were made prior to beginning EMST (baseline), posttreatment (predetraining), and 3 mo postdetraining. Participants demonstrated, on average, a 19% improvement in MEP from pre- to post-EMST. Following the 3 mo detraining period, MEP declined by 2% yet remained 17% above the baseline value. No statistically significant changes were found in swallowing safety from post-EMST to postdetraining period. Following the 3 mo detraining period, seven participants demonstrated no change in swallowing safety, one worsened, and two had improvements. This preliminary study highlights the need for the design of maintenance programs to sustain function following intensive periods of training.

  4. Correlation between Limb Muscle Endurance, Strength, and Functional Capacity in People with Chronic Obstructive Pulmonary Disease

    PubMed Central

    Törnberg, Anna; Wadell, Karin

    2016-01-01

    Purpose: To examine the correlation between limb muscle function (endurance and strength) and functional capacity in upper limbs (ULs) and lower limbs (LLs) of people with chronic obstructive pulmonary disease (COPD). Method: This article describes a secondary analysis of data from a randomized controlled trial. A stationary dynamometer was used to measure isokinetic muscle strength and endurance; the 6-minute walk test, the 6-minute pegboard and ring test, and the unsupported UL exercise test were used to measure functional capacity. Results: Participants were 44 adults with COPD. Muscle strength and endurance in ULs and LLs demonstrated a moderate to strong correlation with functional capacity. When controlling for muscle strength, muscle endurance was moderately correlated with functional capacity in ULs and LLs, but when controlling for muscle endurance, there was no positive and significant correlation between muscle strength and functional capacity for the ULs or LLs. Conclusions: Functional capacity seems to be more closely related to limb muscle endurance than to limb muscle strength in people with COPD. PMID:27504047

  5. Muscle strength and kinetic gait pattern in children with bilateral spastic CP.

    PubMed

    Eek, Meta Nyström; Tranberg, Roy; Beckung, Eva

    2011-03-01

    Cerebral palsy is often associated with an abnormal gait pattern. This study put focus on relation between muscle strength and kinetic gait pattern in children with bilateral spastic cerebral palsy and compares them with a reference group. In total 20 children with CP and 20 typically developing children participated. They were all assessed with measurement of muscle strength in eight muscle groups in the legs and a 3-dimensional gait analysis including force data. It was found that children with CP were not only significantly weaker in all muscle groups but also walked with slower velocity and shorter stride length when compared with the reference group. Gait moments differed at the ankle level with significantly lower moments in children with CP. Gait moments were closer to the maximal muscle strength in the group of children with CP. Furthermore a correlation between plantarflexing gait moment and muscle strength was observed in six of the eight muscle groups in children with CP, a relation not found in the reference group. A similar pattern was seen between muscle strength and generating ankle power with a rho=0.582-0.766. The results of this study state the importance of the relationship of the overall muscle strength pattern in the lower extremity, not only the plantarflexors.

  6. Effect of localised vibration on muscle strength in healthy adults: a systematic review.

    PubMed

    Alghadir, A H; Anwer, S; Zafar, H; Iqbal, Z A

    2017-08-06

    To investigate the effects of local vibration on muscle strength in healthy adults. The electronic databases PubMed, CINAHL, Scopus and Web of Science were searched using a combination of the following keywords: vibration, vibration therapy, power, maximal voluntary contraction, performance, rate of force development and vibratory exercise. In addition, the Medical Subject Headings 'vibration', 'strength' and 'exercise' were used. The bibliographical search was limited to articles published in English. Trials that evaluated the effect of localised vibration on muscle strength in healthy humans were included. Two independent evaluators verified the quality of the selected studies using the PEDro Scale and the Cochrane Collaboration's tool for assessing the risk of bias. Muscle strength was calculated for each intervention. In total, 29 full-text studies were assessed for eligibility. Eighteen studies did not match the inclusion criteria, and were excluded. The 11 studies included in this review had an average PEDro score of 5.36/10. Most of the studies reported significant improvements in muscle strength after the application of local vibration. There was considerable variation in the vibration training parameters and target muscle location. The use of local vibration on the target muscle can enhance muscle strength in healthy adults. Further well-designed controlled studies are required to confirm the effect of local vibration training on muscle strength. Copyright © 2017 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

  7. The reliability of assessing sternocleidomastoid muscle length and strength in adults with and without mild neck pain.

    PubMed

    Cibulka, Michael T; Herren, Jessica; Kilian, Anne; Smith, Steven; Mahmutovic, Fatima; Dolles, Courtney

    2017-04-01

    The sternocleidomastoid (SCM) is an important cervical spine muscle. Weakness of the SCM muscle has been implicated with cervical problems. No studies have examined the reliability of assessing the SCM muscle length or strength. Also no studies exist that have looked to see if imbalances in SCM muscle length or strength exists between the left and right sides in those with and without neck pain. To determine the reliability of assessing the SCM muscle for length and strength and to see if SCM length could predict SCM strength in those with and without neck pain. Cross-sectional study. Fifty-one subjects with and without mild neck pain. Intratester reliability was assessed for SCM muscle length and SCM muscle strength. Differences in SCM length and strength were examined in those with and without neck pain. Intratester reliability was shown to be excellent (ICC (2,2) > 0.90) for the left and right SCM when assessing muscle length and muscle strength for those with and without neck pain. No differences were noted when comparing left to right SCM between those with and without neck pain regarding muscle length or muscle strength. Neither regression models were able to predict SCM muscle strength from SCM muscle length. SCM muscle length and SCM strength can be reliably assessed using a bubble goniometer and HHD. No differences were found when comparing left to right SCM muscle length or strength in those with or without mild neck pain.

  8. Impact of nutrition on muscle mass, strength, and performance in older adults.

    PubMed

    Mithal, A; Bonjour, J-P; Boonen, S; Burckhardt, P; Degens, H; El Hajj Fuleihan, G; Josse, R; Lips, P; Morales Torres, J; Rizzoli, R; Yoshimura, N; Wahl, D A; Cooper, C; Dawson-Hughes, B

    2013-05-01

    Muscle strength plays an important role in determining risk for falls, which result in fractures and other injuries. While bone loss has long been recognized as an inevitable consequence of aging, sarcopenia-the gradual loss of skeletal muscle mass and strength that occurs with advancing age-has recently received increased attention. A review of the literature was undertaken to identify nutritional factors that contribute to loss of muscle mass. The role of protein, acid-base balance, vitamin D/calcium, and other minor nutrients like B vitamins was reviewed. Muscle wasting is a multifactorial process involving intrinsic and extrinsic alterations. A loss of fast twitch fibers, glycation of proteins, and insulin resistance may play an important role in the loss of muscle strength and development of sarcopenia. Protein intake plays an integral part in muscle health and an intake of 1.0-1.2 g/kg of body weight per day is probably optimal for older adults. There is a moderate [corrected] relationship between vitamin D status and muscle strength. Chronic ingestion of acid-producing diets appears to have a negative impact on muscle performance, and decreases in vitamin B12 and folic acid intake may also impair muscle function through their action on homocysteine. An adequate nutritional intake and an optimal dietary acid-base balance are important elements of any strategy to preserve muscle mass and strength during aging.

  9. Muscle strength in patients with acromegaly at diagnosis and during long-term follow-up.

    PubMed

    Füchtbauer, Laila; Olsson, Daniel S; Bengtsson, Bengt-Åke; Norrman, Lise-Lott; Sunnerhagen, Katharina S; Johannsson, Gudmundur

    2017-08-01

    Patients with acromegaly have decreased body fat (BF) and increased extracellular water (ECW) and muscle mass. Although there is a lack of systematic studies on muscle function, it is believed that patients with acromegaly may suffer from proximal muscle weakness despite their increased muscle mass. We studied body composition and muscle function in untreated acromegaly and after biochemical remission. Prospective observational study. Patients with acromegaly underwent measurements of muscle strength (dynamometers) and body composition (four-compartment model) at diagnosis (n = 48), 1 year after surgery (n = 29) and after long-term follow-up (median 11 years) (n = 24). Results were compared to healthy subjects. Untreated patients had increased body cell mass (113 ± 9% of predicted) and ECW (110 ± 20%) and decreased BF (67 ± 7.6%). At one-year follow-up, serum concentration of IGF-I was reduced and body composition had normalized. At baseline, isometric muscle strength in knee flexors and extensors was normal and concentric strength was modestly increased whereas grip strength and endurance was reduced. After one year, muscle strength was normal in both patients with still active disease and patients in remission. At long-term follow-up, all patients were in remission. Most muscle function tests remained normal, but isometric flexion and the fatigue index were increased to 153 ± 42% and 139 ± 28% of predicted values, respectively. Patients with untreated acromegaly had increased body cell mass and normal or modestly increased proximal muscle strength, whereas their grip strength was reduced. After biochemical improvement and remission, body composition was normalized, hand grip strength was increased, whereas proximal muscle fatigue increased. © 2017 European Society of Endocrinology.

  10. Effects of Vitamin D Supplementation on Muscle Strength in Athletes: A Systematic Review.

    PubMed

    Chiang, Chien-Ming; Ismaeel, Ahmed; Griffis, Rachel B; Weems, Suzy

    2017-02-01

    Chiang, C-m, Ismaeel, A, Griffis, RB, and Weems, S. Effects of vitamin D supplementation on muscle strength in athletes: A systematic review. J Strength Cond Res 31(2): 566-574, 2017-The purpose of this systematic review of the literature was to investigate the effects of vitamin D supplementation on muscle strength in athletes. A computerized literature search of 3 databases (PubMed, MEDLINE, and Scopus) was performed. Included in the review were randomized controlled trials (RCTs), published in English, which measured serum vitamin D concentrations and muscle strength in healthy, athletic participants aged 18-45 years. Quality was assessed using the PEDro scale. Five RCTs and 1 controlled trial were identified, and quality assessment showed 5 trials were of "excellent quality" and 1 was of "good quality." Trials lasted from 4 weeks to 6 months and dosages ranged from 600 to 5,000 International Units (IU) per day. Vitamin D2 was found to be ineffective at impacting muscle strength in both studies wherein it was administered. In contrast, vitamin D3 was shown to have a positive impact on muscle strength. In 2 studies, strength outcome measures were significantly improved after supplementation (p ≤ 0.05). In the other 2 studies administering vitamin D3, there were trends for improved muscle strength. Specifically, improvements in strength ranged from 1.37 to 18.75%. Additional studies are needed to confirm these associations.

  11. Muscle Strength Is Protective Against Osteoporosis in an Ethnically Diverse Sample of Adults.

    PubMed

    McGrath, Ryan P; Kraemer, William J; Vincent, Brenda M; Hall, Orman T; Peterson, Mark D

    2017-09-01

    McGrath, RP, Kraemer, WJ, Vincent, BM, Hall, OT, and Peterson, MD. Muscle strength is protective against osteoporosis in an ethnically diverse sample of adults. J Strength Cond Res 31(9): 2586-2589, 2017-The odds of developing osteoporosis may be affected by modifiable and nonmodifiable factors such as muscle strength and ethnicity. This study sought to (a) determine whether increased muscle strength was associated with decreased odds of osteoporosis and (b) identify whether the odds of osteoporosis differed by ethnicity. Data from the 2013 to 2014 National Health and Nutrition Examination Survey were analyzed. Muscle strength was measured with a hand-held dynamometer, and dual-energy x-ray absorptiometry was used to assess femoral neck bone mineral density. A T-score of ≤2.5 was used to define osteoporosis. Separate covariate-adjusted logistic regression models were performed on each sex to determine the association between muscle strength and osteoporosis. Odds ratios (ORs) were also generated to identify if the association between muscle strength and osteoporosis differed by ethnicity using non-Hispanic blacks as the reference group. There were 2,861 participants included. Muscle strength was shown to be protective against osteoporosis for men (OR: 0.94; 95% confidence interval [CI]: 0.94-0.94) and women (OR: 0.90; CI: 0.90-0.90). Although ORs varied across ethnicities, non-Hispanic Asian men (OR: 6.62; CI: 6.51-6.72) and women (OR: 6.42; CI: 6.37-6.48) were at highest odds of osteoporosis. Increased muscle strength reduced the odds of osteoporosis among both men and women in a nationally representative, ethnically diverse sample of adults. Non-Hispanic Asians had the highest odds of developing osteoporosis. Irrespective of sex or ethnicity, increased muscle strength may help protect against the odds of developing osteoporosis.

  12. Effects of transcutaneous electrical nerve stimulation on pain, walking function, respiratory muscle strength and vital capacity in kidney donors: a protocol of a randomized controlled trial

    PubMed Central

    2013-01-01

    Background Pain is a negative factor in the recovery process of postoperative patients, causing pulmonary alterations and complications and affecting functional capacity. Thus, it is plausible to introduce transcutaneous electrical nerve stimulation (TENS) for pain relief to subsequently reduce complications caused by this pain in the postoperative period. The objective of this paper is to assess the effects of TENS on pain, walking function, respiratory muscle strength and vital capacity in kidney donors. Methods/design Seventy-four patients will be randomly allocated into 2 groups: active TENS or placebo TENS. All patients will be assessed for pain intensity, walk function (Iowa Gait Test), respiratory muscle strength (maximal inspiratory pressure and maximal expiratory pressure) and vital capacity before and after the TENS application. The data will be collected by an assessor who is blinded to the group allocation. Discussion This study is the first to examine the effects of TENS in this population. TENS during the postoperative period may result in pain relief and improvements in pulmonary tests and mobility, thus leading to an improved quality of life and further promoting organ donation. Trial registration Registro Brasileiro de Ensaios Clinicos (ReBEC), number RBR-8xtkjp. PMID:23311705

  13. Soccer-Specific Fatigue and Eccentric Hamstrings Muscle Strength

    PubMed Central

    Greig, Matt; Siegler, Jason C

    2009-01-01

    Context: Epidemiologic findings of higher incidences of hamstrings muscle strains during the latter stages of soccer match play have been attributed to fatigue. Objective: To investigate the influence of soccer-specific fatigue on the peak eccentric torque of the knee flexor muscles. Design: Descriptive laboratory study. Setting: Controlled laboratory environment. Patients or Other Participants: Ten male professional soccer players (age  =  24.7 ± 4.4 years, mass  =  77.1 ± 8.3 kg, V̇o2max  =  63.0 ± 4.8 mL·kg−1·min−1). Intervention(s): Participants completed an intermittent treadmill protocol replicating the activity profile of soccer match play, with a passive halftime interval. Before exercise and at 15-minute intervals, each player completed isokinetic dynamometer trials. Main Outcome Measure(s): Peak eccentric knee flexor torque was quantified at isokinetic speeds of 180° · s−1, 300° · s−1, and 60° · s−1, with 5 repetitions at each speed. Results: Peak eccentric knee flexor torque at the end of the game (T300eccH105  =  127 ± 25 Nm) and at the end of the passive halftime interval (T300eccH60  =  133 ± 32 Nm) was reduced relative to T300eccH00 (167 ± 35 Nm, P < .01) and T300eccH15 (161 ± 35 Nm, P  =  .02). Conclusions: Eccentric hamstrings strength decreased as a function of time and after the halftime interval. This finding indicates a greater risk of injuries at these specific times, especially for explosive movements, in accordance with epidemiologic observations. Incorporating eccentric knee flexor exercises into resistance training sessions that follow soccer-specific conditioning is warranted to try to reduce the incidence or recurrence of hamstrings strains. PMID:19295963

  14. Quantitative MRI and strength measurements in the assessment of muscle quality in Duchenne muscular dystrophy.

    PubMed

    Wokke, B H; van den Bergen, J C; Versluis, M J; Niks, E H; Milles, J; Webb, A G; van Zwet, E W; Aartsma-Rus, A; Verschuuren, J J; Kan, H E

    2014-05-01

    The purpose of this study was to assess leg muscle quality and give a detailed description of leg muscle involvement in a series of Duchenne muscular dystrophy patients using quantitative MRI and strength measurements. Fatty infiltration, as well as total and contractile (not fatty infiltrated) cross sectional areas of various leg muscles were determined in 16 Duchenne patients and 11 controls (aged 8-15). To determine specific muscle strength, four leg muscle groups (quadriceps femoris, hamstrings, anterior tibialis and triceps surae) were measured and related to the amount of contractile tissue. In patients, the quadriceps femoris showed decreased total and contractile cross sectional area, attributable to muscle atrophy. The total, but not the contractile, cross sectional area of the triceps surae was increased in patients, corresponding to hypertrophy. Specific strength decreased in all four muscle groups of Duchenne patients, indicating reduced muscle quality. This suggests that muscle hypertrophy and fatty infiltration are two distinct pathological processes, differing between muscle groups. Additionally, the quality of remaining muscle fibers is severely reduced in the legs of Duchenne patients. The combination of quantitative MRI and quantitative muscle testing could be a valuable outcome parameter in longitudinal studies and in the follow-up of therapeutic effects.

  15. Relationship between muscle mass and physical performance: is it the same in older adults with weak muscle strength?

    PubMed

    Kim, Kyoung-Eun; Jang, Soong-Nang; Lim, Soo; Park, Young Joo; Paik, Nam-Jong; Kim, Ki Woong; Jang, Hak Chul; Lim, Jae-Young

    2012-11-01

    the relationship between muscle mass and physical performance has not been consistent among studies. to clarify the relationship between muscle mass and physical performance in older adults with weak muscle strength. cross-sectional analysis using the baseline data of 542 older men and women from the Korean Longitudinal Study on Health and Aging. dual X-ray absorptiometry, isokinetic dynamometer and the Short Physical Performance Battery (SPPB) were performed. Two muscle mass parameters, appendicular skeletal mass divided by weight (ASM/Wt) and by height squared (ASM/Ht(2)), were measured. We divided the participants into a lower-quartile (L25) group and an upper-three-quartiles (H75) group based on the knee-extensor peak torque. Correlation analysis and logistic regression models were used to assess the association between muscle mass and low physical performance, defined as SPPB scores <9, after controlling for confounders. in the L25 group, no correlation between mass and SPPB was detected, whereas the correlation between peak torque and SPPB was significant and higher than that in the H75 group. Results from the logistic models also showed no association between muscle mass and SPPB in the L25 group, whereas muscle mass was associated with SPPB in the H75 group. muscle mass was not associated with physical performance in weak older adults. Measures of muscle strength may be of greater clinical importance in weak older adults than is muscle mass per se.

  16. Muscle strength training to improve gait function in children with cerebral palsy.

    PubMed

    Eek, Meta Nyström; Tranberg, Roy; Zügner, Roland; Alkema, Kristina; Beckung, Eva

    2008-10-01

    The aim of the study was to investigate the influence of muscle strength training on gait outcomes in children with cerebral palsy. Sixteen children (two females, 14 males, Gross Motor Function Classification System levels I-II, mean age 12y 6mo, range 9y 4mo-15y 4mo) underwent muscle strength measurement using a handheld device, Gross Motor Function Measure (GMFM) assessment, three-dimensional gait analysis, joint range of motion assessment, and grading of spasticity before and after 8 weeks of training. All participants had a diagnosis of spastic diplegia and could walk without aids. Training consisted of exercises for lower extremity muscles with free weights, rubber bands, and body weight for resistance, three times a week. Values for muscle strength below normal were identified in all children; this was most pronounced at the ankle, followed by the hip muscles. After training, muscle strength and GMFM scores increased, velocity was unchanged, stride length increased, and cadence was reduced. There was an increase in hip extensor moment and power generated at push off. Eight weeks of muscle strength training can increase muscle strength and improve gait function.

  17. Reference values for maximal inspiratory pressure: a systematic review.

    PubMed

    Sclauser Pessoa, Isabela M B; Franco Parreira, Verônica; Fregonezi, Guilherme A F; Sheel, A William; Chung, Frank; Reid, W Darlene

    2014-01-01

    Maximal inspiratory pressure (MIP) is the most commonly used measure to evaluate inspiratory muscle strength. Normative values for MIP vary significantly among studies, which may reflect differences in participant demographics and technique of MIP measurement. To perform a systematic review with meta-analyses to synthesize MIP values that represent healthy adults. A systematic literature search was conducted using Medline, EMBASE, Cochrane, Cumulative Index to Nursing and Allied Health (CINAHL) and Sport Discus databases. Two reviewers identified and selected articles, and abstracted data. Methodological quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool. A random-effects model was used to calculate overall means and 95% CIs. Of 22 included articles, MIP data were synthesized according to age group and sex from six reports (n=840) in the meta-analyses. The mean QUADAS score was 3.5 of 7. The age range was between 18 and 83 years (426 men, 414 women). MIP began to decrease with age in the 40 to 60 years age range and continued to fall progressively with age. For the same age group, men tended to have higher MIPs than women. Sensitivity analysis of withdrawing studies from the meta-analysis identified one study that contributed more to heterogeneity in some age groups. MIP was higher in men and decreased with age, which was initially apparent in middle age. Several characteristics of participants and MIP technique influence values in healthy individuals. The present meta-analysis provides normative MIP values that are reflective of a large sample (n=840) and likely represents the broadest representation of participant characteristics compared with previous reports of normative data.

  18. Effect of muscle contraction strength on gating of somatosensory magnetic fields.

    PubMed

    Sugawara, Kazuhiro; Onishi, Hideaki; Yamashiro, Koya; Kotan, Shinichi; Kojima, Sho; Miyaguchi, Shota; Tsubaki, Atsuhiro; Kirimoto, Hikari; Tamaki, Hiroyuki; Shirozu, Hiroshi; Kameyama, Shigeki

    2016-11-01

    Afferent somatosensory information is modulated before the afferent input arrives at the primary somatosensory cortex during voluntary movement. The aim of the present study was to clarify the effect of muscular contraction strength on somatosensory evoked fields (SEFs) during voluntary movement. In addition, we examined the differences in gating between innervated and non-innervated muscle during contraction. We investigated the changes in gating effect by muscular contraction strength and innervated and non-innervated muscles in human using 306-channel magnetoencephalography. SEFs were recorded following the right median nerve stimulation in a resting condition and during isometric muscular contractions from 10 % electromyographic activity (EMG), 20 and 30 % EMG of the right extensor indicis muscle and abductor pollicis brevis muscle. Our results showed that the equivalent current dipole (ECD) strength for P35m decreased with increasing strength of muscular contraction of the right abductor pollicis brevis muscle. However, changes were observed only at 30 % EMG contraction level of the right extensor indicis muscle, which was not innervated by the median nerve. There were no significant changes in the peak latencies and ECD locations of each component in all conditions. The ECD strength did not differ significantly for N20m and P60m regardless of the strength of muscular contraction and innervation. Therefore, we suggest that the gating of SEF waveforms following peripheral nerve stimulation was affected by the strength of muscular contraction and innervation of the contracting muscle.

  19. Respiratory muscle training with enzyme replacement therapy improves muscle strength in late - onset Pompe disease.

    PubMed

    Mitja, Jevnikar; Metka, Kodric; Fabiana, Cantarutti; Cifaldi, Rossella; Longo, Cinzia; Rossana, Della Porta; Bruno, Bembi; Marco, Confalonieri

    2015-12-01

    Pompe disease is an autosomal recessive metabolic disorder caused by the deficiency of the lysosomal enzyme acid α-glucosidase. This deficiency leads to glycogen accumulation in the lysosomes of muscle tissue causing progressive muscular weakness particularly of the respiratory system. Enzyme replacement therapy (ERT) has demonstrated efficacy in slowing down disease progression in infants. Despite the large number of studies describing the effects of physical training in juvenile and adult late onset Pompe disease (LOPD). There are very few reports that analyze the benefits of respiratory muscle rehabilitation or training. The effectiveness of respiratory muscle training was investigated using a specific appliance with adjustable resistance (Threshold). The primary endpoint was effect on respiratory muscular strength by measurements of MIP and MEP. Eight late-onset Pompe patients (aged 13 to 58 years; 4 female, 4 male) with respiratory muscle deficiency on functional respiratory tests were studied. All patients received ERT at the dosage of 20 mg/kg/every 2 weeks and underwent training with Threshold at specified pressures for 24 months. A significant increase in MIP was observed during the follow-up of 24 month: 39.6 cm H2O (+ 25.0%) at month 3; 39.5 cm H2O (+ 24.9%) at month 6; 39.1 cm H2O (+ 23.7%) at month 9; 37.3 cm H2O (+ 18.2%) at month 12; and 37.3 cm H2O (+ 17.8%) at month 24. Median MEP values also showed a significant increase during the first 9 months: 29.8 cm H2O, (+ 14.3%) at month 3; 31.0 cm H2O (+ 18.6) at month 6; and 29.5 cm H2O (+ 12.9) at month 9. MEP was then shown to be decreased at months 12 and 24; median MEP was 27.2 cm H2O (+ 4.3%) at 12 months and 26.6 cm H2O (+ 1.9%) at 24 months. The FVC remain stable throughout the study. An increase in respiratory muscular strength was demonstrated with Threshold training when used in combination with ERT.

  20. Association with isokinetic ankle strength measurements and normal clinical muscle testing in sciatica patients.

    PubMed

    Ustun, N; Erol, O; Ozcakar, L; Ceceli, E; Ciner, O Akar; Yorgancioglu, Z R

    2013-01-01

    Sensitive muscle strength tests are needed to measure muscle strength in the diagnosis and management of sciatica patients. The aim of this study was to assess the isokinetic muscle strength in sciatica patients' and control subjects' ankles that exhibited normal ankle muscle strength when measured clinically. Forty-six patients with L5 and/or S1 nerve compression, and whose age, sex, weight, and height matched 36 healthy volunteers, were recruited to the study. Heel-walking, toe-walking, and manual muscle testing were used to perform ankle dorsiflexion and plantar flexion strengths in clinical examination. Patients with normal ankle dorsiflexion and plantar flexion strengths assessed by manual muscle testing and heel-and toe-walking tests were included in the study. Bilateral isokinetic (concentric/concentric) ankle plantar-flexion-dorsiflexion measurements of the patients and controls were performed within the protocol of 30°/sec (5 repetitions). Peak torque and peak torque/body weight were obtained for each ankle motion of the involved limb at 30°/s speed. L5 and/or S1 nerve compression was evident in 46 patients (76 injured limbs). Mean disease duration was two years. The plantar flexion muscle strength of the patients was found to be lower than that of the controls (p=0.036). The dorsiflexion muscle strength of the patients was found to be the same as that of the controls (p=0.211). Isokinetic testing is superior to clinical muscle testing when evaluating ankle plantar flexion torque in sciatica patients. Therefore, isokinetic muscle testing may be helpful when deciding whether to place a patient into a focused rehabilitation program.

  1. Serial Changes of Quadriceps and Hamstring Muscle Strength Following Total Knee Arthroplasty: A Meta-Analysis.

    PubMed

    Moon, Young-Wan; Kim, Hyun-Jung; Ahn, Hyeong-Sik; Lee, Dae-Hee

    2016-01-01

    This meta-analysis was performed to analyze serial changes in thigh muscles, including quadriceps and hamstring muscles, from before to one year after total knee arthroplasty (TKA). All studies sequentially comparing isokinetic quadriceps and hamstring muscle strengths between the TKA side and the contralateral uninjured limb were included in this meta-analysis. Five studies with 7 cohorts were included in this meta-analysis. The mean differences in the strengths of quadriceps and hamstring muscles between the TKA and uninjured sides were greatest three months after surgery (26.8 N∙m, 12.8 N∙m, P<0.001), but were similar to preoperative level at six months (18.4 N∙m, 7.4 N∙m P<0.001) and were maintained for up to one year (15.9 N∙m, 4.1 N∙m P<0.001). The pooled mean differences in changes in quadriceps and hamstring strengths relative to preoperative levels were 9.2 N∙m and 4.9 N∙m, respectively, three months postoperatively (P = 0.041), but were no longer significant after six months and one year. During the year after TKA, quadriceps and hamstring muscle strengths were lowest after 3 months, recovering to preoperative level after six months, but not reaching the muscle strength on the contralateral side. Relative to preoperative levels, the difference in muscle strength between the TKA and contralateral knees was only significant at three months. Because decrease of strength of the quadriceps was significantly greater than decrease in hamstring muscle strength at postoperative three months, early rehabilitation after TKA should focus on recovery of quadriceps muscle strength.

  2. Effects of a Strength Training Session After an Exercise Inducing Muscle Damage on Recovery Kinetics.

    PubMed

    Abaïdia, Abd-Elbasset; Delecroix, Barthélémy; Leduc, Cédric; Lamblin, Julien; McCall, Alan; Baquet, Georges; Dupont, Grégory

    2017-01-01

    Abaïdia, A-E, Delecroix, B, Leduc, C, Lamblin, J, McCall, A, Baquet, G, and Dupont, G. Effects of a strength training session after an exercise inducing muscle damage on recovery kinetics. J Strength Cond Res 31(1): 115-125, 2017-The purpose of this study was to investigate the effects of an upper-limb strength training session the day after an exercise inducing muscle damage on recovery of performance. In a randomized crossover design, subjects performed the day after the exercise, on 2 separate occasions (passive vs. active recovery conditions) a single-leg exercise (dominant in one condition and nondominant in the other condition) consisting of 5 sets of 15 eccentric contractions of the knee flexors. Active recovery consisted of performing an upper-body strength training session the day after the exercise. Creatine kinase, hamstring strength, and muscle soreness were assessed immediately and 20, 24, and 48 hours after exercise-induced muscle damage. The upper-body strength session, after muscle-damaging exercise accelerated the recovery of slow concentric force (effect size = 0.65; 90% confidence interval = -0.06 to 1.32), but did not affect the recovery kinetics for the other outcomes. The addition of an upper-body strength training session the day after muscle-damaging activity does not negatively affect the recovery kinetics. Upper-body strength training may be programmed the day after a competition.

  3. Ultrasonographic quantification of intrinsic hand muscle cross-sectional area; reliability and validity for predicting muscle strength.

    PubMed

    Mohseny, Behnam; Nijhuis, Tim H; Hundepool, Caroline A; Janssen, Wim G; Selles, Ruud W; Coert, J Henk

    2015-05-01

    To investigate whether ultrasonographic measurement of the cross-sectional area (CSA) of the intrinsic hand muscles can be used to predict muscle strength in a valid and reliable manner, and to determine if this method can be used for follow-up of patients with peripheral nerve injury between the wrist and elbow. Repeated-measures cross-sectional study. Clinical and academic hospital. Healthy adults (n=31) and patients with ulnar and median nerve injuries (n=16) between the wrist and elbow who were visiting the Erasmus Medical Center or Maasstad Hospital were included in the study (N=47). Not applicable. Correlation between measured muscle CSA and strength and assessment of inter- and intrarater reliability. Ultrasound and strength measurements of the intrinsic hand muscles were conducted bilaterally. To establish validity, the CSA of 4 muscles (abductor digiti minimi, first dorsal interosseus, abductor pollicis brevis, opponens pollicis) was compared with strength measurements of the same muscles conducted with the Rotterdam Intrinsic Hand Myometer. Repeated measures were conducted to assess inter- and intrarater reliability. The assessed CSA strongly correlated with strength measurements, with correlations ranging from 0.82 to 0.93 in healthy volunteers and from 0.63 to 0.94 in patients. Test-retest reliability showed excellent intrarater reliability (intraclass correlation coefficient range, 0.99-1.00) in patients and volunteers and good interrater reliability (intraclass correlation coefficient range, 0.88-0.95) in healthy volunteers. We found that ultrasound is a valid and reliable method to assess the CSA of specific muscles in the hand. Therefore, this technique could be useful to monitor muscle reinnervation in patients suffering from peripheral nerve injury as a valuable addition to strength dynamometers. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  4. Anabolic and Catabolic Biomarkers As Predictors of Muscle Strength Decline: The InCHIANTI Study

    PubMed Central

    Maggio, Marcello; Lauretani, Fulvio; Bandinelli, Stefania; Ceda, Gian Paolo; Di Iorio, Angelo; Giallauria, Francesco; Guralnik, Jack M.; Ferrucci, Luigi

    2010-01-01

    Abstract Background Poor muscle strength is a major public health concern in older persons, predisposing to functional limitations, increased fall risk, and higher mortality. Understanding risk factors for muscle strength decline may offer opportunities for prevention and treatment. One of the possible causes of muscle strength decline is imbalance between catabolic and anabolic signaling. This study aims to examine whether high levels of multiple catabolic and low levels of multiple anabolic biomarkers predict accelerated decline of muscle strength. Methods In a representative sample of 716 men and women aged ≥65 years in the InCHIANTI study we measured C-reactive protein, interleukin-6 (IL-6), IL-1 receptor antagonist (IL-1RA), tumor necrosis factor-α receptor 1 as well as dehydroepiandrosterone sulfate (DHEA-S), insulin-like growth factor-1, and bioavailable testosterone. Biomarker values were divided into tertiles and the numbers of catabolic/anabolic biomarkers in the highest/lowest tertile were calculated. Hand-grip strength was measured at baseline and 3- and 6-year follow up. Results In adjusted linear mixed models, higher concentration of IL-6 (p = 0.02) and IL-1RA (p = 0.04) as well as lower levels of DHEA-S (p = 0.01) predicted muscle strength decline. After combining all inflammatory markers, the rate of decline in grip strength was progressively greater with the increasing number of dysregulated catabolic biomarkers (p = 0.01). No effect on accelerated muscle strength decline was seen according to number of dysregulated anabolic hormones. Conclusions Having multiple elevated catabolic biomarkers is a better predictor of muscle strength decline than a single biomarker alone, suggesting that a catabolic dysregulation is at the core of the mechanism leading to muscle strength decline with aging. PMID:20230273

  5. Strength measurements of the intrinsic hand muscles: a review of the development and evaluation of the Rotterdam intrinsic hand myometer.

    PubMed

    Schreuders, Ton A R; Selles, Ruud W; Roebroeck, Marij E; Stam, Henk J

    2006-01-01

    Numerous neurological diseases are accompanied by atrophy of the intrinsic muscles of the hand. Muscle strength testing of these muscles is frequently used for clinical decision making. Traditionally, these strength measurements have focused on manual muscle testing (MMT) or on grip and pinch strength dynamometry. We have developed a hand-held dynamometer, the Rotterdam Intrinsic Hand Myometer (RIHM), to measure this intrinsic muscle strength. The RIHM was designed such that it can measure a wide range of muscle groups, such as the abduction and adduction strength of the little finger and index finger, the opposition, palmar abduction (anteposition) and opposition strength of the thumb, and intrinsic muscles of the fingers combined in the intrinsic plus position. We found that the reliability of RIHM measurements in nerve injury patients was comparable to grip and pinch strength measurements and is appropriate to study the functional recovery of the intrinsic muscles of the hand in isolation. We have applied the RIHM in a recent study on the long-term outcome of muscle strength in patients with ulnar and median nerve injuries and found that while recovery of grip and pinch strength was relatively good, recovery of the ulnar nerve innervated muscles measured with the RIHM was poor. This poor recovery could not be detected with manual muscle strength testing or with grip and pinch dynamometry. We conclude that the RIHM provides an accurate clinical assessment of the muscle strength of the intrinsic hand muscles that adds valuable information to MMT and grip and pinch dynamometry.

  6. Neuromuscular adaptations during the acquisition of muscle strength, power and motor tasks.

    PubMed

    Moritani, T

    1993-01-01

    Neuromuscular performance is determined not only by the size of the involved muscles, but also by the ability of the nervous system to appropriately activate the muscles. Adaptive changes in the nervous system in response to training are referred to as neural adaptation. This article briefly reviews current evidence regarding the neural adaptations during the acquisition of muscle strength power and motor tasks and will be organized under four main topics, namely: (i) muscle strength gain: neural factors versus hypertrophy, (ii) neural adaptations during power training, (iii) neuromuscular adaptations during the acquisition of a motor task, and (iv) neuromuscular adaptations during a ballistic movement.

  7. Relationships between Lower Limb Muscle Strength and Locomotor Capacity in Children and Adolescents with Cerebral Palsy Who Walk Independently

    ERIC Educational Resources Information Center

    Ferland, Chantale; Lepage, Celine; Moffet, Helene; Maltais, Desiree B.

    2012-01-01

    This study aimed to quantify relationships between lower limb muscle strength and locomotor capacity for children and adolescents with cerebral palsy (CP) to identify key muscle groups for strength training. Fifty 6- to 16-year-olds with CP (Gross Motor Function Classification System level I or II) participated. Isometric muscle strength of hip…

  8. Relationships between Lower Limb Muscle Strength and Locomotor Capacity in Children and Adolescents with Cerebral Palsy Who Walk Independently

    ERIC Educational Resources Information Center

    Ferland, Chantale; Lepage, Celine; Moffet, Helene; Maltais, Desiree B.

    2012-01-01

    This study aimed to quantify relationships between lower limb muscle strength and locomotor capacity for children and adolescents with cerebral palsy (CP) to identify key muscle groups for strength training. Fifty 6- to 16-year-olds with CP (Gross Motor Function Classification System level I or II) participated. Isometric muscle strength of hip…

  9. Effect of trapezius muscle strength on three-dimensional scapular kinematics

    PubMed Central

    Turgut, Elif; Duzgun, Irem; Baltaci, Gul

    2016-01-01

    [Purpose] This study aimed to investigate the effect of trapezius muscle isometric strength on three-dimensional scapular kinematics in asymptomatic shoulders. [Subjects and Methods] Thirty asymptomatic subjects were included to the study. Isometric strengths of the upper, middle, and lower trapezius muscle were measured using a handheld dynamometer. Three-dimensional scapular kinematics was recorded by an electromagnetic tracking device during frontal and sagittal plane elevation. For each muscle, the cut-off value for muscle strength was determined with the upper bound of the 95% confidence interval, and Student’s t-test was used to compare the scapular kinematics between subjects with relatively weaker or stronger trapezius muscles. [Results] Shoulders with stronger upper trapezius muscles showed greater upward scapular rotation at 30°, 60°, 90°, and 120° of elevation in the frontal plane. Shoulders with stronger middle trapezius had greater scapular upward rotation at 90° of elevation in the frontal plane. Shoulders with stronger lower trapezius showed greater scapular posterior tilt at 90° of elevation in the sagittal plane. [Conclusion] This study’s findings showed that isometric strength of the trapezius muscle affects upward scapular rotation and posterior tilt in asymptomatic shoulders. Therefore, trapezius muscle strength should be assessed and potential weakness should be addressed in shoulder rehabilitation programs. PMID:27390435

  10. Tinetti mobility test is related to muscle mass and strength in non-institutionalized elderly people.

    PubMed

    Curcio, Francesco; Basile, Claudia; Liguori, Ilaria; Della-Morte, David; Gargiulo, Gaetano; Galizia, Gianluigi; Testa, Gianluca; Langellotto, Assunta; Cacciatore, Francesco; Bonaduce, Domenico; Abete, Pasquale

    2016-12-01

    Elderly people are characterized by a high prevalence of falls and sarcopenia. However, the relationship among Tinetti mobility test (TMT) score, a powerful tool to detect elderly people at risk of falls, and sarcopenia is still not thoroughly investigated. Thus, to determine the relationship between TMT score and muscle mass and strength, 337 elderly participants (mean age 77.1 ± 6.9 years) admitted to comprehensive geriatric assessment were enrolled. TMT score, muscle mass by bioimpedentiometer, and muscle strength by grip strength were evaluated. Muscle mass progressively decreased as TMT score decreased (from 15.3 ± 3.7 to 8.8 ± 1.8 kg/m(2); p for trend <0.001). Similarly, muscle strength decreased progressively as Tinetti score decreased (from 34.7 ± 8.0 to 23.7 ± 8.7 kg; p for trend 0.001). Linear regression analysis demonstrated that TMT score is linearly related with muscle mass (y = 4.5x + 0.4, r = 0.61; p < 0.01) and strength (y = 14.0x + 0.8, r = 0.53; p < 0.01). Multivariate analysis confirms the strong relationship between the TMT score and muscle mass (r = 0.48, p = 0.024) and strength (r = 0.39, p = 0.046). The present study indicates that TMT score is significantly related to muscle mass and strength in non-institutionalized elderly participants. This evidence suggests that TMT score, together with evaluation of muscle mass and strength, may identify sarcopenic elderly participants at high risk of falls.

  11. Cycle training induces muscle hypertrophy and strength gain: strategies and mechanisms.

    PubMed

    Ozaki, Hayao; Loenneke, J P; Thiebaud, R S; Abe, T

    2015-03-01

    Cycle training is widely performed as a major part of any exercise program seeking to improve aerobic capacity and cardiovascular health. However, the effect of cycle training on muscle size and strength gain still requires further insight, even though it is known that professional cyclists display larger muscle size compared to controls. Therefore, the purpose of this review is to discuss the effects of cycle training on muscle size and strength of the lower extremity and the possible mechanisms for increasing muscle size with cycle training. It is plausible that cycle training requires a longer period to significantly increase muscle size compared to typical resistance training due to a much slower hypertrophy rate. Cycle training induces muscle hypertrophy similarly between young and older age groups, while strength gain seems to favor older adults, which suggests that the probability for improving in muscle quality appears to be higher in older adults compared to young adults. For young adults, higher-intensity intermittent cycling may be required to achieve strength gains. It also appears that muscle hypertrophy induced by cycle training results from the positive changes in muscle protein net balance.

  12. [Association of muscle strength with early markers of cardiovascular risk in sedentary adults].

    PubMed

    Triana-Reina, Héctor Reynaldo; Ramírez-Vélez, Robinson

    2013-10-01

    To assess the association between muscle strength and early cardiovascular risk (CVR) markers in sedentary adults. A total of 176 sedentary subjects aged 18-30 years were enrolled. Body mass index and fat percentage were calculated, and waist circumference, grip strength by dynamometry, systolic blood pressure, diastolic blood pressure, mean arterial pressure, and maximal oxygen uptake by VO2max were measured as CVR markers. A multivariate logistic regression analysis was used to assess associations between muscle strength and CVR markers. Inverse correlations were found between muscle strength and adiposity (r=-.317; P=.001), waist circumference (r=-.309; P=.001), systolic blood pressure (r=-.401; P=.001), and mean arterial pressure (r=-.256; P=.001). Subjects with lower levels of muscle strength had a 5.79-fold (95% CI 1.57 to 9.34; P=.008) risk of having higher adiposity levels (≥25%) and a 9.67-fold (95% CI=3.86 to 19.22; P<.001) risk of having lower physical capacity values for VO2max (≤31.5mL/kg/min(-1)). In sedentary adults, muscle strength is associated to early manifestations of CVR. It is suggested that muscle strength testing is added to routine measurement of VO2max and traditional risk factors for prevention and treatment of cardiovascular risk. Copyright © 2012 SEEN. Published by Elsevier Espana. All rights reserved.

  13. Relation between systemic inflammatory markers, peripheral muscle mass, and strength in limb muscles in stable COPD patients.

    PubMed

    Ferrari, Renata; Caram, Laura M O; Faganello, Marcia M; Sanchez, Fernanda F; Tanni, Suzana E; Godoy, Irma

    2015-01-01

    The aim of this study was to investigate the association between systemic inflammatory mediators and peripheral muscle mass and strength in COPD patients. Fifty-five patients (69% male; age: 64±9 years) with mild/very severe COPD (defined as forced expiratory volume in the first second [FEV1] =54%±23%) were evaluated. We evaluated serum concentrations of IL-8, CRP, and TNF-α. Peripheral muscle mass was evaluated by computerized tomography (CT); midthigh cross-sectional muscle area (MTCSA) and midarm cross-sectional muscle area (MACSA) were obtained. Quadriceps, triceps, and biceps strength were assessed through the determination of the one-repetition maximum. The multiple regression results, adjusted for age, sex, and FEV1%, showed positive significant association between MTCSA and leg extension (0.35 [0.16, 0.55]; P=0.001), between MACSA and triceps pulley (0.45 [0.31, 0.58]; P=0.001), and between MACSA and biceps curl (0.34 [0.22, 0.47]; P=0.001). Plasma TNF-α was negatively associated with leg extension (-3.09 [-5.99, -0.18]; P=0.04) and triceps pulley (-1.31 [-2.35, -0.28]; P=0.01), while plasma CRP presented negative association with biceps curl (-0.06 [-0.11, -0.01]; P=0.02). Our results showed negative association between peripheral muscle mass (evaluated by CT) and muscle strength and that systemic inflammation has a negative influence in the strength of specific groups of muscles in individuals with stable COPD. This is the first study showing association between systemic inflammatory markers and strength in upper limb muscles.

  14. Relation between systemic inflammatory markers, peripheral muscle mass, and strength in limb muscles in stable COPD patients

    PubMed Central

    Ferrari, Renata; Caram, Laura MO; Faganello, Marcia M; Sanchez, Fernanda F; Tanni, Suzana E; Godoy, Irma

    2015-01-01

    The aim of this study was to investigate the association between systemic inflammatory mediators and peripheral muscle mass and strength in COPD patients. Fifty-five patients (69% male; age: 64±9 years) with mild/very severe COPD (defined as forced expiratory volume in the first second [FEV1] =54%±23%) were evaluated. We evaluated serum concentrations of IL-8, CRP, and TNF-α. Peripheral muscle mass was evaluated by computerized tomography (CT); midthigh cross-sectional muscle area (MTCSA) and midarm cross-sectional muscle area (MACSA) were obtained. Quadriceps, triceps, and biceps strength were assessed through the determination of the one-repetition maximum. The multiple regression results, adjusted for age, sex, and FEV1%, showed positive significant association between MTCSA and leg extension (0.35 [0.16, 0.55]; P=0.001), between MACSA and triceps pulley (0.45 [0.31, 0.58]; P=0.001), and between MACSA and biceps curl (0.34 [0.22, 0.47]; P=0.001). Plasma TNF-α was negatively associated with leg extension (−3.09 [−5.99, −0.18]; P=0.04) and triceps pulley (−1.31 [−2.35, −0.28]; P=0.01), while plasma CRP presented negative association with biceps curl (−0.06 [−0.11, −0.01]; P=0.02). Our results showed negative association between peripheral muscle mass (evaluated by CT) and muscle strength and that systemic inflammation has a negative influence in the strength of specific groups of muscles in individuals with stable COPD. This is the first study showing association between systemic inflammatory markers and strength in upper limb muscles. PMID:26345641

  15. Age-associated changes in hand grip and quadriceps muscle strength ratios in healthy adults.

    PubMed

    Samuel, Dinesh; Wilson, Keely; Martin, Helen J; Allen, Robert; Sayer, Avan Aihie; Stokes, Maria

    2012-06-01

    Muscle strength may decline with age differentially in the upper and lower limbs. This information is difficult to capture through a single measure. The present study therefore aimed to characterize the relative changes in handgrip and lower limb muscle strength with aging by expressing them as a ratio. Thirty-eight healthy volunteers aged 20-82 years performed maximal voluntary contractions (MVC) of quadriceps and handgrip using a custom-built transducer and a Jamar dynamometer respectively. The grip-quadriceps ratios for young adults was similar in males and females (0.75); indicating knee extensor force exceeded grip force by approximately 25%. Ratios were increased in older adults (p=0.05), and strength of the two muscle groups was approximately equal (1.1). Pearson's correlation coefficients for grip against quadriceps strength were r=0.63 (young males), r=0.83 (young females), r=0.35 (older males) and r=0.05 (older females). The ratio used demonstrated clear differences between the age groups. The reduced muscle strength with increasing age was expected, but the higher grip/quadriceps strength ratios quantify a greater loss of quadriceps than grip strength with aging. It remains to be investigated whether the relatively greater rate of decline in quadriceps strength seen in healthy older people is more exaggerated in those who are frail, which would have implications for using grip strength as a physical marker of lower limb strength and function in those at risk of immobility and falls.

  16. Dynamic muscle strength as a predictor of bone mineral density in elderly women.

    PubMed

    Taaffe, D R; Pruitt, L; Lewis, B; Marcus, R

    1995-06-01

    Although muscle strength has been shown to predict bone mineral density (BMD) in older adults, the variance explained by isometric and isokinetic testing has been generally low (< 20%) and limited to only a few exercises and muscle groups. To elucidate the relationship of muscle strength to BMD at multiple sites, and to ascertain the most robust predictor of BMD using isotonic strength testing apparatus, we examined dynamic muscle strength and BMD in 40 healthy elderly women aged 65-82 years. BMD of the spine (L2-4), proximal femur (neck, trochanter, Ward's triangle), forearm (midradius), and whole body were measured by dual-energy X-ray absorptiometry. Dynamic strength (1-RM), utilizing isotonic weight-lifting equipment, was assessed for 10 standard upper and lower body exercises. In stepwise multiple regressions, leg press was the only independent predictor of spine (R2 = 0.11), neck and trochanter (R2 = 0.21 and 0.18), forearm (R2 = 0.21), and whole body BMD (R2 = 0.19), while bench press was an independent predictor of Ward's BMD (R2 = 0.12). The most robust predictor of regional and whole body BMD using isotonic equipment was the leg press, which may reflect overall skeletal health in this population. The portion of variance explained by dynamic muscle strength (11-21%) is similar to that reported when strength is assessed by isometric and isokinetic testing. The relationship of dynamic strength to BMD was not generally site-specific.

  17. Effects of a resistance training program and subsequent detraining on muscle strength and muscle power in multiple sclerosis patients.

    PubMed

    Medina-Perez, Carlos; de Souza-Teixeira, Fernanda; Fernandez-Gonzalo, Rodrigo; de Paz-Fernandez, Jose Antonio

    2014-01-01

    Although resistance training adaptations in multiple sclerosis (MS) patients have been described, the detraining response in this population is largely unknown. [corrected] This study was designed to evaluate the effects of a 12-week detraining period on muscle strength (isometric and endurance) and muscle power of multiple sclerosis (MS) patients that had previously carried out a 12-week resistance training program (RTP). Forty-two MS patients were randomly assigned into two groups: an exercise group (EG) that performed a 12-week RTP for the knee extensors muscles; and a control group (CG), that did not perform any specific training. Knee extension maximal voluntary isometric contraction (MVIC), muscle power and muscle endurance were evaluated before and after the RTP,