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Six-week inspiratory resistance training ameliorates endurance performance but does not affect obesity-related metabolic biomarkers in obese adults: A randomized controlled trial.
Kuo, YC, Chang, HL, Cheng, CF, Mündel, T, Liao, YH
Respiratory physiology & neurobiology. 2020;:103285
Abstract
This investigation examined the effects of a six-week inspiratory resistance training (IRT) on metabolic health biomarkers, pulmonary function, and endurance in obese individuals. Twenty-eight obese adults (BMI > 27 kg/m2 Taiwan obesity criteria) were randomly assigned to either IRT (IRT; N = 16) or sham control (PLA; N = 12). The training parameters (twice/day; 3 days/week; 30 breaths/section; IRT: 55% PImax [maximal inspiratory pressure], PLA: 10% PImax) were identical. The endurance, pulmonary function, and blood lipid profiles were measured before/after intervention. After training, the PImax in IRT was greater than in PLA (+49.6%, p < .001), and the 6-minute walking test (6MWT) performance in IRT was greater than in PLA (+12.9%, p = 0.001). However, there were no differences in pulmonary function (FVC, FEV1, or FEV1/FVC) and lipid profiles between groups. Our results demonstrate that a six-week progressively-programmed IRT was effective to improve endurance capacity and inspiratory muscle strength in obese individuals, whereas the IRT had no effects on pulmonary function, body composition, and blood lipid profiles.
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The effect of inspiratory muscle training on fatigue and dyspnea in patients with heart failure: A randomized, controlled trial.
Hossein Pour, AH, Gholami, M, Saki, M, Birjandi, M
Japan journal of nursing science : JJNS. 2020;(2):e12290
Abstract
AIM: Fatigue and dyspnea are debilitating symptoms in patients with heart failure (HF). The purpose of this study was to evaluate the effects of inspiratory muscle training (IMT) on dyspnea, fatigue and the New York Heart Association (NYHA) functional classification in patients with HF. METHODS In this prospective, randomized, controlled trial, 84 patients with HF (NYHA classes II-III/IV) with a mean age of 56.62 ± 9.56 years were randomly assigned to a 6-week IMT (n = 42) or a sham IMT (n = 42) program. The IMT was performed at 40% of the maximal inspiratory pressure (MIP) in the IMT group and at 10% in the sham group. The main outcomes were assessed at baseline and after the intervention and included dyspnea severity scale (Modified Medical Research Council [MMRC], Fatigue Severity Scale [FSS] and the NYHA functional classification (based on the presenting symptoms). RESULTS The between-group analysis showed significant improvements in dyspnea, fatigue and the NYHA functional classification in the IMT group compared to the sham group (P < .05). The within-group analysis showed significant improvements in dyspnea (from 2.63 ± 0.79 to 1.38 ± 0.66, P < .001), fatigue (from 43.36 ± 8.5 to 28.95 ± 9.11, P < .001) and the NYHA functional classification (from 2.73 ± 0.5 to 2.1 ± 0.6, P = .001) in the IMT group, while fatigue and dyspnea increased significantly in the sham group. CONCLUSIONS The 6-week home-based IMT was found to be an effective and safe tool for reducing dyspnea and fatigue and improving the NYHA functional classification.
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Effects of peripheral and different inspiratory muscle training methods in coronary artery disease patients with metabolic syndrome: A randomized-controlled trial.
Muammer, K, Mutluay, F, Demir, R, Özkan, AA
Respiratory medicine. 2020;:106119
Abstract
UNLABELLED Background OBJECTIVE To investigate the effects of peripheral muscle training (PMT) and different inspiratory muscle training (IMT) methods on respiratory functions, exercise capacity, and biochemistry parameters in coronary artery disease patients with metabolic syndrome. METHODS This prospective, single-blind, randomized-controlled study included 60 patients of stable coronary artery disease with metabolic syndrome (New York Heart Association [NYHA] Class I-II, left ventricular ejection fraction >40%). Patients were randomly divided into three groups: neuromuscular electrical stimulation (NMES) plus PMT group (NMES + PMT group, n = 20), IMT plus PMT group (IMT + PMT group, n = 20) and PMT group (PMT group, n = 20). Treatment continued for six weeks for all groups. The NMES was applied to rectus abdominis, IMT was applied with 30% of maximal inspiratory pressures, and PMT was applied at home. Spirometry, maximal inspiratory and expiratory pressure, dyspnea scores, exercise stress test, and biochemistry parameters were measured before and after training. RESULTS There were significant improvements in spirometric tests, respiratory muscle strength, dyspnea scores, exercise capacity, fasting blood glucose, and antistreptolysin O after treatment in all groups (p < 0.05). Significant improvements in C-reactive protein and erythrocyte sedimentation rate were observed in NMES + PMT and IMT + PMT groups (p < 0.05). Among the groups, there was a significant difference in maximal inspiratory pressure (p = 0.02) and erythrocyte sedimentation rate (p = 0.037) in favor of NMES + PMT group (p < 0.05). CONCLUSION Our study results showed significant improvements in respiratory functions, exercise capacity, and biochemistry markers in all groups. Different IMT methods can be used in cardiopulmonary rehabilitation to improve exercise intolerance in coronary artery disease patients with metabolic syndrome. CLINICAL TRIAL REGISTRATION NUMBER NCT03523026.
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Effectiveness of water-based Liuzijue exercise on respiratory muscle strength and peripheral skeletal muscle function in patients with COPD.
Wu, W, Liu, X, Liu, J, Li, P, Wang, Z
International journal of chronic obstructive pulmonary disease. 2018;:1713-1726
Abstract
OBJECTS The purpose of this study was to quantitatively assess the effects of water-based Liuzijue exercise on patients with COPD and compare it with land-based Liuzijue exercise. MATERIALS AND METHODS Participants were randomly allocated to one of three groups: the water-based Liuzijue exercise group (WG), the land-based Liuzijue exercise group (LG), and the control group (CG). CG participants accepted no exercise intervention, while training groups performed Liuzijue exercise according to Health Qigong Liuzijue (People's Republic of China) in different environments for 60-min sessions twice a week for 3 months. RESULTS Of the 50 patients enrolled, 45 (90%) completed the 3-month intervention. The CG showed decreased expiratory muscle strength, extensor and flexor endurance ratio (ER) of the elbow joints and flexor peak torque (PT), total work (TW), and ER of the knee joints (p<0.05). Both training groups showed improved respiratory muscle strength, which differed from the CG (p<0.001). In addition, extensor and flexor TW of the elbow joints in the training groups were increased (p<0.01), and the WG differed from the CG in extensor TW and ER and flexor TW (p<0.01), while the LG differed from the CG in flexor TW and extensor ER (p<0.05). PT, PT/body weight (BW), and TW in the knee joint extensor in the training groups were increased as well (PT and PT/BW: p<0.05, TW: p<0.01), and the WG differed from the CG in terms of knee joints outcomes, while the LG differed from the CG in flexor TW only (p<0.05). CONCLUSION Water-based Liuzijue exercise has beneficial effects on COPD patients' respiratory muscle strength and peripheral skeletal muscle function, and additional benefits may exist in endurance of upper limbs and strength and endurance of lower limbs when compared with land-based Liuzijue exercise.
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The influence of inspiratory muscle training combined with the Pilates method on lung function in elderly women: A randomized controlled trial.
Alvarenga, GM, Charkovski, SA, Santos, LKD, Silva, MABD, Tomaz, GO, Gamba, HR
Clinics (Sao Paulo, Brazil). 2018;:e356
Abstract
OBJECTIVE Aging is progressive, and its effects on the respiratory system include changes in the composition of the connective tissues of the lung that influence thoracic and lung compliance. The Powerbreathe® K5 is a device used for inspiratory muscle training with resistance adapted to the level of the inspiratory muscles to be trained. The Pilates method promotes muscle rebalancing exercises that emphasize the powerhouse. The aim of this study was to evaluate the influence of inspiratory muscle training combined with the Pilates method on lung function in elderly women. METHODS The participants were aged sixty years or older, were active women with no recent fractures, and were not gait device users. They were randomly divided into a Pilates with inspiratory training group (n=11), a Pilates group (n=11) and a control group (n=9). Spirometry, manovacuometry, a six-minute walk test, an abdominal curl-up test, and pulmonary variables were assessed before and after twenty intervention sessions. RESULTS The intervention led to an increase in maximal inspiratory muscle strength and pressure and power pulmonary variables (p<0.0001), maximal expiratory muscle strength (p<0.0014), six-minute walk test performance (p<0.01), and abdominal curl-up test performance (p<0.00001). The control group showed no differences in the analyzed variables (p>0.05). CONCLUSION The results of this study suggest inspiratory muscle training associated with the Pilates method provides an improvement in the lung function and physical conditioning of elderly patients.
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Cycle ergometer and inspiratory muscle training offer modest benefit compared with cycle ergometer alone: a comprehensive assessment in stable COPD patients.
Wang, K, Zeng, GQ, Li, R, Luo, YW, Wang, M, Hu, YH, Xu, WH, Zhou, LQ, Chen, RC, Chen, X
International journal of chronic obstructive pulmonary disease. 2017;:2655-2668
Abstract
BACKGROUND Cycle ergometer training (CET) has been shown to improve exercise performance of the quadriceps muscles in patients with COPD, and inspiratory muscle training (IMT) may improve the pressure-generating capacity of the inspiratory muscles. However, the effects of combined CET and IMT remain unclear and there is a lack of comprehensive assessment. MATERIALS AND METHODS Eighty-one patients with COPD were randomly allocated to three groups: 28 received 8 weeks of CET + IMT (combined training group), 27 received 8 weeks of CET alone (CET group), and 26 only received 8 weeks of free walking (control group). Comprehensive assessment including respiratory muscle strength, exercise capacity, pulmonary function, dyspnea, quality of life, emotional status, nutritional status, and body mass index, airflow obstruction, and exercise capacity index were measured before and after the pulmonary rehabilitation program. RESULTS Respiratory muscle strength, exercise capacity, inspiratory capacity, dyspnea, quality of life, depression and anxiety, and nutritional status were all improved in the combined training and CET groups when compared with that in the control group (P<0.05) after pulmonary rehabilitation program. Inspiratory muscle strength increased significantly in the combined training group when compared with that in the CET group (ΔPImax [maximal inspiratory pressure] 5.20±0.89 cmH2O vs 1.32±0.91 cmH2O; P<0.05). However, there were no significant differences in the other indices between the two groups (P>0.05). Patients with weakened respiratory muscles in the combined training group derived no greater benefit than those without respiratory muscle weakness (P>0.05). There were no significant differences in these indices between the patients with malnutrition and normal nutrition after pulmonary rehabilitation program (P>0.05). CONCLUSION Combined training is more effective than CET alone for increasing inspiratory muscle strength. IMT may not be useful when combined with CET in patients with weakened inspiratory muscles. Nutritional status had slight impact on the effects of pulmonary rehabilitation. A comprehensive assessment approach can be more objective to evaluate the effects of combined CET and IMT.
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Treadmill walking in water induces greater respiratory muscle fatigue than treadmill walking on land in healthy young men.
Yamashina, Y, Yokoyama, H, Naghavi, N, Hirasawa, Y, Takeda, R, Ota, A, Imai, D, Miyagawa, T, Okazaki, K
The journal of physiological sciences : JPS. 2016;(3):257-64
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Abstract
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.
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Effects of expiratory muscle strength training on oropharyngeal dysphagia in subacute stroke patients: a randomised controlled trial.
Park, JS, Oh, DH, Chang, MY, Kim, KM
Journal of oral rehabilitation. 2016;(5):364-72
Abstract
Expiratory muscle strength training (EMST) involves forcible blowing as a means of generating high expiratory pressure, against adjustable resistance. EMST has recently been introduced as a potential treatment for dysphagia. This study was performed to investigate the effects of EMST on the activity of suprahyoid muscles, aspiration and dietary stages in stroke patients with dysphagia. Twenty-seven stroke patients with dysphagia were randomly divided into two groups. The experimental group performed EMST with a 70% threshold value of maximal expiratory pressure, using an EMST device, 5 days a week for 4 weeks. The placebo group trained with a sham device. The EMST regime involved 5 sets of 5 breaths through the EMST device for a total of 25 breaths per day. Activity in the suprahyoid muscle group was measured using surface electromyography (sEMG). Further, the penetration-aspiration scale (PAS) was used to assess the results of the videofluoroscopic swallowing study (VFSS). In addition, dietary stages were evaluated using the Functional Oral Intake Scale (FOIS). The experimental group exhibited improved suprahyoid muscle group activity and PAS results, when compared to the placebo group. Following intervention, statistical analysis indicated significant differences in measured suprahyoid muscle activity (P = 0·01), liquid PAS outcomes (P = 0·03) and FOIS results (P = 0·06), but not semisolid type PAS outcomes (P = 0·32), between the groups. This study confirms EMST as an effective treatment for the development of suprahyoid muscle activity in stroke patients with dysphagia. Additionally, improvements in aspiration and penetration outcomes were observed.
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Respiratory muscles, exercise performance, and health in overweight and obese subjects.
Frank, I, Briggs, R, Spengler, CM
Medicine and science in sports and exercise. 2011;(4):714-27
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Abstract
PURPOSE Overweight and obese subjects often perceive increased breathlessness during minor exertion and therefore avoid exercise. Respiratory muscle endurance training (RMET) can reduce the perception of breathlessness. We hypothesized that RMET 1 month before and during a 6-month (3 months supervised + 3 months unsupervised) exercise and nutrition counseling program (EN) would improve the benefits of EN. METHODS Twenty-six overweight and obese subjects with significant perception of breathlessness during exercise (age = 33 ± 9 yr, body mass index (BMI) = 31.3 ± 4.9 kg·m(-2)) were randomized to RMET+EN (R+EN) or EN alone. R+EN performed 30 min of normocapnic hyperpnea 5 wk(-1) before and 2 wk(-1) during EN. EN consisted of two strength and three endurance training sessions per week, as well as prescribed nutritional composition and a 2.1-kJ (500-kcal) energy deficit per day. Both groups had an equal number of laboratory visits during the 7 months. Before and after 4 and 7 months, subjects performed a 12-min time trial (TT; 6 + 6 min, 2-min pause) and an incremental cycling test (ICT) to exhaustion, and blood lipids were assessed. RESULTS Weight loss was significant and similar in both groups (-4.2 vs -3.7 kg; both P < 0.05). During the first 4 months, distance covered in 12 min improved more (P < 0.05) with R+EN (1678 vs 1824 m; P < 0.001) than with EN alone (1638 vs 1698 m; P < 0.05), whereas after R+EN, breathlessness during the ICT was reduced. Blood lipids of the pooled group improved in those subjects with pathologic values before the study. Despite reduced training compliance during the unsupervised period, subjects of both groups maintained the benefits attained during the supervised period. CONCLUSIONS R+EN improved TT performance more than EN alone, despite similar weight loss, possibly owing to the reduced perception of breathlessness.
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Effects of N-acetylcysteine on respiratory muscle fatigue during heavy exercise.
Kelly, MK, Wicker, RJ, Barstow, TJ, Harms, CA
Respiratory physiology & neurobiology. 2009;(1):67-72
Abstract
Respiratory muscle fatigue (RMF) occurs during heavy exercise in humans. N-acetylcysteine (NAC) infusion has been shown to reduce RMF, suggesting that oxidative stress is a contributing factor. The purpose of the present study was to determine the effect of an acute oral dose of NAC on RMF during heavy exercise. Subjects (n=8) were given either placebo (PLA) or NAC (1,800 mg) 45 min prior to a 30 min constant load (85V(O)(2peak)), discontinuous exercise test. Maximum respiratory pressures (inspiratory, PI(max); expiratory, PE(max)) and venous blood samples were made prior to and following each 5 min of exercise. There was no difference (p>0.05) in PI(max) between NAC (127.9+/-34.1 cm H(2)O) or PLA (134.1+/-28.1cm H(2)O) at rest. During exercise, PI(max) was significantly lower with PLA ( approximately 14%) compared to NAC at 25 and 30 min suggesting less RMF with NAC. There were no differences (p>0.05) between groups in PE(max), V(O)(2), V(E), or heart rate at rest or throughout exercise. These results suggest that an acute dose of NAC reduces RMF during heavy exercise.