Background
Although inspiratory muscle training (IMT) is an effective intervention for improving breath perception, brain mechanisms have not been studied yet.
Purpose
To examine the effects of IMT ...on insula and default mode network (DMN) using resting‐state functional MRI (RS‐fMRI).
Study Type
Prospective.
Population
A total of 26 healthy participants were randomly assigned to two groups as IMT group (n = 14) and sham IMT groups (n = 12).
Field Strength/Sequence
A 3‐T, three‐dimensional T2* gradient‐echo echo planar imaging sequence for RS‐fMRI was obtained.
Assessment
The intervention group received IMT at 60% and sham group received at 15% of maximal inspiratory pressure (MIP) for 8 weeks. Pulmonary and respiratory muscle function, and breathing patterns were measured. Groups underwent RS‐fMRI before and after the treatment.
Statistical Tests
Statistical tests were two‐tailed P < 0.05 was considered statistically significant. Student's t test was used to compare the groups. One‐sample t‐test for each group was used to reveal pattern of functional connectivity. A statistical threshold of P < 0.001 uncorrected value was set at voxel level. We used False discovery rate (FDR)‐corrected P < 0.05 cluster level.
Results
The IMT group showed more prominent alterations in insula and DMN connectivity than sham group. The MIP was significantly different after IMT. Respiratory rate (P = 0.344), inspiratory time (P = 0.222), expiratory time (P = 1.000), and inspiratory time/total breath time (P = 0.572) of respiratory patterns showed no significant change after IMT. All DMN components showed decreased, while insula showed increased activation significantly.
Data Conclusion
Differences in brain activity and connectivity may reflect improved ventilatory perception with IMT with a possible role in regulating breathing pattern by processing interoceptive signals.
Evidence Level
2
Technical Efficacy
Stage 4
During the COVID-19 pandemic, all countries implemented lockdown to prevent transmission of coronavirus. The prolonged stay-at-home process created some unfavourable effects like unhealthy lifestyle, ...physical inactivity and sedentary behaviour especially in patients with cardiovascular risk. Hypertensive individuals are also affected in the pandemic because of limited access to healthcare services, screening, and altered lifestyles. We aimed to investigate physical activity (PA) level, sedentary behaviour, mental health and healthy lifestyle behaviours in patients with hypertension and compare these parameters with healthy controls. This prospective, cross-sectional study included 40 hypertensive and 40 age-sex matched healthy controls. We assessed PA with the International Physical Activity Questionnaire long-form, quality of life with Short-Form 36 (SF-36) questionnaire, anxiety and depression with Hospital Anxiety and Depression Scale (HADS) and lifestyle behaviours with Health-Promoting Lifestyle Profile Scale-II (HPLP-II). Moderate and vigorous PA levels of hypertensives' were statistically lower than healthy controls (P = 0.001; P = 0.003, respectively). Hypertensive patients exhibited lower SF-36 physical function (P = 0.001), energy/vitality (P = 0.042), body pain scores than those of healthy controls (P = 0.007). Although HADS-anxiety, depression scores were similar (P > 0.05), the depression ratio (45%) was more common in the hypertensive group during the lockdown. The main findings are that hypertensive patients have lower PA levels and worse quality of life than healthy controls during the pandemic. In addition, the presence of depression is more common among hypertensive patients. Considering unhealthy lifestyles, governments, and health professionals should take some precautions and plan interventions against physical inactivity. As known, providing regular physical activity is a keystone to fighting against cardiovascular disease.
Functional changes are essential determinants of mortality and morbidity in individuals with chronic liver disease. However, there is limited information about whether these changes persist long-term ...after liver transplantation (LT). We aimed to compare physical fitness, physical activity, balance, kinesiophobia, and fatigue between patients with LT and healthy controls. All participants underwent evaluation with the Senior Fitness Test (SFT) for exercise capacity and physical fitness, the International Physical Activity Questionnaire (IPAQ) for physical activity, the Timed Up-and-Go Test (TUG) and the Berg Balance Scale (BBS) for balance, the Tampa Scale for Kinesiophobia (TSK) for kinesiophobia, and the Fatigue Severity Scale (FSS) and Fatigue Impact Scale (FIS) for fatigue. We studied 16 persons with LT (M age = 40.56, SD = 15.73 years; M time since LT = 66.81, SD = 72.05 months) and 16 control participants (M age = 39.87, SD = 13.98 years). Compared to controls, participants with LT showed significantly poorer performance on the SFT components assessing upper and lower body strength, aerobic endurance, agility, and dynamic balance (p < .001 for all), significantly lower IPAQ physical activity scores (p = .002) and BBS score (p = .017), and significantly higher TUG time (p < .001) and TSK, FSS, and FIS scores (p = .001, p = .001, and p = .004, respectively). Individuals with post-LT had lower exercise capacity, physical fitness, balance, and physical activity, and higher kinesiophobia and fatigue levels in the long-term compared to their peers. Future studies should focus on frailty in individuals in the long term after LT.
Chronic pain, sensory disturbances, and lymphedema are frequent after breast cancer, leading to arm dysfunction. There is a need for objective performance-based clinical exercise tests for the upper ...extremity in patients with breast cancer.
The aim of this study was to evaluate the validity and reliability of the 6-minute pegboard and ring test (6PBRT) in breast cancer survivors.
Forty-eight women with breast cancer (mean age = 55.40 ± 10.40 years) were included. All patients performed 6PBRT on the first day and one week later to investigate the test-retest reliability of the 6PBRT, and intraclass correlation coefficients (ICC) were calculated. The peak workload (W
) and oxygen consumption level (VO
) during the arm ergometer test were used as outcomes for the criterion validity of the 6PBRT.
The 6PBRT showed good test - retest reliability with an ICC
value of 0.871 95% confidence interval (CI) 0.769-0.928. The first 6PBRT score was very strongly correlated with the second test score (
= 0.866,
< .001). The 6PBRT score was significantly correlated with VO
(
= 0.634,
< .001), and W
(
= 0.546,
< .001). While the 6PBRT score had less effect on VO
, the determination of VO
in the model was very good (R
= 0.832).
The 6PBRT has good test-retest reliability and is a valid test in individuals with breast cancer. These findings suggest that 6PBRT is a practical, useful, valid and reliable assessment tool for determining functional arm exercise capacity in patients with breast cancer.
Background
Primary ciliary dyskinesia (PCD) is a rare, hereditary, autosomal recessive disorder characterized by recurrent upper and lower respiratory tract infections. This study aimed to compare ...pulmonary function, respiratory muscle strength, exercise capacity, physical fitness, and activities of daily living (ADLs) retrospectively between patients with PCD and healthy controls.
Methods
Data from 20 patients with PCD and 20 matched, healthy counterparts recorded between July 2015 and January 2017 were analyzed. The data evaluated and recorded included pulmonary function using a portable spirometer, respiratory muscle strength (using a mouth pressure device, exercise capacity using the incremental shuttle walk test,), physical fitness (using the Munich Fitness Test), and ADLs (using the Glittre ADL test).
Results
Pulmonary function, respiratory muscle strength, incremental shuttle walk test scores (all parameters), and total Munich Fitness Test scores were lower in the PCD group relative to controls (P < 0.05). The duration to complete the Glittre ADL test was higher in PCD patients than in healthy subjects (P < 0.05).
Conclusions
Pulmonary function, respiratory muscle strength, exercise capacity, physical fitness, and ADL were affected by PCD. Thus, pulmonary rehabilitation regimens should be tailored according to these impacts.
ABSTRACT
Background and objective
Inspiratory muscle training (IMT) enhances velocity of inspiratory muscle contraction and modifies inspiratory and expiratory time. This study aimed to examine the ...impact of high‐intensity IMT (H‐IMT) on exercise capacity in bronchiectasis.
Methods
Forty‐five patients were included. Lung function, respiratory muscle strength and endurance, exercise capacity, dyspnoea, fatigue and quality of life (QOL) were evaluated. Patients were randomized into two groups: H‐IMT and control groups. Twenty‐three patients underwent H‐IMT for 8 weeks, using threshold loading with a target workload of maximal inspiratory pressure (MIP) of at least 70%, with 3‐min cycles (as 2‐min training: 1‐min rest intervals) for 21 min. There was a total period of 14 min of loaded breathing and 7 min of recovery. The control group (n = 22) underwent low‐intensity IMT at 10% of the initial MIP and was maintained at the same intensity until the end of the training.
Results
After training, both MIP and maximal expiratory pressure (MEP) and the incremental shuttle walk distance were increased in the H‐IMT group compared with the control group (P < 0.05). There was a significant difference in constant threshold load, time and pressure–time units in the H‐IMT group (P < 0.05) but not in the control group (P > 0.05). A significant decrease was found in fatigue in both groups (P < 0.05). The Leicester Cough Questionnaire social score for the H‐IMT group decreased significantly after the treatment (P < 0.05).
Conclusion
The H‐IMT increased exercise capacity in patients with non‐cystic fibrosis bronchiectasis. It has also positive effects on respiratory muscle strength and endurance, and social aspects of QOL.
The present randomized controlled study contributes to the literature about the impact of high‐intensity inspiratory muscle training (H‐IMT) in bronchiectasis. We showed that H‐IMT increased respiratory muscle strength and endurance, exercise capacity and social aspects of quality of life in patients with non‐cystic fibrosis bronchiectasis
Objective
Extrapulmonary involvement such as balance and reaction time is unclear in cystic fibrosis (CF) patients. The aim of this study was to evaluate visuomotor reaction time (VMRT) and dynamic ...balance in children with CF and non‐CF bronchiectasis compared to healthy children.
Design/Methods
Demographic and clinical characteristics were recorded. All children were evaluated with pulmonary function test (PFT) using a spirometer, incremental shuttle walk test (ISWT) for exercise capacity, Fitlight Trainer for VMRT, and functional reach test (FRT) for dynamic balance.
Results
Fourteen children with CF (10.71 ± 2.94 years, 7 females), 17 children with non‐CF bronchiectasis (12.75 ± 2.81 years, 8 females), and 21 healthy children (11.36 ± 3.28 years, 11 females) were included. Children with CF had longer total VMRT (P = .027), poorer FRT performance (P = .001), and shorter ISWT distances (P = .03) compared to the children with non‐CF bronchiectasis and controls. Although total VMRT was longest in the CF group, there was no significant difference in mean VMRT among the CF, non‐CF bronchiectasis, and control groups (P > .05).
Conclusion
Dynamic balance and VMRT show greater impairment in children with CF than in children with non‐CF bronchiectasis compared to healthy controls. Our findings suggest that VMRT and dynamic balance should be taken into consideration for assessments and exercise programs in pulmonary rehabilitation.
Background
Although both self‐paced and externally paced field tests are widely used in cystic fibrosis (CF), it is still unclear whether they induce clinically relevant and similar cardiorespiratory ...responses. The aim of this study was therefore to compare the incremental shuttle walk test (ISWT) and 6 min walk test (6MWT), and to determine the factors influencing exercise capacity in CF.
Methods
Fifty clinically stable CF patients were included in the study. Pulmonary function, peripheral and respiratory muscle strength were assessed, anthropometric measurements were recorded, and 6MWT and ISWT carried out.
Results
The CF patients covered significantly more distance in the ISWT than 6MWT (P < 0.001). Heart rate response and dyspnea score at the end of the tests and during the recovery phase were significantly higher in the ISWT compared with the 6MWT (P < 0.05). The 6MWT and ISWT had similar moderate–strong correlations with age, height, weight, pulmonary function, respiratory and peripheral muscle strength (P < 0.05). Forty‐nine percent of the variance in 6MWT distance was explained by age and forced expiratory volume in 1 s (FEV1; R2 = 0.49, F(2–48) = 22.033, P < 0.001). The variables contributing to ISWT distance were FEV1, inspiratory muscle strength, and body mass index (R2 = 0.596, F(3–44) = 20.176, P < 0.001).
Conclusions
The ISWT is a better reflection of exercise tolerance in CF than 6MWT. ISWT is a preferable alternative assessment of exercise tolerance in terms of cardiorespiratory response.
Background
To the best of our knowledge, there is no study in the literature investigating the extrapulmonary outcomes of children with non–cystic fibrosis (CF) bronchiectasis and CF under the ...framework of the International Classification of Functioning, Disability, and Health (ICF) model. The purpose of the present study is to evaluate the children with CF and non‐CF bronchiectasis using the ICF model.
Materials and Methods
Children with CF, non‐CF bronchiectasis, and healthy counterparts were evaluated (20 participants in each group) according to the ICF items in domain b (body functions), domain s (body structures), and domain d (activities and participation). The pulmonary functions, respiratory and peripheral muscle strength tests, and posture analysis were carried out for domain b. For domain d, however, the Glittre‐activities of daily living test and Pediatric Outcome Data Collection were used.
Results
Muscle strength of shoulder abductors and hip extensors in children with CF was significantly lower than healthy children and adolescents (P < .05). The severity of lateral and posterior postural abnormalities in children with CF and non‐CF bronchiectasis was higher than those of healthy children (P < .05). Among the patient groups, global function, sports/physical function, expectations, transfers/basic mobility, and pain/comfort were the most affected participation dimensions (P < .05).
Conclusions
This study highlights the need for comprehensive up‐to‐date evaluation methods according to the ICF model for understanding rehabilitation requirements in CF and non‐CF bronchiectasis in different age groups.
Purpose
This study aimed to evaluate respiratory muscle strength and endurance, maximal oxygen consumption, and fatigue of colorectal cancer (CRC) survivors and compare them with healthy individuals.
...Methods
Demographic and clinical characteristics were recorded. Respiratory muscle strength (maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP)) was measured using an electronic mouth pressure device, and respiratory muscle endurance was assessed using a constant workload protocol with linear workload device. Peak oxygen consumption (VO
2
peak) was measured using the cardiopulmonary exercise test (CPET) with modified Bruce protocol. Fatigue was assessed using the Brief Fatigue Inventory (BFI).
Results
The patients had similar demographic characteristics (
p
> 0.05). MEP (cmH
2
O and %predicted) were lower in the CRC group than in healthy controls (
p
< 0.05). MIP (cmH
2
O and %predicted) and test duration did not differ between the groups (
p
> 0.05). VO
2
peak (ml/min and %predicted) and VO
2
peak/kg (%predicted) were significantly lower in the CRC group (
p
< 0.05). BFI score differed significantly in the CRC and control groups (
p
< 0.05).
Conclusion
Respiratory muscle strength, maximal exercise capacity, and fatigue are adversely affected in CRC survivors. Cancer treatment may cause loss of muscle strength and impair energy metabolism and oxygen transmission. These changes can result in decreased exercise capacity and respiratory muscle strength and increased fatigue. Studies examining the effects of different exercise training programs in CRC survivors are needed.
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