scholarly journals Inspiratory muscle strength in subjects with tetraplegia: viability of evaluation through the measurement of maximal inspiratory pressure

2014 ◽  
Vol 27 (3) ◽  
pp. 371-377
Author(s):  
Marlene Aparecida Moreno ◽  
Juliana Viana Paris ◽  
Raphael do Nascimento Pereira ◽  
Antonio Roberto Zamunér ◽  
Tais Mendes de Camargo ◽  
...  

Objective To analyze the values of maximal inspiratory pressure (MIP) and sniff nasal inspiratory pressure (SNIP) and to verify the existence of concordance between the two evaluation methodologies, in subjects with tetraplegia. Materials and methods Cross-sectional study with 17 tetraplegic men, aged 30.42 ± 7.67 years, who underwent MIP and SNIP evaluation using a respiratory pressure meter. Results The MIP and SNIP values obtained showed no difference when compared to each other (88.42 ± 29.39 vs. 86.68 ± 25.40 cmH2O, respectively). They were, however, significantly lower compared to the predicted values (MIP = 128.92 ± 7.18; SNIP = 114.11 ± 3.19 cmH2O), with the MIP values presenting correlation (r2 = 0.94; p < 0.0001) and concordance with those of the SNIP. Conclusions Both the MIP and SNIP values obtained were lower than the predicted values, indicating a reduction in inspiratory muscle strength (IMS). Both techniques showed correlation and concordance, suggesting that MIP can be used as a noninvasive method for IMS evaluation in this population.

Author(s):  
Maura Rigoldi Simões da ROCHA ◽  
Stefane SOUZA ◽  
Carolina Moraes da COSTA ◽  
Daniela Faleiros Bertelli MERINO ◽  
Maria Imaculada de Lima MONTEBELO ◽  
...  

ABSTRACT Background: Bariatric surgery can trigger postoperative pulmonary complications due to factors inherent to the procedure, mainly due to diaphragmatic dysfunction. Aim: To evaluate and compare the effects of two levels of positive pressure and exercises with inspiratory load on lung function, inspiratory muscle strength and respiratory muscle resistance, and the prevalence of atelectasis after gastroplasty. Methods: Clinical, randomized and blind trial, with subjects submitted to bariatric surgery, allocated to two groups: positive pressure group, who received positive pressure at two levels during one hour and conventional respiratory physiotherapy and inspiratory load group, who performed exercises with load linear inspiratory pressure, six sets of 15 repetitions, in addition to conventional respiratory physiotherapy, both of which were applied twice in the immediate postoperative period and three times a day on the first postoperative day. Spirometry was performed for pulmonary function analysis, nasal inspiratory pressure for inspiratory muscle strength and incremental test of respiratory muscle resistance for sustained maximal inspiratory pressure, both preoperatively and on hospital discharge on the second postoperative day. Results: There was no significant difference (p> 0.05) in the expiratory reserve volume and in the tidal volume in the pre and postoperative periods when compared intra and intergroup. There was no significant difference (p>0.05) in the nasal inspiratory pressure and the maximal inspiratory pressure maintained in the inspiratory load group in the intragroup evaluation, but with a significant difference (p<0.05) compared to the positive pressure group. The prevalence of atelectasis was 5% in both groups with no significant difference (p>0.05) between them. Conclusion: Both groups, associated with conventional respiratory physiotherapy, preserved expiratory reserve volume and tidal volume and had a low atelectasis rate. The inspiratory loading group still maintained inspiratory muscle strength and resistance of respiratory muscles.


2004 ◽  
Vol 1 (4) ◽  
pp. 475-478 ◽  
Author(s):  
Hélène Prigent ◽  
Michèle Lejaille ◽  
Line Falaize ◽  
Alain Louis ◽  
Maria Ruquet ◽  
...  

Author(s):  
Patricia Rehder-Santos ◽  
Raphael M. Abreu ◽  
Étore De F. Signini ◽  
Claudio D. da Silva ◽  
Camila A. Sakaguchi ◽  
...  

Background and Objective: Inspiratory muscle training (IMT) produced outstanding results in the physical performance of active subjects; however, little is known about the best training intensity for this population. The objective was to investigate the impact of an IMT of high intensity, using the critical inspiratory pressure (CIP), on inspiratory muscle strength (IMS), inspiratory muscle endurance (IME), peak power, and oxygen uptake of recreational cyclists; and to compare these results with moderate-intensity IMT (60% of maximal inspiratory pressure [MIP]). Methods: Thirty apparently healthy male recreational cyclists, 20–40 years old, underwent 11 weeks of IMT (3 times per week; 55 min per session). Participants were randomized into 3 groups: sham group (6 cmH2O; n = 8); 60% MIP (MIP60; n = 10) and CIP (n = 12). All participants performed the IMS test and incremental IME test at the first, fifth, ninth, and 13th weeks of the experimental protocol. Cardiopulmonary exercise testing was performed on an electromagnetic braking cycle ergometer pre-IMT and post-IMT. Data were analyzed using a 2-way repeated measures ANOVA (group and period factors). Results: IMS increased in CIP and MIP60 groups at the ninth and 13th weeks compared with the sham group (P < .001; β = 0.99). Regarding IME, there was an interaction between the CIP and MIP60 groups in all periods, except in the initial evaluation (P < .001; β = 1.00). Peak power (in watts) increased after IMT in CIP and MIP60 groups (P = .01; β = 0.67). Absolute oxygen uptake did not increase after IMT (P = .49; β = 0.05). Relative oxygen uptake to lean mass values did not change significantly (P = .48; β = 0.05). Conclusion: High-intensity IMT is beneficial on IMS, IME, and peak power, but does not provide additional gain to moderate intensity in recreational cyclists.


2016 ◽  
Vol 29 (2) ◽  
pp. 343-350 ◽  
Author(s):  
Simone Regina Posser ◽  
Sheila Cristina Cecagno-Zanini ◽  
Fabiana Piovesan ◽  
Camila Pereira Leguisamo

Abstract Introduction: Individuals with chronic kidney disease (CKD) undergoing hemodialysis (HD) present low cardiorespiratory fitness and functional capacity. Metabolic changes, due to the disease, can result in a variety of pathophysiological conditions that favor the development of respiratory muscle weakness. However, very little is known about the performance of the respiratory muscles and the influence of HD on them. Aim: To evaluate and correlate pulmonary function, functional capacity and respiratory muscle strength in patients with CKD undergoing HD. Methods: Cross-sectional study comprising 23 patients with CKD, that met the following inclusion criteria: patients of both genders, who perform HD three times a week for a minimum period of three months. Respiratory muscle strength was evaluated using a respiratory pressure meter, lung function through spirometry and functional capacity through the 6-minute walk test (6MWT) before the HD session. Results: All patients were male and mean age was 50.2 ± 15.8 years. The median duration of HD was 3 (1.5 to 6.0) years. The mean values obtained in comparison to those predicted were MIP% 36.0 ± 13.6, MEP% 49.5 ± 15.8, FVC% 93.8 ± 21.1, FEV1% 93.7 ± 21.1, FVC/VEF1% 104.1 ± 10.3, and 6MWT% 66.33 ± 20.53. A statistically significant positive correlation was observed between the 6MWT and MIP (r = .63, p =.001) and MEP (r = .67, p < .001), between the MIP and MEP (r =.79, p < .001) and between the FEV1 and FVC (r = .91, p < .001). Conclusion: Patients with CKD undergoing HD present changes in respiratory muscle strength, with the predicted values decreasing for age and gender, as well as the distance covered in the 6MWT, although, with normal spirometric values. Functional capacity was dependent on respiratory muscle strength, as well as the values of MIP and MEP, and the values of FVC and FEV1.


2020 ◽  
Vol 42 (6) ◽  
pp. 549-554
Author(s):  
Kornanong Yuenyongchaiwat ◽  
Sasipa Buranapuntalug ◽  
Karan Pongpanit ◽  
Chitima Kulchanarat ◽  
Opas Satdhabudha

Background: Poor psychological health and cardiorespiratory fitness prior to open heart surgery (OHS) might be predictors of postoperative pulmonary complications that lead to morbidity and mortality. Assessment of physical and psychological conditions should be considered for patients receiving OHS, to possibly prevent these complications. This study investigates how inspiratory muscle strength (IMS) and functional capacity (FC) relate to the psychological health of preoperative cardiac surgery patients. Method: A cross-sectional study was designed before OHS; the 6-minute walk test and IMS were performed on patients who were admitted for OHS. All participants were requested to complete Hospital Anxiety and Depression Scale. Pearson correlation and hierarchal regression analysis were performed to determine the relationships between IMS and FC and psychological conditions (anxiety and depression). Results: Overall, 36 males and 28 females aged 56.89±10.23 years were recruited. Significant relationships were observed between IMS and anxiety and depression symptoms (r = –0.33 and r = –0.27, respectively). Anxiety was negatively related to FC ( r = –0.25). These relationships remained significant after adjustment for age, sex, and body mass index (BMI) (∆ R2 = 0.11 and ∆ R2 = 0.09). In addition, anxiety was also related to FC after controlling for age, sex, and BMI (∆ R2 = 0.09). Conclusion: Among patients undergoing OHS, those with a higher level of depression or anxiety had a lower cardiorespiratory fitness than those with a low level of depression or anxiety.


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