Cardiopulmonary Rehabilitation Improves Respiratory Muscle Function and Functional Capacity in Children with Congenital Heart Disease. A Prospective Cohort Study

Critical surgical and medical advances have shifted the focus of congenital heart disease (CHD) patients from survival to achievement of a greater health-related quality of life (HRQoL). HRQoL is influenced, amongst other factors, by aerobic capacity and respiratory muscle strength, both of which are reduced in CHD patients. This study evaluates the influence of a cardiopulmonary rehabilitation program (CPRP) on respiratory muscle strength and functional capacity. Fifteen CHD patients, ages 12 to 16, with reduced aerobic capacity in cardiopulmonary exercise testing (CPET) were enrolled in a CPRP involving strength and aerobic training for three months. Measurements for comparison were obtained at the start, end, and six months after the CPRP. A significant improvement of inspiratory muscle strength was evidenced (maximum inspiratory pressure 21 cm H2O, 23%, p < 0.01). The six-minute walking test showed a statistically and clinically significant rise in walked distance (48 m, p < 0.01) and a reduction in muscle fatigue (1.7 out of 10 points, p = 0.017). These results suggest CPRP could potentially improve respiratory muscle function and functional capacity, with lasting results, in children with congenital heart disease, but additional clinical trials must be conducted to confirm this finding.

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Impairment of respiratory muscle function in pulmonary hypertension

Clinical Science ◽

10.1042/cs20070238 ◽

2007 ◽

Vol 114 (2) ◽

pp. 165-171 ◽

Cited By ~ 46

Author(s):

Hans-Joachim Kabitz ◽

Anja Schwoerer ◽

Hinrich-Cordt Bremer ◽

Florian Sonntag ◽

Stephan Walterspacher ◽

...

Keyword(s):

Pulmonary Hypertension ◽

Muscle Strength ◽

Muscle Function ◽

Respiratory Muscle ◽

World Health ◽

Walking Distance ◽

Respiratory Muscle Strength ◽

Control Subjects ◽

Respiratory Muscle Function ◽

Health Organization

It has been suggested that impaired respiratory muscle function occurs in patients with PH (pulmonary hypertension); however, comprehensive investigations of respiratory muscle function, including the application of non-volitional tests, needed to verify impairment of respiratory muscle strength in patients with PH have not yet been performed. In the present study, respiratory muscle function was assessed in 31 patients with PH (20 females and 11 males; mean pulmonary artery pressure, 51±20 mmHg; median World Health Organization class 3.0±0.5; 25 patients with pulmonary arterial hypertension and six patients with chronic thromboembolic PH) and in 31 control subjects (20 females and 11 males) well-matched for gender, age and BMI (body mass index). A 6-min walking test was performed to determine exercise capacity. Volitionally assessed maximal inspiratory (7.5±2.1 compared with 6.2±2.8 kPa; P=0.04) and expiratory (13.3±4.2 compared with 9.9±3.4 kPa; P<0.001) mouth pressures, sniff nasal (8.3±1.9 compared with 6.6±2.2 kPa; P=0.002) and transdiaphragmatic (11.3±2.5 compared with 8.7±2.5 kPa; P<0.001) pressures, non-volitionally assessed twitch mouth (1.46±0.43 compared with 0.97±0.41 kPa; P<0.001) and transdiaphragmatic (2.08±0.55 compared with 1.47±0.72 kPa; P=0.001) pressures during bilateral anterior magnetic phrenic nerve stimulation were markedly lower in patients with PH compared with control subjects. Maximal inspiratory mouth (r=0.58, P<0.001) and sniff transdiaphragmatic (r=0.43, P=0.02) pressures were correlated with the 6-min walking distance in patients with PH. In conclusion, the present study provides strong evidence that respiratory muscle strength is reduced in patients with PH compared with well-matched control subjects. Furthermore, the 6-min walking distance is significantly linked to parameters assessing inspiratory muscle strength.

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The Effect of Habitual Exercise on Respiratory-Muscle Function in Older Adults

Journal of Aging and Physical Activity ◽

10.1123/japa.13.1.34 ◽

2005 ◽

Vol 13 (1) ◽

pp. 34-44 ◽

Cited By ~ 15

Author(s):

Mark L. Watsford ◽

Aron J. Murphy ◽

Matthew J. Pine ◽

Aaron J. Coutts

Keyword(s):

Older Adults ◽

Muscle Strength ◽

Muscle Function ◽

Respiratory Muscle ◽

Endurance Capacity ◽

Respiratory Muscle Strength ◽

Exercise Participation ◽

Inspiratory Muscles ◽

Respiratory Muscle Function ◽

Habitual Exercise

Older adults’ participation in habitual exercise might be affected by alterations to respiratory mechanics such as decreased respiratory-muscle strength. This reduction can cause a decrease in efficiency of the ventilatory pump, potentially compromising exercise participation. This research examined the role of habitual exercise in respiratory-muscle function and the associated implications for exercise performance. Seventy-two healthy older adults (36 men, 64.9 ± 8.6 years, 177.2 ± 8.4 cm, 82.5 ± 11.9 kg; 36 women, 64.9 ± 9.5 years, 161.7 ± 6.4 cm, 61.6 ± 9.2 kg) undertook respiratory-function and walking-performance tests. Active men and women achieved higher scores than their inactive counterparts for all tests except spirometry, where no differences were evident. The results indicate that a significant amount of the elevated fitness level might be accounted for by increased endurance capacity of the inspiratory muscles. Inactive older individuals might be at risk for inadequate respiratory-muscle strength, so interventions should be considered.

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Relationship between respiratory muscle function and age, sex, and other factors

Journal of Applied Physiology ◽

10.1152/jappl.1989.66.2.943 ◽

1989 ◽

Vol 66 (2) ◽

pp. 943-948 ◽

Cited By ~ 90

Author(s):

H. I. Chen ◽

C. S. Kuo

Keyword(s):

Muscle Strength ◽

Pulmonary Function ◽

Duty Cycle ◽

Muscle Function ◽

Respiratory Muscle ◽

Forced Expiratory Volume ◽

Inspiratory Muscle ◽

Muscle Endurance ◽

Respiratory Muscle Strength ◽

Respiratory Muscle Function

To investigate the effects of gender and age on respiratory muscle function, 160 healthy volunteers (80 males, 80 females) were divided into four age groups. Twenty-eight of the male subjects were smokers. After the subjects were familiarized with the experimental procedure, respiratory muscle strength, inspiratory muscle endurance, and spirometric function, including forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FEV1/FVC, tidal volume, breathing rate, and duty cycle, were measured. The respiratory muscle strength was indicated by the maximal static inspiratory and expiratory pressures (PImmax and PEmmax). Inspiratory muscle endurance was determined by the time the subject was able to sustain breathing against an inspiratory pressure load on a modified Nickerson-Keens device. The results showed that 1) except for inspiratory muscle endurance and FEV1/FVC, men had greater respiratory muscle and pulmonary functions than women, 2) respiratory muscle function and pulmonary function decreased with age, 3) smoking tended to lower duty cycle and FEV1/FVC and to enhance PE,mmax, and 4) inspiratory muscle endurance was greater in men who were physically active than in those who were sedentary. Therefore we conclude that there are sexual and age differences in respiratory muscle strength and pulmonary function and that smoking or physical activity may affect respiratory muscle function.

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Respiratory muscle function and inspiratory muscle strength in patients with long COVID, ILD or COPD in comparison to healthy controls: Preliminary results

10.1183/13993003.congress-2021.pa2213 ◽

2021 ◽

Author(s):

Tamara Michalcíková ◽

Pavla Horová ◽

Martin Dvoracek ◽

Zuzana Krsaková ◽

Katerina Neumannová

Keyword(s):

Muscle Strength ◽

Muscle Function ◽

Respiratory Muscle ◽

Inspiratory Muscle ◽

Healthy Controls ◽

Preliminary Results ◽

Respiratory Muscle Function ◽

Inspiratory Muscle Strength

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The Comparison Between Respiratory Muscle Strength, Functional Capacity And Sleep Quality In Adult Controlled Asthmatics And Health Controls

Medicine & Science in Sports & Exercise ◽

10.1249/01.mss.0000487501.59233.4a ◽

2016 ◽

Vol 48 ◽

pp. 835

Author(s):

RENATA TRIMER ◽

Katyane Lopes Zangrando ◽

Paula Angelica Ricci ◽

Humberto Lanzotti ◽

Daniela K. Andaku ◽

...

Keyword(s):

Muscle Strength ◽

Sleep Quality ◽

Functional Capacity ◽

Respiratory Muscle ◽

Respiratory Muscle Strength

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Functional capacity, pulmonary and respiratory muscle strength in individuals undergoing hemodialysis

Fisioterapia em Movimento ◽

10.1590/0103-5150.029.002.ao13 ◽

2016 ◽

Vol 29 (2) ◽

pp. 343-350 ◽

Cited By ~ 2

Author(s):

Simone Regina Posser ◽

Sheila Cristina Cecagno-Zanini ◽

Fabiana Piovesan ◽

Camila Pereira Leguisamo

Keyword(s):

Muscle Strength ◽

Functional Capacity ◽

Respiratory Muscle ◽

Respiratory Muscles ◽

Cross Sectional Study ◽

Respiratory Muscle Strength ◽

Cross Sectional ◽

Mean Values ◽

Pressure Meter ◽

And Gender

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.

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