Inspiratory muscle training of moderate intensity improves respiratory muscle strength, diaphragm thickness, and diaphragm mobility in elderly women and it should be considered to minimize changes associated with senescence.

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.

WBV training improves MVIC of knee extensors in patients with CKD on HD in the interdialytic period. WBV training could be considered in the management of patients with CKD.

This study evaluated the immediate effects of respiratory muscle stretching on chest wall kinematics and electromyographic activity in COPD patients. 28 patients with COPD were randomized into two groups: 14 to the treatment group (TG) and 14 to the control group (CG). The TG underwent a stretching protocol of the rib cage muscles, while the CG remained at rest under similar conditions. After a single session, TG increased the tidal volume of the pulmonary rib cage (Vrcp) (p=0.020) and tidal volume of abdominal rib cage (Vrca) (p=0.043) variations and their percentages in relation to the thoracic wall, Vrcp% (p=0.044) and Vrca% (p=0.022). Also, TG decreased the end-expiratory Vrcp (p=0.013) and the end-inspiratory Vrcp (p=0.011) variations. In addition, there was a reduction in respiratory rate (RR) (p=0.011) and minute volume (MV) (p=0.035), as well as an increase in expiratory time (Te) (p=0.026). There was also an immediate reduction in sternocleidomastoid (p=0.043) and upper trapezium (p=0.034) muscle electrical activity. Then, the study supports the use of stretching to improve COPD chest wall mobility with positive effects on chest wall mechanics, on volume distribution and electromyography.

BACKGROUND: Heliox and forward-leaning posture (torso inclined forward at 50 -60°with the elbows resting on the thighs) are adjuncts in the administration of nebulized bronchodilator to patients with acute asthma. METHODS: We randomized 59 patients who presented to the emergency department in severe asthma crisis, into 4 treatment groups: nebulized bronchodilator ؉ oxygen; nebulized bronchodilator ؉ oxygen ؉ forward-leaning posture; nebulized bronchodilator ؉ heliox; and nebulized bronchodilator ؉ heliox ؉ forward-leaning posture. Before and after the bronchodilator treatments the subjects were seated with torso erect, breathing room air. Each subject received 2 doses, 20 min apart, of nebulized fenoterol (2.5 mg) plus ipratropium bromide (0.25 mg) in 3 mL of 0.9% saline, delivered with a semi-closed valved aerosol reservoir. The nebulizer was run with oxygen or 80:20 heliox. The post-treatment pulmonary function tests were performed 15 min after the second nebulization. The group's mean age was 35.1 ؎ 13.6 y, and there were 20 men and 39 women. RESULTS: The oxygen ؉ forward-leaning-posture group had a greater FEV 1 improvement than the oxygen group (59% vs 38%, P ‫؍‬ .02). The heliox ؉ forwardleaning-posture group had a greater FEV 1 improvement than the oxygen group (103% vs 38%, P ‫؍‬ .001) and the heliox group (103% vs 42%, P ‫؍‬ .03). The heliox group had greater reduction in respiratory rate than the oxygen group (P ‫؍‬ .03). The heliox ؉ forward-leaning-posture group had significantly greater peak expiratory flow improvement than any of the other groups. CON-CLUSIONS: Heliox plus forward-leaning posture during bronchodilator nebulization improves bronchodilator efficacy in patients with severe acute asthma. (ClinicalTrials.gov registration NCT00922350).

Introduction: The literature presents different findings about the vibration training efficacy on muscle per- formance, even using protocols with similar parameters. Objective: The purpose of this systematic review was to investigate the effects of whole body vibration (WBV) on strength and quality of life in health elderly people, presenting a meta-analisys. Methods: PubMed, CINAHL, SciELO, LILACS and PEDro databases were systematically searched for studies that used WBV in healthy elderly. These searches were supplemented with material identified in references and a qualitative and quantitative analysis was performed to sum- marize the findings. The search was performed by two independent researchers with a third was selected to solve problems of search disagreement, data collection, and quality score. Results: Nine studies with strength outcome and two studies with quality of life outcome were identified, with sample ranging 21 to 220 elderly, all studies had control groups performing exercises or guidelines. Some studies have shown sig- nificant improvements in muscle strength, muscle power, vertical jump height, timed get up and go test and quality of life. Conclusion: The meta-analysis of the findings in these studies shows that WBV could benefit health elderly, increasing muscle strength and improving the quality of life mainly in functional capacity. The number of publications found in the databanks searched is small, with limitations in design of protocols with a weakness to the interpretation of the findings, suggesting the need of investigation with WBV with well-designed protocols and controlled parameters into the effects of WBV training in elderly people.

Type II diabetes (TIIDM) is characterized by high levels of blood glucose followed by excessive insulin release so that the target cells become less sensitive, developing insulin resistance and maintaining hyperglycemic levels. Physical activity is the strongest element to prevent and to manage the TIIDM, and the majority of patients do not remain in regularly active levels, because the premature fatigue in these patients decreases the adherence to the training. Contrastingly, the whole body vibration (WBV) training may improve the glucose metabolism in diabetic patients, reducing the peripheral blood sugar, decreasing the physical discomfort and perceived exertion. Therefore, the purpose of the study was to determine the effect of an acute WBV session as therapy to promote fasting decreases in insulin levels in peripheral blood in TIIDM when compared to healthy elderly. For this, fifteen healthy elderly women and fourteen diabetic elderly women, all sedentary, were allocated in diabetic or control groups, and we made an acute whole body session composed of 10 bouts lasting 2 minutes each one, separated by a 30-second rest period. The WBV was executed in a triaxial platform MY3 Power Plate® at 35 hertz and has been chosen a peak-to-peak displacement of 4 millimeters. After the protocol, both groups decreased the glycemic levels and increased lactate production in relation to the basal levels and when compared diabetic and control, where the most important results have been shown in diabetic women. This study revealed that WBV training in TIIDM has had significant beneficial effects on the control of glucose levels, still in an acute session. So that, the complete training probably will show better results about glycemic control and this finding could be especially important when prescribing exercise for elderly who are unable or unwilling to use traditional loads or who show poor exercise compliance.

INTRODUÇÃO: A asma é uma desordem inflamatória crônica que, em casos graves, altera o fluxo aéreo, mesmo no período intercrise. OBJETIVO: Verificar, em crianças asmáticas, a influência das posturas sentada ereta e sentada inclinada para frente sobre o efeito da nebulização medicamentosa, avaliando as forças inspiratória e expiratória máximas (PI máx e PE máx) e o pico de fluxo expiratório (PFE). MÉTODO: 57 crianças, na faixa etária de 6 a 12 anos, foram distribuídas em três grupos: Grupo I, com crianças na postura sentada ereta e sentada inclinada para frente; Grupo II, com crianças na postura sentada ereta antes e após a nebulização; e Grupo III, com crianças na postura sentada inclinada para frente antes e após a nebulização. As crianças foram avaliadas três vezes nas medidas analisadas. Para comparação, foi utilizado o teste t de student (pareado) RESULTADOS: A PI máx, a PE máx e o PFE foram maiores na posição sentada inclinada para frente, com p = 0,003, p = 0,006 e p = 0,000, respectivamente. Após a nebulização, o Grupo II apresentou aumentos de 44,16% na PI máx, 36,02% no PEF e 34,88% na PE máx. Após a nebulização, o Grupo III apresentou elevação de 69,46% na PI máx, 60,87% na PE máx e 52,05% no PFE. Comparados os grupos II e III, os ganhos são maiores no Grupo III, com (p < 0,05) para as medidas do PFE e da PE máx. CONCLUSÃO: A postura sentada inclinada para frente oferece maior vantagem mecânica para a musculatura expiratória, favorecendo a redução da obstrução, por evidenciar aumentos na PE máx e no PFE.