Flutter Valve™ increases sputum removal during treatment and diminishes total and peripheral airway resistance in hypersecretive patients with bronchiectasis. Impulse oscillometry is a user-friendly tool to evaluate the effects of airway clearance techniques on respiratory mechanics.
ObjectiveEvaluate and compare the isolated and combined effects of Inspiratory Muscle Training (IMT) and Aerobic Training (AT) on respiratory and functional parameters, inflamatory biomarkers, redox status and health-related quality of life (HRQoL) in hemodialysis patients.MethodsA randomised controlled trial with factorial allocation and intention-to-treat analysis was performed in hemodialysis patients. Volunteers were randomly assigned to performe 8-weeks of IMT at 50% of maximal inspiratory pressure (MIP), low intensity AT or combined training (CT). Before the interventions, all the volunteers went 8-weeks through a control period (without training). Measures are taken at baseline, 8-week (after control period) and 16-week (after the interventions). Primary outcomes were functional capacity (incremental shuttle walk test), MIP and lower limbs strength (Sit-to-Stand test of 30 seconds). Plasma levels of interleukin-6 (IL-6), soluble tumor necrosis factor receptor 1 (sTNFR1) and 2 (sTNFR2), adiponectin, resistin and leptin, redox status parameters and HRQoL (KDQOL-SF questionnaire) were the scondary outcomes. Data analyses were performed by two-way repeated measurements ANOVA.Results37 hemodialysis patients aged 48.2 years old (IC95% 43.2–54.7) were randomized. Increase of MIP, functional capacity, lower limbs strength and resistin levels, and reduction of sTNFR2 levels in 16-week, compared to baseline and 8-week, were observed in all the groups (p<0.001). IMT improved functional capacity, MIP and lower limbs strength in 96.7m (IC95% 5.6–189.9), 34.5cmH2O (IC95% 22.4–46.7) and 2.2repetitions (IC95% 1.1–3.2) respectively. Increase in resistin leves and reduction in sTNFR2 leves after IMT was 0.8ng/dL (IC95% 0.5–1.1) and 0.8ng/dL (IC95% 0.3–1.3), respectively, without between-group differences. Compared to baseline and 8-week, adiponectin levels (p<0.001) and fatigue domain of the HRQoL (p<0.05) increased in 16-week only in CT.ConclusionIMT, AT and CT improved functional parameters and modulated inflammatory biomarkers, in addition, IMT provoked a similar response to low intensity AT in hemodialysis patients.Trial registrationRegistro Brasileiro de Ensaios clínicos RBR-4hv9rs.
Background
: Osteoarthritis of the knee (kOA) is a chronic, progressive, degenerative health condition that contributes to the imbalance between the synthesis and destruction of articular cartilage. Recently, whole body vibration (WBV) training has been recommended as an effective alternative for strength training in elderly people, and various physiological effects are obtained in response to exercise performed on a vibratory platform, such as an increase in muscle activation and improved muscle performance. However, the effects of WBV particularly on the strength of the quadriceps muscle and neuronal plasticity are unknown.
Objective
: The aim of this study was to evaluate the effects of adding WBV to squat training on the isometric quadriceps muscle strength (IQMS) and the plasma levels of brain-derived neurotrophic factor (BDNF) in elderly woman with kOA.
Methods
: Fifteen elderly women ≥65 years of age with kOA were randomized into two interventions: (1) the vibration group (VG), in which participants performed squat exercise training in association with WBV or (2) the exercise group (EG), in which participants performed squat exercise training without vibration, for 12 weeks 3×/week.
Results
: Compared to the EG group, the VG group demonstrated a significantly greater delta (Δ) in IQMS values (IC95% 0.43–7.06;
p
≤ 0.05) and in Δ BDNF plasma levels (IC95% −32.51 to 4.217;
p
≤ 0.05) after the intervention period. There was an association between increase of Δ BDNF plasma levels and increase of Δ IQMS (
β
= 0.57;
R
2
= 0.32;
p
= 0.03).
Conclusion
: The addition of WBV to squat exercise training improves lower limb muscle performance in elderly women with kOA. These findings suggest that the improvement in muscle performance is related to neuromuscular adaptations induced by WBV.
Clinical Trial Registration
:
www.ClinicalTrials.gov
, identifier NCT03918291.
Symptoms in post-COVID-19 patients who require hospitalization can persist for months, significantly affecting their health-related quality of life (HRQoL). Thus, the present study aimed to discuss the main findings regarding HRQoL in post-COVID-19 patients who required hospitalization. An electronic search was performed in the MEDLINE, EMBASE, CINAHL, Web of Science, LILACS, and Scopus databases, without date and language restrictions, until July 2021. Twenty-four articles were included in the analysis. It seems that HRQoL partially improved soon after hospital discharge, although the negative impact on HRQoL may persist for months. The physical and mental aspects are affected because patients report pain, discomfort, anxiety, and depression. The HRQoL of COVID-19 infected patients was worse than that of uninfected patients. Additionally, HRQoL seemed worse in patients admitted to the intensive care unit than in those who remained in the ward. Improvements in HRQoL after hospital discharge are independent of imaging improvement, and there seems to be no association between HRQoL after hospital discharge and disease severity on hospital admission. Many factors have been identified as determinants of HRQoL, with women and advanced age being the most related to worse HRQOL, followed by the duration of invasive mechanical ventilation and the need for intensive care. Other factors included the presence and number of comorbidities, lower forced vital capacity, high body mass index, smoking history, undergraduate education, and unemployment. In conclusion, these findings may aid in clinical management and should be considered in the aftercare of patients.
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