Effects of respiratory muscle training on endothelium and oxidative stress biomarkers in hemodialysis patients: A randomized clinical trial

Campos, Nataly Gurgel; Marizeiro, Débora Fortes; Florêncio, Ana Carolina Lins; Silva, Ítalo Caldas; Meneses, Gdayllon Cavalcante; Bezerra, Gabriela Freire; Martins, Alice Maria Costa; Libório, Alexandre Braga

doi:10.1016/j.rmed.2017.12.005

Cited by 24 publications

(19 citation statements)

References 42 publications

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“…However, the improvement of MDA and NO from the FDBT is very interesting and should be studied further. A previous study in hemodialysis patients showed that RMT did not affect the MDA level;53 thus, some mechanisms may reduce MDA and NO production. Interesting results of MDA and NO levels, when applied to the FDBT, significantly reduced both parameters with possible clinical benefits because high NO and MDA are related to disease severity and airflow obstruction 6.…”

Section: Discussionmentioning

confidence: 86%

Preliminary study: comparative effects of lung volume therapy between slow and fast deep-breathing techniques on pulmonary function, respiratory muscle strength, oxidative stress, cytokines, 6-minute walking distance, and quality of life in persons with COPD

Leelarungrayub¹,

Puntumetakul²,

Sriboonreung³

et al. 2018

COPD

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BackgroundLung volume therapy with the Voldyne® device can improve lung volume and has a nonsignificant benefit on respiratory muscle strength via the slow deep-breathing technique (SDBT); whereas respiratory muscle training with a respiratory muscle trainer via the fast deep-breathing technique (FDBT) has produced a significant improvement in people with COPD. Thus, the aim of this study was to compare the efficiency of lung volume therapy with the Voldyne® device with the SDBT and FDBT on pulmonary function, respiratory muscle strength, oxidative stress, cytokines, walking capacity, and quality of life (QoL) in people with COPD.MethodsA total of 30 COPD patient volunteers with mild (stage I) to moderate (stage II) severity were randomized into two groups: SDBT (n=15) and FDBT (n=15). Pulmonary function (FVC, FEV1, and FEV1/FVC), maximal inspiratory mouth pressure (PImax), oxidative stress status (total antioxidant capacity [TAC], glutathione [GSH], malondialdehyde [MDA], and nitric oxide [NO]), inflammatory cytokines (tumor necrosis factor-alpha [TNF-α] and IL-6), 6-minute walking distance (6MWD), and total clinical COPD questionnaire (CCQ) score were evaluated before and after 4 weeks of training.ResultsAll the parameters had no statistical difference between the groups before training. The PImax, TAC, IL-6, total QoL score, and 6MWD changed significantly in the SDBT group after the 4-week experiment as compared to those in the pre-experimental period, whereas FVC, FEV1, FEV1%, FEV1/FVC%, PImax, TAC, MDA, NO, TNF-α, IL-6, 6MWD, and total CCQ score changed significantly in the FDBT group as compared to those in the pre-experimental period. The FEV1%, PImax, TNF-α, IL-6, and total CCQ score differed significantly in the FDBT group in the post-experimental period as compared to those in the SDBT group.ConclusionThis preliminary study concluded that the application of incentive spirometry with the Voldyne® device via fast deep breathing possibly improved respiratory muscle strength and QoL and reduced inflammatory cytokines, MDA, and NO better than that via slow deep breathing among people with COPD.

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Section: Discussionmentioning

confidence: 86%

Preliminary study: comparative effects of lung volume therapy between slow and fast deep-breathing techniques on pulmonary function, respiratory muscle strength, oxidative stress, cytokines, 6-minute walking distance, and quality of life in persons with COPD

Leelarungrayub¹,

Puntumetakul²,

Sriboonreung³

et al. 2018

COPD

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“…Twenty-nine potentially relevant studies were retrieved for detailed analysis 8,11,18–34. Only 10 articles met the eligibility criteria 9,35–43Figure 1 shows the flowchart of the study selection process.…”

Section: Resultsmentioning

confidence: 99%

“…Six studies compared the effects of low-intensity IMT,9,35,36,38,40,43 two studies examined moderate intensity IMT39,41 and two studies examined high-intensity IMT 37,42. Four studies used a medium resistance spring load device (PowerBreathe Classic, PoweBreathe International Ltd., Warwickshire, England, UK) to produce IMT,39–42 five studies used another spring-loaded device (Threshold IMT, Philips, Rotterdam, Netherlands)9,36,38,39,43 and one used another form of IMT (Threshold PEP, Philips). 35 The studies were quite heterogeneous, and Table 3 provides a summary of the interventions employed in the different studies.…”

Section: Resultsmentioning

confidence: 99%

<p>Current insights of inspiratory muscle training on the cardiovascular system: a systematic review with meta-analysis</p>

Cipriano¹,

Júnior²,

Santos³

et al. 2019

IBPC

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Background: Cardiorespiratory limitation is a common hallmark of cardiovascular disease which is a key component of pharmacological and exercise treatments. More recently, inspiratory muscle training (IMT) is becoming an effective complementary treatment with positive effects on muscle strength and exercise capacity. We assessed the effectiveness of IMT on the cardiovascular system through autonomic function modulation via heart rate variability and arterial blood pressure. Methods: Randomized controlled trials (RCTs) were identified from searches of The Cochrane Library, MEDLINE and EMBASE to November 2018. Citations, conference proceedings and previous reviews were included without population restriction, comparing IMT intervention to no treatment, placebo or active control. Results: We identified 10 RCTs involving 267 subjects (mean age range 51–71 years). IMT programs targeted maximum inspiratory pressure (MIP) and cardiovascular outcomes, using low ( n =6) and moderate to high intensity ( n =4) protocols, but the protocols varied considerably (duration: 1–12 weeks, frequency: 3–14 times/week, time: 10–30 mins). An overall increase of the MIP (cmH 2 O) was observed (−27.57 95% CI −18.48, −37.45, I 2 =64%), according to weighted mean difference (95%CI), and was accompanied by a reduction of the low to high frequency ratio (−0.72 95% CI−1.40, −0.05, I 2 =50%). In a subgroup analysis, low- and moderate-intensity IMT treatment was associated with a reduction of the heart rate (HR) (−7.59 95% CI −13.96, −1.22 bpm, I 2 =0%) and diastolic blood pressure (DBP) (−8.29 [−11.64, −4.94 mmHg], I 2 =0%), respectively. Conclusion: IMT is an effective treatment for inspiratory muscle weakness in several populations and could be considered as a complementary treatment to improve the cardiovascular system, mainly HR and DBP. Further research is required to better understand the above findings.

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“…The result of the study showed no significant difference in patients assigned to control or RMT groups in relation to cardiovascular or respiratory parameters baseline even before and after the 6MWT, except for heart rate was (76.5 ± 14.3) & (86.1 ± 17.0) before and after 6MWT respectively of the RMT group and (77.1 ± 12.5) & (86.9 ± 12.8) before and after 6MWT of the control group [22].…”

Section: Discussionmentioning

confidence: 80%

“…Tool two: the physical assessment sheet included two parts Part I: Six-minute Walk Test (6MWT): adopted from [22]. is an easy and inexpensive way to evaluate physical function of an individual and reflects the ability to undertake day-to-day activities.…”

Section: Tools Of Data Collectionmentioning

confidence: 99%

Impact of Intradialytic Rehabilitation Program on General Health of Chronic Kidney Disease Patients

Elbaky¹,

Zaki²,

Amin³

et al. 2018

AJNR

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Background: CKD patients received intradialytic rehabilitation program developed improvement in their general health. Exercise also improve solute removal which increase the HD efficiency. Aim: to evaluate the impact of intradialytic rehabilitation program on general health of CKD patients. Design: Quasi experimental. Setting: The study conducted at hemodialysis unit of Minia urology hospital. Sampling: 60 patients divided in two groups 30 for each. Results: more than half of both groups were female. More than half of both group were diabetic and hypertensive. Mean age of both groups were (39.73 ± 8.17) & (40.00 ± 8.27). The 6 MWT was lower in the control group (325.3 ±24.1, 310.6 ±18.3 & 308 ±17.8) at the three observations than the study (352.3 ±46.8, 393.8 ±78.4 & 448 ±26.9). Small percentage of the rehabilitation group experienced dyspnea (16.6 % and 26 %). The study group showed improvement in mean serum creatinine (4.85± 0.54 & 4.58±0.54) than the control group (5.58± 0.68 & 5.58± 0.68). After rehabilitation program half of the study had low depression and only (13.3%) of them had high depression level. Conclusion: Intradialytic rehabilitation program for CKD patients enhance their activities of daily living abilities which improves their psychological health status.

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Effects of respiratory muscle training on endothelium and oxidative stress biomarkers in hemodialysis patients: A randomized clinical trial

Abstract: A short-term RMT program ameliorate FVC, FEV1 and reduces syndecan-1 and angiopoietin-2 biomarker levels. Finally, better blood pressure control was attained during training and it was associated with a reduction in endothelin-1 levels.

Cited by 24 publications

References 42 publications

Preliminary study: comparative effects of lung volume therapy between slow and fast deep-breathing techniques on pulmonary function, respiratory muscle strength, oxidative stress, cytokines, 6-minute walking distance, and quality of life in persons with COPD

Preliminary study: comparative effects of lung volume therapy between slow and fast deep-breathing techniques on pulmonary function, respiratory muscle strength, oxidative stress, cytokines, 6-minute walking distance, and quality of life in persons with COPD

<p>Current insights of inspiratory muscle training on the cardiovascular system: a systematic review with meta-analysis</p>

Impact of Intradialytic Rehabilitation Program on General Health of Chronic Kidney Disease Patients

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