Impairment of respiratory muscle function in pulmonary hypertension

2007 ◽  
Vol 114 (2) ◽  
pp. 165-171 ◽  
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.

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

2005 ◽  
Vol 13 (1) ◽  
pp. 34-44 ◽  
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.

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

1989 ◽  
Vol 66 (2) ◽  
pp. 943-948 ◽  
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.

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

2020 ◽  
Vol 17 (12) ◽  
pp. 4328
Author(s):  
Francisco José Ferrer-Sargues ◽  
Esteban Peiró-Molina ◽  
Pablo Salvador-Coloma ◽  
José Ignacio Carrasco Moreno ◽  
Ana Cano-Sánchez ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Muscle Strength ◽  
Functional Capacity ◽  
Aerobic Capacity ◽  
Muscle Function ◽  
Respiratory Muscle ◽  
Congenital Heart ◽  
Respiratory Muscle Strength ◽  
Respiratory Muscle Function

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.

scholarly journals Expiration Training Maneuver for Chronic Obstructive Pulmonary Disease with Congestive Heart Failure Grade II: A Case Report

2019 ◽  
Vol 7 (01) ◽  
pp. 28
Author(s):  
Nury Nusdwinuringtyas ◽  
Siti Chandra Widjanantie
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Muscle Strength ◽  
Pulmonary Disease ◽  
Respiratory Muscle ◽  
Walking Distance ◽  
Chronic Obstructive ◽  
Respiratory Muscle Strength ◽  
Obstructive Pulmonary Disease ◽  
Before And After ◽  
Grade Ii

Introduction: Chronic Obstructive Pulmonary Disease (COPD) was characteristic by the inflammatory process in the airway which causes air trapping and hyperinflation, then followed by decreasing the respiratory muscle strength. Breathing training using the positive expiratory pressure (PEP) increasing respiratory muscle strength.Methods: A case presentation of a male, age was 60 years old diagnosed as COPD by The Global Initiative for Chronic Obstructive Lung Disease (GOLD) grade 4 group D, and Chronic Heart Failure (CHF) grade II, with complication of excessive phlegm, underweight, and weakness of respiratory muscle, have PEP for 8 weeks.Results: Spirometry evaluation before and after eight week of PEP have found; FEV1 22.12 and 22.42%, FVC 34.24 and 56%, FEV1/FVC 76.8 and 64%. Respiratory muscle strength before and after PEP showed the Muscle Inspiratory Pressure (MIP) 46 and 71 cmH2O, Muscle Expiratory Pressure (MEP) 48 and 104 cmH2O.The values of Six Minute Walk Test (6MWT) evaluation by BORG modified scale before and after PEP were 11 and 13 ( efforts), 2 and 3 (dyspnea), 0 and 1 (Leg Fatigue). The six-minute walking distance (6MWD) before and after PED were 170 and 190 m, equation reference with Nury’s formula showed percentage prediction before and after PEP respectively 29.2 and 32%, VO2Max; 4.96 and 6L, METs; 1.41 and 1.7. The St GeorgeRespiratory Questionnaire (SGRQ) before and after PEP were 20.6 and 49.5% (symptom), 86.6 and 45.1% (activity), 45.5 and 18.4% (impact) and 53.6 and 42% for total.Conclusion: Positive airway pressure exercise had beneficial effect on reducing air-trapping process in COPD and increasing the respiratory muscle strength for both expiratory and inspiratory muscle strength.Keywords: Chronic obstructive pulmonary disease, positive expiratory pressure device, respiratory muscle strength, six minutes walking distance

PULMONARY PHYSIOLOGY IN CHILDREN

PEDIATRICS ◽  
1960 ◽  
Vol 25 (5) ◽  
pp. 766-774
Author(s):  
C. D. Cook ◽  
H. Barrie ◽  
S. A. DeForest ◽  
P. J. Helliesen
Keyword(s):  
Muscle Strength ◽  
Idiopathic Scoliosis ◽  
Muscle Function ◽  
Respiratory Muscle ◽  
Vertebral Column ◽  
Flow Resistance ◽  
Vital Capacity ◽  
Respiratory Muscle Strength ◽  
Lung Volumes ◽  
Pulmonary Physiology

Measurements of lung volumes, compliance and resistance, and effective respiratory muscle strength have been carried out in a series of patients with idiopathic scoliosis, scoliosis secondary to poliomyelitis and scoliosis secondary to abnormalities of the vertebral column. The patients with idiopathic scoliosis showed, in general, moderate reductions in vital capacity, while those with poliomyelitis and associated paralysis showed more marked decreases. Residual volume on the average was essentially unchanged in both groups. Compliance was only moderately but consistently reduced in both groups while flow-resistance was only slightly to moderately increased. In the group of patients with idiopathic scoliosis, effective respiratory muscle strength was normal for given lung volumes but inspiratory strength was subnormal. Serial studies show that after fusion, the patients tended to have a further decrease both in respiratory muscle function and in lung volumes. The frequently serious pulmonary dysfunction accompanying the scoliosis secondary to vertebral abnormalities is illustrated.

scholarly journals Muscle function and quality of life in the Crohn’s disease

2017 ◽  
Vol 30 (2) ◽  
pp. 337-345 ◽  
Author(s):  
Andrea Lemos Cabalzar ◽  
Diana Junqueira Fonseca Oliveira ◽  
Maycon de Moura Reboredo ◽  
Fernando Azevedo Lucca ◽  
Júlio Maria Fonseca Chebli ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Muscle Strength ◽  
Muscle Function ◽  
Respiratory Muscle ◽  
Control Group ◽  
Respiratory Muscle Strength ◽  
Peripheral Muscle ◽  
Sf 36 ◽  
Inflammatory Bowel

Abstract Introduction: Crohn’s disease (CD) is an inflammatory bowel disease, marked by exacerbations and remissions periods. Peripheral manifestations in CD may be present with the syndrome of skeletal muscle dysfunction (SMD), which is characterized by loss of muscle strength, fatigue complain, limited exercise capacity and impaired quality of life of these patients. Objective: Evaluate muscle strength, physical capacity and quality of life of patients with CD and compare them with healthy controls. Methods: 18 patients CD and 12 healthy controls matched for age and sex were involved. Peripheral muscle strength evaluated by handgrip strength of the dominant hand and respiratory muscle strength by measures of respiratory muscle strength (maximal inspiratory/expiratory pressure - MIP and MEP). Exercise capacity evaluated by Shuttle test (ST) and the quality of life by the Short-form 36 (SF-36) and by the Inflammatory Bowel Disease Questionnaire (IBDQ). Results: Patients with CD presented a lower respiratory muscle strength (MIP = -68.93 ± 26.61 vs 29.63 ± -100 cmH2O, p = 0.0013 and MEP = 81.07 ± 30.26 vs 108 ± 25.30 cmH2O, p = 0.032) and a tendency the lower peripheral muscle strength (31.72 ± 8.55 vs 39.00 ± 13.37 kgf, p = 0.09). In addition, CD patients presented worse physical capacity on the ST compared to the control group (513.7 ± 237m vs 983.0 ± 263m, p < 0.05) and worse quality of life in 7 of 8 domains of the SF-36 and in all dimensions of the IBDQ. Conclusion: Patients with CD showed muscle functional impairment and poorer quality of life compared to healthy control group. These findings suggest that the assessment and maybe interventions in the muscle function must be used in clinical practice.

The Combination of Exercise and Respiratory Training Improves Respiratory Muscle Function in Pulmonary Hypertension

Lung ◽  
2013 ◽  
Vol 192 (2) ◽  
pp. 321-328 ◽  
Author(s):  
Hans-Joachim Kabitz ◽  
Hinrich-Cordt Bremer ◽  
Anja Schwoerer ◽  
Florian Sonntag ◽  
Stephan Walterspacher ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Muscle Function ◽  
Respiratory Muscle ◽  
Respiratory Muscle Function ◽  
Respiratory Training

scholarly journals Inspiratory muscle training in pulmonary hypertension: TREMMI protocol

2020 ◽  
pp. 1-5
Author(s):  
Marília Souza Leão ◽  
Lucas Mellaci Bergamascki ◽  
Vivian Bertoni Xavier ◽  
Rodrigo Boemo Jaenisch ◽  
Roberto Stirbulov ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Muscle Strength ◽  
Functional Capacity ◽  
Respiratory Muscle ◽  
Respiratory Muscle Strength ◽  
Walk Test ◽  
Muscle Training ◽  
Six Minute Walk Test ◽  
Minute Walk ◽  
Training Protocol

Background: Although the progressive nature of pulmonary hypertension (PH), including the impairment of respiratory muscle function, studies have demonstrated beneficial effects of physical exercise on the functional limitations caused by the disease in this population, being an important ally to the conventional drug therapy. There is no training protocol focused exclusively on respiratory musculature that is performed without supervision, since these patients have low adherence to the rehabilitation programs performed in an outpatient setting. Respiratory muscle training (RMT) improves functional capacity and quality of life (QoL) in patients with chronic diseases such as heart failure and COPD. However, the effects of an unsupervised RMT protocol on PH are not yet known. Objective: To developed an unsupervised, home-based RMT protocol for patients with PH. Methods: A double-blind, controlled, randomized clinical trial to evaluate the effectiveness of this protocol on respiratory muscle strength and endurance, functional capacity, by the six-minute walk test and QoL with the questionnaire The Medical Outcomes Study 36- item Short Form Health Survey (Sf-36) before and after an unsupervised training protocol and performed in a home environment with POWERbreathe. Two groups (IMT and SHAM) will be followed for 12 weeks with training performed 30 minutes daily. Results: We hope the intervention idealized by the protocol may will increase the respiratory muscle strength and endurance, the walk distance in six-minute walk test and QoL. Conclusions: Patients with PH who perform the intervention with inspiratory muscle training protocol may will be increase the respiratory muscle strength, functional capacity and QoL.

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