Current Insights of Inspiratory Muscle Training on the Cardiovascular System: An Update of the Systematic Review with Meta-Analysis | Chapter 6 | Advancement and New Understanding in Medical Science Vol. 1

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) has become an effective complementary treatment with positive effects on muscle strength and exercise capacity.

Aim: 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 2023. We included studies examining a program of IMT (≥) one-week treatment) offered as a sole intervention or as an adjuvant to another form of exercise. Citations, conference proceedings, and previous reviews were included without population restriction, comparing IMT intervention to no treatment, placebo, or active control.

Results: We identified 20 RCTs involving 521 subjects (mean age range 21-71 years). IMT programs targeted maximum inspiratory pressure (MIP) and cardiovascular outcomes, using low (n=11) and moderate to high intensity (n=9) 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 (cmH2O) was observed (23.66 95% CI 15.95 to 31.37, I2=77%), according to weighted mean difference (95%CI) and was accompanied by a reduction of the low to high-frequency ratio (-0.70 95% CI -1.34 to -0.05, I2=42%). In a subgroup analysis, low- and moderate-intensity IMT treatment was associated with a reduction of the systolic blood pressure (SBP) (-5.08 95% CI -9.11 to -1.06 mmHg, I2=0%), heart rate (HR) (-3.58 95% CI -5.94 to -1.21 bpm, I2=63.4%) and diastolic blood pressure (DBP) (-11.25 95% CI -16.46 to -6.05 mmHg, I2=0%), respectively.

Conclusion: IMT is an effective treatment for inspiratory muscle weakness in several populations and could be considered a complementary treatment to improve the cardiovascular system, mainly SBP, HR, and DBP. Further research is required to understand the above findings better. More studies are needed to better understand the role of IMT as a component or alternative to regular exercise protocols for treating individuals with increased blood pressure response.

Author(s) Details:

Rafael Pena,
Graduate Program in Human Movement and Rehabilitation, Evangelical University of Goias, Brazil.

Francisco V. Santos,
Cancer Institute of São Paulo, Intensive Care Unit, São Paulo, Brazil.

Graziella F. B. Cipriano,
Physical Therapy Department, University of Brasilia, Brasilia, Brazil.

Gerson Cipriano Jr.,
Physical Therapy Department, University of Brasilia, Brasilia, Brazil.

Adriana M. Güntzel Chiappa,
Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil.

Lawrence Patrick Cahalin,
Department of Physical Therapy, University of Miami Miller School of Medicine, Coral Gables, Florida, USA.

Gaspar R. Chiappa,
Graduate Program in Human Movement and Rehabilitation, Evangelical University of Goias, Brazil.

Please see the link here: https://stm.bookpi.org/ANUMS-V1/article/view/13003

Breathing- Mechanism of Breathing, Muscles of Respiration, Breathing Pattern and Breathing Exercises | Chapter 14 | Emerging Trends in Disease and Health Research Vol. 6

 The process of breathing, also known as ventilation, is critical for gas exchange. Inhalation and exhalation are the two processes that make up the breathing mechanism. The diaphragm is the major muscle of inspiration during stop breathing, whereas auxiliary muscles of inspiration are engaged during deep breathing or in illness processes. Expiration is a passive process that occurs when the rib cage recoils and the inspiratory muscles relax. The auxiliary muscles of expiration are engaged during vigorous expiration. During the process of breathing, the thoracic cavity experiences various pressure and volume changes. Ventilation and perfusion must be balanced for optimal gas exchange of oxygen and carbon dioxide in the lungs. Breathing exercises, also known as ventilatory training, are a type of care that aims to enhance a patient's pulmonary condition as well as their general endurance and function throughout daily activities. These are critical strategies for the prevention and treatment of impairments caused by acute or chronic pulmonary diseases. Simply said, breathing exercises are intended to retrain the muscles of respiration, increase ventilation, reduce the amount of labour required to breathe, promote gaseous exchange, and improve the patient's general function in daily activities. Exercises to increase ventilation are frequently paired with medicine, airway clearance, the use of respiratory treatment devices, and a graded exercise (aerobic conditioning) programme, depending on a patient's underlying pathology and impairments.

Author(S) Details

Sonia Pawaria
Faculty of Physiotherapy, SGT University, Gurugram, Haryana, India.

View Book:- https://stm.bookpi.org/ETDHR-V6/article/view/6426

A Case Report on Physiotherapy Management of a Middle-Aged Adult Male with Severe Symptoms of Coronavirus Disease (COVID 19) | Chapter 02 | Emerging Trends in Disease and Health Research Vol. 3

 COVID-19 has afflicted persons of all ages, with symptoms ranging from asymptomatic to severe respiratory failure, with mild symptoms requiring little or no medical intervention and severe symptoms necessitating hospitalisation and early medical management. The following case report depicts the recovery of a patient with severe COVID-19 symptoms in the Municipal Corporation of Greater Mumbai's COVID specialised tertiary care facility. In the management of patients with severe respiratory disorders, physiotherapy has long been a part of the multidisciplinary team. The report focuses on the physiotherapy management for the above-mentioned patient, as well as the medical management that aids in the patient's recovery.

Author(S) Details

Chhaya V. Verma
Physiotherapy School & Centre, TN Medical College & BYL Nair Charitable Hospital, Maharashtra, India.

Suresh K. Patel
Physiotherapy School & Centre, TN Medical College & BYL Nair Charitable Hospital, Maharashtra, India.

Gayatri S. Jere
Physiotherapy School & Centre, TN Medical College & BYL Nair Charitable Hospital, Maharashtra, India.

View Book:- https://stm.bookpi.org/ETDHR-V3/article/view/5868