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Exercise and Rehabilitation in Heart Failure
Published in Andreas P. Kalogeropoulos, Hal A. Skopicki, Javed Butler, Heart Failure, 2023
Audrey Borghi-Silva, Flávia Rossi Caruso, Renata Gonçalves Mendes
In this context, some strategies that promote unloading of respiratory muscles and improve peripheral muscle fatigue could help these patients exercise at higher intensity and thus benefit more from a rehabilitation program. In hospitalized patients, Oliveira et al. showed that a short exercise training program combined with non-invasive ventilation can be safely applied to patients with acute HF, leading to improvements in walking distance, amelioration of dyspnea, and reduced length of stay.22 Other studies have shown the potential effects of various modalities of non-invasive ventilation, e.g., proportional assisted ventilation,23,24 continuous or bilevel positive airway pressure,24 reducing the overload of respiratory muscles, reducing dyspnea, and improving exercise tolerance in chronic HF.24–26 However, larger studies are needed to confirm these results.
Muscle Disorders
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Kourosh Rezania, Peter Pytel, Betty Soliven
Respiratory therapy includes inspiratory resistive exercises that may increase the endurance of respiratory muscles. Cough assist devices may aid respiratory function. Noninvasive ventilation at night may help to improve respiration during sleep. Long-term assisted ventilation in advanced muscular dystrophy raises ethical questions and is controversial.
Respiratory muscle function in rehabilitation
Published in Claudio F. Donner, Nicolino Ambrosino, Roger S. Goldstein, Pulmonary Rehabilitation, 2020
Thierry Troosters, Michael I. Polkey, Rik Gosselink
When respiratory muscle strength is moderately to severely reduced, discrete clinical symptoms may occur, and this may prompt assessment of the respiratory muscles to help in the diagnostic process. The cardinal, but rather unspecific, symptom of respiratory muscle weakness is dyspnoea. Dyspnoea may first be present in situations where the demand on the respiratory muscles is increased. Typically this is during exercise, although high levels of exercise may be precluded by locomotor muscle weakness in patients with generalized neurological syndromes.
Is there a relationship between respiratory function and trunk control and functional mobility in patients with relapsing–remitting multiple sclerosis?
Published in Neurological Research, 2023
Melike Sumeyye Ozen, Ebru Calik-Kutukcu, Yeliz Salci, Ecem Karanfil, Asli Tuncer, Kadriye Armutlu
Trunk and respiratory muscle weakness accompanies the muscle weakness predominantly seen in the lower extremities in individuals with MS [3,4]. Most of the respiratory muscles are also part of the core stability muscles controlling the trunk to maintain balance and mobility [5]. Core stability muscles contribute to stabilization by contracting lower extremity muscles. Thus, trunk control is provided in response to changes caused by extremity movements, and thus movement is enabled within safe limits [6]. Weaknesses in the core stability muscles manifest as trunk control disorders [7]. It has been reported that trunk control in individuals with MS is reduced and is associated with the level of disability. Therefore, evaluation of the trunk should not be ignored when planning treatment programs for individuals with MS [8].
Targets for obstructive sleep apnea pharmacotherapy: principles, approaches, and emerging strategies
Published in Expert Opinion on Therapeutic Targets, 2023
The mechanical properties of the upper airspace have been well characterized [23–25] and only the key points relevant to this review focussing on therapeutic targets are identified here. Ultimately, the pharynx is the collapsible region of the upper airway situated between two non-collapsible regions above and below. Contraction of the diaphragm and other primary respiratory muscles creates the driving sub-atmospheric airway pressures necessary for airflow into the lungs (Figure 1). The resulting pressure gradient along the conducting airways from nose to lung includes sub-atmospheric airway pressures in the pharynx that constitute an airway narrowing force (PAirway, Figure 1). The positive pressure applied on the collapsible airway by the surrounding tissue also constitutes a closing force (PTissue, Figure 1). PTissue results from the tissue and bony structures that surround the airspace, with the tissues constrained within those bony structures and compartment (i.e. the mandible and spinal vertebrae).
Exercise capacity, physical activity and quality of life in patients with newly diagnosed hematologic malignancies: a cross-sectional study
Published in Physiotherapy Theory and Practice, 2023
Zeliha Celik, Meral Boşnak Güçlü, Zübeyde Nur Özkurt
Impairments in respiratory muscles were also comparatively demonstrated in our patients. In the study of Vermaete, Wolter, Verhoef, and Gosselink (2014) mean MIP and MEP values of patients were not deteriorated compared to predicted values. However, percentage means of MIP and MEP were consistent with our results. Additionally, Okubo et al. (2017) demonstrated that respiratory muscles weaken in myelodysplastic syndrome in patients with anemia. They also identified anemia has a crucial role in muscle weakness. On the other hand, two other studies conducted before and after HSCT had significant number of hematologic malignancies patients with inspiratory and expiratory muscle weakness (Kovalszki et al., 2008; White, Terrin, Miller, and Ryan, 2005). Our study demonstrated that decreased respiratory muscle strength does not depend on treatments. According to all of our findings, patients with newly diagnosed hematologic malignancies have weakened respiratory muscles, and respiratory muscle strength dramatically decreases from the time of diagnosis to after HSCT (Kovalszki et al., 2008; Vermaete, Wolter, Verhoef, and Gosselink, 2014). To avoid this weakness, inspiratory muscle training should be recommended even at diagnosis (Barğı et al., 2016).