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PubMed1992

[Effect of qigong on electrocardiographic autopower spectrum function].

The Changes of positive rate of 17 coronary heart disease cases with frequency domain-correlative cardiogram (FCG) > or = 7 grades were evaluated with electrocardiographic autopower spectrum function before and after Qigong exercise. 17 Qigong-exerciser aged from 54 to 72 (mean 66 year old, male 5, female 12) underwent Qigong exercise in 65 to 103 days and were evaluated using FCG to compare with pre-Qigong exercise status. The results showed that the positive rate of abnormal electrocardiographic autopower spectrum function of lead V5 (Gxx 1/2) decreased from 59% (10/17) to 0% (0/17), the lead II (Gyy 1/2) from 82% (14/17) to 41% (7/17), P < 0.01 and 0.05. This study suggested that Qigong exercise could significantly decrease the positive rate of abnormal electrocardiographic autopower spectrum function and improve perfusion of coronary artery or cardiac dysfunction produced by myocardial ischemia.

Aged↗
PubMed1996

Ventilatory responses to imagined exercise.

We studied whether the ventilatory responses to imagined exercise are influenced by automatic processes. Twentynine athletes produced mental images of a sport event with successive focus on the environment, the preparation, and the exercise. Mean breathing frequency increased from 15 to 22 breaths/min. Five participants reported having voluntarily controlled breathing, two of them during preparation. Twenty participants reported that their breathing pattern changed during the experiment: 11 participants were unable to correctly report on the direction of changes in frequency, and 13 incorrectly reported changes in amplitude. This finding suggests that these changes were not voluntary in most participants and may therefore reveal automatic forebrain influences on exercise hyperpnea. However, these changes may also reflect nonspecific processes (e.g., arousal) different from those occurring during actual exercise.

Adult↗
PubMed2004

Evidence underlying breathing retraining in people with stable chronic obstructive pulmonary disease.

The efficacy of pursed-lip breathing (PLB) and diaphragmatic breathing (DB) in the rehabilitation of people with chronic obstructive pulmonary disease (COPD) remains unclear. This review examines the evidence regarding the usefulness of these techniques in improving the breathing of people with stable COPD. The studies included in our review of the literature used either PLB or DB in isolation, contained a clear description of the methods, and used outcomes that were measured with what we considered to be appropriate procedures. Pursed-lip breathing slows the respiratory rate, and evidence suggests that this decreases the resistive pressure drop across the airways and, therefore, decreases airway narrowing during expiration. This decrease in airway narrowing may account for the decreased dyspnea some people experience when using this technique. Diaphragmatic breathing has negative and positive effects, but the latter appear to be caused by simply slowing the respiratory rate. Evidence supports the use of PLB, but not DB, for improving the breathing of people with COPD.

Breathing Exercises↗
PubMed1982

The diaphragm in health and disease.

The diaphragm consists of two separate muscles, the costal and crural parts, with different segmental innervation and different action on the rib cage. Diaphragmatic endurance is determined by the balance between energy supply and demand. Both an increase in demand and a decrease in supply of energy lead to diaphragmatic fatigue. Under conditions of reduced O2 transport to the body, the inspiratory muscles may command a disproportionate amount of the total body O2 consumption, particularly if the work of breathing is increased. Their energy demands may thus contribute significantly to the pathogenesis of cardiogenic shock and lactic acidosis. Inspiratory muscle fatigue can be diagnosed by observing and palpating: (1) abdominal paradox, a fall in abdominal pressure and an inward displacement of the abdomen during inspiration, and (2) respiratory alternans, a variation in abdominal pressure changes from breath to breath, reflected in variations in the inspiratory movements of rib cage and abdomen. Treatment consists in decreasing energy demands and increasing supplies. Artificial ventilation should be considered to accomplish the former. Methyl xanthines improve diaphragmatic contractility and specific diaphragmatic training programs improve diaphragmatic endurance.

Acidosis↗
PubMed1980

Rehabilitation principles in the care of gynecologic and obstetric patients.

Literature examining disabilities and rehabilitation in gynecologic and obstetric patients is limited. Among the musculoskeletal, vascular, neurologic, hormonal, and sexual problems described, pelvic floor laxity is the etiology for several dysfunctional states and is common to both parous and nonparous women. The focus of this paper is on one of the dysfunctional states--urinary stress incontinence--which in previous work had a reported incidence of 30% of all women and may affect up to 63% of postmenopausal women. This study, applying rehabilitation principles to diagnosis and treatment, found the incidence of stress incontinence to be 20 to 30% of women, pregnant or not, who did no specific pelvic floor exercise. A group of women, not pregnant, who did Kegel exercises for pelvic floor strengthening had only a 6% incidence of stress incontinence. There is a need to determine whether pelvic floor exercise, done effectively, could minimize this problem in postmenopausal women. Rehabilitation principles may be applied to the diagnosis and treatment of other disabling conditions in gynecology and obstetrics.

Adult↗
PubMed1997

Effect of exercise-induced hyperventilation on airway resistance and cycling endurance.

The purpose of the present study was to investigate the effect of exercise induced hyperventilation and hypocapnia on airway resistance (Raw), and to try to answer the question whether a reduction of Raw is a mechanism contributing to the increase of endurance time associated with a reduction of exercise induced hyperventilation as for example has been observed after respiratory training. Eight healthy volunteers of both sexes participated in the study. Cycling endurance tests (CET) at 223 (SD 47) W, i.e. at 74 (SD 5)% of the subject's peak exercise intensity, breathing endurance tests and body plethysmograph measurements of pre- and postexercise Raw were carried out before and after a 4-week period of respiratory training. In one of the two CET before the respiratory training CO2 was added to the inspired air to keep its end-tidal concentration at 5.4% to avoid hyperventilatory hypocapnia (CO2-test); the other test was the control. The pre-exercise values of specific expiratory Raw were 8.1 (SD 2.8), 6.8 (SD 2.6) and 8.0 (SD 2.1) cm H2O.s and the postexercise values were 8.5 (SD 2.6), 7.4 (SD 1.9) and 8.0 (SD 2.7) cm H2O.s for control CET, CO2-CET and CET after respiratory training, respectively, all differences between these tests being nonsignificant. The respiratory training significantly increased the respiratory endurance time during breathing of 70% of maximal voluntary ventilation from 5.8 (SD 2.9) min to 26.7 (SD 12.5) min. Mean values of the cycling endurance time (tcend) were 22.7 (SD 6.5) min in the control, 19.4 (SD 5.4) min in the CO2-test and 18.4 (SD 6.0) min after respiratory training. Mean values of ventilation (VE) during the last 3 min of CET were 123 (SD 35.8) l.min-1 in the control, 133.5 (SD 35.1) l.min-1 in the CO2-test and 130.9 (SD 29.1) l.min-1 after respiratory training. In fact, six subjects ventilated more and cycled for a shorter time, whereas two subjects ventilated less and cycled for a longer time after the respiratory training than in the control CET. In general, the subjects cycled longer the lower the VE, if all three CET are compared. It is concluded that Raw measured immediately after exercise is independent of exercise-induced hyperventilation and hypocapnia and is probably not involved in limiting tcend, and that tcend at a given exercise intensity is shorter when VE is higher, no matter whether the higher VE occurs before or after respiratory training or after CO2 inhalation.

Adult↗
PubMed1999

Effects of hyperoxia on oxygen uptake kinetics in cystic fibrosis patients as determined by pseudo-random binary sequence exercise.

Patients with cystic fibrosis (CF) have been shown to exhibit impaired oxygen uptake (VO2) kinetics independent of their physical fitness. This study investigated whether oxygen supplementation improves VO2 kinetics in CF as determined by cycle ergometry at submaximal exercise intensities using a pseudo-random binary sequence exercise test i.e. a simultaneous application of different frequencies of sinusoidal work. The subjects were 9 CF patients and 13 healthy controls (HC) and they exercised while breathing humidified and heated air with a fractional concentration of oxygen in inspired air (F(I)O2) of either 0.21 or 0.40. With a F(I)O2 of 0.21 the respiratory exchange ratio (R) was higher in CF than in HC both at rest (0.91 vs 0.81) and during exercise (0.97 vs 0.89). Oxygen saturation (SO2) was slightly lower in CF. but remained above 90% during exercise (92.7% vs 95.2%). Spectrum analysis revealed that in CF, the amplitude ratio (AR) between V02 and exercise intensity was lower over a wide frequency range (P < 0.05). In addition, CF showed a larger negative phase shift (PS) at lower frequencies (P < 0.005). With a F(I)O2 of 0.40, SO2 increased to about 97% in both groups; while R remained higher in CF (0.92) compared to HC (0.81). In the control group, the O2 supplement raised AR but the VO, kinetics of the CF patients were not significantly affected. In HC the enhanced AR during oxygen supplementation would suggest a cardiopulmonary limitation of VO2 at the onset of submaximal exercise. In CF patients low AR and PS would indicate an attenuated VO2 response attributable to an impaired oxygen utilization in the muscles because the oxygen supplement normalised SO2 but failed to improve R and VO2 kinetics.

Adolescent↗
PubMed2000

Nasal airflow dynamics: mechanisms and responses associated with an external nasal dilator strip.

The adhesive external nasal dilator strip (ENDS) is widely advocated for prevention of snoring and promotion of nasal breathing during exercise. In the present study, the effects of the ENDS on nasal airflow resistance (Rn) in normal subjects were examined and factors determining individual responses to the ENDS explored. Using posterior rhinomanometry, 20 healthy Caucasian adults (10 males, 10 females; age: 18-56 yrs) were studied during quiet tidal breathing and voluntary hyperpnoea with (ENDS) and without (control) ENDS and with a placebo strip (placebo) before and after application of a topical nasal decongestant (oxymetazoline hydrochloride). During tidal breathing, only nine subjects showed a significantly (p<0.05) decreased inspiratory and/or expiratory Rn with the ENDS ("responders"). During the control, inspiratory Rn (at 0.4 L x s(-1)) was higher in "responders" than "nonresponders" (3.28+/-0.16 versus 2.60+/-0.08 cmH2O x L(-1) x s; p=0.04). The effects of nasal decongestant and the ENDS were additive. During voluntary hyperpnoea, inspiratory Rn (at 1.0 L x s(-1)) and the hysteresis of the inspiratory transnasal pressure/flow curve were decreased with the ENDS in most subjects. It is concluded that the external nasal dilator strip influences nasal airflow dynamics by both dilation of the nasal valve and stabilization of the lateral nasal vestibule walls and may be more effective in subjects with a high resting nasal airflow resistance.

Adolescent↗
PubMed2005

Exercise training and inspiratory muscle training in patients with bronchiectasis.

BACKGROUND: Bronchiectasis is a chronic suppurative lung disease often characterised by airflow obstruction and hyperinflation, and leading to decreased exercise tolerance and reduced health status. The role of pulmonary rehabilitation (PR) and inspiratory muscle training (IMT) has not been investigated in this group of patients. METHODS: Thirty two patients with idiopathic bronchiectasis were randomly allocated to one of three groups: PR plus sham IMT (PR-SHAM), PR plus targeted IMT (PR-IMT), or control. All patients (except the control group) underwent an 8 week training programme of either PR or PR plus targeted IMT. Exercise training during PR was performed three times weekly at 80% of the peak heart rate. IMT was performed at home for 15 minutes twice daily over the 8 week period. RESULTS: PR-SHAM and PR-IMT resulted in significant increases in the incremental shuttle walking test of 96.7 metres (95% confidence interval (CI) 59.6 to 133.7) and 124.5 metres (95% CI 63.2 to 185.9), respectively, and in endurance exercise capacity of 174.9% (95% CI 34.7 to 426.1) and 205.7% (95% CI 31.6 to 310.6). There were no statistically significant differences in the improvements in exercise between the two groups. Significant improvements in inspiratory muscle strength were also observed both in the PR-IMT group (21.4 cm H2O increase, 95% CI 9.3 to 33.4; p = 0.008) and the PR-SHAM group (12.0 cm H2O increase, 95% CI 1.1 to 22.9; p = 0.04), the magnitude of which were also similar (p = 0.220). Improvements in exercise capacity were maintained in the PR-IMT group 3 months after training, but not in the PR-SHAM group. CONCLUSION: PR is effective in improving exercise tolerance in bronchiectasis but there is no additional advantage of simultaneous IMT. IMT may, however, be important in the longevity of the training effects.

Breathing Exercises↗
PubMed2006

Optimal intensity for respiratory muscle endurance training in patients with spinal cord injury.

OBJECTIVE: Respiratory muscle endurance of able-bodied persons, assessed by normocapnic hyperpnoea at 70% of their maximal voluntary ventilation, usually ranges from 10 to 20 minutes. The aim of this study was to determine the level of ventilation that patients with paraplegia and tetraplegia can sustain for 10-20 minutes to later be used as the guideline for respiratory muscle endurance training. DESIGN: Pilot study; cross-over setting. SUBJECTS: Two groups, 8 patients with paraplegia and 6 with tetraplegia. METHODS: Respiratory muscle endurance tests were performed at 3 different intensities of normocapnic hyperpnoea, i.e. 20%, 40% and 60% maximal voluntary ventilation. Subjects performed partial re-breathing from a bag to assure normocapnia. Respiratory endurance was separately analysed for patients with paraplegia and tetraplegia. RESULTS: Mean respiratory endurance times were 46.0, 18.9 and 4.2 minutes at 20%, 40% and 60% maximal voluntary ventilation in patients with tetraplegia and 51.8, 38.8 and 12.2 minutes in patients with paraplegia. The duration differed significantly at 60% maximal voluntary ventilation between the groups. CONCLUSION: Minute ventilation to perform respiratory muscle endurance training can be set at around 40% of maximal voluntary ventilation for patients with tetraplegia and around 60% of maximal voluntary ventilation for patients with paraplegia, as these levels can be sustained for 10-20 minutes.

Adolescent↗
PubMed1983

When should respiratory muscles be exercised?

1. Normal respiratory muscles have a large functional reserve. 2. Muscles have a tremendous capacity for adaptation. Adaptation is task-specific (eg, muscles use similar motor units for the same tasks). 3. Muscular fatigue results when motor units are required to perform an unaccustomed task. Continued effort in the face of fatigue, especially high-tension low-repetition effort, may produce a reversible "use atrophy" (eg, fiber damage, splitting, and regeneration). 4. Exercising damaged or regenerating muscle may produce irreversible damage. 5. Exercising the respiratory muscles of some patients may make them more susceptible to fatigue or, at least, produce no further improvement in function. Alternating rest and exercise improves pulmonary function tests in some patients. 6. Retraining a weak or damaged muscle requires that it first be "shut down" and rested before attempting retraining. 7. Training a rested muscle to different tasks--before these tasks are needed--may be the critical step in successful rehabilitation. 8. Resistance breathing probably improves both respiratory muscle strength and respiratory muscle endurance. 9. There are at least three immediate tasks for clinicians to define: Where in the present natural history of COPD should respiratory muscles be rested? How long should they be rested? How best can they be retrained?

Breathing Exercises↗
PubMed1997

Training improves endothelium-dependent vasodilation in resistance vessels of patients with heart failure.

The effects of physical training on endothelium-dependent vasodilation in skeletal muscle resistance vessels were investigated in patients with heart failure. Forearm blood flows (ml.min-1.100 ml-1) in response to brachial arterial administration of acetylcholine (5 x 10(-5) and 5 x 10(-4) M at 1 ml/min) and nitroglycerin (5 x 10(-6) and 5 x 10(-5) M at 1 ml/min) were determined by strain-gauge venous occlusion plethysmography before and after 8 wk of daily handgrip exercise in 12 patients with chronic heart failure. After 8 wk of daily handgrip exercise, the vasodilatory responses to acetylcholine significantly increased from pretraining values, i.e., 16.6 +/- 2.0 vs. 8.6 +/- 1.3 ml.min-1.100 ml-1 (P < 0.05) and 27.5 +/- 1.5 vs. 14.6 +/- 1.7 ml.min-1.100 ml-1 (P < 0.05), respectively, whereas the vasodilatory responses to nitroglycerin did not change. Handgrip exercise training appears to specifically enhance endothelium-dependent vasodilation in the forearm skeletal muscle circulation of patients with heart failure.

Acetylcholine↗
PubMed1978

Influence of heat and humidity on the airway obstruction induced by exercise in asthma.

We examined the degree of airway obstruction that developed in eight asthmatics who exercised while breathing air under four conditions: (a) ambient room temperature and water content; (b) body temperature and ambient water content; (c) ambient room temperature fully saturated; and (d) body temperature fully saturated. These test conditions were performed in random order. Multiple aspects of pulmonary mechanics were measured before and 5 min after exercise. When air at ambient conditions was inhaled, the expected airway obstruction developed after exercise, and all variables changes significantly from their pre-challenge values. Heating the air to body temperature did not influence this response. Increasing the humidity at ambient temperatures significantly blunted the response, and by inhaling body temperature, fully saturated air completely prevented it from occurring. Thus, the water content of inspired air is an important variable in the development of exercise induced asthma.

Adult↗
PubMedDate not supplied

Exercise training and chronic obstructive pulmonary disease: past and future research directions.

Chronic obstructive pulmonary disease (COPD) is a major cause of death and disability in the United States. It is characterized by symptoms of breathlessness that result in sedentary lifestyle, physical deconditioning, and reduced quality of life. Previous research has shown that exercise training in patients with COPD will improve physical function and may help improve the quality of life. Unfortunately, the majority of these previous studies have not been pursued with adequate scientific rigor and the conclusions regarding the efficacy of exercise as an adjunct in the treatment of COPD are equivocal. The purpose of this article is to review the previous research that has focused on the effects of exercise training on individuals with COPD, to examine the problems with this previous research, and to emphasize the need and identify topics for further outcome-based research.

Aging↗
PubMed1984

The anaerobic threshold measurement to evaluate exercise performance.

During exercise, the oxygen consumption above which aerobic energy production is supplemented by anaerobic mechanisms, and which results in a significant increase in lactate, is termed the anaerobic threshold (AT). This power output has important functional implications because it is a demarcation of the work rate above which metabolic acidosis accelerates the stimulation to breathing, and exercise endurance becomes reduced. The justification for relating lactate increase to tissue anaerobiosis during exercise is presented, and the gas exchange methods for measuring the AT are described. The form of work affects the AT, treadmill being about 10% greater than cycling in sedentary subjects. It is useful for predicting the ability of the subject to sustain a given work rate for a prolonged period and for determining the VO2 above which there is cardiovascular insufficiency in meeting tissue O2 requirements.

Acidosis↗