OBJECTIVE: The Japanese Society for Respiratory Care and Rehabilitation, Japanese Association on Sarcopenia and Frailty, Japanese Society of Respiratory Physical Therapy, and Japanese Association of Rehabilitation Nutrition proposed the definition and diagnosis of respiratory sarcopenia using low respiratory muscle strength and appendicular skeletal muscle mass (ASM; ASM/height2) instead of respiratory muscle mass; however, these parameters have not been validated. This study aimed to confirm the validity of the respiratory sarcopenia definition proposed by these four professional organizations.
METHODS: Participants of our cohort study in 2015 of 468 community-dwelling older people who were evaluated for sarcopenia and underwent spirometry were included in this analysis. We determined two respiratory sarcopenia models based on low skeletal muscle mass and respiratory muscle strength. Low skeletal muscle mass was defined by low ASM/height2, and low respiratory muscle strength was defined by peak expiratory flow rate (PEFR) or percentage of predicted PEFR (%PEFR). Survival status was assessed 5 years after baseline assessment (in 2020). To evaluate the validity of the cut-off values for PEFR and %PEFR, we determined different respiratory sarcopenia models by sequentially varying the cut-off values for each parameter, including ASM/height2, from high to low. We subsequently calculated the hazard ratio (HR) for mortality for each respiratory sarcopenia model using the Cox proportional hazards model. Additionally, we plotted the HR for each combination of cut-off values for ASM/height2 and PEFR or %PEFR on a three-dimensional chart to observe the relationship between the different cut-off values and HR.
RESULTS: A total of 31 people died during the 5-year observation period. With ASM/height2 cut-off values of approximately 7.0 kg/m2 for men and 5.7 kg/m2 for women and %PEFR cut-off values of 66-75%, respiratory sarcopenia was associated with mortality risk (HR, 2.36-3.27, point estimation range).
CONCLUSIONS: The definition of respiratory sarcopenia by the four professional organizations is related to future health outcomes, and this definition is valid. Geriatr Gerontol Int 2024; ••: ••-••.

BACKGROUND: Inspiratory muscle fatigue has been shown to have effects on limbs blood flow and physical performance. This study aimed to evaluate the influence of an inspiratory muscle fatigue protocol on respiratory muscle strength, vertical jump performance and muscle oxygen saturation in healthy youths.
METHODS: A randomized and double-blinded controlled clinical trial, was conducted. Twenty-four participants aged 18-45 years, non-smokers and engaged in sports activity at least three times a week for a minimum of one year were enrolled in this investigation. Participants were randomly assigned to three groups: Inspiratory Muscle Fatigue (IMFG), Activation, and Control. Measurements of vertical jump, diaphragmatic ultrasound, muscle oxygen saturation, and maximum inspiratory pressure were taken at two stages: before the intervention (T1) and immediately after treatment (T2).
RESULTS: The IMFG showed lower scores in muscle oxygen saturation and cardiorespiratory variables after undergoing the diaphragmatic fatigue intervention compared to the activation and control groups (p < 0.05). For the vertical jump variables, intragroup differences were found (p < 0.01), but no differences were shown between the three groups (p > 0.05).
CONCLUSIONS: Inspiratory muscle fatigue appears to negatively impact vertical jump performance, muscle oxygen saturation and inspiratory muscle strength in healthy youths.
BACKGROUND: ClinicalTrials.gov ID: NCT06271876. Date of registration 02/21/2024. https://clinicaltrials.gov/study/NCT06271876 .

OBJECTIVE: Posture correction bands (PCBs) have been proposed as aids to help chest expansion and to enhance respiratory function. However, the impact of PCBs on community-based older individuals engaged in inspiratory muscle training (IMT) at home remains unclear.
METHODS: Community-based individuals aged 65 years and older were divided into the PCB group, wearing PCBs, and the NPCB group, not wearing PCBs. The IMT regimen lasted 8 weeks, with sessions 5 times a week, including 4 sets per day and 15 repetitions per set. Training intensity was set at 50% of the maximum inspiratory pressure of each subject. To assess the effects of IMT, respiratory function, 6-minute walk test, and grip strength were measured before, during, and after the training period. Data were analyzed using repeated-measures analysis of variance, with post-hoc evaluation employing Bonferroni correction.
RESULTS: A total of 40 subjects were evenly divided into the PCB group and the NPCB group, with 20 subjects in each group. No significant difference was observed in respiratory muscle strength based on PCB use. However, during the initial 4 weeks, the PCB group exhibited a trend towards an increase in respiratory muscle strength compared to the NPCB group; this trend, however, did not prove to be statistically significant by the end of the 8-week period. Performance on the 6-minute walk test significantly improved in both groups.
CONCLUSIONS: The PCB group exhibited a tendency for increase in respiratory muscle strength in the first 4 weeks; however, ultimately there was no significant difference compared to the NPCB group.
BACKGROUND: This study was registered with the Clinical Research Information Service, part of the World Health Organization\'s International Clinical Trials Registry Platform (Clinical Research Information Service No. KCT0008075).

OBJECTIVE: Recently, handgrip, knee extensor and respiratory muscle strength were proposed as candidate biomarkers to assess the neuromuscular function of vitality capacity in older persons. This umbrella review aims to provide an overview of the available instruments and their measurement properties to assess these biomarkers.
METHODS: The databases PubMed, Web of Science and Embase were systematically screened for systematic reviews and meta-analyses reporting on handgrip, knee extensor or respiratory muscle strength assessments, resulting in 7,555 articles. The COSMIN checklist was used to appraise psychometric properties and the AMSTAR for assessing methodological quality.
RESULTS: Twenty-seven systematic reviews were included in this study. Some of the identified reviews described the psychometric properties of the assessment tools. We found five assessment tools that can be used to measure neuromuscular function in the context of healthy ageing. Those are the handheld dynamometer for handgrip strength, the dynamometer for knee extensor strength and regarding respiratory muscle strength, the sniff nasal inspiratory pressure, maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP).
CONCLUSIONS: The handheld dynamometer for hand grip strength, the dynamometer for knee extensor strength, sniff nasal inspiratory pressure, MIP and MEP were identified. Therefore, these assessments could be used to identify community-dwelling older adults at risk for a declined neuromuscular function in the context of vitality capacity.

BACKGROUND: Most studies on improvements in respiratory muscle strength, activities of daily living (ADL) and quality of life (QoL) in stroke patients receiving threshold respiratory muscle training (TRMT) have small sample sizes, and some studies have contradictory results.
OBJECTIVE: To evaluate the effectiveness of TRMT on respiratory muscle strength, pulmonary function and exercise endurance in stroke patients.
METHODS: PubMed, Cochrane Library, Physical Therapy Evidence Database (PEDro), Embase (via OVID) and Web of Science databases were searched for randomized controlled trial (RCT) from inception to January 17, 2024. The primary outcome was maximum inspiratory pressure (MIP) or maximum expiratory pressure (MEP). Secondary outcomes included pulmonary function measured by forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1) and peak expiratory flow (PEF), and exercise endurance measured by 6-minute walk test (6MWT).
RESULTS: A total of eight randomized controlled trials(RCTs), including 305 persons, were included in this study. The training time ranged from 3 weeks to 10 weeks. Among them, the intervention group in 4 studies used inspiratory muscle training, and the other 4 studies used inspiratory muscle training and expiratory muscle training. For the primary outcome, TRMT significantly improved MIP (mean=14.68 cmH2O, 95 %CI=2.28 to 27.09 cmH2O, P=0.02) and MEP (mean=9.37 cmH2O, 95 %CI=2.89 to 15.84 cmH2O, P=0.005) in stroke patients. Regarding the secondary outcomes, TRMT improved FVC, FEV1 and 6MWT (P<0.05) but did not significantly improve PEF.
CONCLUSIONS: TRMT improved inspiratory muscle strength and expiratory muscle strength, improved exercise endurance, and improved FVC and FEV1 of pulmonary function but did not significantly improve PEF.

UNASSIGNED: The aim of this study was to estimate the effects of a pulmonary rehabilitation programme (PR) on the functional capacity and respiratory muscle strength of patients with post-COVID syndrome.
UNASSIGNED: A cross-sectional study was conducted using hospital data on patients who participated in a pulmonary rehabilitation programme at the Clinic for Lung Diseases, University Hospital Centre Zagreb, Croatia, between January 2021 and December 2022. Data on the spirometry, respiratory muscle strength, and functional exercise capacity of patients were collected at baseline and three weeks after the start of rehabilitation. The study included 80 patients (43 females, 37 males) with a mean age of 51±10 years.
UNASSIGNED: A significant increase in respiratory muscle strength (P<0.001) was observed after pulmonary rehabilitation, with effect sizes ranging from small to large (Cohen\'s d from 0.39 to 1.07), whereas the effect for PImax expressed as a percentage was large (Cohen\'s d=0.99). In addition, the pulmonary rehabilitation programme significantly improved the parameters of the six-minute walk test in patients, and the parameters of lung function, FVC, FEV1, and DLCO also improved significantly after PR (P<0.05).
UNASSIGNED: The results showed that the pulmonary rehabilitation programme has clinically significant effects on functional capacity and respiratory muscle strength in patients with post-COVID syndrome.
UNASSIGNED: Cilj te študije je bil oceniti učinek programa pljučne rehabilitacije na funkcionalno sposobnost in moč dihalnih mišic pri bolnikih z dolgim covidom.
UNASSIGNED: Opravili smo presečno študijo na podlagi bolnišničnih podatkov o bolnikih, ki so med januarjem 2021 in decembrom 2022 sodelovali v programu pljučne rehabilitacije v Kliniki za pljučne bolezni v Univerzitetnem bolnišničnem centru v Zagrebu. Podatke o spirometriji, moči dihalnih mišic in funkcionalni zmogljivosti za telesno aktivnost bolnikov smo zbrali ob izhodišču in tri tedne po začetku rehabilitacije. Študija je vključevala 80 bolnikov (43 žensk, 37 moških) povprečne starosti 51±10 let.
UNASSIGNED: Ugotovili smo bistveno povečanje moči dihalnih mišic (P < 0,001) po pljučni rehabilitaciji, pri čemer so bile velikosti učinka od majhnih do velikih (Cohen d od 0,39 do 1,07), učinek za PImax, izražen v odstotku, pa je bil velik (Cohen d = 0,99). Poleg tega je program pljučne rehabilitacije precej izboljšal parametre 6-minutnega sprehoda pri bolnikih, parametri pljučne funkcije FVC, FEV1 in DLCO pa so se po pljučni rehabilitaciji prav tako znatno izboljšali (P < 0,05).
UNASSIGNED: Rezultati so pokazali, da ima program pljučne rehabilitacije pri bolnikih z dolgim covidom klinično pomemben učinek na funkcionalno sposobnost in moč dihalnih mišic.

UNASSIGNED: To date, it is unknown whether respiratory training interventions can benefit Long COVID-19 patients. The main objective was to analyze the effects of respiratory training on patients with Long COVID-19, concretely on respiratory muscle strength, lung function, dyspnea, and functional capacity.
UNASSIGNED: We performed a systematic review following PRISMA statement using PubMed, Scopus, and PEDro (last search November 2023). The risk of bias was assessed using the Cochrane tool. We included randomized controlled trials testing the effect of respiratory training interventions in Long COVID-19 patients versus no intervention, control, or placebo intervention. The data was pooled, and a meta-analysis was complete.
UNASSIGNED: We selected 7 studies, which included 572 patients. Meta-analysis results show significant differences in favor of respiratory training in respiratory muscle strength (MD = 13.71; 95% CI = 5.41; 22; p = 0.001), dyspnea (SDM = 1.39; 95% CI = 0.33; 2.46; p = 0.01) and functional capacity (SDM = 0.90; 95% CI = 0.37; 1.43; p = 0.0009), but not in lung function (MD = 0.28; 95%CI = -0.27; 0.83; p = 0.32).
UNASSIGNED: The results of this systematic review with meta-analysis suggest that respiratory training improves respiratory muscle strength and functional capacity in Long COVID-19 patients, as well as dyspnea if combined with therapeutic exercise. However, respiratory training does not improve lung function in these patients.
UNASSIGNED: CRD42022371820.

OBJECTIVE: Respiratory muscle function is compromised in children recovering from chest wall burns, which potentially leads to more impact on exercise capacity and quality of life. This study investigates the effects of an inspiratory muscle training intervention accompanied with a pulmonary rehabilitation program on respiratory muscle strength, lung function, functional capacity, and quality of life in chest burned children.
METHODS: Forty children with burns, aged from 10 to 18 years old and total body surface area of 30% to 50%, were randomly allocated to the inspiratory muscle training group (IMT- G: n = 20) or control group (CG: n = 20). They received IMT plus pulmonary rehabilitation or pulmonary rehabilitation with sham IMT, respectively for eight weeks. The outcomes were the respiratory muscle strength measured by maximum inspiratory pressure (MIP) and maximum expiratory pressure (MEP); lung functions (FEV1, FVC and FEV1/FVC ratio); functional capacity as well as Pediatric Quality of Life to measure physical and psychosocial functioning. outcome measures were assessed at before and after intervention (after eight weeks).
RESULTS: Based on the pre-intervention assessments, we found no significant difference between both groups (p > 0.05). Significant post-intervention differences were reported between both groups in MIP (P = .003), MEP (P = .017), FVC (P = .001), FEV1 (P = .007), FEV1/FVC ratio (P = .028), functional capacity (P = .003), physical domain of QoL (P = .006) and psychological domain of QoL (P = .002) in favor of the IMT group.
CONCLUSIONS: Eight weeks of inspiratory muscle training combined with pulmonary rehabilitation program improved children with chest burns\' respiratory muscles strength, lung functions, functional capacity, and quality of life. Inspiratory muscle training may be employed in burn rehabilitation programs. It is a safe and effective therapy in chest burned children.

BACKGROUND: Functional Movement Screening (FMS) is a battery used for injury prediction, identifying asymmetry and weak connections in basic functional movement patterns. The muscles assessed in FMS are also respiratory muscles. Therefore, FMS scores were thought to be related to respiratory muscle strength. The aim of our study was to examine the relationship between Functional Movement Screen and respiratory muscles strength in professional football players and sedentary individuals.
METHODS: The study included 23 male professional football players (mean age: 25 ± 6.22 years) and 22 sedantery healthy volunteers (mean age: 24.54 ± 2.75 years). Functional Movement Screen tests were applied by the certified researcher. Respiratory muscle strength measurement were measured with an additional mouth apparatus attached to the portable spirometer \'Pony FX Desktop Spirometry\' device.
RESULTS: Trunk stability push-up (p = 0.01; r = 0.490), rotational stability (p = 0.025; r = 0,519), and Functional Movement Screen total score (p = 0.02; r = 0.568) with maximum expiratory pressure were moderately positive correlated in professional football players. In the sedantery group, Functional Movement Screen sub-parameters were not correlated respiratory muscle strength (p > 0.05).
CONCLUSIONS: The higher Functional Movement Screen total score in professional football players and their skills in functional movements that require trunk and core stabilization increase expiratory muscle strength were found compared to sedentary individuals.
CONCLUSIONS: Increase of expiratory muscle strength may be useful in the treatment program when the aim was to Improving functional movement patterns, trunk and core stabilization.

BACKGROUND: The analysis of patients submitted to heart surgery at three assessment times has been insufficiently described in the literature.
OBJECTIVE: To analyze chest expansion, maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP), distance traveled on the six-minute walk test (6MWT), and quality of life in the preoperative period, fourth postoperative day (4th PO), and 30th day after hospital discharge (30th-day HD) in individuals submitted to elective heart surgery.
METHODS: A descriptive, analytical, cross-sectional study was conducted with 15 individuals submitted to elective heart surgery between 2016 and 2020 who did not undergo any type of physiotherapeutic intervention in Phase II of cardiac rehabilitation. The outcome variables were difference in chest expansion (axillary, nipple, and xiphoid), MIP, MEP, distance on 6MWT, and quality of life. The assessment times were preoperative period, 4th PO, and 30th-day HD.
RESULTS: Chest expansion diminished between the preoperative period and 4th PO, followed by an increase at 30th-day HD. MIP, MEP, and distance traveled on the 6MWT diminished between the preoperative period and 4th PO, with a return to preoperative values at 30th-day HD. General quality of life improved between the preoperative period and 4th PO and 30th-day HD. An improvement was found in the social domain between the preoperative period and the 30th-day HD.
CONCLUSIONS: Heart surgery causes immediate physical deficit, but physical functioning can be recovered 30 days after hospital discharge, resulting in an improvement in quality of life one month after surgery.