Effect of respiratory muscle training in asthma: a systematic review and meta-analysis

Review[Abstract] Background: The last systematic review about respiratory muscle training (RMT) in people with asthma was published almost 10 years ago. Since then, several works have been published. Objective: To review the effect of RMT in people with asthma. Methods: We conducted a systematic review of research included up to September 2021 in PubMed/MEDLINE, PEDro, Scopus, Web of Science, CINAHL, LILACS, Cochrane Central Register of Controlled Trials and ClinicalTrials.gov. We included randomized controlled trials and quasi-experimental studies assessing the effect of RMT on respiratory muscle function, rescue medication, asthma-related symptoms, lung function, exercise capacity, healthcare use, health-related quality of life (HRQoL) and adverse effects in people with asthma. Risk of bias and methodological quality were assessed with the Cochrane Risk of Bias assessment tool and the PEDro scale. Meta-analysis was performed whenever possible; otherwise a qualitative approach was followed. Results: Eleven studies (270 participants) were included, 10 with only adults and were included in the meta-analysis. Inspiratory muscle training (IMT) had beneficial effects on maximal inspiratory pressure (PImax: mean difference [MD] 21.95 cmH2O [95% confidence interval [CI] 15.05; 28.85]), with no changes in maximal expiratory pressure (MD 14.97 cmH2O [95%CI -5.65; 35.59]), lung function (forced expiratory volume in 1 sec: MD 0.06 [95%CI -0.14; 0.26] L; force vital capacity: MD 0.39 [95%CI -0.24; 1.02] L) and exercise capacity (standard mean difference [SMD] 1.73 [95%CI -0.61; 4.08]). Subgroup analysis revealed that IMT load >50% PImax and duration >6 weeks were beneficial for exercise capacity. The qualitative analysis suggested that IMT may have benefits on respiratory muscle endurance, rescue medication and exertional dyspnoea, with no adverse effects. Conclusions: This systematic review and meta-analysis showed a significant increase in PImax after IMT in adults with asthma and reinforced the relevance of the dose-response principle of training. More evidence is needed to clarify the effect of IMT in respiratory muscle endurance, rescue medication, exercise capacity, healthcare use and HRQoL

Biceps Femoris Activation during Hamstring Strength Exercises: A Systematic Review

Background: The aim of the study was to systematically evaluate the biceps femoris long head activation across cross-sectional hamstring strength exercise studies. Methods: A systematic review design was followed. The search strategy conducted in PubMed, Cochrane Library, and Web of Sciences databases found a total of 3643 studies. Once inclusion and exclusion criteria were applied, 29 studies were finally included in this systematic review. A total of 507 participants and 114 different exercises were analyzed. Exercises were evaluated individually and grouped into several categories: Nordics, isokinetic exercises, lunges, squats, deadlifts, good mornings, hip thrusts, bridges, leg curls, swings, hip and back extensions, and others. Results: Results showed the isokinetic and Nordic exercises as the categories with highest biceps femoris activation (>60% of Maximal Voluntary Isometric Contraction). Nordic hamstring exercise ankle dorsiflexion was the exercise that achieved the highest biceps femoris long head activation (128.1% of its Maximal Voluntary Isometric Contraction). Conclusions: The results from this systematic review suggest that isokinetic and Nordic exercises seem to be the best option to activate biceps femoris long head. Future studies evaluating the implementation of these exercises in prevention programs are neede

Effects of Adding an Online Exercise Program on Physical Function in Individuals Hospitalized by COVID-19: A Randomized Controlled Trial

The worldwide pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus has impacted all healthcare systems. One potential sequela experienced by hospitalized coronavirus disease 2019 (COVID-19) survivors includes muscle weakness with a reduction in strength and, consequently, a possible increase in frailty. The aim of this clinical trial was to evaluate the efficacy of adding an online therapeutic exercise program for 8 weeks to the medical prescriptions on functional variables in patients hospitalized due to COVID-19. A randomized controlled trial including 70 previously hospitalized COVID-19 survivors was conducted. Patients were randomly allocated to an experimental (n = 35) or control (n = 35) group. Both groups received regular prescriptions provided by their medical doctors. The experimental group also received a live online therapeutic exercise program for 8 weeks (3 sessions/week). Handgrip strength, gait speed, lower-extremity strength, balance, and frailty were assessed at baseline, at the end of the program, and one month after the end of the intervention. The repeated measures analysis of variance revealed significant Group*Time interactions for all the outcomes: (handgrip dominant: F = 17.395, p < 0.001, η2 = 0.24; handgrip non-dominant: F = 33.197, p < 0.001, η2 = 0.33; 4 m walk test (4WT): F = 13.039, p = 0.001, η2 = 0.16; short physical performance battery (SPPB): F = 26.421, p < 0.001, η2 = 0.28; the five chair-raise test (5CRT): F = 5.628, p = 0.004, η2 = 0.08; FRAIL scale: F = 11.249, p = 0.001, η2 = 0.14): patients in the experimental group experienced greater improvements in all outcomes than those assigned to the control group. This study revealed that the addition of an online exercise program for 8 weeks obtained greater improvements in handgrip strength, gait speed, lower-extremity strength, balance, and frailty in a sample of previously hospitalized COVID-19 survivors than application of just usual medical prescription

Análisis de la respuesta neuromuscular y la proyección del ángulo de la rodilla en el plano frontal en sujetos físicamente activos: implicaciones para la lesión de ligamento cruzado anterior

La lesión de ligamento cruzado anterior es una de las lesiones más devastadoras en el ámbito deportivo. El valgo dinámico de rodilla durante el gesto deportivo puede ser uno de los mecanismos más comunes en la lesión del ligamento cruzado anterior. Entender el valgo dinámico de rodilla puede resultar fundamental para actuar adecuadamente en la prevención de dicha lesión o en su posterior rehabilitación. El objetivo principal de la presente tesis doctoral es analizar si existe una correlación entre diferentes parámetros de la respuesta neuromuscular de la musculatura de la extremidad inferior y el máximo ángulo de proyección de la rodilla en el plano frontal durante un aterrizaje unipodal. Esta tesis doctoral se divide en tres estudios con un diseño observacional con carácter transversal en participantes hombres, sanos y físicamente activos. El primer estudio evaluó la correlación entre el máximo ángulo de proyección de la rodilla en el plano frontal durante un salto con aterrizaje unipodal y el tono y la rigidez de la musculatura posterior de la extremidad inferior en 50 hombres. El máximo ángulo de proyección de la rodilla en el plano frontal fue evaluado mediante el programa de análisis de movimiento en dos dimensiones Kinovea® software. El tono y la rigidez muscular fueron evaluados mediante la tensiomiografía y la miotonometría. El segundo estudio evaluó la correlación entre el máximo ángulo de proyección de la rodilla en el plano frontal durante un salto con aterrizaje unipodal y la actividad muscular de la musculatura posterior de la extremidad inferior y del cuádriceps durante la realización del salto en 35 hombres. Se utilizó el software Kinovea® para el análisis del máximo ángulo de proyección de la rodilla en el plano frontal y el electromiógrafo de superficie mDurance® para analizar la actividad muscular. El tercer estudio evaluó la validez y fiabilidad de una aplicación móvil desarrollada para medir el máximo ángulo de proyección de la rodilla en el plano frontal durante acciones estáticas y dinámicas en 35 hombres. Se utilizó el software Kinovea® y la aplicación MyMocap® para evaluar el máximo ángulo de proyección de la rodilla en el plano frontal. En el primer estudio no se encontraron correlaciones significativas entre el máximo ángulo de proyección de la rodilla en el plano frontal y el tono muscular o la rigidez de la musculatura posterior de la extremidad inferior. En el segundo estudio se encontraron correlaciones significativas entre el máximo ángulo de proyección de la rodilla en el plano frontal y la actividad muscular del glúteo mayor, glúteo medio, bíceps femoral y semitendinoso tanto para la extremidad dominante como para extremidad no dominante. Es decir, cuanta más actividad muscular, el máximo ángulo de proyección de la rodilla era mayor. Se encontraron correlaciones significativas entre el máximo ángulo de proyección de la rodilla en el plano frontal y la actividad muscular de los gastrocnemios únicamente para la extremidad no dominante. No se encontraron correlaciones significativas entre el máximo ángulo de proyección de la rodilla en el plano frontal y la actividad muscular del cuádriceps. El tercer estudio demostró la validez de la aplicación MyMocap para medir el ángulo de proyección de la rodilla en el plano frontal durante una posición estática de sentadilla. La validez de la aplicación para medir el máximo ángulo de proyección de la rodilla en el plano frontal durante acciones dinámicas fue entre justa y moderada. La fiabilidad interna de la aplicación obtuvo buenos resultados test-retest

Effects of protein supplementation combined with resistance training on the strength and physical function of elderly

The ageing of the world's population, and the physical inactivity of older adults represent a major public health problem. For instance, only 27–44% of older U.S. adults meet international physical activity recommendations (≥ 150 min per week of moderate-to-vigorous physical activity). Lower mortality and increasing lifespan, has led to a diversification and growth in chronic disease morbidity. Such growth includes an increased prevalence of aging-related mobility impairments, even with aging in the absence of disease. Reductions in physiological resilience often lead to physical disability, mobility impairment, falls, and decreased independence and quality of life. Age-related sarcopenia is directly and causally linked to both muscle weakness and physical disability. It has an estimated prevalence of 10% in adults older than 60 years, rising to 50% in adults older than 80 years. Physical frailty has consistently been linked to improve cognitive impairment, dementia, Alzheimer disease, physical function, health-related quality of life, risk of hospitalization, falls and fall-associated injuries, and fractures. In addition, physical function is considered a direct biomarker of health, unlike other biochemical markers that provide more indirect information. It is interesting to think that the improvement in physical condition will improve the function of these patients. For this reason, strength training in the elderly can be an interesting tool for avoiding sarcopenia. In addition to the physical activity, different studies have shown a positive relationship between dietary protein supplementation with muscle mass, strength and function in the elderly. In fact, International Society of Sports Nutrition (ISSN) position stand suggests that the combination of protein supplementation and strength training improves strength and muscle mass in athletes. Four meta-analysis have been performed previously, all of them have shown that protein supplementation during resistance training promote greater increase in fat-free mass than resistance training alone. However, due to the diversity existence of studies, there is no systematic review with meta-analyses that evaluated protein supplementation and strength training in improving the function of older people. The aim of this study is to evaluate the effectiveness of the combination of strength training combined with protein supplementation, and strength training alone in improving the functionality of older people

Does specific injury prevention programes reduce number of injuries in track and field, soccer and rugby? A systematic review and meta-analysis

Sport-related injuries are common and they have an important economic, social and performance impact among track and field athletes, rugby players and soccer players. Sport-field research has been focusing on developing injury prevention strategies in order to reduce number and severity of injuries among this population. A lot of specific injury prevention programes have been created. Some of them have shown good results but others efficacy remains unclear. We aim to systematically review randomized controlled trials which evaluate the effectiveness of specific injury prevention programes as "FIFA 11+", "RugbySmart", etc on reducing number of injuries among track and field athletes, soccer players and rugby players. A meta-analysis will be conducted to quantify the effectiveness of these programes