Effects of breathing maneuver and sitting posture on muscle activity in inspiratory accessory muscles in patients with chronic obstructive pulmonary disease

BACKGROUND: To determine the influence of breathing maneuver and sitting posture on tidal volume (TV), respiratory rate (RR), and muscle activity of the inspiratory accessory muscles in patients with chronic obstructive pulmonary disease (COPD). METHODS: Twelve men with COPD participated in the study. Inductive respiratory plethysmography and surface electromyography were used to simultaneously measure TV, RR, and muscle activity of the inspiratory accessory muscles [the scalenus (SM), sternocleidomastoid (SCM), and pectoralis major (PM) muscles] during quiet natural breathing (QB) and pursed-lips breathing (PLB) in three sitting postures: neutral position (NP), with armm support (WAS), and with arm and head support (WAHS). RESULTS: Two-way repeated-measures analysis of variance was employed. In a comparison of breathing patterns, PLB significantly increased TV and decreased RR compared to QB. Muscle activity in the SM and SCM increased significantly in PLB compared to QB. In a comparison of sitting postures, the muscle activity of the SM, SCM, and PM increased in the forward-leaning position. CONCLUSIONS: The results suggest that in COPD, PLB induced a favorable breathing pattern (increased TV and reduced RR) compared to QB. Additionally, WAS and WAHS positions increased muscle activity of the inspiratory accessory muscles during inspiration versus NP. Differential involvement of accessory respiratory muscles can be readily studied in COPD patients, allowing monitoring of respiratory load during pulmonary rehabilitation

Discutindo a educação ambiental no cotidiano escolar: desenvolvimento de projetos na escola formação inicial e continuada de professores

A presente pesquisa buscou discutir como a Educação Ambiental (EA) vem sendo trabalhada, no Ensino Fundamental e como os docentes desta escola compreendem e vem inserindo a EA no cotidiano escolar., em uma escola estadual do município de Tangará da Serra/MT, Brasil. Para tanto, realizou-se entrevistas com os professores que fazem parte de um projeto interdisciplinar de EA na escola pesquisada. Verificou-se que o projeto da escola não vem conseguindo alcançar os objetivos propostos por: desconhecimento do mesmo, pelos professores; formação deficiente dos professores, não entendimento da EA como processo de ensino-aprendizagem, falta de recursos didáticos, planejamento inadequado das atividades. A partir dessa constatação, procurou-se debater a impossibilidade de tratar do tema fora do trabalho interdisciplinar, bem como, e principalmente, a importância de um estudo mais aprofundado de EA, vinculando teoria e prática, tanto na formação docente, como em projetos escolares, a fim de fugir do tradicional vínculo “EA e ecologia, lixo e horta”.Facultad de Humanidades y Ciencias de la Educació

Understanding the Left Right Judgement Test: A Literature Review

Background: The body schema, which is constantly updated using somatosensory information, enables accurate movement. Since pain is reported as a possible source to alter the body schema, the left right judgement test (LRJT) has been widely used in the pain rehabilitation. However, there was a lack of consistency in the effect of the pain on the LRJT results, and for the effect of the LRJT as a part of intervention programs for pain patients. The deeper understand of the LRJT is necessary for better reproducibility, and to expand the therapeutic applications of the LRJT in the pain and musculoskeletal rehabilitation. Objects: This literature review aimed to understand the LRJT and to study the potential of the LRJT for therapeutic applications. Methods: The PubMed database was searched for studies relevant to LRJT. To establish the query set, the term was regarded from various perspectives. Results: The selected studies were classified into three categories: LRJT development, factors influencing LRJT, and therapeutic applications. Conclusion: Left right judgement test is the evaluation tool for the integrity of body schema as well as a tool for implicit motor imagery. Pain, proprioception, and other factors influence the performance of the LRJT

Effect of Home-based Rehabilitation on Balance and Gait Function in Patient With Stroke: A Systematic Review and Meta-analysis

Stroke is one of the most common disabilities experienced by the elderly in the community. However, stroke progresses to a chronic level, patients are discharged from medical institu-tions and eventually no longer receive therapeutic interventions at home. In this systematic re-view, we compared home-based rehabilitation (HBR) with comparison for patients with stroke. Literature published in Cumulative Index for Nursing and Allied Health Literature (CINAHL), Embase, Physiotherapy Evidence Database (PEDro), PubMed, and Google Scholar were re-viewed. A total of 1,158 studies were initially retrieved. After reading the full texts, 11 articles were included in the systematic review. Quality assessment of the included studies was con-ducted using Risk of Bias (RoB) 2.0, and Egger’s regression test was used to evaluate publica-tion bias. Data analysis was performed using the R studio software (R Studio). According to the quality assessment using RoB 2.0, three studies were evaluated as low risk, two as of some concern, and three as high risk. The overall effect size was moderate (0.309). The value of the balance function was a small effect size (0.201), while the value of the gait function was a moderate effect size (0.353). The values were small and moderate effect (0.154, 0.411) for the chronic and subacute conditions, respectively. According to the Egger’s regression test, no publication bias was observed. The findings of this study indicate that HBR resulted in the greatest improvement in gait function in patients with subacute stroke compared to those with chronic stroke. Therefore, the application of this intervention to patients with stroke in the community is recommended

Risk Factors for Sarcopenia, Sarcopenic Obesity, and Sarcopenia Without Obesity in Older Adults

Background: Muscle undergoes change continuously with aging. Sarcopenia, in which muscle mass decrease with aging, is associated with various diseases, the risk of falling, and the deterioration of quality of life. Obesity and sarcopenia also have a synergy effect on the disease of the older adults. Objects: This study examined the risk factors for sarcopenia, sarcopenic obesity, and sarcopenia without obesity and developed prediction models. Methods: This machine-learning study used the 2008–2011 Korea National Health and Nutrition Examination Surveys in the analysis. After data curation, 5,563 older participants were selected, of whom 1,169 had sarcopenia, 538 had sarcopenic obesity, and 631 had sarcopenia without obesity; the remaining 4,394 were normal. Decision tree and random forest models were used to identify risk factors. Results: The risk factors for sarcopenia chosen by both methods were body mass index (BMI) and duration of moderate physical activity; those for sarcopenic obesity were sex, BMI, and duration of moderate physical activity; and those for sarcopenia without obesity were BMI and sex. The areas under the receiver operating characteristic curves of all prediction models exceeded 0.75. BMI could predict sarcopenia-related disease. Conclusion: Risk factors for sarcopenia-related diseases should be identified and programs for sarcopenia-related disease prevention should be developed. Data-mining research using population data should be conducted to enhance the effectiveness of early treatment for people with sarcopenia-related diseases through predictive models

Comparative Effects of Novel Modified Sleeper and Cross-body Stretching on Scapular Anterior Tilting and Shoulder Internal Rotation in Subjects With Anterior Tilted Scapular and Shoulder Internal Rotation Deficits

Background: Posterior capsule tightness (PCT), commonly seen in overhead athletes, is a soft tissue adaptation that is also noted in non-throwers. PCT is associated with scapular and humeral kinematic alterations, significant restriction of shoulder internal rotation (IR) range of motion (ROM), and significant scapular anterior tilting. Sleeper and cross-body stretches (CBS) are suggested for PCT and IR deficits, and have been modified since introduction. A novel modified sleeper stretch (NMSS) was designed in this study to prevent the risk of anterior translation of the humeral head. Though the effects of posterior shoulder stretching exercise have been widely studies, to the best of our knowledge, no previous studies have investigated the effectiveness of posterior shoulder exercises in decreasing scapular anterior tilting. Objects: To compare the immediate effects of two posterior shoulder stretching exercises (NMSS and CBS) on scapular anterior tilting and shoulder IR ROM. Methods: Thirty-two subjects with anteriorly tilted scapula and IR deficits [mean age: 24.3 ± 2.5 years; 15 males and 17 females] participated in this study. Subjects were randomly assigned to either the NMSS or CBS groups. Scapular anterior tilting (at rest and at shoulder 60° active IR) and shoulder IR ROM were measured before and immediately after intervention. Results: Scapular anterior tilting significantly decreased, while the shoulder IR ROM significantly increased in both groups. However, there was no significant group-by-time interaction effect or significant difference between the groups. Conclusion: Both stretching exercises were effective in restoring shoulder IR ROM and decreasing scapular anterior tilting

Focal Muscle Vibration Changes the Architecture of the Medial Gastrocnemius Muscle in Persons With Limited Ankle Dorsiflexion

Background: The gastrocnemius tightness can easily occur. Gastrocnemius tightness results in gait disturbance. Thus, various interventions have been used to release a tight gastrocnemius muscle and improve gait performance. Moreover, focal muscle vibration (FMV) has recently been extensively researched in terms of tight muscle release and muscle performance. However, no study has investigated the effects of FMV application on medial gastrocnemius architectural changes. Objects: In this study, we aimed to investigate the effects of FMV on medial gastrocnemius architecture in persons with limited ankle dorsiflexion. Methods: Thirty one persons with <10° of passive ankle dorsiflexion participated in this study. We excluded persons with acute ankle injury within six months prior to study onset, a history of ankle fracture, leg length discrepancy greater than 2 cm, no history of neurological dysfunction, or trauma affecting the lower limb. The specifications of the FMV motor were as follows: a fixed frequency (fast wave: 150 Hz) and low amplitude (0.3–0.5 mm peak to peak) of vibration; the motor was used to release the medial gastrocnemius for 15 minutes. Each participant completed three trials for 10 days; a 30-second rest period was provided between each trial. Medial gastrocnemius architectural parameters [muscle thickness (MT), fiber bundle length (FBL), and pennation angle (PA)] were measured via ultrasonography. Results: MT significantly decreased after FMV application (p < 0.05). FBL significantly increased from its baseline value after FMV application (p < 0.05). PA significantly decreased from its baseline value after FMV application (p < 0.05). Conclusion: FMV application may be advantageous in reducing medial gastrocnemius excitability following a decrease in the amount of contractile tissue. Furthermore, FMV application can be used as a stretching method to alter medial gastrocnemius architecture

Relationship Between Muscle Mass and Usual Walking Speed Mediated by Muscle Strength, Respiration and Depression in Elderly Female

Background: The elderly population is increasing rapidly worldwide. Muscle mass, usual walking speed (UWS), knee extension strength (KES), hand grip strength (HGS), peak expiratory flow (PEF), and depression is used for sarcopenia diagnosis. All four of these factors (KES, HGS, PEF, and depression) correlated with UWS and also to muscle mass. But, many studies have suggested that no correlation exists between muscle mass and UWS. Objects: This study aimed: 1) to investigate whether muscle mass reduction affected UWS, as mediated by KES, HGS, PEF and depression, and 2) to explored whether significant changes in these mediators varied by the body segment in which muscle mass evaluated in elderly female aged 65–80 years. Methods: A total of 100 female aged 65–80 years were surveyed. Muscle mass was measured by body segment (upper and lower segment), and KES, HGS, PEF, depression, and UWS were also assessed. Median analyses were progressed in IBM SPSS software (ver. 23.0, IBM Co.) using a downloaded INDIRECT macro. Results: The direct effect of the KES and PEF were significant, and the indirect effect of KES and PEF were not significant. Thus, KES and PEF served as full mediators of the effect of muscle mass on UWS. Regardless of bodily region, KES and PEF combined with muscle mass were significant mediators of UWS, with similar indirect effect sizes. Conclusion: KES and PEF are the only mediators regardless of body part. Therefore, mediating the KES and PEF may prevent sarcopenia progression in elderly female. Also, sarcopenia can be readily assessed by evaluating either the upper or lower body; it is not necessary to measure total muscle mass

The Effects of Augmented Somatosensory Feedback on Postural Sway and Muscle Co-contraction in Different Sensory Conditions

Background: Augmented somatosensory feedback stimulates the mechanoreceptor to deliver information on bodily position, improving the postural control. The various types of such feedback include ankle-foot orthoses (AFOs) and vibration. The optimal feedback to mitigate postural sway remains unclear, as does the effect of augmented somatosensory feedback on muscle co-contraction. Objects: We compared postural sway and ankle muscle co-contraction without feedback (control) and with either of two forms of somatosensory feedback (AFOs and vibration). Methods: We recruited 15 healthy subjects and tested them under three feedback conditions (control, AFOs, vibration) with two sensory conditions (eyes open, or eyes closed and the head tilted back), in random order. Postural sway was measured using a force platform; the mean sway area of the 95% confidence ellipse (AREA) and the mean velocity of the center-of-pressure displacement (VEL) were assessed. Co-contraction of the tibialis anterior and gastrocnemius muscles was measured using electromyography and converted into a cocontraction index (CI). Results: We found significant main effects of the three feedback states on postural sway (AREA, VEL) and the CI. The two sensory conditions exerted significant main effects on postural sway (AREA and VEL). AFOs reduced postural sway to a level significantly lower than that of the control (p = 0.014, p < 0.001) or that afforded by vibration (p = 0.024, p < 0.001). In terms of CI amelioration, the AFOs condition was significantly better than the control (p = 0.004). Vibration did not significantly improve either postural sway or the CI compared to the control condition. There was no significant interaction effect between the three feedback conditions and the two sensory conditions. Conclusion: Lower-extremity devices such as AFOs enhance somatosensory perception, improving postural control and decreasing the CI during static standing