activities of daily living (ADLs), such as personal hygiene, eating, and dressing ( Mitchell et al., 2009 ; Pathan et al., 2011 ). These impairments contribute to a decrease of respiratory function and physical activity participation ( Hesseberg et al., 2016 ), and quality of life, thus increasing
Cátia Paixão, Ana Tavares and Alda Marques
Roy J. Shephard
Aging leads to a progressive deterioration of lung function, including a decrease of vital capacity, an increase of residual volume, a tendency for the airways to collapse during expiration, enlargement of all components of the respiratory dead space, a poor mixing of inspired gas, poor matching of ventilation with perfusion, a decrease of pulmonary diffusing capacity, and a substantial increase in the work of breathing. Ventilatory demand is increased during most physical tasks, but arterial blood homeostasis is surprisingly well maintained when elderly persons undertake vigorous exercise because peak cardiac output declines in parallel with the loss of ventilatory function. However, dyspnea progressively restricts peak effort as one ages. The exercise specialist cannot restore aged or damaged pulmonary tissue but can attempt to reduce the rate of future functional loss by encouraging smoking cessation, avoiding air pollution, and controlling acute infections. Enhanced fitness, stronger skeletal muscles, and better coordination can reduce ventilatory demand. Resisted breathing exercises may also strengthen the chest muscles and allow a mechanically more efficient pattern of breathing.
Mark L. Watsford, Aron J. Murphy, Matthew J. Pine and Aaron J. Coutts
Older adults’ participation in habitual exercise might be affected by alterations to respiratory mechanics such as decreased respiratory-muscle strength. This reduction can cause a decrease in efficiency of the ventilatory pump, potentially compromising exercise participation. This research examined the role of habitual exercise in respiratory-muscle function and the associated implications for exercise performance. Seventy-two healthy older adults (36 men, 64.9 ± 8.6 years, 177.2 ± 8.4 cm, 82.5 ± 11.9 kg; 36 women, 64.9 ± 9.5 years, 161.7 ± 6.4 cm, 61.6 ± 9.2 kg) undertook respiratory-function and walking-performance tests. Active men and women achieved higher scores than their inactive counterparts for all tests except spirometry, where no differences were evident. The results indicate that a significant amount of the elevated fitness level might be accounted for by increased endurance capacity of the inspiratory muscles. Inactive older individuals might be at risk for inadequate respiratory-muscle strength, so interventions should be considered.
Fumi Hirayama, Andy H. Lee and Tetsuo Hiramatsu
Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide. Because only 20% of cigarette smokers develop COPD, certain environmental and lifestyle factors may protect against the disease development.
To investigate the relationship between life-long physical activity involvement and the COPD risk, a case-control study was conducted in central Japan. A total of 278 eligible patients (244 men and 34 women) age 50 to 75 years were referred by respiratory physicians, while 335 controls (267 men and 68 women) were recruited from the community. All participants underwent spirometric measurements of lung function. Information on demographic and lifestyle characteristics was obtained by face-to-face interview using a structured questionnaire.
Older adults who remained physically active had better lung function than others inactive over the life course. The COPD patients were found to be less active than their healthy counterparts. Significant reductions in risk of COPD and breathlessness were evident by being active life-long, with adjusted odds ratio 0.59 (95% CI 0.36−0.97) and 0.56 (95% CI 0.36−0.88), respectively.
The study suggested an inverse association between life-long physical activity and the risk of COPD and breathlessness. Promotion of physical activity to prevent this major disease should be encouraged.
Andrew Cox, Marcie B. Fyock-Martin and Joel R. Martin
suggested that the ETM may be beneficial for improving respiratory function. 5 , 6 Figure 1 —Flow diagram of the search process. Table 1 Characteristics of Included Studies Authors Characteristics Maher and Figueroa 6 Porcari et al. 5 Biggs et al. 7 Warren et al. 8 Study design RCT RCT RCT RCT Participants
Leila Ahmadnezhad, Ali Yalfani and Behnam Gholami Borujeni
warm-up with an ergometer with a constant speed and resistance and 3 min of full-body stretching movements). Table 2 The Result of Respiratory Function and Pain Intensity Before and After IMT Variables Group BT Mean (SD) AT Mean (SD) F (WG) P (WG) F (BG) P (BG) Effect size, d VC Training 3.91 (0
Han-Kyu Park, Dong-Woo Kim and Tae-Ho Kim
have reported that the abdominal muscles are indispensable to postural control and respiratory function in daily life. 14 , 15 , 19 , 20 Athletes in a variety of sport activities (eg, running, swimming and diving, and cycling) are using respiration training more often. 21 – 23 Numerous researchers
Barton E. Anderson and Kellie C. Huxel Bliven
Research has shown a link between poor core stability and chronic, nonspecific low back pain, with data to suggest that alterations in core muscle activation patterns, breathing patterns, lung function, and diaphragm mechanics may occur. Traditional treatment approaches for chronic, nonspecific low back pain focus on exercise and manual therapy interventions, however it is not clear whether breathing exercises are effective in treating back pain.
Focused Clinical Question:
In adults with chronic, nonspecific low back pain, are breathing exercises effective in reducing pain, improving respiratory function, and/or health related quality of life?
Summary of Key Findings:
Following a literature search, 3 studies were identified for inclusion in the review. All reviewed studies were critically appraised at level 2 evidence and reported improvements in either low back pain or quality of life following breathing program intervention.
Clinical Bottom Line:
Exercise programs were shown to be effective in improving lung function, reducing back pain, and improving quality of life. Breathing program frequencies ranged from daily to 2–3 times per week, with durations ranging from 4 to 8 weeks. Based on these results, athletic trainers and physical therapists caring for patients with chronic, nonspecific low back pain should consider the inclusion of breathing exercises for the treatment of back pain when such treatments align with the clinician’s own judgment and clinical expertise and the patient’s preferences and values.
Strength of Recommendation:
Grade B evidence exists to support the use of breathing exercises in the treatment of chronic, nonspecific low back pain.
Leyre Gravina, Frankie F. Brown, Lee Alexander, James Dick, Gordon Bell, Oliver C. Witard and Stuart D.R. Galloway
Omega-3 fatty acid (n-3 FA) supplementation could promote adaptation to soccer-specific training. We examined the impact of a 4-week period of n-3 FA supplementation during training on adaptations in 1RM knee extensor strength, 20-m sprint speed, vertical jump power, and anaerobic endurance capacity (Yo-Yo test) in competitive soccer players. Twenty six soccer players were randomly assigned to one of two groups: n-3 FA supplementation (n-3 FA; n = 13) or placebo (n = 13). Both groups performed two experimental trial days. Assessments of physical function and respiratory function were conducted pre (PRE) and post (POST) supplementation. Training session intensity, competitive games and nutritional intake were monitored during the 4-week period. No differences were observed in respiratory measurements (FEV1, FVC) between groups. No main effect of treatment was observed for 1RM knee extensor strength, explosive leg power, or 20 m sprint performance, but strength improved as a result of the training period in both groups (p < .05). Yo-Yo test distance improved with training in the n-3 FA group only (p < .01). The mean difference (95% CI) in Yo-Yo test distance completed from PRE to POST was 203 (66–340) m for n-3 FA, and 62 (-94–217) m for placebo, with a moderate effect size (Cohen’s d of 0.52). We conclude that 4 weeks of n-3 FA supplementation does not improve strength, power or speed assessments in competitive soccer players. However, the increase in anaerobic endurance capacity evident only in the n-3 FA treatment group suggests an interaction that requires further study.
. Butterworth * Dru A. Henson * 10 1993 1 1 22 33 10.1123/japa.1.1.22 Scholarly Reviews Physical Activity and Depression in the Elderly Patrick J. O’Connor * Louis E. Aenchbacher III * Rod K. Dishman * 10 1993 1 1 34 58 10.1123/japa.1.1.34 Research Aging, Respiratory Function, and Exercise Roy J