Armèle Dornelas de Andrade

Summary: Tidal breathing measurements by Opto‐Electronic Plethysmography (OEP) has been reported for infants limited to protocols with two chest wall compartments. Standard protocol for the analysis of adults, with three compartments of chest wall, has been unavailable for analysis of infants. We aimed to study the agreement of simultaneous measurements of tidal volume by OEP (V_T,OEP) and a heated pneumotachograph (PNT) (V_T,PNT) performed during sleeping in 20 infants (gestational age 35.1 ± 4.6 weeks) at 3–4 months postconceptual age with a three compartment protocol. From PNT and OEP measurements, tidal volume corrected (V_T,PNT) for ambient conditions were calculated with a total number of 200 breaths. The two methods were in good agreement with tidal volume mean difference of 0.02 ml and limit of agreement −4.11 to 4.08 ml (95%CI), no relationship was found between differences and means of OEP and PNT measurements. Pulmonary rib cage, abdominal rib cage and abdomen contributed by 12.4 ± 9.7%, 5.2 ± 5.1%, and 82.4 ± 11.4% to V_T,OEP, respectively. The OEP experimental protocol based on 52 markers and a three‐compartment model of the chest wall could be used in spontaneously sleeping infants. Pediatr Pulmonol. 2016;51:850–857.

Aging results in a decline in the function of the respiratory muscles. Inspiratory muscle training is emerging as a possible intervention to attenuate the decline of respiratory muscles in the elderly. The aim of this study was to evaluate the efficacy of inspiratory muscle training on respiratory strength, diaphragm thickness, and diaphragmatic mobility in elderly women. This was a controlled, randomized, and double-blind clinical trial, performed on 22 elderly women distributed in two groups, training (TG) and control (CG). Over an 8-week period a moderate intensity inspiratory muscle training protocol was followed in the TG, while CG followed a sham protocol. In addition maximum expiratory and inspiratory pressure, mobility of the diaphragm and diaphragmatic thickness were evaluated by ultrasound. After training, in TG maximal inspiratory pressure, maximal expiratory pressure, diaphragm thickness, and mobility increased by 37%, 13%, 11%, and 9% respectively, and their values were significantly higher than CG (p < .005, p = .013, p = .001, and p = .001). Inspiratory muscle training of moderate intensity improves respiratory muscle strength, diaphragm thickness, and diaphragm mobility in elderly women and it should be considered to minimize changes associated with senescence.

To analyze in obese women the acute effects of the breath stacking technique on thoraco-abdominal expansion. Nineteen obese women (BMI≥30 kg/m²) were evaluated by anthropometry, spirometry and maximal respiratory muscle pressures and successively analyzed by Opto-Electronic Plethysmography and a Wright respirometer during quiet breathing and breath stacking maneuvers and compared with a group of 15 normal-weighted healthy women. The acute effects of the maneuvers were assessed in terms of total and compartmental chest wall volumes at baseline, end of the breath stacking maneuver and after the maneuver. Obese subjects were successively classified into two groups, accordingly to the response during the maneuver, group 1 = prevalent rib cage or group 2 = abdominal expansion. Age was significantly lower in group 1 than group 2. When considering the two obese groups, FEV₁ was lower and minute ventilation was higher only in group 2 compared to controls group. During breath stacking, inspiratory capacity was significant differences in obese subjects with a smaller expansion of the pulmonary rib cage and a greater expansion of the abdomen compared to controls and also between groups 1 and 2. A significant inverse linear relationship was found between age and inspiratory capacity of the pulmonary rib cage but not of the abdomen. In obese women the maximal expansion of the rib cage and abdomen is influenced by age and breath stacking maneuver could be a possible therapy for preventing respiratory complications.

To increase the global impact of health promotion related to non-communicable diseases, health professionals need evidence-based core competencies in health assessment and lifestyle behavior change. Assessment of health promotion curricula by health professional programs is a first step. Such program assessment is a means of 1. demonstrating collective commitment across health professionals to prevent non-communicable diseases; 2. addressing the knowledge translation gap between what is known about non-communicable diseases and their risk factors consistent with ‘best’ practice; and, 3. establishing core health-based competencies in the entry-level curricula of established health professions.

Background and Purpose: Immersion in water, with the head above the water line, causes acute physiological changes in the pulmonary and cardiovascular systems. The aim of this study was to evaluate the acute physiological responses to immersion on lung volumes and respiratory muscle strength at different depths.Methods: A cross‐sectional study was conducted in 28 healthy individuals (21.75 ± 1.99 years; 13 men and 15 women). Anthropometric and spirometric data as well as respiratory muscle strength were evaluated. Evaluations were carried out on dry land (DL) and in a pool at three different levels of immersion: iliac crests (IC), xiphoid appendix of the sternum (XA) and clavicles (CL). The order of evaluation for spirometry and maximal inspiratory and expiratory pressures between DL and the different levels of immersion was randomized. The ANOVA test for repeated measures with post hoc Tukey was applied to compare the variables.Results: Vital capacity exhibited lower values at the CL level compared with DL, XA and IC (p < 0.01). The most significant change in forced expiratory volume in the first second (FEV₁) occurred under immersion at CL and XA levels. No differences in maximal expiratory pressure were found in the comparisons between the different levels of immersion and DL (p = 0.19). There was nevertheless a decrease in maximum inspiratory pressure with immersion at the CL level (91 ± 23 cmH₂O) compared with DL (105 ± 29 cmH₂O), XA (99 ± 24 cmH₂O) and IC (101 ± 25 cmH₂O) values (p < 0.01).Conclusion: The results suggest that immersion at the level of the clavicles and xiphoid appendix alters lung function and respiratory muscle strength when compared with the values measured out of the water and immersed at the IC level in healthy individuals, demonstrating the influence of hydrostatic pressure on the respiratory system. Copyright © 2013 John Wiley & Sons, Ltd.