Celedonia Igual Camacho

Effects of inspiratory muscle training and yoga breathing exercises on respiratory muscle function in institutionalized frail older adults: a randomized controlled trial.

Background:In older adults, respiratory function may be seriously compromised when a marked decrease of respiratory muscle (RM) strength coexists with comorbidity and activity limitation. Respiratory muscle training has been widely studied and recommended as a treatment option for people who are unable to participate in whole-body exercise training (WBET); however, the effects of inspiratory muscle training and yoga breathing exercises on RM function remain unknown, specifically in impaired older adults. Purpose:To evaluate the effects of inspiratory threshold training (ITT) and yoga respiratory training (YRT) on RM function in institutionalized frail older adults. Methods:Eighty-one residents (90% women; mean age, 85 years), who were unable to perform WBET (inability to independently walk more than 10 m), were randomly assigned to a control group or one of the 2 experimental groups (ITT or YRT). Experimental groups performed a supervised interval-based training protocol, either through threshold inspiratory muscle training device or yoga breathing exercises, which lasted 6 weeks (5 days per week). Outcome measures were collected at 4 time points (pretraining, intermediate, posttraining, and follow-up) and included the maximum respiratory pressures (maximum inspiratory pressure [MIP] and maximum expiratory pressure [MEP]) and the maximum voluntary ventilation (MVV). Results:Seventy-one residents completed the study: control (n = 24); ITT (n = 23); YRT (n = 24). The treatment on had a significant effect on MIP YRT (F6,204 = 6.755, P < .001, &eegr;2 = 0.166), MEP (F6,204 = 4.257, P < .001, &eegr;2 = 0.111), and MVV (F6,204 = 5.322, P < .001, &eegr;2 = 0.135). Analyses showed that the YRT group had a greater increase of RM strength (MIP and MEP) and endurance (MVV) than control and/or ITT groups. Conclusion:Yoga respiratory training appears to be an effective and well-tolerated exercise regimen in frail older adults and may therefore be a useful alternative to ITT or no training, to improve RM function in older population, when WBET is not possible.

Intervención fisioterápica preventiva del deterioro de la musculatura respiratoria en ancianas institucionalizadas con limitación funcional

INTRODUCTION In elderly seniors (>80 years), respiratory function may be compromised when, in addition to the presence of comorbidity and loss of mobility, there is also reduced respiratory muscle (RM) strength. The literature has shown that RM training could be an effective method to improve RM function and prevent clinical deterioration, particularly in population with RM weakness. The main purpose of this paper was to assess the effectiveness of RM training on the respiratory muscle strength and endurance of institutionalized elderly women with functional impairment. METHOD Fifty-four residents (mean=85 years, SD=6.7) were randomly assigned to either a control (n=27) or training (n=27) group. A supervised training program was developed with Threshold(®)IMT, five times per week for 6-weeks. The main variables of the intervention were: maximum inspiratory pressure (PI(max)), maximum expiratory pressure (PE(max)) and maximal voluntary ventilation (MVV), all of which were measured at weeks 0, 4, 7 and 10. RESULTS Statistical analysis revealed no significant differences in PI(max) (F(3,114)=1.04, p=0.368, R(2)=0.027), PE(max) (F(3,114)=1.86, p=0.14, R(2)=0.047) and MVV (F(3,114)=1.74, p=0.162, R(2)=0.044) between the two groups after the intervention. However, the workload significantly improved with the training sessions (F(5,100)=72.031, p<0.001, R(2)=0.791). CONCLUSION In a 6-week interval-based training program, the threshold loading device does not significantly improve parameters related to RM strength and endurance of the study population.

La Diplomatura de Fisioterapia en el nuevo Espacio Europeo de Educación Superior: la visión del docente

Resumen La adaptacion al Espacio Europeo de Educacion Superior (EEES) promueve un nuevo paradigma del proceso de ensenanza y aprendizaje. En este, el docente proporciona al discente un enfoque mas autonomo de las estrategias de aprendizaje, lo que supone prestar una atencion especial al principal protagonista de este proceso: el estudiante. El principal objetivo de este estudio es investigar y evaluar, por un lado, el nivel de conocimiento y, por otro, que piensa y que espera (o que motivacion da al estudiante este nuevo paradigma metodologico) el estudiante de la adaptacion de la titulacion de fisioterapia al EEES. Para acometer este objetivo, nuestro enfoque metodologico se ha basado en una serie de entrevistas individuales, semiestructuradas, a tres discentes de la Escuela de Fisioterapia de la Universitat de Valencia (EUFUV) y, a continuacion, hemos analizado cualitativamente los datos recogidos. A partir de los datos obtenidos, podemos concluir que el estudiante ve en el nuevo titulo de grado en Fisioterapia el cumplimiento de alguna de sus expectativas, como la equiparacion de la titulacion espanola a la de los demas Estados de la Union Europea. Por otra parte, podemos inferir falta de informacion y de implicacion del alumnado, aspecto que puede estar condicionado por el reconocimiento de su opinion y su esfuerzo.