Journal articles: 'Inspiratory capacity'

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Reig, Rafael Peset, and Thomas W. van der Mark. "Inspiratory and Expiratory Vital Capacity." Chest 88, no. 5 (November 1985): 797–98. http://dx.doi.org/10.1378/chest.88.5.797b.

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McCool, F. D., M. B. Hershenson, G. E. Tzelepis, Y. Kikuchi, and D. E. Leith. "Effect of fatigue on maximal inspiratory pressure-flow capacity." Journal of Applied Physiology 73, no. 1 (July 1, 1992): 36–43. http://dx.doi.org/10.1152/jappl.1992.73.1.36.

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The inspiratory muscles can be fatigued by repetitive contractions characterized by high force (inspiratory resistive loads) or high velocities of shortening (hyperpnea). The effects of fatigue induced by inspiratory resistive loaded breathing (pressure tasks) or by eucapnic hyperpnea (flow tasks) on maximal inspiratory pressure-flow capacity and rib cage and diaphragm strength were examined in five healthy adult subjects. Tasks consisted of sustaining an assigned breathing frequency, duty cycle, and either a “pressure-time product” of esophageal pressure (for the pressure tasks) or peak inspiratory flow rate (for the flow tasks). Esophageal pressure was measured during maximal inspiratory efforts against a closed glottis (Pesmax), maximal transdiaphragmatic pressure was measured during open-glottis expulsive maneuvers (Pdimax), and maximal inspiratory flow (VImax) was measured during maximal inspiratory efforts with no added external resistance before and after fatiguing pressure and flow tasks. The reduction in Pesmax) with pressure fatigue (-25 +/- 7%) was significantly greater than the change in Pesmax with flow fatigue (-8 +/- 8%, P less than 0.01). In contrast, the reductions in Pdimax (-11 +/- 8%) and VImax (-16 +/- 3%) with flow fatigue were greater than the changes in Pdimax (-0.6 +/- 4%, P less than 0.05) or VImax (-3 +/- 4%, P less than 0.05) with pressure fatigue. We conclude that respiratory muscle performance is dependent not only on the presence of fatigue but whether fatigue was induced by pressure tasks or flow tasks. The specific impairment of Pesmax and not of Pdimax or flow with pressure fatigue may reflect selective fatigue of the rib cage muscles.(ABSTRACT TRUNCATED AT 250 WORDS)

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Begle, R. L., J. B. Skatrud, and J. A. Dempsey. "Ventilatory compensation for changes in functional residual capacity during sleep." Journal of Applied Physiology 62, no. 3 (March 1, 1987): 1299–306. http://dx.doi.org/10.1152/jappl.1987.62.3.1299.

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The role of conscious factors in the ventilatory compensation for shortened inspiratory muscle length and the potency of this compensatory response were studied in five normal subjects during non-rapid-eye-movement sleep. To shorten inspiratory muscles, functional residual capacity (FRC) was increased and maintained for 2–3 min at a constant level (range of increase 160–1,880 ml) by creating negative pressure within a tank respirator in which the subjects slept. Minute ventilation was maintained in all subjects over the entire range of increased FRC (mean change +/- SE = -3 +/- 1%) through preservation of tidal volume (-2 +/- 2%) despite slightly decreased breathing frequency (-6 +/- 2%). The decrease in frequency (-13 +/- 2%) was due to a prolongation in expiratory time. Inspiratory time shortened (-10 +/- 1%). Mean inspiratory flow increased 15 +/- 3% coincident with an increase in the slope of the moving time average of the integrated surface diaphragmatic electromyogram (67 +/- 21%). End-tidal CO2 did not rise. In two subjects, control tidal volume was increased 35–50% with CO2 breathing. This augmented tidal volume was still preserved when FRC was increased. We concluded that the compensatory response to inspiratory muscle shortening did not require factors associated with the conscious state. In addition, the potency of this response was demonstrated by preservation of tidal volume despite extreme shortening of the inspiratory muscles and increase in control tidal volumes caused by CO2 breathing. Finally, the timing changes we observed may be due to reflexes following shortening of inspiratory muscle length, increase in abdominal muscle length, or cardiovascular changes.

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Cohen, Judith, Dirkje S. Postma, Karin Vink-Klooster, Wim van der Bij, Erik Verschuuren, Nick H. T. ten Hacken, Gerard H. Koëter, and W. Rob Douma. "FVC to Slow Inspiratory Vital Capacity Ratio." Chest 132, no. 4 (October 2007): 1198–203. http://dx.doi.org/10.1378/chest.06-2763.

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O'Donnell, Denis E., Jordan A. Guenette, François Maltais, and Katherine A. Webb. "Decline of Resting Inspiratory Capacity in COPD." Chest 141, no. 3 (March 2012): 753–62. http://dx.doi.org/10.1378/chest.11-0787.

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Yildirim, Yavuz Selim, Erol Senturk, Selahattin Tugrul, and Orhan Ozturan. "Evaluation of the nasal contractility capacity in postmenopausal women." Rhinology journal 52, no. 4 (December 1, 2014): 397–402. http://dx.doi.org/10.4193/rhino13.107.

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Background: The aim of this study was to objectively compare nasal contractility in premenopausal and postmenopausal patients by means of rhinomanometry, acoustic rhinometry, and peak inspiratory nasal flow. Methods: Design: prospective, clinical case-controlled study. Setting: university tertiary-care hospital, referral center. Participants: the study included 97 participants divided into two groups: 49 postmenopausal (the study group) and 48 premenopausal (control) females. Nasal evaluations were made utilizing anterior rhinoscopy, peak inspiratory nasal flow, acoustic rhinometry, and anterior rhinomanometry. Results: The differences between before and after decongestant application of Minimal Cross-sectional Area (MCA) 1, Minimal Cross-sectional Area (MCA) 2, Peak inspiratory nasal flow (PNIF), Rhinomanometry (RMM), Flow, and Volume values were been statistically significant in both postmenopausal and premenopausal group (control). Conclusion: Before and after all the subjects were administered nasal decongestant, nasal contractility was evaluated using objective nasal tests (acoustic rhinometry, rhinomanometry, and peak inspiratory nasal flow. Results showed that erectile tissues were not affected after menopause: postmenopausal women have the same nasal contractility capacity as premonopausal women.

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Hegazy, Fatma A., Sara M. Mohamed Kamel, Ahmed S. Abdelhamid, Emad A. Aboelnasr, Mahmoud Elshazly, and Ali M. Hassan. "Effect of postoperative high load long duration inspiratory muscle training on pulmonary function and functional capacity after mitral valve replacement surgery: A randomized controlled trial with follow-up." PLOS ONE 16, no. 8 (August 27, 2021): e0256609. http://dx.doi.org/10.1371/journal.pone.0256609.

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Objectives Although, pre-operative inspiratory muscle training has been investigated and reported to be an effective strategy to reduce postoperative pulmonary complications, the efficacy of postoperative inspiratory muscle training as well as the proper load, frequency, and duration necessary to reduce the postoperative pulmonary complications has not been fully investigated. This study was designed to investigate the effect of postoperative high-load long-duration inspiratory muscle training on pulmonary function, inspiratory muscle strength, and functional capacity after mitral valve replacement surgeries. Design Prospective randomized controlled trial. Methods A total of one hundred patients (mean age 38.3±3.29years) underwent mitral valve replacement surgery were randomized into experimental (n = 50) and control (n = 50) groups. The control group received conventional physiotherapy care, while experimental group received conventional care in addition to inspiratory muscle training, with 40% of the baseline maximal inspiratory pressure targeting a load of 80% by the end of the 8 weeks intervention protocol. Inspiratory muscle training started on the patient’s first day in the inpatient ward. Lung functions, inspiratory muscle strength, and functional capacity were evaluated using a computer-based spirometry system, maximal inspiratory pressure measurement and 6MWT respectively at 5 time points and a follow-up assessment was performed 6 months after surgery. Repeated measure ANOVA and post-hoc analyses were used (p <0.05). Results Group-time interactions were detected for all the studied variables (p<0.001). Between-group analysis revealed statistically significant postoperative improvements in all studied variables in the experimental group compared to the control group (p <0.001) with large effect size of η2 ˃0.14. Within-group analysis indicated substantial improvements in lung function, inspiratory pressure and functional capacity in the experimental group (p <0.05) over time, and these improvements were maintained at follow-up. Conclusion High intensity, long-duration postoperative inspiratory muscle training is highly effective in improving lung function, inspiratory muscle strength, and functional capacity after mitral valve replacement surgeries.

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Palau, Patricia, Eloy Domínguez, José María Ramón, Laura López, Antonio Ernesto Briatore, J. Pablo Tormo, Bruno Ventura, Francisco J. Chorro, and Julio Núñez. "Home-based inspiratory muscle training for management of older patients with heart failure with preserved ejection fraction: does baseline inspiratory muscle pressure matter?" European Journal of Cardiovascular Nursing 18, no. 7 (May 31, 2019): 621–27. http://dx.doi.org/10.1177/1474515119855183.

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Background:Heart failure with preserved ejection fraction is a clinical syndrome characterised by reduced exercise capacity. Some evidence has shown that a simple and home-based programme of inspiratory muscle training offers promising results in terms of aerobic capacity improvement in patients with heart failure with preserved ejection fraction. This study aimed to investigate whether the baseline inspiratory muscle function predicts the changes in aerobic capacity (measured as peak oxygen uptake; peak VO2) after a 12-week home-based programme of inspiratory muscle training in patients with heart failure with preserved ejection fraction.Methods:A total of 45 stable symptomatic patients with heart failure with preserved ejection fraction and New York Heart Association II–III received a 12-week home-based programme of inspiratory muscle training between June 2015 and December 2016. They underwent cardiopulmonary exercise testing and measurements of maximum inspiratory pressure pre and post-inspiratory muscle training. Maximum inspiratory pressure and peak VO2were registered in both visits. Multivariate linear regression analysis was used to assess the association between changes in peak VO2(Δ-peakVO2) and baseline predicted maximum inspiratory pressure (pp-MIP).Results:The median (interquartile range) age was 73 (68–77) years, 47% were women and 35.6% displayed New York Heart Association III. The mean peak VO2at baseline and Δ-peakVO2post-training were 10.4±2.8 ml/min/kg and +2.2±1.3 ml/min/kg (+21.3%), respectively. The median (interquartile range) of pp-MIP and Δ-MIP were 71% (64–92) and 39.2 (26.7–80.4) cmH2O, respectively. After a multivariate analysis, baseline pp-MIP was not associated with Δ-peakVO2(β coefficient 0.005, 95% confidence interval −0.009–0.019, P=0.452).Conclusions:In symptomatic and deconditioned older patients with heart failure with preserved ejection fraction, a home-based inspiratory muscle training programme improves aerobic capacity regardless of the baseline maximum inspiratory pressure.

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Bauerle, O., and M. Younes. "Role of ventilatory response to exercise in determining exercise capacity in COPD." Journal of Applied Physiology 79, no. 6 (December 1, 1995): 1870–77. http://dx.doi.org/10.1152/jappl.1995.79.6.1870.

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The progression of chronic obstructive pulmonary disease (COPD) is generally associated with decreased exercise capacity. Differences in forced expired volume in 1 s (FEV1) among patients account for only a fraction of the variability in maximal oxygen consumption (VO2max). We hypothesized that variability in ventilatory response to exercise and in inspiratory mechanics and body mass index contributes importantly to variability in VO2max in this disease. We analyzed the files of 53 patients with established diagnosis of COPD who underwent a recent symptom-limited exercise test. We used inspiratory capacity and maximum inspiratory flow as measures of variability in inspiratory mechanics. The minute ventilation (VE) at the subject's VO2max was divided by the predicted in a normal subject at the same VO2 to obtain a ratio (VE,max/VE,pred). The ventilatory response during exercise provided the best correlation with peak VO2 (r = 0.62). FEV1 and inspiratory capacity also correlated with peak oxygen consumption but not as well as the ventilatory response (r = 0.49 and r = 0.46, respectively). Maximum inspiratory flow and body mass index showed only weak positive correlations (r = 0.23, not significant). The stepwise analysis generated the following equation: VO2max (%predicted) = (77.26 x VE,pred/VE,max) + [0.45 x FEV1 (%predicted)] - 23.66; r = 0.76, P < 0.001. We conclude that variability in the ventilatory response during exercise is one of the main determinants of variability in exercise capacity in COPD patients.

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dos Santos, Tamires Daros, Sergio Nunes Pereira, Luiz Osório Cruz Portela, Marisa Bastos Pereira, Adriane Schmidt Pasqualoto, Aron Ferreira da Silveira, and Isabella Martins de Albuquerque. "Influence of inspiratory muscle strength on exercise capacity before and after cardiac rehabilitation." International Journal of Therapy and Rehabilitation 28, no. 2 (February 2, 2021): 1–12. http://dx.doi.org/10.12968/ijtr.2020.0027.

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Background/Aims Coronary artery bypass grafting is a complex procedure that triggers a series of clinical and functional complications. The reduction of inspiratory muscle strength that persists during the late postoperative period has been suggested as an important determinant of functional capacity after coronary artery bypass grafting. The aim of this study was to investigate whether inspiratory muscle strength, functional capacity and quality of life are determinants of exercise capacity before and after a short-term phase II cardiac rehabilitation programme in patients who have had coronary artery bypass graft surgery. Methods A prospective quasi-experimental study was undertaken with 20 patients who had recevied coronary artery bypass surgery. All patients completed a short-term, moderate-to-high intensity inspiratory muscle training programme, followed by aerobic and resistance exercise, two times a week for 12 weeks, totalling 24 sessions, under the direct supervision of a physical therapist. Results Pre-intervention, peak oxygen consumption (peak VO2) was associated with maximum inspiratory pressure (β=0.037; 95% confidence interval 0.01–0.06; P=0.002). Post-intervention, peak VO2 was associated with maximum inspiratory pressure (β=0.03; 95% confidence interval 0.007–0.053; P=0.014) and the 6-Minute Walk Test (β=0.007; 95% confidence interval, 0.001–0.013; P=0.024). Conclusions Inspiratory muscle strength influences exercise capacity before and after a short-term cardiac rehabilitation programme in patients who have had coronary artery bypass graft surgery.

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Kikuchi, Y., W. Hida, T. Chonan, C. Shindoh, H. Sasaki, and T. Takishima. "Decrease in functional residual capacity during inspiratory loading and the sensation of dyspnea." Journal of Applied Physiology 71, no. 5 (November 1, 1991): 1787–94. http://dx.doi.org/10.1152/jappl.1991.71.5.1787.

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The purposes of the present study were to determine the changes in functional residual capacity (FRC) during inspiratory loading and to examine their mechanisms. We studied seven normal subjects seated in a body plethysmograph. In both graded inspiratory elastic (35, 48, and 68 cmH2O/l) and resistive (21, 86, and 192 cmH2O.l-1.s) loading, FRC invariably decreased from control FRC and phasic expiratory activity increased. The reduction in FRC was greater with greater loads. A single inspiratory effort against an inspiratory occlusion at three different target mouth pressures (-25, -50, and -75 cmH2O) and durations (1, 2, and 5 s) also resulted in a decrease in FRC with an increase in expiratory electromyogram activity in the following expiration. The decrease in FRC was greater with greater target pressure and duration. This decrease in FRC is qualitatively similar to that during inspiratory loaded breathing, and we suspect that the same mechanisms are at work. Because neither vagal nor chemoreceptor reflex can account for these responses, we suspect conscious awareness of breathing or behavioral control to be responsible. In an additional study, the sensation of discomfort of breathing during elastic loading decreased with a decrease in FRC. These results suggest that the reduced FRC may be due to behavioral control of breathing to reduce the sensation of dyspnea during inspiratory loading.

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ManiArasi, P. S., V. P. Hathila, and D. Jayaprakash. "Combined Effect of Active Cycle of Breathing Technique and Autogenic Drainage on PEFR and Inspiratory Capacity in Participants Following Upper Abdominal Surgery - A Randomized Controlled Clinical Trial Study." International Journal of Health Sciences and Research 12, no. 2 (February 4, 2022): 26–36. http://dx.doi.org/10.52403/ijhsr.20220204.

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Background: The purpose of the study is to find the Combined effect of Active cycle of breathing technique and Autogenic drainage on PEFR and inspiratory capacity in participants following upper abdominal surgery. Post-operative pulmonary complication are common which increases the patients mortality. Changes in the respiratory system determines the risk factors of complications. These risk factors can be modified or reduced by the immediate post-operative management given to the patient at an early stage which can be aimed in improving the lung volume and clearance of secretions. Early physiotherapy is believed to reduce the pulmonary complications following major surgery. Lung function which is declined due to anaesthetic effect and the incisional pain which alters the normal ventilatory function in abdominal surgery. Therefore the study is aimed to analyse the outcomes of peak expiratory flow rate and inspiratory capacity in participants subjected to upper abdominal surgery on performing Active cycle of breathing technique and autogenic drainage in the post-operative period. Methods: 30 subjects between the age of 30 to 60 years who have undergone urgent and elective abdominal surgery were included in the study. 15 subjects were given Active cycle of breathing technique while another 15 subjects were given both Active cycle of breathing technique and autogenic drainage. The exercises were given for a period of 6 days, and the outcome measure of PEFR and Inspiratory capacity are measured on the first day and 6th day for the comparison. Statistical analysis were done using students “t” test. Results: The subjects who had performed only Active cycle of breathing technique for a period of 6 days shown significant improvement in both PEFR and inspiratory capacity. Similarly the subjects who performed both Active cycle of breathing technique and autogenic drainage also shown improvement on PEFR and inspiratory capacity. The PEFR on the Day 6 in Group B (338 ± 52.81) had significant difference than Group A where the PEFR was (263.33 ± 47.61). The inspiratory capacity on the Day 6 in Group B (2273.33 ± 201.66) had significant difference than Group A where the inspiratory capacity was (2106.67 ± 190.74). Conclusion: The above study had proved that combined techniques of Active cycle of breathing technique and autogenic drainage increases the peak expiratory flow rate and inspiratory capacity, the lung function which helps to reduce the post-operative pulmonary complications in participants who have undergone upper abdominal surgery. This accepts the alternate hypothesis. Key words: Active cycle of breathing technique, Autogenic drainage, Peak expiratory flow rate, Inspiratory capacity, Upper abdominal surgery.

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LARSON, JANET L., and NANCY K. LEIDY. "Chronic Obstructive Pulmonary Disease: Strategies to Improve Functional Status." Annual Review of Nursing Research 16, no. 1 (January 1998): 253–86. http://dx.doi.org/10.1891/0739-6686.16.1.253.

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People with chronic obstructive pulmonary disease (COPD) experience deterioration in functional status, therefore improving functional status is a major goal of treatment. We reviewed interventions to improve functional status in people with COPD published from 1980 through September 1996. Randomized controlled clinical trials were reviewed to document outcomes in terms of functional capacity and functional performance for the following interventions: pharmacologic therapy including theophylline, inhaled bronchodilators, steroids, antianxiolytics and antidepressants; general exercise strategies including exercise training, exercise and comprehensive pulmonary rehabilitation, and upper extremity training; inspiratory muscle therapy including inspiratory muscle training and inspiratory muscle rest; nutritional therapy; oxygen therapy; and specialized nursing care. Improvements for functional capacity were documented in terms of strength of the inspiratory muscles and upper extremities, walking tests, and peak oxygen uptake. Most interventions were targeted to enhance functional capacity, and few were aimed at enhancing functional performance. Further research is needed to examine the relationship between functional capacity and functional performance and to design and test interventions to improve functional performance.

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Leblanc, P., E. Summers, M. D. Inman, N. L. Jones, E. J. Campbell, and K. J. Killian. "Inspiratory muscles during exercise: a problem of supply and demand." Journal of Applied Physiology 64, no. 6 (June 1, 1988): 2482–89. http://dx.doi.org/10.1152/jappl.1988.64.6.2482.

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The capacity of inspiratory muscles to generate esophageal pressure at several lung volumes from functional residual capacity (FRC) to total lung capacity (TLC) and several flow rates from zero to maximal flow was measured in five normal subjects. Static capacity was 126 +/- 14.6 cmH2O at FRC, remained unchanged between 30 and 55% TLC, and decreased to 40 +/- 6.8 cmH2O at TLC. Dynamic capacity declined by a further 5.0 +/- 0.35% from the static pressure at any given lung volume for every liter per second increase in inspiratory flow. The subjects underwent progressive incremental exercise to maximum power and achieved 1,800 +/- 45 kpm/min and maximum O2 uptake of 3,518 +/- 222 ml/min. During exercise peak esophageal pressure increased from 9.4 +/- 1.81 to 38.2 +/- 5.70 cmH2O and end-inspiratory esophageal pressure increased from 7.8 +/- 0.52 to 22.5 +/- 2.03 cmH2O from rest to maximum exercise. Because the estimated capacity available to meet these demands is critically dependent on end-inspiratory lung volume, the changes in lung volume during exercise were measured in three of the subjects using He dilution. End-expiratory volume was 52.3 +/- 2.42% TLC at rest and 38.5 +/- 0.79% TLC at maximum exercise.

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Guenette, Jordan A., Roberto C. Chin, Julia M. Cory, Katherine A. Webb, and Denis E. O'Donnell. "Inspiratory Capacity during Exercise: Measurement, Analysis, and Interpretation." Pulmonary Medicine 2013 (2013): 1–13. http://dx.doi.org/10.1155/2013/956081.

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Cardiopulmonary exercise testing (CPET) is an established method for evaluating dyspnea and ventilatory abnormalities. Ventilatory reserve is typically assessed as the ratio of peak exercise ventilation to maximal voluntary ventilation. Unfortunately, this crude assessment provides limited data on the factors that limit the normal ventilatory response to exercise. Additional measurements can provide a more comprehensive evaluation of respiratory mechanical constraints during CPET (e.g., expiratory flow limitation and operating lung volumes). These measurements are directly dependent on an accurate assessment of inspiratory capacity (IC) throughout rest and exercise. Despite the valuable insight that the IC provides, there are no established recommendations on how to perform the maneuver during exercise and how to analyze and interpret the data. Accordingly, the purpose of this manuscript is to comprehensively examine a number of methodological issues related to the measurement, analysis, and interpretation of the IC. We will also briefly discuss IC responses to exercise in health and disease and will consider how various therapeutic interventions influence the IC, particularly in patients with chronic obstructive pulmonary disease. Our main conclusion is that IC measurements are both reproducible and responsive to therapy and provide important information on the mechanisms of dyspnea and exercise limitation during CPET.

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Macario, Ciro Casanova, and Bartolomé R. Celli. "Should We Be Paying Attention to Inspiratory Capacity?" Archivos de Bronconeumología ((English Edition)) 43, no. 5 (January 2007): 245–47. http://dx.doi.org/10.1016/s1579-2129(07)60061-5.

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Hentschel, Roland, Nicole Semar, and Josef Guttmann. "Inspiratory capacity at inflation hold in ventilated newborns." Pediatric Critical Care Medicine 13, no. 5 (September 2012): 560–67. http://dx.doi.org/10.1097/pcc.0b013e31823c99f5.

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Semizorov, Evgeni, Nikolai Prokopev, Denis Gubin, and Svetlana Solovyeva. "Resilience to hypoxia of students aged 18-22 studying different programs at various universities." SCIENCE AND SPORT: current trends 7, no. 3 (September 2019): 116–24. http://dx.doi.org/10.36028/2308-8826-2019-7-3-116-124.

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Purpose: to study body resilience to hypoxia of students from different regions enrolled to the specialized universities of Tiumen, with the use of Stange and Genchi tests. Research methods and organization. The study involved 105 students enrolled to three specialized universities in Tiumen, who used to live in urban areas (UA) and rural areas (RA). We studied the parameters of respiratory function by means of Stange and Genchi tests. Results and discussion. The study revealed that young men from rural areas demonstrate higher timed inspiratory capacity according to the results of Stange test than young men from urban areas do. Timed inspiratory and expiratory capacity varied depending on the age of young people, with the maximum peak occurring at the age of 18 and 19 years. Breath-holding capacity decreased when young men reached the first mature age. Conclusion. According to Stange test, students from rural areas demonstrate higher timed inspiratory capacity and volitional effort than the students from urban areas do. It characterizes a high level of non-specific adaptive capacity of their bodies. Physical education requires wide exploitation of a simple, accessible and informative indicator of timed inspiratory and expiratory capacity for objective assessment of respiratory function. We should take into consideration that breath-holding capacity decreases with advancing age.

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Souza, Aline Soares de, Priscila Abreu Sperandio, Adriana Mazzuco, Maria Clara Alencar, Flávio Ferlin Arbex, Mayron Faria de Oliveira, Denis Eunan O'Donnell, and José Alberto Neder. "Influence of heart failure on resting lung volumes in patients with COPD." Jornal Brasileiro de Pneumologia 42, no. 4 (August 2016): 273–78. http://dx.doi.org/10.1590/s1806-37562015000000290.

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ABSTRACT Objective: To evaluate the influence of chronic heart failure (CHF) on resting lung volumes in patients with COPD, i.e., inspiratory fraction-inspiratory capacity (IC)/TLC-and relative inspiratory reserve-[1 − (end-inspiratory lung volume/TLC)]. Methods: This was a prospective study involving 56 patients with COPD-24 (23 males/1 female) with COPD+CHF and 32 (28 males/4 females) with COPD only-who, after careful clinical stabilization, underwent spirometry (with forced and slow maneuvers) and whole-body plethysmography. Results: Although FEV1, as well as the FEV1/FVC and FEV1/slow vital capacity ratios, were higher in the COPD+CHF group than in the COPD group, all major "static" volumes-RV, functional residual capacity (FRC), and TLC-were lower in the former group (p < 0.05). There was a greater reduction in FRC than in RV, resulting in the expiratory reserve volume being lower in the COPD+CHF group than in the COPD group. There were relatively proportional reductions in FRC and TLC in the two groups; therefore, IC was also comparable. Consequently, the inspiratory fraction was higher in the COPD+CHF group than in the COPD group (0.42 ± 0.10 vs. 0.36 ± 0.10; p < 0.05). Although the tidal volume/IC ratio was higher in the COPD+CHF group, the relative inspiratory reserve was remarkably similar between the two groups (0.35 ± 0.09 vs. 0.44 ± 0.14; p < 0.05). Conclusions: Despite the restrictive effects of CHF, patients with COPD+CHF have relatively higher inspiratory limits (a greater inspiratory fraction). However, those patients use only a part of those limits, probably in order to avoid critical reductions in inspiratory reserve and increases in elastic recoil.

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Beck, Jennifer, Christer Sinderby, Lars Lindström, and Alex Grassino. "Crural diaphragm activation during dynamic contractions at various inspiratory flow rates." Journal of Applied Physiology 85, no. 2 (August 1, 1998): 451–58. http://dx.doi.org/10.1152/jappl.1998.85.2.451.

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The purpose of this study was to evaluate the influence of velocity of shortening on the relationship between diaphragm activation and pressure generation in humans. This was achieved by relating the root mean square (RMS) of the diaphragm electromyogram to the transdiaphragmatic pressure (Pdi) generated during dynamic contractions at different inspiratory flow rates. Five healthy subjects inspired from functional residual capacity to total lung capacity at different flow rates while reproducing identical Pdi and chest wall configuration profiles. To change the inspiratory flow rate, subjects performed the inspirations while breathing across two different inspiratory resistances (10 and 100 cmH2O ⋅ l−1 ⋅ s), at mouth pressure targets of −10, −20, −40, and −60 cmH2O. The diaphragm electromyogram was recorded and analyzed with control of signal contamination and electrode positioning. RMS values obtained for inspirations with identical Pdi and chest wall configuration profiles were compared at the same percentage of inspiratory duration. At inspiratory flows ranging between 0.1 and 1.4 l/s, there was no difference in the RMS for the inspirations from functional residual capacity to total lung capacity when Pdi and chest wall configuration profiles were reproduced ( n = 4). At higher inspiratory flow rates, subjects were not able to reproduce their chest wall displacements and adopted different recruitment patterns. In conclusion, there was no evidence for increased demand of diaphragm activation when healthy subjects breathe with similar chest wall configuration and Pdi profiles, at increasing flow rates up to 1.4 l/s.

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Pehlivan, Esra, Fatma Mutluay, Arif Balcı, and Lütfiye Kılıç. "The effects of inspiratory muscle training on exercise capacity, dyspnea and respiratory functions in lung transplantation candidates: a randomized controlled trial." Clinical Rehabilitation 32, no. 10 (May 30, 2018): 1328–39. http://dx.doi.org/10.1177/0269215518777560.

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Objective: To investigate whether inspiratory muscle training would contribute to the improvement of exercise capacity, dyspnea perception and respiratory functions in lung transplantation candidates. Design: Prospective randomized controlled trial. Setting: Pulmonary Rehabilitation center. Subjects: A total of 34 patients with severe lung disease requiring lung transplantation were randomly allocated to either pulmonary rehabilitation plus inspiratory muscle training group (PR + IMT group, n = 17) or pulmonary rehabilitation group (PR group, n = 17) before any lung transplantation operation. Methods: All patients underwent supervised pulmonary rehabilitation program on two days per week for three months. The PR + IMT group received inspiratory muscle training in addition to the standard pulmonary rehabilitation program. The 6-minute walk test, maximal inspiratory pressure, modified Medical Research Concile dyspnea scores and spirometric parameters were measured for each patient. Results: The PR + IMT group had statistically significantly increased in walking distance (100 m, P = 0.03), maximum inspiratory pressure (26 cmH2O, P = 0.001) and alveolar volume ratio of carbonmonoxide diffusion capacity (9%, P = 0.02) than PR group. Although both groups demonstrated a statistically significant decrease in the dyspnea score, no significant differences were found between the groups ( P = 0.075). There was no change in spirometric variables in both groups. Conclusion: A greater increase in exercise capacity was observed in the PR + IMT group. Our study showed that inspiratory muscle training improved exercise capacity even further and increased the benefits provided by pulmonary rehabilitation.

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O’Donnell, Denis E., Laurence K. L. Chau, and Katherine A. Webb. "Qualitative aspects of exertional dyspnea in patients with interstitial lung disease." Journal of Applied Physiology 84, no. 6 (June 1, 1998): 2000–2009. http://dx.doi.org/10.1152/jappl.1998.84.6.2000.

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We compared qualitative and quantitative aspects of perceived exertional dyspnea in patients with interstitial lung disease (ILD) and normal subjects and sought a physiological rationale for their differences. Twelve patients with ILD [forced vital capacity = 64 ± 4 (SE) %predicted] and 12 age-matched normal subjects performed symptom-limited incremental cycle exercise tests with measurements of dyspnea intensity (Borg scale), ventilation, breathing pattern, operational lung volumes, and esophageal pressures (Pes). Qualitative descriptors of dyspnea were selected at exercise cessation. Both groups described increased “work and/or effort” and “heaviness” of breathing; only patients with ILD described “unsatisfied inspiratory effort” (75%), “increased inspiratory difficulty” (67%), and “rapid breathing” (58%) ( P < 0.05 patients with ILD vs. normal subjects). Borg-O2 uptake (V˙o 2) and Borg-ventilation slopes were significantly greater during exercise in patients with ILD ( P < 0.01). At peak exercise, when dyspnea intensity and inspiratory effort (Pes-to-maximal inspiratory pressure ratio) were similar, the distinct qualitative perceptions of dyspnea in patients with ILD were attributed to differences in dynamic ventilatory mechancis, i.e., reduced inspiratory capacity, heightened Pes-to-tidal volume ratio, and tachypnea. Factors contributing to dyspnea intensity in both groups were also different: the best correlate of the Borg-V˙o 2slope in patients with ILD was the resting tidal volume-to-inspiratory capacity ratio ( r = 0.58, P < 0.05) and in normal subjects was the slope of Pes-to-maximal inspiratory pressure ratio overV˙o 2( r = 0.60, P < 0.05).

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Moawd, Samah A., Alshimaa R. Azab, Saud M. Alrawaili, and Walid Kamal Abdelbasset. "Inspiratory Muscle Training in Obstructive Sleep Apnea Associating Diabetic Peripheral Neuropathy: A Randomized Control Study." BioMed Research International 2020 (June 12, 2020): 1–8. http://dx.doi.org/10.1155/2020/5036585.

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Objective. This work is aimed at assessing the effects of inspiratory muscle training on lung functions, inspiratory muscle strength, and aerobic capacity in diabetic peripheral neuropathy (DPN) patients with obstructive sleep apnea (OSA). Methods. A randomized control study was performed on 55 patients diagnosed with DPN and OSA. They were assigned to the training group (IMT, n=28) and placebo training group (P-IMT, n=27). Inspiratory muscle strength, lung functions, and aerobic capacity were evaluated before and after 12 weeks postintervention. An electronic inspiratory muscle trainer was conducted, 30 min a session, three times a week for 12 consecutive weeks. Results. From seventy-four patients, 55 have completed the study program. A significant improvement was observed in inspiratory muscle strength (p<0.05) in the IMT group while no changes were observed in the P-IMT group (p>0.05). No changes were observed in the lung function in the two groups (p>0.05). Also, VO2max and VCO2max changed significantly after training in the IMT group (p<0.05) while no changes were observed in the P-IMT group (p>0.05). Other cardiopulmonary exercise tests did not show any significant change in both groups (p>0.05). Conclusions. Based on the outcomes of the study, it was found that inspiratory muscle training improves inspiratory muscle strength and aerobic capacity without a notable effect on lung functions for diabetic patients suffering from DPN and OSA.

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Mulvey, D. A., N. G. Koulouris, M. W. Elliott, C. M. Laroche, J. Moxham, and M. Green. "Inspiratory muscle relaxation rate after voluntary maximal isocapnic ventilation in humans." Journal of Applied Physiology 70, no. 5 (May 1, 1991): 2173–80. http://dx.doi.org/10.1152/jappl.1991.70.5.2173.

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We have investigated whether the capacity of the inspiratory muscles to generate pressure and flow during a ventilatory load is related to changes in inspiratory muscle relaxation rate. Five highly motivated normal subjects performed voluntary maximal isocapnic ventilation (MIV) for 2 min. Minute ventilation and esophageal, gastric, and transdiaphragmatic pressures were measured breath by breath. We observed that ventilation, peak inspiratory and expiratory pressures, and inspiratory flow rate declined from the start of the run to reach a plateau at 60 s that was sustained for the remainder of the exercise. In a subsequent series of studies, MIV was performed for variable durations between 15 and 120 s. The normalized maximum relaxation rate of unoccluded inspiratory sniffs (sniff MRR, %pressure loss/10 ms) was determined immediately on stopping MIV. Sniff MRR slowed as the duration of MIV increased and paralleled the decline in inspiratory pressure and ventilation observed during the 2-min exercise. No further slowing in MRR occurred when ventilation became sustainable. We conclude that, during MIV, the progressive loss of ventilation and capacity to generate pressure is associated with the early onset and progression of a peripheral fatiguing process within the inspiratory muscles.

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Lage, Susan Martins, Danielle Aparecida Gomes Pereira, Anna Luísa Corradi Magalhães Nepomuceno, Anna Cláudia de Castro, Augusto Gonçalves Araújo, Mariana Hoffman, Bruna Mara Franco Silveira, and Verônica Franco Parreira. "Efficacy of inspiratory muscle training on inspiratory muscle function, functional capacity, and quality of life in patients with asthma: A randomized controlled trial." Clinical Rehabilitation 35, no. 6 (January 6, 2021): 870–81. http://dx.doi.org/10.1177/0269215520984047.

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Objective: To evaluate the efficacy of an inspiratory muscle training protocol on inspiratory muscle function, functional capacity, and quality of life in patients with asthma. Design: A single-blind, randomized controlled clinical trial. Setting: Community-based. Subjects: Patients with asthma, aged between 20 and 70 years old, non-smokers. Interventions: Participants were randomized into two groups: inspiratory muscle training group performed inspiratory muscle training 5 days a week for 8 weeks, consisting of six sets of 30 breaths per day with a training load ⩾50% of maximal inspiratory pressure, plus an educational program; the control group only received the educational program. Main measurements: Maximal inspiratory pressure, inspiratory muscle endurance, and the distance performed on the incremental shuttle walking test were assessed pre-intervention, post-intervention and at follow-up (3 months after the end of the intervention). The asthma quality of life questionnaire was applied pre and post-intervention. Results: Data from 39 participants were analyzed. Maximal inspiratory pressure in percentage of predicted and endurance test duration were significantly higher post-intervention in the inspiratory muscle training group (∆ post–pre: 50.8% vs 7.3% of predicted – P < 0.001 and ∆ post–pre: 207.9 seconds vs 2.7 seconds – P < 0.001, respectively). There was no significant difference in the incremental shuttle walking distance between groups (∆ post–pre: 30.9 m vs −8.1 m, P = 0.165). Quality of life was perceived as significantly better, without a difference between groups ( P > 0.05). Conclusions: About 8 weeks of inspiratory muscle training in patients with controlled asthma significantly increased inspiratory muscle strength and endurance.

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Tresia Fransiska Ulianna Tambunan, Moerdjajati Angka, Anita Ratnawati, and Zulkifi Amin. "Effects of Inspiratory Muscle Training with Incentive Spirometry to Maximum Inspiratory Capacity and Quality of Life on Chronic Obstructive Pulmonary Disease Patients." Indonesian Journal of Physical Medicine & Rehabilitation 2, no. 01 (June 16, 2013): 55–63. http://dx.doi.org/10.36803/ijpmr.v2i01.227.

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Objectives: to determine whether the incentive spirometry respiratory muscle training can increase the maximum inspiratory capacity, decrease difficulty of breathing, functional lung capacity and quality oflife according to St. George’s Respiratory Questionnaire on Chronic Obstructive Pulmonary Disease patients.Methods: an intervention pre-post and case control group of twenty subjects with mild COPD who came to Medical Rehabilitation Department. They divided into two groups: control group (10 subjects)and study group (10 subjects). All subjects underwent pre interventional test which are : maximum inspiratory capacity, dyspnoea rating scale, pulmonary functional test (PFT) and questionnaire forquality of life. The study group were given respiratory muscle training with incentive spirometry and breathing control exercise while the control group only given the breathing control exercise. After 8weeks, all participant underwent post interventional test. Every subject still using the basic medication.Results: There are statistically improvement of maximum inspiratory capacity, dyspnoea rating scale and quality of life in study group compare with the control group (p<0,05). Mean difference of SGRQbetween pre and post intervention shows significant results in activity, impact and total component (p<0,05) and there is no significant results on symptoms components (p>0,05). No changes were foundin FEV1% value with the study or control group (p>0,05).Conclusions: Combination between incentive spirometry respiratory muscle training and breathing control exercise can improve maximum inspiratory capacity, dyspnoea rating scale and quality of life inCOPD patients within 8 weeks.Keywords: COPD, Incentive spirometry muscle training, Maximum inspiratory capacity, Quality of life.

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Raharjo, Angga M., Suradi Suradi, and Jatu Aphridasari. "The Effect of Harmonica Exercise on Inspiratory Capacity, Dyspnea, Exercise Capacity and Quality of Life of Chronic Obstructive Pulmonary Disease Patients." Jurnal Respirologi Indonesia 39, no. 1 (January 2, 2020): 1–13. http://dx.doi.org/10.36497/jri.v39i1.42.

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Background: Chronic inflammation in chronic obstructive pulmonary disease (COPD) causes respiratory muscle dysfunction and decreased respiratory muscle capacity. Incongruity of the capacity and the burden of the respiratory muscle results in increased symptoms of breathlessness, decreased inspiratory capacity, exercise capacity, and quality of life. The objectives of the study were to analyze the effect of harmonica exercise as a pulmonary rehabilitation modality on inspiratory capacity, shortness of breath symptoms, exercise capacity, and quality of life on stable COPD patient. Methods: Clinical trials with pre and post test group design were performed on 30 stable COPD patients at the respiratoy clinic at Dr. Moewardi Hospital Surakarta in August - September 2017 taken by purposive sampling. Evaluation of inspiratory capacity (IC) by spirometry, symptoms of breathlessness by mMRC, exercise capacity by 6MWT and quality of life by SGRQ were measured at baseline and after 6 weeks in the harmonic and control exercises group. Results: A total 30 stable COPD subjects met criteria and divided into two groups. The harmonica training group increased IC (1.78±0.30 litre) and 6MWT (420.00±35.49 meters), decreased mMRC score (1.00±0.458) and SGRQ score (33.87±6.05) after exercise were had significant differences (p

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Plachi, Franciele, Fernanda Machado Balzan, Ricardo Gass, Rui Gustavo Dorneles, Reisi Zambiazi, Danton Pereira da Silva, Paulo R. Sanches, Nadine Oliveira Clausell, and Danilo C. Berton. "Low exertional inspiratory capacity is not related to dynamic inspiratory muscle weakness in heart failure." Respiratory Physiology & Neurobiology 254 (August 2018): 32–35. http://dx.doi.org/10.1016/j.resp.2018.04.005.

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Zeren, Melih, Rengin Demir, Zerrin Yigit, and Hulya N. Gurses. "Effects of inspiratory muscle training on pulmonary function, respiratory muscle strength and functional capacity in patients with atrial fibrillation: a randomized controlled trial." Clinical Rehabilitation 30, no. 12 (July 10, 2016): 1165–74. http://dx.doi.org/10.1177/0269215515628038.

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Objective: To investigate the effects of inspiratory muscle training on pulmonary function, respiratory muscle strength and functional capacity in patients with atrial fibrillation. Design: Prospective randomized controlled single-blind study. Setting: Cardiology department of a university hospital. Subjects: A total of 38 patients with permanent atrial fibrillation were randomly allocated to either a treatment group ( n = 19; age 66.2 years (8.8)) or a control group ( n = 19; age 67.1 years (6.4)). Methods: The training group received inspiratory muscle training at 30% of maximal inspiratory pressure for 15 minutes twice a day, 7 days a week, for 12 weeks alongside the standard medical treatment. The control group received standard medical treatment only. Spirometry, maximal inspiratory and expiratory pressures and 6-minute walking distance was measured at the beginning and end of the study. Results: There was a significant increase in maximal inspiratory pressure (27.94 cmH2O (8.90)), maximal expiratory pressure (24.53 cmH2O (10.34)), forced vital capacity (10.29% (8.18) predicted), forced expiratory volume in one second (13.88% (13.42) predicted), forced expiratory flow 25%–75% (14.82% (12.44) predicted), peak expiratory flow (19.82% (15.62) predicted) and 6-minute walking distance (55.53 m (14.13)) in the training group ( p < 0.01). No significant changes occurred in the control group ( p > 0.05). Conclusion: Inspiratory muscle training can improve pulmonary function, respiratory muscle strength and functional capacity in patients with atrial fibrillation.

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Eikermann, Matthias, Harald Groeben, Johannes Hüsing, and Jürgen Peters. "Accelerometry of Adductor Pollicis Muscle Predicts Recovery of Respiratory Function from Meeting Abstracts." Anesthesiology 98, no. 6 (June 1, 2003): 1333–37. http://dx.doi.org/10.1097/00000542-200306000-00006.

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Background Residual paralysis increases the risk of pulmonary complications but is difficult to detect. To test the hypothesis that accelerometry predicts effects of residual paralysis on pulmonary and upper airway function, the authors related tests of pulmonary and pharyngeal function to accelerometry of adductor pollicis muscle in 12 partially paralyzed volunteers. Methods Rocuronium (0.01 mg/kg + 2-10 microg x kg-1 x min-1) was administered to maintain train-of-four (TOF) ratios (assessed every 15 s) of approximately 0.5 and 0.8 over a period of more than 5 min. The authors evaluated pharyngeal and facial muscle functions during steady state relaxation and performed spirometric measurements every 5 min until recovery. Upper airway obstruction was defined as a mean ratio of expiratory and inspiratory flow at 50% of vital capacity of greater than 1. The TOF ratio associated with "acceptable" pulmonary recovery (forced vital capacity and forced inspiratory volume in 1 s of > or =90% of baseline) was calculated using a linear regression model. Results At peak blockade (TOF ratio 0.5 +/- 0.16), forced inspiratory flow was impaired (53 +/- 19%) to a greater degree than forced expiratory flow (75 +/- 20%) with a mean ratio of expiratory and inspiratory flow at 50% of vital capacity of 1.18 +/- 0.6. Upper airway obstruction, observed in 8 of 12 volunteers, paralleled an impaired ability to swallow reported by 10 of 12 volunteers. In contrast, all volunteers except one could sustain a head lift for more than 5 s. The authors calculated that a mean TOF ratio of 0.56 (95% confidence interval, 0.22-0.71) predicts "acceptable" recovery of forced vital capacity, whereas forced inspiratory volume in 1 s was impaired until a TOF ratio of 0.95 (0.82-1.18) was reached. A 100% recovery of TOF ratio predicts an acceptable recovery of forced vital capacity, forced inspiratory volume in 1 s, and mean ratio of expiratory and inspiratory flow at 50% of vital capacity in 93%, 73%, and 88% of measurements (calculated negative predictive values), respectively. Conclusion Impaired inspiratory flow and upper airway obstruction frequently occur during minimal neuromuscular blockade (TOF ratio 0.8), and extubation may put the patient at risk. Although a TOF ratio of unity predicts a high probability of adequate recovery from neuromuscular blockade, respiratory function can still be impaired.

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Markstrom, Agneta M., Michael Lichtwarck-Aschoff, Bjorn A. Svensson, K. Anders Nordgren, and Ulf H. Sjostrand. "Ventilation with Constant Versus Decelerating Inspiratory Flow in Experimentally Induced Acute Respiratory Failure." Anesthesiology 84, no. 4 (April 1, 1996): 882–89. http://dx.doi.org/10.1097/00000542-199604000-00016.

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Background Recognition of the potential for ventilator-associated lung injury has renewed the debate on the importance of the inspiratory flow pattern. The aim of this study was to determine whether a ventilatory pattern with decelerating inspiratory flow, with the major part of the tidal volume delivered early, would increase functional residual capacity at unchanged (or even reduced) inspiratory airway pressures and improve gas exchange at different positive end-expiratory pressure levels. Methods Surfactant depletion was induced by repeated bronchoalveolar lavage in 13 anesthetized piglets. Decelerating and constant inspiratory flow ventilation was applied at positive end-expiratory pressure levels of 22, 17, 13, 9, and 4 cm H(2)O. Tidal volume, inspiration-to-expiration ratio, and ventilatory frequency were kept constant. Airway pressures, gas exchange, functional residual capacity (using a wash-in/washout method with sulfurhexafluoride), central hemodynamics, and extravascular lung water (using the thermo-dye-indicator dilution technique) were measured. Results Decelerating inspiratory flow yielded a lower arterial carbon dioxide tension compared to constant flow, that is, it improved alveolar ventilation. There were no differences between the flow patterns regarding end-inspiratory occlusion airway pressure, end-inspiratory lung volume, static compliance, or arterial oxygen tension. No differences were seen in hemodynamics and oxygen delivery. Conclusions The decelerating inspiratory flow pattern increased carbon dioxide elimination, without any reduction of inspiratory airway pressure or apparent improvement in arterial oxygen tension. It remains to be established whether these differences are sufficiently pronounced to justify therapeutic consideration.

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Vaz, Lorena de Oliveira, Juliana de Carvalho Almeida, Karla Simone dos Santos Oliveira Froes, Cristiane Dias, Elen Beatriz Pinto, and Jamary Oliveira-Filho. "Effects of inspiratory muscle training on walking capacity of individuals after stroke: A double-blind randomized trial." Clinical Rehabilitation 35, no. 9 (March 11, 2021): 1247–56. http://dx.doi.org/10.1177/0269215521999591.

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Objectives: Identify the effects of inspiratory muscle training (IMT) on walking capacity, strength and inspiratory muscle endurance, activities of daily living, and quality of life poststroke. Design: Double-blind randomized trial. Setting: The Sarah Network of Rehabilitation Hospitals. Subjects: Adult poststroke inpatients with inspiratory muscle weakness. Interventions: The Experimental Group (EG) ( n = 23) underwent IMT for 30 minutes/day, five times/week over six weeks. The Control Group (CG) ( n = 27) performed sham IMT. Both groups underwent standard rehabilitation. Main measures: Primary outcome was post-intervention six-minute walking test (6MWT) distance. We also measured maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), inspiratory muscle endurance, activities of daily living (functional independence measure – FIM), and quality of life at baseline and post-intervention. Three months after intervention, we measured MIP, walking capacity and quality of life. Results: Baseline characteristics were similar, with mean age 53 ± 11 years and FIM 74 ± 10p. Both groups similarly increased the walking capacity at six weeks (63 vs 67 m, P = 0.803). Compared to the CG, the EG increased the inspiratory endurance (22 vs 7 cmH2O, P = 0.034) but there was no variation in MEP (14 vs 5 cmH2O, P = 0.102), MIP (27 vs 19 cmH2O, P = 0.164), FIM (6 vs 6, P = 0.966) or quality of life (0 vs 0.19, P = 0.493). Gains in both groups were sustained at three months. Conclusion: Adding IMT to a rehabilitation program improves inspiratory muscle endurance, but does not further improve MIP, 6-MWT distance, activities of daily living or quality of life of individuals after stroke beyond rehabilitation alone. Registered in Clinical Trials, NCT03171272.

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Apoorva Bhatnagar, Sonia Pawaria, and Sheetal Kalra. "Inspiratory muscle training versus Aerobic training: Improvement on pulmonary function, exercise capacity and cardiorespiratory fitness in females with hypothyroidism." International Journal of Research in Pharmaceutical Sciences 11, no. 4 (September 28, 2020): 5659–64. http://dx.doi.org/10.26452/ijrps.v11i4.3207.

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The effect of hypothyroidism on the respiratory system is proven in various studies. The study is aimed to compare Inspiratory muscle training and Aerobic training on lung functions, exercise capacity & cardiorespiratory fitness in females having hypothyroidism. This comparative study was executed on 66 subjects based on the criteria of the study, which were randomly divided into Group A & B. Subjects in Group A received Inspiratory Muscle Training. Still, subjects in Group B received Aerobic Training for four weeks. Spirometry assessed pulmonary functions, exercise capacity was evaluated by the 6-Minute Walk Test, and cardiorespiratory fitness was assessed by Step Harvard test. All measurements were taken at the baseline, on the last day of 2nd week and final day of 4th week. Independent t-test and Analysis of Variance (ANOVA) were used to analyze the data. More significant improvement in terms of pulmonary functions, exercise capacity and Cardiorespiratory fitness was observed, in group B who received Aerobic training in contrast to group A that received Inspiratory muscle training. Results of this study showed Aerobic training to be more effective and beneficial in improving pulmonary functions, exercise capacity and cardiorespiratory fitness than Inspiratory Muscle Training.

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Ramon, Maria A., Jaume Ferrer, Elena Gimeno-Santos, David Donaire-Gonzalez, Esther Rodríguez, Eva Balcells, Jordi de Batlle, et al. "Inspiratory capacity-to-total lung capacity ratio and dyspnoea predict exercise capacity decline in COPD." Respirology 21, no. 3 (December 30, 2015): 476–82. http://dx.doi.org/10.1111/resp.12723.

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Lau, Ying-Tung, Chi-Feng Liu, and C. C. Tsai. "Cutaneous Vasoconstrictor Response Induced by Inspiratory Gasp in Relation to Sex and Age." Clinical Science 89, no. 3 (September 1, 1995): 233–37. http://dx.doi.org/10.1042/cs0890233.

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1. Vasoconstrictor responses to inspiratory gasp were determined in fingertip skin by laser Doppler flowmetry in relation to age and gender of healthy adults. Variations of the responses were examined together with variations in body mass index and vital capacity. 2. In the absence of any significant difference in the baseline blood flow, the index of vasoconstrictor response (per cent change) induced by inspiratory gasp was higher in young males than in young females (71.4% versus 59.4%; P<0.05), and in the same direction as the change in vital capacity determined in the same laboratory setting. Similar parallel differences in the indexes of vasoconstrictor response and vital capacity existed between young and middle-aged males, suggesting that the differences observed were not due to gender or age per se. 3. Strong positive correlations between the index of the vasoconstrictor response and vital capacity in the same subject were found when young males and females were pooled together and when young and middle-aged males were pooled together. Furthermore, after graded inspiratory gasp, graded vasoconstrictor response was observed in the same subject, indicating a close relationship between the depth of inspiration (magnitude of stimulus) and the index of the vasoconstrictor response (reactivity). 4. We concluded that the index of the vasoconstrictor response induced by inspiratory gasp depends significantly on the magnitude of the vital capacity. These results provide a new approach for quantifying dynamic changes in skin blood flow and raise caveats about comparing differences in neurovascular functions using single measurements of vasoconstrictor response induced by inspiratory gasp as an index.

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Enright, Stephanie J., Viswanath B. Unnithan, Clare Heward, Louise Withnall, and David H. Davies. "Effect of High-Intensity Inspiratory Muscle Training on Lung Volumes, Diaphragm Thickness, and Exercise Capacity in Subjects Who Are Healthy." Physical Therapy 86, no. 3 (March 1, 2006): 345–54. http://dx.doi.org/10.1093/ptj/86.3.345.

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Abstract Background and Purpose. Previous investigations have demonstrated that a regimen of high-intensity inspiratory muscle training (IMT) resulted in changes in ventilatory function and exercise capacity in patients with chronic lung disease, although the effect of high-intensity IMT in subjects who are healthy is yet to be determined. The purpose of this study, therefore, was to examine whether high-intensity IMT resulted in changes in ventilatory function and exercise capacity in subjects who were healthy. Subjects. Twenty subjects were randomly assigned to 2 groups. Methods. The training group completed an 8-week program of IMT set at 80% of maximal effort. The control group did not participate in any form of training. Baseline and posttraining measures of body composition, pulmonary function, inspiratory muscle function (including maximal and sustained maximal inspiratory pressures [MIP and SMIP]), relaxed and contracted diaphragm thickness and thickening ratio (Tdi.rel, Tdi.cont, and TR), and exercise capacity were determined. Results. The training group demonstrated significant increases in MIP, SMIP, Tdi.cont, TR, VC, total lung capacity, and exercise capacity compared with the control group, which demonstrated no change from baseline measurements at 8 weeks. Discussion and Conclusion. The findings of this study suggest that high-intensity IMT results in increased contracted diaphragm thickness and increased lung volumes and exercise capacity in people who are healthy. [Enright SJ, Unnithan VB, Heward C, et al. Effect of high-intensity inspiratory muscle training on lung volumes, diaphragm thickness, and exercise capacity in subjects who are healthy.

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Caleffi Pereira, Mayra, Letícia Z. Cardenas, Jeferson G. Ferreira, Vinícius C. Iamonti, Pauliane Vieira Santana, André Apanavicius, Pedro Caruso, et al. "Unilateral diaphragmatic paralysis: inspiratory muscles, breathlessness and exercise capacity." ERJ Open Research 7, no. 1 (January 2021): 00357–2019. http://dx.doi.org/10.1183/23120541.00357-2019.

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BackgroundPatients with unilateral diaphragmatic paralysis (UDP) may present with dyspnoea without specific cause and limited ability to exercise. We aimed to investigate the diaphragm contraction mechanisms and nondiaphragmatic inspiratory muscle activation during exercise in patients with UDP, compared with healthy individuals.MethodsPulmonary function, as well as volitional and nonvolitional inspiratory muscle strength were evaluated in 35 patients and in 20 healthy subjects. Respiratory pressures and electromyography of scalene and sternocleidomastoid muscles were continuously recorded during incremental maximal cardiopulmonary exercise testing until symptom limitation. Dyspnoea was assessed at rest, every 2 min during exercise and at the end of exercise with a modified Borg scale.Main resultsInspiratory muscle strength measurements were significantly lower for patients in comparison to controls (all p<0.05). Patients achieved lower peak of exercise (lower oxygen consumption) compared to controls, with both gastric (−9.8±4.6 cmH2O versus 8.9±6.0 cmH2O) and transdiaphragmatic (6.5±5.5 cmH2O versus 26.9±10.9 cmH2O) pressures significantly lower, along with larger activation of both scalene (40±22% EMGmax versus 18±14% EMGmax) and sternocleidomastoid (34±22% EMGmax versus 14±8% EMGmax). In addition, the paralysis group presented significant differences in breathing pattern during exercise (lower tidal volume and higher respiratory rate) with more dyspnoea symptoms compared to the control group.ConclusionThe paralysis group presented with exercise limitation accompanied by impairment in transdiaphragmatic pressure generation and larger accessory inspiratory muscles activation compared to controls, thereby contributing to a neuromechanical dissociation and increased dyspnoea perception.

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PEDERSEN, SØREN. "Inspiratory Capacity Through the Turbuhaler in Various Patient Groups." Journal of Aerosol Medicine 7, s1 (January 1994): S—55—S—58. http://dx.doi.org/10.1089/jam.1994.7.suppl_1.s-55.

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Celli, Bartolome R., Marc Decramer, Theodore Lystig, Steven Kesten, and Donald P. Tashkin. "Longitudinal inspiratory capacity changes in chronic obstructive pulmonary disease." Respiratory Research 13, no. 1 (2012): 66. http://dx.doi.org/10.1186/1465-9921-13-66.

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Freitas-Santos, Clarice G., Carlos Alberto d. Pereira, and Carlos Alberto d. Viegas. "INSPIRATORY CAPACITY, 6 MINUTES WALK TEST AND COPD SEVERITY." Chest 128, no. 4 (October 2005): 132S. http://dx.doi.org/10.1378/chest.128.4_meetingabstracts.132s-b.

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Hart, N. "Inspiratory muscle load and capacity in chronic heart failure." Thorax 59, no. 6 (June 1, 2004): 477–82. http://dx.doi.org/10.1136/thx.2003.007724.

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Shahin, Barakat. "Benefits of short inspiratory muscle training on exercise capacity, dyspnea, and inspiratory fraction in COPD patients." International Journal of Chronic Obstructive Pulmonary Disease Volume 3 (September 2008): 423–27. http://dx.doi.org/10.2147/copd.s1822.

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McKenzie, David K., Jane E. Butler, and Simon C. Gandevia. "Respiratory muscle function and activation in chronic obstructive pulmonary disease." Journal of Applied Physiology 107, no. 2 (August 2009): 621–29. http://dx.doi.org/10.1152/japplphysiol.00163.2009.

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Inspiratory muscles are uniquely adapted for endurance, but their function is compromised in chronic obstructive pulmonary disease (COPD) due to increased loads, reduced mechanical advantage, and increased ventilatory requirements. The hyperinflation of COPD reduces the flow and pressure-generating capacity of the diaphragm. This is compensated by a threefold increase in neural drive, adaptations of the chest wall and diaphragm shape to accommodate the increased volume, and adaptations of muscle fibers to preserve strength and increase endurance. Paradoxical indrawing of the lower costal margin during inspiration in severe COPD (Hoover's sign) correlates with high inspiratory drive and severe airflow obstruction rather than contraction of radially oriented diaphragm fibers. The inspiratory muscles remain highly resistant to fatigue in patients with COPD, and the ultimate development of ventilatory failure is associated with insufficient central drive. Sleep is associated with reduced respiratory drive and impairments of lung and chest wall function, which are exaggerated in COPD patients. Profound hypoxemia and hypercapnia can occur in rapid eye movement sleep and contribute to the development of cor pulmonale. Inspiratory muscles adapt to chronic loading with an increased proportion of slow, fatigue-resistant fiber types, increased oxidative capacity, and reduced fiber cross-sectional area, but the capacity of the diaphragm to increase ventilation in exercise is compromised in COPD. In COPD, neural drive to the diaphragm increases to near maximal levels in exercise, but it does not develop peripheral muscle fatigue. The improvement in exercise capacity and dyspnea following lung volume reduction surgery is associated with a substantial reduction in neural drive to the inspiratory muscles.

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Laoutaris, Ioannis D., Stamatis Adamopoulos, Athanassios Manginas, Demosthenes B. Panagiotakos, Dennis V. Cokkinos, and Athanasios Dritsas. "Inspiratory work capacity is more severely depressed than inspiratory muscle strength in patients with heart failure: Novel applications for inspiratory muscle training." International Journal of Cardiology 221 (October 2016): 622–26. http://dx.doi.org/10.1016/j.ijcard.2016.07.102.

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Chhabra, S. K. "Forced Vital Capacity, Slow Vital Capacity, or Inspiratory Vital Capacity: Which Is the Best Measure of Vital Capacity?" Journal of Asthma 35, no. 4 (January 1998): 361–65. http://dx.doi.org/10.3109/02770909809075669.

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Luu, Billy L., Rhys J. McDonald, Bart Bolsterlee, Martin E. Héroux, Jane E. Butler, and Anna L. Hudson. "Movement of the ribs in supine humans for small and large changes in lung volume." Journal of Applied Physiology 131, no. 1 (July 1, 2021): 174–83. http://dx.doi.org/10.1152/japplphysiol.01046.2020.

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Rib movements over inspiratory capacity are comparable for healthy controls and participants with chronic obstructive pulmonary disease when normalized to the change in lung volume. The kinematics of the ribs during tidal breathing were described from four-dimensional computed tomography images. For large changes in lung volume with inspiratory capacity, pump-handle movements of the ribs are four times greater than bucket-handle movements, whereas at tidal volume, pump-handle movements are 20% smaller than bucket-handle movements.

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Caine, M. P., T. M. Waller, and A. Wilcox. "Design considerations for inspiratory muscle training systems." Proceedings of the Institution of Mechanical Engineers, Part B: Journal of Engineering Manufacture 217, no. 2 (February 1, 2003): 291–95. http://dx.doi.org/10.1243/095440503321148911.

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Inspiratory muscle training can be used to strengthen the muscles employed when breathing in. This has been shown to benefit the exercise performance of a diverse group of users including elite sports people. Unfortunately, existing training devices do not provide an optimum training stimulus. The principal limitations of current devices are that they can only be used statically, i.e. not during exercise, and that the load they provide does not reflect the force generating capacity of the targeted muscle group. These limitations could be overcome if an ambulatory responsive loading technology were developed. Ambulatory training would allow users to ‘wear’ the training device while performing exercise, thereby ensuring that improvements to breathing are functionally relevant to the particular demands of a given sport or task. Responsive loading would ensure that the load applied to the inspiratory muscles is specific to the force-generating capacity of the inspiratory muscles during exercise. The purpose of the present project was to explore the feasibility of ambulatory responsive inspiratory muscle training. A series of potential design solutions were identified. This paper describes the design and development process undertaken and draws conclusions regarding the feasibility of ambulatory responsive inspiratory muscle training.

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Innes, J. A., M. J. Morrell, I. Kobayashi, R. D. Hamilton, and A. Guz. "Central and reflex neural control of genioglossus in subjects who underwent laryngectomy." Journal of Applied Physiology 78, no. 6 (June 1, 1995): 2180–86. http://dx.doi.org/10.1152/jappl.1995.78.6.2180.

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Inspiratory activation of the genioglossus (GG) may occur by central drive or as a reflex to negative airway pressure. To distinguish between these, we studied seven laryngectomy patients who breathe via tracheal stomas. Negative pressure stimuli (-15 and -25 cmH2O for 500 ms) were applied 1) at functional residual capacity and 2) during early inspiration via (i) the upper airway (UA) and (ii) the tracheal stoma. Intraoral surface GG electromyogram was quantified, as described previously (R. L. Horner, J. A. Innes, K. Murphy, and A. Guz, J. Physiol. Lond. 436: 15-29, 1991). Phasic GG activity was also measured from an integrated electromyogram during spontaneous and inspiratory loaded breathing. Reflex GG activation occurred with negative UA pressure both at functional residual capacity and during inspiration (P < 0.001), but pressure stimuli at the stoma caused no significant activation (P = 0.07). Phasic inspiratory activation occurred in four patients at rest and in all seven patients during inspiratory loading (P < 0.02). These patients demonstrate 1) reflex activation of the GG by negative UA pressure without airflow or respiratory effort and 2) central inspiratory GG activation that is not mediated by negative airway pressure.

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Decramer, Marc. "Response of the respiratory muscles to rehabilitation in COPD." Journal of Applied Physiology 107, no. 3 (September 2009): 971–76. http://dx.doi.org/10.1152/japplphysiol.91459.2008.

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Respiratory rehabilitation is known to improve outcomes in patients with chronic obstructive pulmonary disease (COPD). The question addressed in the present review is whether these beneficial effects are related to improvements in inspiratory muscle function. Respiratory muscle fatigue often did not occur during exercise in patients with COPD, since exercise limitation usually occurred when significant force reserve in the inspiratory muscles was still present. Notwithstanding, a number of observations may provide indirect evidence that respiratory muscle fatigue may occur during exercise. Some evidence is present that, in normal humans, whole body exercise training improved inspiratory muscle endurance, but no studies are available in patients with COPD. Animal studies invariably demonstrated that exercise training increased the number of oxidative fibers and oxidative enzyme activity in inspiratory muscles. These effects, however, were considerably smaller than the effects found on peripheral muscles with similar fiber composition. Clear evidence indicated that inspiratory muscle training (IMT) improved inspiratory muscle function. Two large meta-analyses indicated that, if the training load was properly controlled, IMT alone or combined with general exercise reconditioning improved inspiratory muscle strength and endurance and dyspnea. The combination did not result in greater improvements in functional exercise capacity. Animal studies and one patient study confirmed the occurrence of structural remodeling of the inspiratory muscles in response to IMT. The final question is whether improvements in inspiratory muscle function produced by IMT lead to improved outcomes in COPD. In all five studies in which training load was adequately controlled, a significant reduction of dyspnea during activities of daily living was found. Eight randomized studies examined the effects of the combination. Greater improvements in exercise capacity were only found in three studies, and none showed a greater reduction in dyspnea.

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Collett, P. W., and L. A. Engel. "Influence of lung volume on oxygen cost of resistive breathing." Journal of Applied Physiology 61, no. 1 (July 1, 1986): 16–24. http://dx.doi.org/10.1152/jappl.1986.61.1.16.

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We examined the relationship between the O2 cost of breathing (VO2 resp) and lung volume at constant load, ventilation, work rate, and pressure-time product in five trained normal subjects breathing through an inspiratory resistance at functional residual capacity (FRC) and when lung volume (VL) was increased to 37 +/- 2% (mean +/- SE) of inspiratory capacity (high VL). High VL was maintained using continuous positive airway pressure of 9 +/- 2 cmH2O and with the subjects coached to relax during expiration to minimize respiratory muscle activity. Six paired runs were performed in each subject at constant tidal volume (0.62 +/- 0.2 liters), frequency (23 +/- 1 breaths/min), inspiratory flow rate (0.45 +/- 0.1 l/s), and inspiratory muscle pressure (45 +/- 2% of maximum static pressure at FRC). VO2 resp increased from 109 +/- 15 ml/min at FRC by 41 +/- 11% at high VL (P less than 0.05). Thus the efficiency of breathing at high VL (3.9 +/- 0.2%) was less than that at FRC (5.2 +/- 0.3%, P less than 0.01). The decrease in inspiratory muscle efficiency at high VL may be due to changes in mechanical coupling, in the pattern of recruitment of the respiratory muscles, or in the intrinsic properties of the inspiratory muscles at shorter length. When the work of breathing at high VL was normalized for the decrease in maximum inspiratory muscle pressure with VL, efficiency at high VL (5.2 +/- 0.3%) did not differ from that at FRC (P less than 0.7), suggesting that the fall in efficiency may have been related to the fall in inspiratory muscle strength. During acute hyperinflation the decreased efficiency contributes to the increased O2 cost of breathing and may contribute to the diminished inspiratory muscle endurance.

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Journal articles on the topic 'Inspiratory capacity'

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