BackgroundSickle Cell Disease (SCD), which is characterized by a mutation in the gene encoding beta hemoglobin, causes bodily dysfunctions such as impaired pulmonary function and reduced functional capacity. ObjectiveTo assess changes in pulmonary function and functional capacity in patients with SCD and to identify the relationships between these variables.MethodWe evaluated sociodemographic, anthropometric, lung function (spirometry), respiratory (manovacuometer), peripheral muscle strength (Handgrip strength - HS) and functional capacity (i.e., the six-minute walk test) parameters in 21 individuals with SCD (average age of 29±6 years). Shapiro-Wilk, paired Student's, Wilcoxon, Pearson and Spearman correlation tests were used for statistical analyses, and the significance threshold was set at p<0.05. ResultsA total of 47.6% of the study subjects exhibited an altered ventilation pattern, 42.8% had a restrictive ventilatory pattern (RVP) and 4.8% exhibited a mixed ventilatory pattern (MVP). The observed maximal inspiratory pressure (MIP) values were below the predicted values for women (64 cmH2O), and the maximum expiratory pressure (MEP) values, HS values and distance walked during the 6MWT were below the predicted values for both men (103 cmH2O, 39 Kgf and 447 m, respectively) and women (64 cmH2O; 27 Kgf; 405 m, respectively). Positive correlations were observed between maximum voluntary ventilation (MVV) and MEP (r=0.4; p=0.046); MVV and BMI (r=0.6; p=0.003); and between HS and MIP (r=0.7; p=0.001), MEP (r=0.6; p=0.002), MVV (r=0.5; p=0.015), distance walked in the 6MWT (r=0.4; p=0.038) and BMI (r=0.6; p=0.004). ConclusionsSCD promoted changes in lung function and functional capacity, including RVPs and a reduction in the distance walked in the 6MWT when compared to the predictions. In addition, significant correlations between the variables were observed.

The optimized MI-E maneuver, applied with slow insufflation, resulted in a higher expiratory flow bias, which made the therapy more effective at moving mucus outward, compared with the standard MI-E maneuver, typically applied with fast insufflation.

Background: Sickle cell disease is a prevalent condition in Brazil. Its clinical presentation includes vascular occlusion that result in ischemia,

ResumoIntrodução: Dentre os sistemas do organismo, acredita-se que o respiratório seja o que envelhece mais rapidamente, devido à maior exposição a poluentes ambientais ao longo dos anos. O método Pilates surge como forma de condicionamento físico particularmente interessado em proporcionar bem-estar geral ao indivíduo. Objetivo: Avaliar os efeitos de exercícios do método Pilates na força muscular respiratória de idosas antes e após 11 semanas de treinamento. Métodos: Trata-se de ensaio clínico, longitudinal e prospectivo. Foram selecionadas sete mulheres com idade igual e superior a 60 anos e com autonomia cognitiva preservada. A Prova de Função Pulmonar (Espirometria) foi realizada por meio do espirômetro marca Vitalograph® modelo 8600. A força muscular respiratória foi obtida pelas técnicas de medidas da pressão inspiratória máxima e pressão expiratória máxima, por meio de um manovacuômetro analógico da marca Gerar. O período experimental foi de 11 semanas. Para a análise comparativa dos dados obtidos nas avaliações, foi aplicado o teste t pareado e nível de significância de 5%. Resultados: Os resultados do estudo mostraram aumento significativo (p≤0,01) em relação à pressão expiratória máxima de 46±18 para 75±29 cmH2O. Conclusão: Os resultados apresentaram aumento significativo na pressão expiratória máxima, sendo o método Pilates uma das práticas recomendadas à população idosa. Registro Ensaio Clínico: ClinicalTrials.gov ID: NCT02189044 AbstractIntroduction: Among the systems of the organism, it is believed that the respiratory system is the one that gets older faster due to the greater exposure to environmental pollutants over the years. The Pilates method has emerged as a form of fitness particularly providing general welfare to the individual. Objective: To evaluate the effects of Pilates' exercises on respiratory muscle strength in elderly women before and after eleven weeks of training. Methods: This is a clinical, longitudinal, prospective trial study. We have studied seven women aged 60 and over, with preserved autonomy

| Objective: To evaluate the impact of frailty on respiratory function in a community-dwelling elderly. Method: 51 community-dwelling elderly were evaluated (mean age of 73±6 years), being 29 men (56.7%) and 22 women (43.3%). We collect the following variables: sociodemographic characteristics, frailty phenotype, pulmonary function test and assessment of the respiratory muscles using an analog manometer. The statistical analysis was performed using the Kolmogorov and Smirnov tests, one-way ANOVA, Paired Student's t-test and Pearson correlation coefficient (p<0.05). Results: There were no statistically significant between-group differences among the frail group (FG=9.8%), pre-frail group (PG=47.1%) and non-frail group (NG=43.1%), in relation to anthropometric, demographic and spirometric data. Regarding to the maximum inspiratory and expiratory pressures (MIP and MEP), statistically significant between-group differences were observed among the three groups, being these pressures significantly lower in the FG and PG compared to the NG. With regards to the obtained and predicted values, the FG and PG showed statistically significant difference (p=0.004). The PG showed positive correlations between the MIP and MEP with the values of hand grip strength (r=0.7). The NG showed positive correlation between the MEP and the values of physical activity level (r=0.7). Conclusions: The study demonstrated that maximal respiratory pressures may decrease according to the frailty condition among the nonfrail, pre-frail and frail elderly. Furthermore, it also indicated a positive correlation between inspiratory muscle strength, expiratory muscle strength and hand grip strength in pre-frail elderly. Further investigation with regards to prevention or intervention programs that incorporate actions to minimize the loss of respiratory function are necessary in order to reverse or prevent the progression of the frailty condition.