Implications of expiratory muscle strength training for rehabilitation of the elderly: Tutorial

Abstract

With age, physical functions decline, which influences respiratory performance. One of the physical changes associated with aging is sarcopenia, a reduction in muscle strength and power. Sarcopenia has been extensively studied in the elderly with regard to limb function but less with regard to respiratory function. Elderly individuals experience reduced muscle mass and strength in respiratory musculature, which may hinder the ability to generate adequate expiratory driving force for both ventilatory and nonventilatory activities. Increasing expiratory muscle strength may enhance an elderly individual's ability to generate and maintain the expiratory driving force critical to cough, speak, and swallow. Previous studies demonstrate that expiratory muscle strength training (EMST) improves ventilatory and nonventilatory functions. This paper discusses the potential impact that EMST can have on the rehabilitation of respiratory muscle decline, particularly in the elderly. This tutorial reviews an EMST paradigm, its physiological underpinnings, and its potential outcomes.

Effects of a Pilates exercise program on muscle strength, postural control and body composition: results from a pilot study in a group of post-menopausal women

“…These changes involve muscular strength (Yassierli et al 2007) and peak power output (Runge et al 2004), which appears to be related to loss of muscle mass due to an age-related factor as well as neuromuscular changes (Kim and Sapienza 2005). These contributors are all related with fall risk, that is one of the major public health issue associated with substantial healthcare costs and risk for disability, hospitalization, nursing home admission, and mortality among older adults (Patel et al 2014).…”

Maximal respiratory pressure in healthy 20 to 89 year-old sedentary individuals of central São Paulo State

“…The evaluation of respiratory muscle strength through maximal respiratory pressure (MRP) has been used since the 1960s and 70s because of its important diagnostic and prognostic role in neuromuscular 10 , lung 11 and cardiovascular 12 disease. It is a quick, simple, practical, low-cost and non-invasive method [13][14][15] for the evaluation of both healthy individuals and individuals with certain chronic diseases 2 .…”

Efeitos de exercícios do método Pilates na força muscular respiratória de idosas: um ensaio clínico

“…2 Estudo de Gonçalves et al 19 observou que exercícios físicos gerais apresentaram aumento significativo na força muscular respiratória (p=0,0001). Rendas et al 20 Baseando-se em princípios da cultura oriental, como ioga, artes marciais e meditação, o Pilates se caracteriza pela tentativa do controle dos músculos envolvidos nos movimentos da forma mais consciente possível.…”

“…A redução da força muscular respiratória pode ser amenizada com a prática de exercícios físicos. 2 Baseando-se em princípios da cultura oriental -como ioga, artes marciais e meditação -, o Pilates se caracteriza pela tentativa do controle dos músculos envolvidos nos movimentos da forma mais consciente possível. 6 Segundo McNeill, 7 o Pilates, técnica criada no início da década de 1920 por Joseph Pilates, se baseia numa integração geral de todos os movimentos do corpo, envolvendo contrações musculares de alto ou baixo limiar, e explora exercícios de amplitude de movimento completa ou com a articulação em posição neutra.…”