However, similar changes in skeletal muscle have been found with aging, disuse and malnutrition and may not be peculiar to patients with COPD. Whatever, the determinants of RM endurance are more complex than the determinants of RM strength.
For the respiratory muscles, four factors could reduce the endurance time: low basal energy stores, low rate of energy supply, reduced efficiency, and an increased external power of breathing.
The diaphragm and intercostal muscle of COPD patients have reduced energy stores, which possibly could lead to a reduction of RM endurance. Measurement of energy stores would require muscle biopsies which we did not do in this study. Read the rest of this entry »

Respiratory Muscle Performance in Normal Elderly Subjects and Patients with COPD: OutcomeIn the endurance test of Nickerson and Keens, mean SIP/MIP percent was 68 ±3 percent. Our normal elderly subjects had a Ppk/MIP of 79 ±19 percent which was similar to the SIP max/MIP of 77 ± 6 percent found in normal younger subjects by Martyn et al. This suggests that learning occurs during the first 2-min incremental test with no significant change in results on repeated visits. In our patients with COPD, mean Ppk/MIP was 48 ± 16 percent (61 percent of the mean Ppk/MIP of the normal elderly group). read more

However, Belman and Mittman found MSVC/MW in ten COPD patients prior to training to be 79 ± 22 percent. This is very similar to the value noted before for normal subjects by Leith and Bradley. Read the rest of this entry »

The MIP increased on subsequent visits in the normal elderly subjects, primarily from visit 1 to visit 2. Since the tests were spaced one week apart and only took 30 min to complete, there should not have been a training effect. Therefore, the increase in MIP suggests a learning effect. This was seen only in the normal subjects who had no experience with any lung function testing. Although the COPD group had not undergone RM endurance testing previously, they were familiar with other pulmonary function tests. Nickerson and Keens found a 10 percent increase in MIP when 12 normal younger subjects were retested after two weeks. A third test on four subjects did not show further improvement. Read the rest of this entry »

Respiratory Muscle Performance in Normal Elderly Subjects and Patients with COPD: DiscussionThis study showed that measures of inspiratory muscle strength and endurance (as measured by the 2-min incremental loading test) were significantly less in naive COPD patients than in the normal elderly subjects matched for age, height, weight and sex distribution. The MEP, max load, Pmean and Ppk/ MIP were reproducible on repeated testing in both groups. The MIP increased on repeat visits in the normal elderly group but did not change in naive COPD subjects. Read the rest of this entry »

There was no difference between the normal elderly subjects and COPD patients in age, sex, height or weight (Table 1). The COPD patients had severe airflow limitation and markedly reduced MW (Table 1). The FEVi, FVC and MW were not different in either group from visit 1 to visit 3.
The MIP was less in COPD patients than normal subjects (p<0.05, Fig 2) at each visit while MEP was not different in the two groups at any visit. The MIP increased at visits 2 and 3 (compared with that at visit 1) in normal subjects (polynominal contrasts, p<0.05) but no difference in MIP was observed between visits in COPD patients. Read the rest of this entry »

Respiratory Muscle Performance in Normal Elderly Subjects and Patients with COPD: Data AnalysisThe RM endurance was measured using a 2-min incremental threshold loading test. Section A of Figure 1 illustrates the weighted plunger and inspiratory port with an orifice of 6.6 cm2. Increased weights on the plunger required increased pressure to open the inspiratory port when the stopper was in place. Inspired minute ventilation and Vt were measured using the turbine flow transducer shown in Section B of Figure 1. Inspiratory pressures were measured at the mouth with a ± 100 cm H,0 differential pressure transducer (model 45-32; Validyne Co., Northridge, CA). Peak inspiratory mouth pressure with each breath and Pmean were recorded. The Pmean was obtained on line by passing the mouth pressure signal through a second-order low pass filter with a time constant of 20 s. All signals (time, volume, pressure) were recorded on a strip chart (Gould Instruments, Ballain Villiers, France). canadian health mall
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In our laboratory, Martyn et al used a device similar to that of Nickerson and Keens but with the ability to add weights externally. Martyn et al started with low inspiratory loads which were increased at 2-min intervals so that subjects could develop strategies for managing progressively greater loads. This test was found to be relatively simple and reproducible in normal young subjects.
Many patients with diseases affecting respiratory muscle function are elderly. Therefore, in this study we determine normal values for elderly subjects for RM strength and the 2-min incremental loading test, and their reproducibility. In addition, we compare RM performance in the normal elderly with RM performance in patients who have COPD. Read the rest of this entry »

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Blog invites submissions of review articles, reports on clinical techniques, case reports, conference summaries, and articles of opinion pertinent to the control of pain and anxiety in dentistry.

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    Tactical CAP Lab, Emergency Medicine, 2014
    Tactical CAP Lab, Emergency Medicine, 2014
    Tactical CAP Lab, Emergency Medicine, 2014
    Tactical CAP Lab, Emergency Medicine, 2014
    Tactical CAP Lab, Emergency Medicine, 2014
    Tactical CAP Lab, Emergency Medicine, 2014
    Tactical CAP Lab, Emergency Medicine, 2014
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