Background: Malnutrition is an effective factor in respiratory MUSCLES dysfunction in patients with chronic obstructive pulmonary disease (COPD). The present study was performed to evaluate the effect of improved nutrition on INSPIRATORY MUSCLES in patients with advanced COPD. Materials and Methods: Total of 33 patients suffering from emphysema were studied during a 3-year period using a quasi experimental (before- after study) method. All of them had forced expiratory volume in one second (FEV1) <30% and had received Atrovent, Salmeterol, Becotide (in maximum doses) and oxygen therapy for at least one year. Initially, FEV1 and airways resistance of patients were measured using body plethysmography. After a 35 Kcal/kg diet including 20-40% fat, 40% protein and 20% carbohydrates, these patients were followed by monthly scheduled visits. Spirometric parameters were measured again 3 and 6 months later and the results were analyzed using Freedman method. Results: Pulmonary function tests of the under study patients at the beginning, 3 and 6 months later were as follows respectively; FEV1; 18.3%, 19.57%, 20.95%, airways resistance; 65.3%, 63.7%, 64.9% and maximal INSPIRATORY pressure (MIP); 2.59, 3.062 and 3.29 cmH2O. There was a significant difference in FEV1 and MIP of patients in 3 and 6 months period (P<0.05). Meanwhile, there was no significant difference in airways resistance of patients (P=0.08). Conclusion: Improved nutrition results in increased MIP and FEV1 without changing in other indices (i.e. constant airways resistance indicates constant treatment status of the patient). Thus, an appropriate nutritional diet including sufficient calorie with small frequent meals at least for six months can increase FEV1 by reinforcing INSPIRATORY MUSCLES resulting in improved pulmonary function.    

Background: COPD is known as the main cause of morbidity and mortality in the world. Morbidity in COPD patients is mainly due to the respiratory muscle dysfunction especially diaphragm and chest wall MUSCLES. Respiratory muscle dysfunction is mostly seen in severe and progressive stages of the disease. COPD results in increased functional residual capacity (FRC). In severe cases of COPD, respiratory muscle dysfunction and FRC raise lead to the deterioration of hyperinflation.Materials and Methods: In our study, 30 COPD patients (28 males, 2 females) referred to Masih Daneshvari Hospital were evaluated. All cases were studied with the exact same body plethysmography equipment and the same technician.Results: The average age, height, weight and BMI of cases were 53±11 yrs,168.86±6.33 cm, 65.44±16.78 kg and 23.56±6.32, respectively. The mean FEV1 according to the GOLD criteria was in the range of moderate to severe. Hyperinflation noted characterized by RV and reverse RV/TLC, was clearly noticed in our study (RV=225.9±82.11, RV/TLC%= 195±34.49).Conclusion: Based on our study results, there was a significant correlation between FEV1, hyperinflation (RV/TLC, RV), respiratory muscle function (PImax/P1) and respiratory time cycle Ti/Ttot .It should be mentioned that there was a significant correlation between PImax and Tension Time Index as well.

Background: Hyper-kyphosis is one of the most common malalignments in adolescent boys and can affect their breathing. INSPIRATORY muscle training (IMT) may improve the function of the respiratory MUSCLES in adolescents and may influence their skeletal structure as well. So, this study aimed to examine the effects of INSPIRATORY muscle training on the thoracic spine curve, INSPIRATORY volume and cardio-respiratory endurance in hyperkyphotic boys Methods: This study was a semi experimentally in design, pre and post-test design with a control group. Twenty-two 12-15 boys, with thoracic spine curve more than 49 degrees were randomly divided into control and experimental groups. Both groups performed the same corrective exercise for hyper-kyphosis, the experimental group also performed INSPIRATORY muscle training five days a week using the power breathing device, based on the training protocol. Both groups were evaluated before and after 12 weeks of training in terms of the thoracic spine curve, INSPIRATORY volume, S-index, PIF, and cardiorespiratory endurance. Results: The data analysis showed that the thoracic spine curve decreased significantly in the IMT group (Pvalue=0. 025). The IMT group showed significantly increase in INSPIRATORY S-index (T=4. 058, Pvalue=0. 002), PIF (T=4. 06, Pvalue=0. 002) and cardio-respiratory endurance (T=2. 62, Pvalue=0. 050) at posttest in compare to control group. Conclusions: Based on the study findings, it can be concluded that respiratory muscle strengthening alone may not be by itself sufficient for the improvement of Hyper-kyphosis, and corrective exercises can also be recommended along with it.