The important role of postural stability in exercise performance has been determined by several authors. Despite this, few studies have analyzed the relationship between respiratory muscles’ strength and postural stability in athletes. For this reason, the aim of this study was to investigate the relationship between postural stability and respiratory muscles’ function in male soccer players. A case-control study was conducted over twenty-eight healthy men (18 soccer players; 10 non-athletes). Inspiratory muscle strength (MIP) and respiratory resistance (MVV) were obtained through a digital spirometer. Stability variables were obtained in standing position on a stabilometric platform and in open and closed eyes conditions. The area and length of the center of pressures and displacements in the X and Y range were analyzed. Pearson’s coefficient was used to measure the linear correlation between MIP, MVV and stabilometric variables. In the soccer players’ group, MIP and MIP % predictive were inversely correlated with length (r = −0.535 and r = −0.585; p < 0.05) and X range (r = −0.527 and r = −0.560; p < 0.05), whereas MVV was directly correlated with length (r = 0.606; p < 0.01) and Y range (r = 0.558; p < 0.05). Our results show that the greater the inspiratory muscle strength, the less displacement of the pressure center, while at higher respiratory rates there is greater displacement.

Introduction. After a stroke, patients with hemiparesis and / or hemiplegia will present a notable asymmetry of the trunk and pelvis, and decreased postural stability and balance, affecting, consequently, respiratory function. Objective. The objective of this study is to analyze the effects of inspiratory muscle training (IMT) on lung function, inspiratory muscle strength, postural and trunk control and balance in stroke survivors in the subacute phase. Materials and methods. 16 survivors of stroke in the subacute phase participated in RCT (experimental = 8; placebo = 8). The experimental group received IMT program, 5 days a week, once a day, for 8 weeks, with a progressive intensity from 15% to 60% of the PImax. The placebo group performed the same program, but with a fixed load of 7cmH(2)O. Inspiratory muscle strength (PImax), lung function (FVC, FEV1, PEF, VMV), trunk control (TCT), and postural control and balance (PASS and Berg Scale) were evaluated. Results. Experimental and placebo groups showed significant increases in PImax, with a difference between groups. There was a moderate and negative correlation between the initial PImax value and the percentage change (Delta PImax) ) (r = -0.572; p = 0.021). Significant increases in VMV (I/m) were observed in the experimental group, and increases in PASS in both groups, but without significant differences between groups. Conclusions. Inspiratory muscle training, although low intensity, is effective in improving inspiratory muscle strength in stroke survivors. However, the effects on postural control and balance remain uncertain.

Respiratory muscle training can improve strength and reduce respiratory muscle fatigue during high-intensity exercise. Little is known about the existing evidence in soccer players. A systematic review with a meta-analysis was performed to analyse the existing evidence on the effects of respiratory muscle training in soccer players. Two independent researchers reviewed 17 databases until July 2019. Inclusion criteria were controlled clinical trials (randomised or not), soccer players (professional or recreational), females and/or males, and respiratory muscle training compared with simulated or regular training groups. The methodological quality and quality of evidence were evaluated with the Cochrane Collaboration Tool and GRADE score, respectively. Statistical analysis was performed using the integral meta-analysis 3.3.070. Nine studies met the eligibility criteria. The meta-analysis was performed for eight variables related to respiratory muscle function, lung function and sports performance. Respiratory muscle training provided a significant improvement compared with simulated or regular training in maximal inspiratory buccal pressure (6 studies, SDM = 0.89; 95 % CI = 0.42, 1.35) and maximum consumption of oxygen (3 studies, SDM = 0.92; 95 % CI = 0.24; 1.61). No significant improvements were observed for other variables. The quality of the evidence was rated as low or very low. Atemmuskeltraining kann die Kraft verbessern und die Ermüdung der Atemmuskulatur während eines Trainings mit hoher Intensität verringern. Über die vorhandenen Beweise bei Fußballspielern ist wenig bekannt. Eine systematische Überprüfung mit Metaanalyse wurde durchgeführt, um die vorhandenen Beweise für die Auswirkungen des Atemmuskeltrainings bei Fußballspielern zu analysieren. Zwei unabhängige Forscher überprüften bis Juli 2019 17 Datenbanken. Die Einschlusskriterien waren kontrollierte klinische Studien (randomisiert oder nicht), Fußballspieler (beruflich oder Freizeit), Frauen und/oder Männer, Atemmuskeltraining im Vergleich zu simulierten oder regulären Trainingsgruppen. Die methodische Qualität und die Qualität der Evidenz wurden mit dem Cochrane Collaboration Tool bzw. dem GRADE-Score bewertet. Die statistische Analyse wurde mit der integralen Metaanalyse 3.3.070 durchgeführt. Neun Studien erfüllten die Zulassungskriterien. Die Metaanalyse wurde für 8 Variablen durchgeführt, die sich auf die Atemmuskelfunktion, die Lungenfunktion und die sportliche Leistung beziehen. Das Atemmuskeltraining führte zu einer signifikanten Verbesserung im Vergleich zum simulierten oder regelmäßigen Training des maximalen inspiratorischen bukkalen Drucks (6 Studien, SDM = 0,89; 95 %-KI 0,42–1,35) und des maximalen Sauerstoffverbrauchs (3 Studien, SDM = 0,92; 95 %-KI 0,24–1,61). Für andere Variablen wurden keine signifikanten Verbesserungen beobachtet. Die Qualität der Beweise wurde als niedrig oder sehr niedrig bewertet. Die Ergebnisse dieser systematischen Überprüfung zeigen, dass das Atemmuskeltraining einen erheblichen Einfluss auf die inspiratorische Muskelkraft und den maximalen Sauerstoffverbrauch bei Fußballspielern hat. Publication Date: 14 July 2021 (online) © 2021. Thieme. All rights reserved. Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany

Aims and Objectives: The aim of this study is to explore the perceptions of parents of children with physical disabilities concerning the quality of their interaction with health professionals in early intervention programs.Background: Despite the consensus on the need for Patient and Family‐Centered Care, there are still difficulties when executing such care. The quality of interaction among patients, families, and professionals is essential to facilitate the implementation of the programs.Design: A qualitative descriptive study with thematic analysis using a Modified Grounded Theory approach.Methods: Data were collected through seven focus groups with 28 parents of children with physical disabilities who were undergoing early intervention programs in three centres. The study followed the COREQ guidelines and checklist.Results: Two themes emerged from the experiences: ‘exchange of information and education’, which included all the activities, procedures, exercises and skills taught by the professionals to help parents care for their child; and ‘interpersonal skills’, which focused on the way the professional relates with the child and the parents. Several subthemes emerged within each theme.Conclusions: This study identified which elements of the professional‐parent interaction are considered by parents when evaluating the quality of their interaction with the health care provider of their children.Relevance to Clinical Practice: The results of this study bring to light certain behaviours and interactions that health professionals should consider in order to improve the perceptions of parents of children with disabilities regarding the quality of interaction in the context of early childhood intervention.Patient or Public Contribution: Parents contributed to the data collected. Early intervention professionals were involved in participant checking to ensure the rigour of the study.

Inspiratory muscle training (IMT) is effective in improving postural stability and balance in different clinical populations. However, there is no evidence of these effects in soccer players. A single-blind, two-arm (1:1), randomized, placebo-controlled pilot study on 14 soccer players was performed with the main aim of assessing the effect of IMT on static balance, and secondarily, of examining changes in the respiratory muscle function. The experimental group (EG) received an IMT program with progressive intensity, from 20% to 80%, of the maximal inspiratory pressure (MIP). The sham group (SG) performed the same program with a fixed load of 20% of the MIP. Static balance and respiratory muscle function variables were assessed. A two-factor analysis of variance for repeated measures was used to assess differences after training. Statistical significance was set at p < 0.05. Significant increases were observed in the EG on length of sway under eyes open (from 2904.8 ± 640.0 to 3522.4 ± 509.0 mm, p = 0.012) and eyes closed (from 3166.2 ± 641.3 to 4173.3 ± 390.8 mm, p = 0.004). A significant increase in the maximal voluntary ventilation was observed for both groups (EG p = 0.005; SG p = 0.000). No significant differences existed between the groups. IMT did not improve the static balance in a sample of soccer players. Conducting a high-scale study is feasible and could refine the results and conclusions stemming from the current pilot study.

Background: Despite wide use of the Global Initiative for Chronic Obstructive Pulmonary Disease (GOLD) 2011, little is known about between-stage transitions and what factors predict worsening transitions in patients with chronic obstructive pulmonary disease (COPD). Objective: To investigate the transition frequency between GOLD 2011 stages among patients with stable COPD over a 2-year follow-up, to identify potential non-pulmonary predictor factors for worsening transitions, and to compare transition frequencies between GOLD 2011 stages and the new GOLD 2017 stages. Patients and Methods: We prospectively included 137 patients with stable COPD (mean age, 66.9 ± 8.3 years). GOLD 2011 and GOLD 2017 stages were measured at baseline, 1-year follow-up, and 2-year follow-up. To evaluate non-pulmonary variables as potential predictors of worsening transitions, we used regression models adjusted for sociodemographic, clinical, and pulmonary variables using generalized estimating equations. Results: The study period included 246 opportunities for transition, and 39 worsening transitions occurred within GOLD 2011 stages. Predictors of worsening transitions included BODE index (OR, 1.20; 95% CI, 1.00– 1.44), quadriceps strength (OR, 0.87; 95% CI, 0.76– 0.99), and limited mobility activities (OR, 1.02; 95% CI, 1.00– 1.05). The frequency of worsening transitions for stages B and C differed between GOLD 2011 and GOLD 2017. Stages A and D were the most stable in both classifications. Conclusion: Non-pulmonary factors predicted worsening transitions among the GOLD 2011 stages of COPD severity. The choice of GOLD 2011 versus GOLD 2017 may influence transition identification, especially for stages B and C.