Background: It is known that the consumption of single phytochemicals improves respiratory function in chronic obstructive pulmonary disease (COPD) patients. Since phytochemicals have a synergistic effect on health, a more comprehensive analysis is needed. The aim of this study was to estimate the intake of phytochemicals using the dietary phytochemical index (DPI) and assess their association with respiratory function, inspiratory muscle strength and function, and peripheral muscle strength. Methods: This study was conducted at the Special Hospital for Pulmonary Diseases in Zagreb (September 2023 to May 2024). The DPI was assessed using three 24 h recalls from 71 COPD patients (66.5 ± 8.4 years; 53.5% men). Anthropometric measurements, respiratory function, inspiratory muscle function and strength, and peripheral muscle strength were assessed during pulmonary rehabilitation following standard protocols. Results: Patients were divided into DPI tertiles with mean values of 7.3 ± 3.0, 16.0 ± 3.0, and 32.2 ± 8.8, respectively. After controlling for confounding factors, a significant association was found between DPI tertiles and FEV₁ (p-trend < 0.001), FVC (p-trend = 0.002), FEV₁/FVC (p-trend < 0.001), MIP (p-trend = 0.012), and MSUE (p-trend = 0.002). In addition, an inverse association was found between DPI tertiles and diaphragm thickness during inhalation (p-trend = 0.012) and exhalation (p-trend = 0.013). Conclusions: This study suggests that a higher intake of phytochemicals could be beneficial in dietary interventions for COPD therapy. Future prospective studies are needed to confirm these findings.

Background: Achalasia is a rare primary esophageal motility disorder characterizedby impaired lower esophageal sphincter relaxation and absent or impaired esophagealperistalsis. Progressive esophageal dilatation may result in severe dysphagia, recurrentaspiration, respiratory complications, and, in selected patients with end-stage disease,the need for esophagectomy.Case Presentation: A 46-year-old woman with end-stage achalasia underwent subtotalIvor Lewis esophagectomy with intrathoracic esophagogastric anastomosis after progressivedysphagia and recurrent aspiration pneumonia. Three months after surgery, shepresented with persistent dry cough, hoarseness, impaired breathing pattern, postoperativepain, and markedly reduced exercise tolerance. Baseline physiotherapeutic assessmentdemonstrated inspiratory muscle weakness, reduced peripheral muscle strength,and decreased functional exercise capacity, whereas ultrasonographic examinationconfirmed preserved diaphragmatic function. The patient subsequently completed aseven-week individualized outpatient pulmonary rehabilitation program comprisingbreathing retraining, inspiratory muscle training, aerobic exercise, and progressive resistancetraining.Results: Following rehabilitation, maximal inspiratory pressure increased from 46 to 75cmH₂O (51% to 83% of the predicted value), the 6-minute walk distance improved from403 to 555 m, and bilateral handgrip strength increased from 18 to 26 kg. The patient alsoreported marked reductions in cough, postoperative pain, and dyspnea during physicalactivity. Persistent hoarseness was subsequently attributed to unilateral vocal cord paresis,and speech therapy was initiated.Conclusion: This case demonstrates that a comprehensive pulmonary rehabilitationprogram may substantially improve respiratory muscle performance, functional exercisecapacity, peripheral muscle strength, and postoperative symptoms following esophagectomyfor end-stage achalasia.

Uvod: Terapija pokretom predstavlja jednu od najstarijih metoda fizioterapije kojaprema nekim zapisima postoji već više od 6000 godina. Neizostavna je u rehabilitacijibolesnih, nakon ozljeda ili operacija. Cilj ovog rada bio je prikupiti jasne znanstvenedokaze o učincima terapije pokretom niskog intenziteta na bol, mišićnu snagu, ravnotežu,opću pokretljivost, kardiovaskularnu funkciju i psihološko zdravlje te kvalitetuživota i sigurnost pacijenta.Metode: Proveden je pregled literature pretraživanjem relevantnih baza podatakaPubMed, MEDLINE, Cochrane, SCOPUS, Hrčak. Ključne riječi za pregled bile su: terapijapokretom niskog intenziteta, učinak, koristi, znanstveni dokazi, fizioterapija.Rezultati: Pronađeno je ukupno 378 radova. U ovom preglednom radu izdvojeno je11 studija koje su zadovoljile kriterije uključivanja i isključivanja.Zaključak: Dobiveni rezultati potvrđuju važnost primjene terapije pokretom niskogintenziteta u fizioterapiji kao sigurne i učinkovite za pacijente. Istraživanja pokazujuučinak terapije niskog intenziteta na bol, ravnotežu, pokretljivost, psihičko zdravlje ikvalitetu života.