Inspiratory Muscle Training and Functional Capacity in Patients Undergoing Cardiac Surgery The impact of noninvasive ventilation during the physical training in patients with moderate-to-severe chronic obstructive pulmonary disease (COPD). Effects of Physical Training on Functional Status in Patients With Prolonged Mechanical Ventilation Effects of Exercise Training on Pulmonary Mechanics and Functional Status in Patients With Prolonged Mechanical Ventilation The Effect of Strength Training on Functional Fitness in Older Patients with Chronic Lung Disease Enrolled in Pulmonary Rehabilitation Physical training is beneficial to functional status and survival in patients with prolonged mechanical ventilation. Influence of the resistance training on heart rate variability, functional capacity and muscle strength in the chronic obstructive pulmonary disease. Functional Recovery Following Physical Training in Tracheotomized and Chronically Ventilated Patients Exercise training in COPD: how to distinguish responders from nonresponders. Training in MS: influence of two different endurance training protocols (aquatic versus overland) on cytokine and neurotrophin concentrations during three week randomized controlled trial Efficacy of a physical exercise training programme COPD in primary care: study protocol of a randomized controlled trial Benefits and problems of a physical training programme for asthmatic patients. Changes in cardiorespiratory fitness, psychological wellbeing, quality of life, and vocational status following a 12 month cardiac exercise rehabilitation programme. [Physical training as interval or continuous training in chronic heart failure for improving functional capacity, hemodynamics and quality of life--a controlled study]. Eccentric training in chronic heart failure: feasibility and functional effects. Results of a comparative study. Cardiorespiratory adaptations to training at specified intensities in children. Inspiratory muscle training improves respiratory muscle strength, functional capacity and quality of life in patients with chronic kidney disease: a systematic review.
Introduction Cardiac surgery is a highly complex procedure which generates worsening of lung function and decreased inspiratory muscle strength . The inspiratory muscle training becomes effective for muscle strengthening and can improve functional capacity . Objective To investigate the effect of inspiratory muscle training on functional capacity submaximal and inspiratory muscle strength in patients undergoing cardiac surgery . Methods This is a clinical r and omized controlled trial with patients undergoing cardiac surgery at Instituto Nobre de Cardiologia . Patients were divided into two groups : control group and training . Preoperatively , were assessed the maximum inspiratory pressure and the distance covered in a 6-minute walk test . From the third postoperative day , the control group was managed according to the routine of the unit while the training group underwent daily protocol of respiratory muscle training until the day of discharge . Results 50 patients , 27 ( 54 % ) males were included , with a mean age of 56.7±13.9 years . After the analysis , the training group had significant increase in maximum inspiratory pressure ( 69.5±14.9 vs. 83.1±19.1 cmH2O , P=0.0073 ) and 6-minute walk test ( 422.4±102.8 vs. 502.4±112.8 m , P=0.0031 ) . Conclusion We conclude that inspiratory muscle training was effective in improving functional capacity submaximal and inspiratory muscle strength in this sample of patients undergoing cardiac surgery OBJECTIVE To evaluate the influence of physical training with or without noninvasive ventilation at 2 levels of pressure in the airways ( BiPAP ) in patients with chronic obstructive pulmonary disease . METHODS Eighteen patients with FEV(1 ) = 34 + /- 8 % of predicted values , mean age of 68 + /- 9 years were r and omly distributed into 2 groups , one group performing physical training on a treadmill and the other group performing physical training associated with BiPAP ( physical training+B ) , for 30 minutes , 3 times a week for 12 weeks . The training velocity was based on a test of cardiopulmonary force performed pre- and postintervention , which registered the values for heart rate , systolic blood pressure , diastolic blood pressure , peripheral oxygen saturation , blood lactate , sensation of dyspnea , respiratory muscle strength , and analysis of gases expired such as oxygen consumption and the production of carbon dioxide . RESULTS For both groups , there was a significant improvement in dyspnea and peripheral oxygen saturation at identical levels of physical exercise , in distance walked during the physical training , and in respiratory muscle strength ( P < 0.05 ) . Only the physical training+B group had a significant improvement in heart rate , systolic blood pressure , and oxygen consumption after training ( P < 0.05 ) . Significant reductions of blood lactate were observed at identical levels of exercise in physical training+B when compared to isolated physical training ( from 1.3 + /- 0.7 mMol/L versus 2.5 + /- 0.9 mMol/L , ( P < 0.05 ) , respectively ) . CONCLUSION Physical training associated with BiPAP enhanced the oxidative muscular capacity and could be an adjunctive recourse for physical rehabilitation in patients with chronic obstructive pulmonary disease Background and Purpose . Patients requiring prolonged mechanical ventilation ( PMV ) are frequently deconditioned because of respiratory failure precipitated by the underlying disease , the adverse effects of medications , and a period of prolonged immobilization . The effects of 6 weeks of physical training on the strength of respiratory and limb muscles , on ventilator-free time , and on functional status in patients requiring PMV were examined . Subjects . Thirty-nine patients with PMV were initially enrolled in the study and were assigned to either a treatment group ( n=20 ) or a control group ( n=19 ) . Three subjects in the treatment group and 4 subjects in the control group died during the 6-week intervention period and thus their data were excluded from the final analysis . Methods . Subjects in the treatment group received physical training 5 days a week for 6 weeks . Strength of respiratory and limb muscles , ventilator-free time , and functional status , which was measured by the Barthel Index of Activities of Daily Living ( BI ) and Functional Independence Measure ( FIM ) , were examined at baseline and at the third and sixth weeks of the study period . Results . Respiratory and limb muscle strength improved significantly at the third and sixth weeks in the treatment group compared with baseline measurements . Total BI and FIM scores increased significantly in the treatment group and remained unchanged in the control group . Effect sizes of the BI and FIM scores were 2.02 and 1.93 , respectively , at the sixth week . Discussion and Conclusion . The results show that a 6-week physical training program may improve limb muscle strength and ventilator-free time and thus improve functional outcomes in patients requiring PMV BACKGROUND : The functional status and outcomes in patients with prolonged mechanical ventilation ( PMV ) are often limited by poor endurance and pulmonary mechanics , which result from the primary diseases or prolonged time bedridden . We evaluate the impact of exercise training on pulmonary mechanics , physical functional status , and hospitalization outcomes in PMV patients . METHODS : Twenty-seven subjects with PMV in our respiratory care center ( RCC ) were divided r and omly into an exercise training group ( n = 12 ) and a control group ( n = 15 ) . The exercise program comprised 10 sessions of exercise training . The measurement of pulmonary mechanics and physical functional status ( Functional Independence Measurement and Barthel index ) were performed pre- study and post- study . The hospitalization outcomes included : days of mechanical ventilation , hospitalization days , and weaning and mortality rates during RCC stay . RESULTS : The training group had significant improvement in tidal volume ( 143.6 mL vs 192.5 mL , P = .02 ) and rapid shallow breathing index after training ( 162.2 vs 110.6 , P = .009 ) . No significant change was found in the control group except respiratory rate . Both groups had significant improvement in functional status during the study . However , the training group had greater changes in FIM score than the control group ( 44.6 vs 34.2 , P = .024 ) . The training group also had shorter RCC stay and higher weaning and survival rates than the control group , although no statistical difference was found . CONCLUSIONS : Subjects with PMV in our RCC demonstrated significant improvement in pulmonary mechanics and functional status after exercise training . The application of exercise training may be helpful for PMV patients to improve hospitalization outcomes & NA ; The purpose of this study was to compare the effects of a strength training‐enhanced program and a traditional pulmonary rehabilitation ( PR ) program on functional fitness ( FF ) in older patients with chronic obstructive pulmonary disease ( COPD ) , using the Senior Fitness Test . Twenty patients were recruited from an outpatient PR program . After completing baseline measures , including muscular strength and the Senior Fitness Test , patients were r and omly assigned to the strength training program ( TR+ST , n = 10 ) or traditional PR program ( TR , n = 10 ) . Patients completed 16 exercise sessions that were conducted twice a week for 8–10 weeks , after which patients repeated outcome measurements . Independent t tests were conducted to determine whether groups differed between measures . Both the TR+ST and TR groups improved on all FF measures . Moderate effect sizes were found for two of the FF measures when the groups were compared . The addition of strength training to PR may have a favorable impact on FF in older patients with COPD BACKGROUND / PURPOSE Early physical training is necessary for severely deconditioned patients undergoing prolonged mechanical ventilation ( PMV ) , because survivors often experience prolonged recovery . Long-term outcomes after physical training have not been measured ; therefore , we investigated outcome during a 1-year period after physical training for the PMV patients . METHODS We conducted a prospect i ve r and omized control trial in a respiratory care center . Thirty-four patients were r and omly assigned to the rehabilitation group ( n = 18 ) and the control group ( n = 16 ) . The rehabilitation group participated in supervised physical therapy training for 6 weeks , and continued in an unsupervised maintenance program for 6 more weeks . The functional independence measurement ( FIM ) was used to assess functional status . Survival status during the year after enrollment , the number of survivors discharged , and the number free from ventilator support were collected . These outcome parameters were assessed at entry , immediately after the 6 weeks physical therapy training period , after 6 weeks unsupervised maintenance exercise program , and 6 months and 12 months after study entry . RESULTS The scores of total FIM , motor domain , cognitive domain , and some sub-items , except for the walking/wheelchair sub-item , increased significantly in the rehabilitation group at 6 months postenrollment , but remained unchanged for the control group . The eating , comprehension , expression , and social interaction subscales reached the 7-point complete independence level at 6 months in the rehabilitation group , but not in the control group . The 1-year survival rate for the rehabilitation group was 70 % , which was significantly higher than that for the control group ( 25 % ) , although the proportion of patients discharged and who were ventilator-free in the rehabilitation and control groups did not differ significantly . CONCLUSION Six weeks physical therapy training plus 6 weeks unsupervised maintenance exercise enhanced functional levels and increased survival for the PMV patients compared with those with no such intervention . Early physical therapy interventions are needed for the PMV patients in respiratory care centers BACKGROUND The chronic obstructive pulmonary disease ( COPD ) is associated with the strength and resistance decreasing in addition to the dysfunction on autonomic nervous system ( ANS ) . The aerobic training isolated or in association with the resistance training showed evidence of beneficial effects on an autonomic modulation of COPD ; however , there are no studies addressing the effect of isolated resistance training . AIMS This study aims at investigating the influence of resistance training on an autonomic modulation through heart rate variability ( HRV ) , functional capacity and muscle strength in individuals with COPD . DESIGN Clinical series study . SETTING Out patients . POPULATION The study involved 13 individuals with COPD . METHODS The experimental protocol was composed by an initial and final evaluation that consisted in autonomic evaluations ( HRV ) , cardiopulmonary functional capacity evaluation ( 6-minute walk test ) and strength evaluation ( dynamometry )  in addition by the resistance training performed by 24 sessions lasted 60 minutes each one and on a frequency of three times a week . The intensity was determined initially with 60 % of one maximum repetition and was progressively increased in each five sessions until 80 % . RESULTS The HRV temporal and spectral indexes analysis demonstrates improvement of autonomic modulation , with significant statistical increases to sympathetic and parasympathetic components of ANS representing by SDNN , LF and HF . In addition , it was observed significant statistical increases to shoulder abduction and knee flexion strength and functional capacity . CONCLUSION The exclusive resistance training performed was able to positively influence the autonomic modulation ; in addition it promoted benefits on cardiorespiratory functional capacity and strength benefits in individuals with COPD . CLINICAL REHABILITATION IMPACT This study could contribute to clinical and professionals research ers that act with COPD , even though the resistance component of pulmonary rehabilitation presents consensual benefits on several healthy indicators parameters . There is no evidence about the effects on HRV before . Moreover , this study showed , on clinical practice , the HRV uses as an ANS activity on sinus node evaluation and highlights further importance on scientific context BACKGROUND : Rehabilitation is a non-pharmacologic therapy that can restore health and reverse the patient 's disability , but the efficacy of rehabilitation in critically ill patients is not well documented . METHODS : In a prospect i ve cohort study , we assessed whether the degree of change in functional status after comprehensive rehabilitation influenced clinical outcomes in 77 tracheotomized patients ( mean ± SD age 75 ± 7 y ) admitted for difficult weaning to our regional weaning center . The care plan , including peripheral muscle training , was delivered daily . We recorded admission demographic , anthropometric , and functional characteristics . We measured the change in basic activities of daily living score ( ΔBADL ) , survival , and weaning success rate as clinical outcomes . We performed the Pearson correlation analysis and linear regression , with ΔBADL as the dependent variable , to test the predictive power of the baseline measurements . RESULTS : Sixty-seven patients ( 87 % ) survived , and 55 of them ( 74 % ) succeeded in weaning during their stay in the weaning center . The mean ± SD ΔBADL improvement was 2.5 ± 2.0 points ( median 2 points ) . Baseline performance of the latissimus dorsi predicted ΔBADL ( β = 0.388 , 95 % CI 0.111–1,664 , P = .03 ) . The probability of remaining ventilator-free ( P = .043 ) and survival ( P = .001 ) differed across the 4 ΔBADL categories ( 0 = no change , 1–2 = least improvement , and > 2 = improvement above median change ) . CONCLUSIONS : Mortality rate and weaning success differ according to ΔBADL following active rehabilitation/training in tracheotomized , ventilated , difficult-to-wean patients . The performance of the latissimus dorsi was the only significant predictor of change PURPOSE Pulmonary rehabilitation programs consistently have improved exercise capacity , quality of life , and symptoms over the past decade . Although training has been shown to be an essential component of the rehabilitation program , individual patients do not always benefit to the same extent . The present study was design ed to investigate which patients were achieving significant benefit of exercise training . METHODS Forty-nine stable out patients with moderate to severe COPD ( FEV1 37 (15)%pred ) were evaluated before and after 12 weeks of exercise training ( 3 times per week ) . Responders in exercise capacity were defined as having 15 % increase in maximal workload and /or 25 % increase in walking distance , while responders in quality of life showed an improvement of at least 10 points on the chronic respiratory disease question naire . With multivariate discriminant analysis , responders were distinguished from nonresponders based upon their initial characteristics . RESULTS Thirty-two patients were responders in terms of improved exercise capacity . Ventilatory reserve ( VE/MVV ) , inspiratory muscle strength ( Plmax ) , and peripheral muscle strength ( h and grip force and quadriceps force ) were significant predictors of the training response ( P < 0.05 ) ( accuracy 80 % P < 0.001 ) . Although the explained variance was modest , patients that were clearly ventilatory limited and had normal skeletal muscle strength were not likely to benefit from exercise training in terms of exercise capacity . No physiologic variables predicted whether a patient would increase quality of life after exercise training . CONCLUSION Patients with reduced exercise capacity who experience less ventilatory limitation to exercise and more reduced respiratory and peripheral muscle strength  are more likely to improve with exercise training . Improvements in quality of life after exercise training were significant but remained unpredictable with variables included in the present trial Background : The influences of exercising on cytokine response , fatigue and cardiorespiratory values are important aspects of rehabilitation in persons with multiple sclerosis ( PwMS ) .  Exercise performed within these programs is often practised in water but the effects of immersion on PwMS have not been systematic ally investigated . Objective : The objective of this study is to determine differences in cytokine and neurotrophin concentrations , fatigue and cardiorespiratory values in response to 3 week endurance training conducted on a cycle ergometer or an aquatic bike . Methods : A r and omized controlled clinical trial was conducted in 60 MS patients ( Exp and ed Disability Status Scale range 1.0–6.5 ) .  Resting serum levels of brain-derived neurotrophic factor ( BDNF ) , nerve growth factor ( NGF ) , Interleukin-6 , soluble receptor of IL-6 and tumor necrosis factor alpha , and concentrations in response to cardiopulmonary exercise test ( CPET ) , fatigue and cardiorespiratory values were determined at entry and discharge . Subjects performed daily 30 minute training at 60 % of VO2max . Results : Cytokines and neurotrophins showed no significant differences between groups over the training intervention . Within the water group BDNF resting and post-CPET concentrations ( p<0.05 ) showed a significant increase and NGF tended to increase after the training intervention . Short-term effects on BDNF ( CEPT ) tended to increase at the start and significantly thereafter ( p<0.05 ) . No changes occurred in the l and group . Other cytokines and fatigue scores remained unchanged over the training period . Cardiorespiratory values improved significantly over time within both groups . Conclusion : This study indicates that aquatic training activates BDNF regulation and can be an effective training method during rehabilitation in PwMS Background Chronic obstructive pulmonary disease ( COPD ) is recognized as a systemic illness with significant extra-pulmonary features , such as exercise intolerance and muscle weakness . Pulmonary rehabilitation has been shown to be very effective in counteracting these consequences in patients with more advanced COPD . However , limited data is available on the efficacy of a physical exercise training programme in patients with mild to moderate COPD in primary care . Furthermore , it is unknown if improved exercise capacity translates into enhanced daily physical activities . The aim of this paper is to describe the design of a r and omized controlled trial to assess the efficacy of a physical exercise training programme in patients with mild to moderate COPD . Methods / design In this r and omized controlled trial situated in the primary care setting , 102 patients with mild to moderate airflow obstruction ( FEV1 ≥ 50 % of predicted ) , dyspnoea and a physically inactive lifestyle will be r and omized to an intervention or control group . The intervention group receives a 4-month physical exercise training programme at a local physiotherapy practice , which includes exercise training , resistance training , breathing exercises and advises on how to increase the level of physical activity . The control group receives usual care , i.e. advises on how to increase the level of physical activity and a sham treatment at a local physiotherapy practice of which no physiological training stimulus can be expected . Primary outcome is functional exercise capacity at 4-months measured on the six-minute walk distance . Secondary outcomes include peripheral muscle strength , physical activity in daily life , health related quality of life , Medical Research Council ( MRC ) dyspnoea score and patients ’ perceived effectiveness . Follow-up measurement will take place at 6 months after baseline . Discussion This will be one of the first studies to evaluate the efficacy of a physical exercise training programme in patients with mild to moderate COPD completely recruited and assessed in primary care . The results of this trial may give a unique insight into the potential of the implementation of an easy , close-to-home rehabilitation programme . Trial registration The Netherl and s National Trial Register NTR1471 The clinical and physiological effects of a medically supervised , indoor physical training programme were investigated in 36 asthmatic subjects aged 16 - 40 years . After clinical evaluation , lung function assessment , and progressive incremental exercise testing subjects were r and omly allocated to control and training groups . The measurements were repeated after a six week run in period and after a further three months in which those in the training group underwent an indoor training programme . The measurements made at three months were compared with those at the end of the run in period . There was no significant change in anthropometric characteristics , blood lipid profiles , or the provocative concentration of histamine causing a 20 % fall in FEV1 ( histamine PC20 ) in the group who underwent training . After training there were significant increases in mean maximal oxygen uptake ( ml kg-1 min-1 ) from 23 ( 5 ) to 28 ( 6 ) , oxygen pulse ( ml/beat ) from 8.8 ( 2.3 ) to 10.8 ( 2.4 ) , and anaerobic threshold ( 1/min ) from 1.11 ( 0.27 ) to 1.38 ( 0.33 ) . These changes were significantly greater in the group undergoing training than in the control group . There was also a significant fall in breathlessness scores ( Borg ratings ) , blood lactate , carbon dioxide output , and minute ventilation during submaximal exercise in the training group , with no change in the control group . The subject 's motivation , the initial level of fitness , and the symptom score at the time of training were the most important factors influencing improvements in cardiorespiratory fitness . Thus submaximal physical exercise of controlled intensity , sustained for three months , produced significant improvements in fitness and cardiorespiratory performance that should be advantageous to the exercising asthmatic patient . The availability of medical supervision throughout the exercise programme appears to have contributed to the successful outcome OBJECTIVE To examine and evaluate improvements in cardiorespiratory fitness , psychological wellbeing , quality of life , and vocational status in postmyocardial infa rct ion patients during and after a comprehensive 12 month exercise rehabilitation programme . SUBJECTS The sample population comprised 124 patients with a clinical diagnosis of myocardial infa rct ion ( 122 men and two women ) . INTERVENTIONS 62 patients were r and omly allocated to a regular weekly aerobic training programme , three times a week for 12 months , and compared with 62 matched controls who did not receive any formal exercise training . A five year follow up question naire/interview was subsequently conducted on this population to determine selected vocational/lifestyle changes . RESULTS Significant improvements in cardiorespiratory fitness ( p < 0.01 - 0.001 ) , psychological profiles ( p < 0.05 - 0.001 ) , and quality of life scores ( p < 0.001 ) were recorded in the treatment population when compared with their matched controls . Although there were no significant differences in mortality , a larger percentage of the regular exercisers resumed full time employment and they returned to work earlier than the controls . Controls took lighter jobs , lost more time from work , and suffered more non-fatal reinfa rct ions ( p < 0.05 - 0.01 ) . CONCLUSIONS Regularly supervised and prolonged aerobic exercise training improves cardiorespiratory fitness , psychological status , and quality of life . The trained population also had a reduction in morbidity following myocardial infa rct ion , and significant improvement in vocational status over a five year follow up period We conducted a three-week r and omized trial comparing the improvement of functional capacity by exercise training in chronic heart failure by the steady-state ( EF 27.3 % , n = 20 ) and the interval modus ( EF 29.3 % , n = 20 ) with a control group ( EF = 26.6 % , n = 10 ) . Minimal EF was 10 % , the lowest maximal oxygen consumption was 9.3 ml/kg/min and the lowest cardiac output was 1.9 l/min ; 9 patients had been evaluated for HTX .  VO2 at the anaerobic threshold and at maximal exercise increased in the continuous exercise group by 1.4 or 1.6 ml/kg/min , respectively , corresponding to an increase of 13.7 % ( p < 0.05 ) and 9.3 % ( p < 0.05 ) . In the interval training group the increase was 1.3 and 1.5 ml/kg/min corresponding to 14 % ( p < 0.05 ) and 8.1 % ( p < 0.05 ) . Continuous short-term exercise had no impact to central hemodynamics as pulmonary artery pressure ( PA ) , capillary wedge pressure ( pc ) , cardiac index ( CI ) or stroke volume index ( SVI ) , whereas after interval training a significant increase at maximal exercise could be seen in CI ( p < 0.05 ) and SVI ( p < 0.01 ) with a concomitant drop in systemic peripheral resistance ( p < 0.05 ) compared to the steady-state modus . Interval training was further characterized by a higher short-term but lower mean work load with a significantly smaller increase in lactate . Quality of life was improved according to the SF-36 question naire in both training groups but the psychologic sum factor was three times as high , increasing to 24.2 % in the steady-state exercise group . It can be concluded that clinical ly stable patients with heart failure and even those already having been evaluated for cardiac transplantation profit from short-term physical training . Both training modalities seem equally suited to improve functional capacity . However interval training leads to more pronounced improvement in hemodynamics compared to the steady-state exercise , whereas the later had a greater impact on psychological well-being and quality of life .  Patients with heart failure and severe peripheral deconditioning tolerate higher workloads with more peripheral stress by an interval training modus . Long-term training modalities need to be established to further improve and stabilize functional status OBJECTIVES To evaluate , in chronic heart failure ( CHF ) patients , feasibility , safety , compliance and functional improvements of an eccentric ( ECC ) cycle training protocol personalized by the rate of perceived exertion ( RPE ; 9 - 11 Borg Scale ) , compared to concentric ( CON ) training at workload corresponding to the first ventilatory threshold . METHODS Thirty patients were r and omly allocated to ECC or CON training ( 20 sessions ) . Compliance was evaluated with RPE , visual analog scale for muscle soreness and monitoring of heart rate ( HR ) . Functional parameters were measured by the distance walked and the VO(2 ) uptake during the 6-minute walk test ( 6MWT ) before and after training . RESULTS Two patients were excluded due to adverse effects in each group .  RPE was 9 - 11 in ECC training while it reached 12 - 14 in CON training . HR remained stable in ECC group during exercise whereas it increased during CON exercise . 6MWT distance improved in both group ( ECC : + 53 m ; CON : + 33 m ) . 6MWT VO(2 ) uptake remained stable in ECC group whereas it increased in CON group . CONCLUSION ECC training tailored by RPE appears to be an efficient and safe alternative for CHF patients . Indeed , it induces functional improvement similar to conventional CON training with lower dem and on the cardiovascular system during exercise ABSTRACT .Thirty-six boys , aged 11 - 13 , were tested on a bicycle ergometer prior to and following a six week training program . The subjects were ranked according to their Vo2 max , blocked into three fitness levels and then r and omly assigned to one of the four treatment groups . The first group ( T1 ) QUESTION Does inspiratory muscle training improve respiratory muscle strength , functional capacity , lung function and quality of life of patients with chronic kidney disease ? Does inspiratory muscle training improve these outcomes more than breathing exercises ? DESIGN Systematic review and meta- analysis of r and omised trials . PARTICIPANTS People with chronic kidney disease undergoing dialysis treatment . OUTCOME MEASURES The primary outcomes were : maximal inspiratory pressure , maximal expiratory pressure , and distance covered on the 6-minute walk test . The secondary outcomes were : forced vital capacity , forced expiratory volume in the first second ( FEV1 ) , and quality of life . RESULTS The search identified four eligible studies . The sample consisted of 110 participants . The inspiratory muscle training used a Threshold ® or PowerBreathe ® device , with a load ranging from 30 to 60 % of the maximal inspiratory pressure and lasting from 6 weeks to 6 months . The studies showed moderate to high risk of bias , and the quality of the evidence was rated low or very low , due to the studies ' method ological limitations . The meta- analysis showed that inspiratory muscle training significantly improved maximal inspiratory pressure ( MD 23 cmH2O , 95 % CI 16 to 29 ) and the 6-minute walk test distance ( MD 80 m , 95 % CI 41 to 119 ) when compared with controls . Significant benefits in lung function and quality of life were also identified . When compared to breathing exercises , significant benefits were identified in maximal expiratory pressure ( MD 6 cmH2O , 95 % CI 2 to 10 ) and FEV1 ( MD 0.24litres 95 % CI 0.14 to 0.34 ) , but not maximal inspiratory pressure or forced vital capacity . CONCLUSION In patients with chronic renal failure on dialysis  , inspiratory muscle training with a fixed load significantly improves respiratory muscle strength , functional capacity , lung function and quality of life . The evidence for these benefits may be influenced by some sources of bias . REGISTRATION PROSPERO ( CRD 42015029986 ) . [ de Medeiros AIC , Fuzari HKB , Rattesa C , Br and ão DC , de Melo Marinho PÉ ( 2017 ) Inspiratory muscle training  improves respiratory muscle strength , functional capacity and quality of life in patients with chronic kidney disease : a systematic review . Journal of Physiotherapy 63 : 76 - 83 ]
According to the GRADE system , there is very low quality evidence that functional training is better than other interventions to improve cardiovascular parameters .
BACKGROUND Functional training is a new training vision that was prepared from the gesture imitation of daily activities .
Although your use has become popular in clinical practice , the influence of the several cardiorespiratory adjustments performed during the functional training in different population s and conditions is unknown .
So , the aim of this systematic review was to gather information in the literature regarding the influence of functional training on cardiorespiratory parameters .