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Conclusions | OSA | Within the limitations of this study, we conclude that there is no significant difference in the effects of an MAD allowing limited vertical opening and an MAD allowing free vertical opening on respiratory parameters and upper airway dimensions in patients with mild to moderate OSA. | PMC10160211 | |
Clinical relevance | OSA | MADs allowing limited vertical opening and allowing free vertical opening have similar effects on respiratory parameters and upper airway dimensions in patients with mild to moderate OSA.
Trial registration: ClinicalTrials.gov Identifier: NCT02724865. | PMC10160211 | |
Keywords | PMC10160211 | |||
Introduction
| obstructions of the upper airway, arousals, OSA | OBSTRUCTIVE SLEEP APNEA | Obstructive sleep apnea (OSA) is characterized by recurrent obstructions of the upper airway, often resulting in oxygen desaturations and arousals from sleep [Continuous positive airway pressure (CPAP) is the most efficacious therapy for OSA [There is a large variety of commercially available customized MADs. Over the ... | PMC10160211 |
Material and methods | PMC10160211 | |||
Overview | This study was a multi-center RCT with a parallel design, in which the effects of two types of titratable MADs on respiratory parameters and upper airway dimensions were compared. The allocation sequence was automatically generated through an electronic data capture system (Castor EDC), using random block size of eithe... | PMC10160211 | ||
Participants | OSA symptoms, OSA, apnea, daytime sleepiness, snoring | Eligible patients, diagnosed with OSA at four sleep centers in the Netherlands (Onze Lieve Vrouwe Gasthuis Ziekenhuis (OLVG), Nederlands Slaap Instituut, Medisch Centrum Jan van Goyen, and AMC), were referred to the department of Oral and Maxillofacial Surgery of AMC to participate in the present study. The inclusion c... | PMC10160211 | |
MADs | The two types of MAD compared in this study were MAD-H (Herbst appliance; 4Dental labs, Amsterdam, the Netherlands) and MAD-S (SomnoDent appliance; SomnoDent Flex, SomnoMed, Sydney, Australia). The MAD-H consisted of two splints connected to each other with adjustable iron-bars for titration. The vertical opening was l... | PMC10160211 | ||
MAD side-effects and compliance | temporomandibular complaints | The self-reported side effects were recorded at each clinical visit, including the following: 1. sensitive teeth in the morning; 2. painful jaw muscles; 3. painful temporomandibular complaints; and 4. changed occlusion in the morning. The compliance information was collected by a telephone survey, which consisted of fo... | PMC10160211 | |
Polysomnography (PSG) recordings | Every patient underwent a baseline PSG recording and a 3-month follow-up PSG recording with MAD in situ at one of the afore-mentioned sleep centers. A digital PSG system (Embla ASleep and respiration were analyzed following the criteria of the American Academy of Sleep Medicine (AASM) Task Force [ | PMC10160211 | ||
Cone beam computed tomography (CBCT) | epiglottis, overbite | All patients underwent two CBCT scans (NewTom 5G, QR systems, Italy) at the department of Oral Radiology of ACTA: a baseline scan and a follow-up scan with the MAD in situ (in the same protrusion position as during the follow-up PSG recording). The exposure settings were 110 kV, 4 mA, 0.3 mm voxel size, 3.6-s exposure ... | PMC10160211 | |
Sample size | According to the guidelines of Cohen, an effect size d, which is defined as a standardized difference in the means of an outcome variable between two groups, of 0.20 is small, one of 0.5 is medium, and one of 0.8 is large [ | PMC10160211 | ||
Statistical analysis | SECONDARY | Normality of continuous data was tested by Shapiro–Wilk test. Independent The intra-rater reliability for the upper airway variables was assessed using a two-way mixed, absolute agreement, single measures intraclass correlation coefficient (ICC). Reliability was defined as poor (ICC < 0.5), moderate (ICC = 0.5–0.75), g... | PMC10160211 | |
Results | PMC10160211 | |||
Flowchart of participants | OSA | OBSTRUCTIVE SLEEP APNEA | The flow-chart of 49 patients with OSA who were recruited for this study is shown in Fig. Flowchart of the patients in the study. OSA: obstructive sleep apnea; CBCT: cone beam computed tomography; PSG: Polysomnography; n: sample size; MAD: mandibular advancement device; MAD-H: Herbst appliance; MAD-S: SomnoDent applian... | PMC10160211 |
Reliability of the upper airway assessment | SECONDARY | The intra-rater reliability for the upper airway assessment was excellent, with ICC = 0.96 for the CSAmin and ICC = 0.90 to 0.94 for the secondary outcome variables. | PMC10160211 | |
Discussion | OSA | The aim of this RCT was to compare the effects of MAD-H (allowing limited vertical opening) and MAD-S (allowing free vertical opening) on respiratory parameters and upper airway dimensions in patients with mild to moderate OSA. The results showed that despite differences in the freedom of mandibular vertical opening, t... | PMC10160211 | |
MAD-H vs MAD-S | teeth and painful jaw muscles | MINOR | In the present study, there was no significant difference between the MAD-H and MAD-S in affecting the AHI-supine, as well as AHI and AHI-non-supine. According to the post hoc power analysis, the effect size f of the AHI-supine was 0.29 in the PP analysis and was 0.10 in the ITT analysis, which is qualified as small to... | PMC10160211 |
Overall MAD effects | enlargement | ENLARGEMENT | For respiratory parameters, there was significant decrease in the AHI and AHI-non-supine but no significant decrease in the AHI-supine with MAD in situ in the total group, which indicated that the MADs used in this study were less effective in reducing the AHI in supine position. As MADs used in this study allow more o... | PMC10160211 |
Limitations | OSA | The present study has several limitations. Firstly, the information of the patients who were initially screened for this study was missing. With these data missing, we cannot be certain that our sample represents the total population of OSA patients that are being seen in the clinics in Amsterdam. Although the dropout ... | PMC10160211 | |
Strengths | The standardized titration protocol used for both types of MAD is one of the major strengths of the present study. To the best of our knowledge, when comparing different MADs, few previous studies have reported a standardized titration protocol. In the present study, a detailed standardized titration protocol was appli... | PMC10160211 | ||
Acknowledgements | The authors gratefully acknowledge Dr. Naichuan Su, Department of Oral Public Health, Academic Centre for Dentistry Amsterdam (ACTA), for his assistance with the statistical analyses of this study; and the staff of the OLVG, Netherlands Slaap Instituut, Medisch Centrum Jan van Goyen and AMC for their assistance with th... | PMC10160211 | ||
Funding | Xiaoxin Shi has received a scholarship from the China Scholarship Council. | PMC10160211 | ||
Data availability | The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request. | PMC10160211 | ||
Declarations | PMC10160211 | |||
Ethics approval | This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Medical Research Ethics Committee of the Academic Medical Center Amsterdam (AMC) (#: NL44085.018.13). | PMC10160211 | ||
Informed consent | Informed consent was obtained from all individual participants included in the study. | PMC10160211 | ||
Conflict of interest | FRANK | Xiaoxin Shi declares that she has no conflicts of interest. Frank Lobbezoo is a member of the Academic Advisory Boards for Grind Care and Oral Function of Sunstar Suisse S.A. and receives research grants from Sunstar Suisse S.A., SomnoMed, Vivisol, Health Holland, and Airway Management. Hui Chen declares that she has n... | PMC10160211 | |
References
| PMC10160211 | |||
Introduction | Plakoutsis, injuries, Motor behaviors, ’ | Evidence has shown that imagining a complex action, like backward-walking, helps improve the execution of the gesture. Despite this, studies in sport psychology have provided heterogeneous results on the use of motor imagery (MI) to improve performance. We aimed to fill this gap by analyzing how sport experience influe... | PMC10858124 | |
Materials and methods | PMC10858124 | |||
Participants | psychiatric | MOTOR DISORDERS | We recruited 41 women from the “Federico II” University of Naples, divided into two experimental groups: active group (Inclusion criteria were normal or corrected-to-normal vision and right-handedness. Alternatively, exclusion criteria comprised the current or past presence of psychopathology, psychiatric, neurological... | PMC10858124 |
Imagery task | A mental chronometry task was administered to participants to assess their motor imagery abilities. There were two randomly assigned tasks in the procedure: a forward-walking task (FW) and a backward-walking task (BW). In both tasks (each consisting of one trial), participants had first to imagine (forward and backward... | PMC10858124 | ||
Self-report assessment | The Vividness of Movement Imagery Questionnaire (VMIQ-2) (Roberts et al., | PMC10858124 | ||
Data analysis | One-way ANOVA was used to separately analyzed differences between groups (Active, Sedentary) in the forward and the backward imagery task. To investigate whether imagination perspectives (internal, external, kinesthetic) affect the performance of active and sedentary participants differently, we performed a generalized... | PMC10858124 | ||
Discussion | Fournier | SECONDARY, FOURNIER | The present study aimed to gain insight into complex action imagery processes, such as backward-walking, as they can be useful in developing training protocols based on MI. Specifically, our main hypothesis concerns the influence of physical activity and sport performance on MI abilities. We tested a sample of young wo... | PMC10858124 |
Limitations and future directions | Given its preliminary nature, this study presents some limitations. First, our sample consisted entirely of young adult women. Since gender differences significantly influence the processes of mental imagery, testing young adult men is essential to gain stronger insights and extend these results to the general populati... | PMC10858124 | ||
Author contributions | Conceptualization: LM, FL; methodology: NP, FL; investigation: LM, NP, FL; data curation: NP, FL; Validation: LM, NP, FL; formal analysis: NP, FL; visualization: NP; writing—original draft: LM, NP; writing—review & editing: LM, FL. | PMC10858124 | ||
Funding | Open access funding provided by Università degli Studi di Napoli Federico II within the CRUI-CARE Agreement. This research was supported by funding from the Department of Humanities, University of Naples Federico II (Fondi ricerca dipartimentale 2023) to L.M. This research did not receive any specific grant from fundin... | PMC10858124 | ||
Data availability | The data are available from the corresponding author upon request | PMC10858124 | ||
Declarations | PMC10858124 | |||
Conflict of interest | The authors declare that there are no conflicts of interest and that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. | PMC10858124 | ||
Ethical approval | The study was approved by Ethical Committee of Psychological Research of the Department of Humanities of the University of Naples Federico II (n. prot. 11/2020) and was conducted in accordance with the Declaration of Helsinki. Written informed consent was obtained from all individual participants included in the study. | PMC10858124 | ||
References | PMC10858124 | |||
Introduction | death, HIV treatment initiation, viral suppression | The HIV Prevention Trials Network (HPTN) 074 study demonstrated a positive effect of an integrated systems navigation and psychosocial counseling intervention on HIV treatment initiation, viral suppression, medication assisted treatment (MAT) enrollment, and risk of death among people who inject drugs (PWID). In this s... | PMC10173611 | |
Methods | The HPTN 074 randomized clinical trial was conducted in Indonesia, Ukraine, and Vietnam. HIV-infected PWID with unsuppressed viral load (indexes) were recruited together with at least one of their HIV-negative injection partners. Indexes were randomized in a 1:3 ratio to the intervention or standard of care. | PMC10173611 | ||
Results | depression, deaths, death | The trial enrolled 502 index and 806 partner participants. Overall, 13% (66/502) of indexes and 3% (19/806) of partners died during follow-up (crude mortality rates 10.4 [95% CI 8.1–13.3] and 2.1 [1.3–3.3], respectively). These mortality rates were for indexes nearly 30 times and for partners 6 times higher than expect... | PMC10173611 | |
Conclusions | death | The results confirm that both HIV-infected and uninfected PWID remain at a starkly elevated risk of death compared to general population. Mortality related to HIV and other causes can be significantly reduced by scaling-up ART and MAT. Access to these life-saving treatments can be effectively improved by flexible integ... | PMC10173611 | |
Supplementary Information | The online version contains supplementary material available at 10.1186/s12879-023-08201-3. | PMC10173611 | ||
Keywords | PMC10173611 | |||
Introduction | death, opioid dependence, overdose, AIDS-related, initiation and retention | People who inject drugs (PWID) are at higher risk of death compared to their non-drug using peers. The all-cause mortality rate in a global systematic review of cohort studies among PWID was 2.9 per 100 person-years (PY), which is nearly 15 times higher than expected in an age-adjusted population [Widespread scale-up o... | PMC10173611 | |
Methods | PMC10173611 | |||
Population and setting | HIV INFECTION, RECRUITMENT | The study was conducted at three sites (Jakarta, Indonesia; Kyiv, Ukraine; and Thai Nguyen, Vietnam). The sites were selected based on estimated high HIV incidence and prevalence among PWID. Participants were recruited in a city hospital (Jakarta), two district health centers (Thai Nguyen), and a community-based harm r... | PMC10173611 | |
Data collection | death | The study procedures and data collection methods for the main outcomes are presented in detail in the main study report [All instances of death were systematically investigated by the local study teams. After becoming aware of a possible death case, study personnel contacted relatives, peers or medical staff to confirm... | PMC10173611 | |
Statistical analysis | depression, deaths, death | DISEASE, DELETION | Crude mortality rates per 100 person years (CMR) were calculated based upon person-time between study enrollment and either the date of death or last follow-up visit. For time-varying covariates, the amount of person time in each category was determined based on the covariate value at the end of each follow-up interval... | PMC10173611 |
Results | The trial enrolled 502 index (194 [39%] in Vietnam, 187 [37%] in Ukraine, and 121 [24%]) in Indonesia) and 806 partner participants (305 [38%] in Vietnam, 318 [39%] in Ukraine, and 183 [23%]) in Indonesia). A majority were men (87%, 1143/1308); most women (77%, 127/165) enrolled at the Ukrainian site. The median age at... | PMC10173611 | ||
Discussion | deaths, overdose | In this analysis of the randomized clinical trial conducted at three sites in Indonesia, Vietnam, and Ukraine, we found that PWID, regardless of their HIV status, have significantly higher mortality rates than expected in a population of the same age and gender. The majority of deaths among HIV-infected indexes were re... | PMC10173611 | |
Mortality rates | AIDS, TB, death, overdose, HIV infected, deaths | AIDS, LIVER DISEASES, TUBERCULOSIS | The observed crude mortality rates were consistent with the recent systematic review of cohort studies, reporting the pooled CMR of 2.71/100PY among people who inject opioids [In our study, the risk of death among PWID living with HIV who were not treated effectively was thirty times higher than expected in a general p... | PMC10173611 |
The effect of the intervention | deaths, death | In our study, we demonstrated a clear and strong effect of the intervention on death outcomes. Among indexes, mortality in the intervention arm compared to the SoC was decreased by more than half. As evident from the multivariable models, the effect of the intervention appears to be mediated by improved immune status, ... | PMC10173611 | |
Other predictors of mortality | depression, death | We assessed the effects of recent injecting and non-injecting substance use on the risk of death. Among indexes, mortality was lower among participants self-reporting hazardous alcohol use or any type of injecting drug use in the past 3 months, and higher among those reporting no injecting or non-injecting drug use. On... | PMC10173611 | |
Limitations | depression, deaths, death | The participants in our study were recruited using targeted outreach and peer referral; therefore the sample should not be considered representative of the entire PWID population in these countries. Our participants are likely to be more closely linked to HIV prevention and treatment services, also as a result of study... | PMC10173611 | |
Conclusion | death | The HPTN 074 randomized controlled trial, conducted in Indonesia, Vietnam, and Ukraine, documented directly measured mortality rates in PWID. The results confirm that both HIV-infected and uninfected PWID remain at a starkly elevated risk of death compared to the general population of the same age. Mortality related to... | PMC10173611 | |
Acknowledgements | We thank Myron S Cohen for his assistance in the earliest stages of this study, including its conceptualisation and securing HIV Prevention Trials Network (HPTN) funding. We also thank Wafaa M El-Sadr for her support throughout the study and critical review of the manuscript. We thank Katherine Davenny for her advocacy... | PMC10173611 | ||
Authors’ contributions | RS | WCM, IFH, CAL, and DSM conceived the study. WCM, IFH, CAL, DSM, KEL and VFG assisted with the study design. IFH, BH, TVH, KD, ZD, OZ, RS, SMR, CAL, DSM, KEL, VFG, EPM, PR, and WCM developed the protocol and assisted with study implementation or oversight. CAL, DSM, KEL, and VFG developed the intervention. BH and XG ana... | PMC10173611 | |
Funding | AIDS | INFECTIOUS DISEASES, AIDS, ABUSE, ALLERGY | This work was supported by the National Institute of Allergy and Infectious Diseases (NIAID), the National Institute of Mental Health (NIMH), and the National Institute on Drug Abuse (NIDA) of the National Institutes of Health (NIH); award numbers UM1AI068619 [HPTN Leadership and Operations Center], UM1AI068617 [HPTN S... | PMC10173611 |
Availability of data and materials | The datasets supporting the conclusions of this article and respective data dictionaries are included within the additional files. | PMC10173611 | ||
Declarations | PMC10173611 | |||
Ethics approval and consent to participate | All study procedures were carried out in accordance with relevant guidelines and regulations. Written informed consent was obtained from all participants enrolled in HPTN 074. The study protocol was approved by the following institutional review boards: Ukrainian Institute on Public Health Policy IRB#1 (Ukraine); Ethic... | PMC10173611 | ||
Consent for publication | Not applicable. | PMC10173611 | ||
Competing interests | This study was supported by the National Institutes of Health (NIH) and multiple investigators received grants or support from NIH (IFH, BH, TVH, CAL, DSM, KEL, VFG, EPM, PR, and WCM). All other authors declare no competing interests. | PMC10173611 | ||
References | PMC10173611 | |||
BACKGROUND: | stroke, acute stroke therapies, upper limb motor impairment | STROKE | Despite improvements in acute stroke therapies and rehabilitation strategies, many stroke patients are left with long-term upper limb motor impairment. We assessed whether an inhibitory repetitive transcranial magnetic stimulation treatment paradigm started within 3 weeks after stroke onset promotes upper limb motor re... | PMC10358447 |
METHODS: | stroke, upper limb motor impairment, intracerebral hemorrhage, ischemic stroke | STROKE, CORTEX, INTRACEREBRAL HEMORRHAGE, ISCHEMIC STROKE | We performed a single-center randomized, sham-controlled clinical trial. Patients with ischemic stroke or intracerebral hemorrhage and unilateral upper limb motor impairment were randomized to 10 daily sessions of active or sham continuous theta-burst stimulation (cTBS) of the contralesional primary motor cortex combin... | PMC10358447 |
RESULTS: | poststroke | We enrolled 60 patients between April 2017 and February 2021, of whom 29 were randomized to active cTBS and 31 to sham cTBS. One patient randomized to active cTBS withdrew consent before the intervention and was excluded from the analyses. The mean difference in the change in Action Research Arm Test score from baselin... | PMC10358447 | |
CONCLUSIONS: | stroke, disability | STROKE, CORTEX | Ten daily sessions of cTBS of the contralesional primary motor cortex combined with upper limb training, started within 3 weeks after stroke onset, promote recovery of the upper limb, reduce disability and dependence and leads to earlier discharge from the rehabilitation center. | PMC10358447 |
REGISTRATION: | stroke, Upper limb motor impairment, ischemic stroke | INTRACEREBRAL HAEMORRHAGE, STROKE, ISCHEMIC STROKE | URL:
Upper limb motor impairment is one of the most frequent long-term neurological consequences of ischemic stroke or intracerebral haemorrhage.Spontaneous recovery after stroke is believed to be driven by neurobiological processes that occur mainly during a period of heightened brain plasticity in the first 3 months... | PMC10358447 |
METHODS | PMC10358447 | |||
Study Design | We performed a single-center, prospective, randomized, sham-controlled clinical trial with a single-blind intervention and a double-blind primary outcome evaluation at rehabilitation center De Hoogstraat (Utrecht, the Netherlands), according to the CONSORT (Consolidated Standards of Reporting Trials) guidelines. Deiden... | PMC10358447 | ||
Participants | paresis, first-ever ischemic stroke, intracerebral hemorrhage | PARESIS, INTRACEREBRAL HEMORRHAGE | We included patients aged ≥18 years with first-ever ischemic stroke or intracerebral hemorrhage and a paresis of 1 arm, as defined by a Motricity Index | PMC10358447 |
Randomization and Masking | Patients were randomly assigned to 10 daily sessions of contralesional cTBS or to sham cTBS during 2 weeks, in addition to regular care upper limb therapy, using a secured online allocation system (Research Online V2.0, Julius Centre, the Netherlands) by the investigator performing the treatment. Randomization was stra... | PMC10358447 | ||
Procedures | CARAS, Stroke | STROKE, BRAIN | Treatment was delivered in 10 daily sessions on consecutive working days. cTBS was delivered over the contralesional M1, which was defined as the position on the scalp at which motor-evoked potentials (MEPs) with the largest peak-to-peak amplitude could be evoked in the contralateral first dorsal interosseous (FDI) mus... | PMC10358447 |
Outcomes | poststroke, stroke, Stroke | STROKE, SECONDARY, STROKE | The primary outcome measure was the change in the Action Research Arm Test (ARAT) score from baseline at 3 months after stroke, as recommended by the Stroke Recovery and Rehabilitation Roundtable.Predefined secondary outcomes included the change in ARAT score <12 hours, 1 week, and 1 month posttreatment, and 6 and 12 m... | PMC10358447 |
Statistical Analysis | SECONDARY | The sample size calculation was based on an effect size of 0.55 on the ARAT score obtained from a meta-analysis.We followed the prespecified statistical analysis plan, which is available in the We performed similar analyses for the effect of treatment on the secondary outcomes at all visits except for the mRS and lengt... | PMC10358447 | |
DISCUSSION | Headache, anxiety, disability and dependency, stroke, pain, headache/nausea, poststroke | ADVERSE EVENTS, STROKE | Patients who received active cTBS showed greater improvement in upper limb recovery as measured with the ARAT at 3 months poststroke compared with patients who received sham cTBS. The mean additional improvement of 9.5 points (17% of the maximum ARAT score) on the ARAT is clinically meaningful and exceeds the previousl... | PMC10358447 |
Limitations | SECONDARY | Our study had some limitations. First, the researchers were not blinded to the treatment allocation due to practical reasons concerning the sham condition, what could have introduced bias during the treatment period. In addition, although we performed double-blinded assessment of the primary outcome at 3 months, most s... | PMC10358447 | |
Future Research | stroke | STROKE | The results in this single-center study are promising and provide a strong foundation for future multicenter trials to provide conclusive evidence on the efficacy of cTBS treatment in the promotion of upper limb recovery after stroke. These trials could tailor treatment to individual patients, as recent studies suggest... | PMC10358447 |
Conclusions | stroke | STROKE | In the present study, treatment with cTBS of the contralesional M1 combined with upper limb training, started within 3 weeks after stroke onset, improved upper limb motor recovery and led to better functional outcomes. Some treatment benefits persisted up to at least 12 months after stroke. | PMC10358447 |
ARTICLE INFORMATION | PMC10358447 | |||
Acknowledgments | Stroke | STROKE, BRAIN | The authors thank all patients and investigators for their contribution to the B-STARS study (Brain Stimulation for Arm Recovery After Stroke). | PMC10358447 |
Sources of Funding | BRAIN | This work was supported by the Netherlands Organization for Scientific Research (VICI 016.130.662) and in part by Brain Science Tools B.V. The funders had no role in study design, data collection, data analysis, data interpretation, or writing of the article. | PMC10358447 | |
Disclosures | HEART, DER, BRAIN | J.J.T. Vink is a part-time employee of and Dr Neggers is the CEO and shareholder of Brain Science Tools B.V. Data analysis was performed during J.J.T. Vink’s part-time employment at Brain Science Tools B.V. Dr van der Worp is consultant for Bayer and receives funding from the Dutch Heart Foundation, Horizon 2020 Framew... | PMC10358447 | |
SUPPLEMENTAL MATERIAL | Tables S1–S2Trial protocolStatistical analysis planCONSORT checklist | PMC10358447 | ||
Supplementary Material | PMC10358447 | |||
Nonstandard Abbreviations and Acronyms | Action Research Arm TestConcise Arm and Hand Rehabilitation Approach in Strokecontinuous theta-burst stimulationFugl-Meyer Assessmentlow-frequencyprimary motor cortexmodified Rankin Scaleresting motor thresholdrepetitive transcranial magnetic stimulationJ.J.T. Vink and E.C.C. van Lieshout contributed equally.For Source... | PMC10358447 | ||
REFERENCES | PMC10358447 | |||
Subject terms | diaphragmatic dyskinesias, Parkinson’s disease, PD | AIRWAY OBSTRUCTION | Upper airway obstruction, reduced maximal expiratory and inspiratory flows, reduced lung volumes, abnormal ventilatory control, and diaphragmatic dyskinesias are reported in patients with Parkinson’s disease (PD). Inspiratory muscle training (IMT) has been reported to be effective in improving respiratory functions; ho... | PMC9925741 |
Introduction | respiratory problems, Parkinson's disease, tremors, respiratory dysfunction, PD, muscle rigidity | DISEASE, PARKINSON'S DISEASE, RESPIRATORY COMPLICATIONS, NEURODEGENERATIVE DISORDER, COMPLICATIONS | Parkinson's disease (PD) is a neurodegenerative disorder that is progressive and characterized by muscle rigidity, tremors, postural instability, bradykinesia, and autonomic dysfunctionsTherefore, treating respiratory problems in PD should be part of disease management to avoid complications in the respiratory system. ... | PMC9925741 |
Methods | PMC9925741 | |||
Study design | Two arms pretest–posttest experimental research design was used with random allocation of participants into two groups, i.e., the Incentive spirometer (IS) group, and the threshold inspiratory muscle trainer (TIMT) group. | PMC9925741 | ||
Instrumentation | LUNG |
PHILIPS Respironics Threshold IMT Lung Adjustable Constant Pressure Muscle Trainer (Threshold IMT, Philips Respironics, Inc., Murrysville, PA, USA)PORTEX Coach 2 incentive spirometer (Smiths Medical)Computerized Pulmonary Function Test Machine (RMS Helios 401, India)Portable MicroRPM (Respiratory Pressure Meter) (ICC ... | PMC9925741 |
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