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[Abstract] Introduction: Sniff nasal inspiratory (SNIP) and expiratory pressure (SNEP) may complement the assessment of respiratory muscle strength. Thus, specifying their reliability is relevant to improving the clinical consistency of both tests. Objective: To assess the reliability of SNIP and SNEP in healthy young adults. Methods: This cross-sectional study included self-reported healthy aged 18 to 29 years. SNIP was performed using a plug to occlude one nostril, while SNEP was conducted using a facemask. Participants performed 20 SNIP and SNEP maneuvers with 30-second intervals in between. The intraclass correlation coefficient (ICC), standard error of measurement (SEM), and minimum detectable change (MDC) assessed the reliability of SNIP and SNEP. Analyses were conducted between the highest peak pressure and the first reproducible maneuver in men and women. Results: The total sample comprised 32 participants: 16 men and 16 women. The ICC, SEM, and MDC for SNIP maneuvers were 0.994 (95%CI 0.988 to 0.997), 1.820 cmH2O, and 5.043 cmH2O, respectively. For SNEP, these parameters were 0.950 (95%CI 0.897 to 0.976), 6.03 cmH2O, and 16.716 cmH2O. The SNIP and SNEP in men showed ICC of 0.992 (95%CI 0.977 to 0.997) and 0.877 (95%CI 0.648 to 0.957), SEM of 2.07 and 7.66 cmH2O, and MDC of 5.74 and 21.23 cmH2O. In women, SNIP and SNEP presented ICC of 0.992 (95%CI 0.977 to 0.997) and 0.957 (95%CI 0.878 to 0.985), SEM of 1.15 and 6.11 cmH2O, and MDC of 3.19 and 16.95 cmH2O. Also, 60% of the highest SNIPs occurred among the 11th and 20th maneuvers in men and women. In men, 55% of the highest SNEPs occurred among the 11th and 20th maneuvers; this value was 50% in women. Conclusion: SNIP and SNEP showed excellent reliability. The reliability of SNIP and SNEP in men was good and excellent, respectively, whereas both tests had excellent reliability in women. Also, women reached the highest peak pressure faster than men in both tests.

[Resumen] Introducción. La silicosis es una enfermedad respiratoria incurable, ocasionada por la inhalación del polvo de sílice, siendo Galicia una de las comunidades autónomas donde se ha producido un mayor incremento de los casos. La silicosis crónica puede presentarse con un conjunto de síntomas como la disnea, fatiga, tos y sensación de opresión torácica. La Fisioterapia, y más concretamente los programas de rehabilitación pulmonar, podrían suponer una estrategia clave para el abordaje de estos sujetos. Objetivo. Analizar los posibles beneficios de la participación en un programa de rehabilitación pulmonar de pacientes con silicosis crónica en contraposición con aquellos sometidos a los cuidados habituales de la enfermedad, como herramienta para el control de las secuelas. Material y métodos. Se plantea un ensayo clínico aleatorizado simple ciego, para el cual se reclutarán pacientes derivados del Servicio de neumología del Hospital Universitario de A Coruña y del Hospital Provincial de Pontevedra. La muestra será de 74 sujetos en total, divididos aleatoriamente en dos grupos, un grupo de intervención sometido a un programa de rehabilitación pulmonar, y un grupo control sometido a los cuidados habituales de la enfermedad, ambos por un periodo de 8 semanas. Se evaluarán las posibles diferencias entre grupos respecto a la disnea, la función pulmonar, la tolerancia al ejercicio, la fuerza de la musculatura periférica, la fuerza de la musculatura respiratoria y la calidad de vida, al finalizar la intervención y a los 6 meses., [Abstract] Background. Silicosis is an incurable respiratory disease caused by the inhalation of silica dust, being Galicia one of the autonomous communities that has experienced a significant increase in cases. Chronic silicosis may be accompanied by dyspnea, fatigue, cough, and chest tightness may persist. Physiotherapy, specifically pulmonary rehabilitation programs, could provide a new therapeutic approach for these individuals. Objective. To analyze the potential benefits of participation in a pulmonary rehabilitation program for patients with chronic silicosis compared to those receiving usual care for the disease, as a tool for managing the sequelaes. Materials and methods. A blind randomized clinical trial is proposed, in which patients referred from the Pulmonology Department of the University Hospital of A Coruña and the Provincial Hospital of Pontevedra will be recruited. The sample will consist of a total of 74 subjects, randomly divided into two groups: an intervention group undergoing a pulmonary rehabilitation program and a control group receiving usual care for the disease, both during a period of 8 weeks. Possible differences between groups will be evaluated regarding dyspnea, lung function, exercise tolerance, peripheral muscle strength, respiratory muscle strength, and quality of life at the end of the intervention and at 6 months., [Resumo] Introdución. A silicose é unha enfermidade respiratoria incurable, producida pola inhalación de po de sílice, sendo Galicia unha das comunidades autónomas onde se rexistrou un maior incremento dos casos. A silicose crónica pode presentarse cun conxunto de sintomas como a disnea, fatiga, tose e sensación de opresión no peito. A Fisioterapia, e mais concretamente os programas de rehabilitación pulmonar, poderían ser unha estratexia clave para o abordaxe destes individuos. Obxectivo. Analizar os posibles beneficios na participación dun programa de rehabilitación pulmonar para pacientes con silicose crónica fronte ós que reciben a atención habitual da enfermidade, como ferramenta para o control das secuelas. Material e métodos. Plantexase un ensaio clínico aleatorizado simple cego, para o que se reclutarán pacientes derivados do Servicio de Neumoloxía do Hospital Universitario da Coruña e do Hospital Provincial de Pontevedra. A mostra será dun total de 74 suxetos, distribuidos aleatoriamente en dous grupos, un grupo de intervención sometido a un programa de rehabilitación pulmonar, e un grupo control sometido á atención habitual da enfermidade, ambos durante un periodo de 8 semanas. As posibles diferenzas entre grupos en canto á disnea, función pulmonar, tolerancia ao exercicio, forza da musculatura periférica, forza da musculatura respiratoria e calidade de vida, avaliaranse ao final da intervención e aos 6 meses.

[Abstract] Background: Patients with asthma often consider their symptomatology a barrier to exercise, leading to a reduced physical activity level. This study aims to determine whether the effect of a Nordic walking (NW) training program plus education and usual care is superior to educational and usual care only, in terms of exercise tolerance and other health-related outcomes in patients with asthma. The second aim is to explore the patients' experience with the NW program. Methods: A randomized controlled trial will be conducted with 114 adults with asthma recruited in sanitary area of A Coruña, Spain. Participants will be randomized to NW or control groups in blocks of six and in the same proportion in each group. Participants in the NW group will enrol in supervised sessions during eight weeks, three times/week. All participants will receive three educational sessions on asthma self-management plus usual care (S1 Appendix). Outcomes such as exercise tolerance (primary outcome), physical activity level, asthma-related symptoms and asthma control, dyspnea, lung function, handgrip strength, health related quality of life, quality of sleep, treatment adherence and healthcare resources use will be measured pre and postintervention, and at three and six months of follow-up. Participants in the NW group will additionally participate in focus groups. Discussion: This is the first study analysing the effect of NW in patients with asthma. NW combined with education and usual care is expected to improve exercise tolerance, but also asthma-related outcomes. If this hypothesis is confirmed, a new community-based therapeutic approach will be available for patients with asthma.

[Abstract] Background: The last systematic review about respiratory muscle training (RMT) in people with asthma was published almost 10 years ago. Since then, several works have been published. Objective: To review the effect of RMT in people with asthma. Methods: We conducted a systematic review of research included up to September 2021 in PubMed/MEDLINE, PEDro, Scopus, Web of Science, CINAHL, LILACS, Cochrane Central Register of Controlled Trials and ClinicalTrials.gov. We included randomized controlled trials and quasi-experimental studies assessing the effect of RMT on respiratory muscle function, rescue medication, asthma-related symptoms, lung function, exercise capacity, healthcare use, health-related quality of life (HRQoL) and adverse effects in people with asthma. Risk of bias and methodological quality were assessed with the Cochrane Risk of Bias assessment tool and the PEDro scale. Meta-analysis was performed whenever possible; otherwise a qualitative approach was followed. Results: Eleven studies (270 participants) were included, 10 with only adults and were included in the meta-analysis. Inspiratory muscle training (IMT) had beneficial effects on maximal inspiratory pressure (PImax: mean difference [MD] 21.95 cmH2O [95% confidence interval [CI] 15.05; 28.85]), with no changes in maximal expiratory pressure (MD 14.97 cmH2O [95%CI -5.65; 35.59]), lung function (forced expiratory volume in 1 sec: MD 0.06 [95%CI -0.14; 0.26] L; force vital capacity: MD 0.39 [95%CI -0.24; 1.02] L) and exercise capacity (standard mean difference [SMD] 1.73 [95%CI -0.61; 4.08]). Subgroup analysis revealed that IMT load >50% PImax and duration >6 weeks were beneficial for exercise capacity. The qualitative analysis suggested that IMT may have benefits on respiratory muscle endurance, rescue medication and exertional dyspnoea, with no adverse effects. Conclusions: This systematic review and meta-analysis showed a significant increase in PImax after IMT in adults with asthma and

[Resumen] Antecedentes y objetivos. El plan de estudios del Grado en Fisioterapia debe dar respuesta a las demandas de los usuarios de Fisioterapia en las principales áreas de su práctica profesional y preparar a los fisioterapeutas para actuar en un entorno complejo y cambiante. El objetivo del presente estudio es elaborar y validar un listado de conocimientos (syllabus) de Fisioterapia cardiorrespiratoria en el título de Grado. Material y métodos. Estudio Delphi con tres rondas de consulta realizadas entre febrero y marzo de 2021, mediante encuesta digital. Para ello, se formó un grupo de 14 expertos en Fisioterapia cardiorrespiratoria, de toda España, con diferentes perfiles profesionales. Para establecer el grado de acuerdo en las diferentes rondas se empleó el índice estadístico Free-Marginal Multirater Kappa, siendo necesario al menos un 70% de consenso. Para analizar la estabilidad en las respuestas se empleó el estadístico Kappa de Cohen (K). Resultados. Se obtuvieron un 100% de respuestas en las tres rondas de consulta realizadas. Al final del proceso se alcanzó un syllabus formado por 11 bloques temáticos, con 48 ítems, con un porcentaje medio de acuerdo del 90,64%, y una estabilidad en las repuestas de K = 0,57 (p < 0,001), lo que equivale a una concordancia moderada. Conclusiones. El syllabus validado por un grupo de 14 fisioterapeutas expertos y expertas en Fisioterapia respiratoria y cardíaca define los contenidos que deberían formar parte del Grado en Fisioterapia para poder dar respuesta a las necesidades asistenciales en afecciones cardiorrespiratorias, en un contexto complejo y cambiante, acorde a una intervención contemporánea., [Abstract] Background and objectives. The curricula of the Bachelor's degree in physiotherapy must respond to the current demands of physiotherapy clients in the main areas of their professional practice and prepare physiotherapists to act in a challenging and complex context. The aim of this study is to elaborate and validate a list of knowledge (syllabus) about cardiorespiratory physiotherapy in Bachelor's degree programs. Material and methods. A digital survey conducted a three-round Delphi study between February and March 2021. A group of 14 experts in cardiorespiratory physiotherapy from all over Spain and with different professional profiles were contacted. To establish the degree of agreement in the consultation rounds, the free-marginal multirater kappa statistical index was used, requiring at least 70% of consensus. Cohen's kappa statistic (K) was used to analyze the responses’ stability. Results. Hundred percentage of responses were obtained in the three rounds of consultation conducted with the expert panel. At the end of the process, a syllabus made up of 11 thematic sections and 48 items was reached. An average of 90.64% of agreement and a stability in the responses of K = 0.57 (p < 0.001), which equates to moderate agreement, was achieved. Conclusions. This syllabus validated by 14 respiratory and cardiac physiotherapy experts, determines the contents that should be part of physiotherapy in Bachelor's degree programs. This knowledge is crucial to address the rehabilitation necessities of cardiorespiratory alterations in a challenging and complex context, according to a contemporary approach of physiotherapy.

[Abstract] Background: Effects of chronic stroke on pulmonary function are largely unknown. Aim: To compare lung volumes in people with chronic stroke with a control group of healthy people matched by age and sex, as well as to investigate the relationship between the lung volumes and functional capacity. Methods: A cross-sectional study involving people with chronic stroke. Cases were matched to a control group of healthy people. Lung function and the distance walked during the Six-Minute Walk Test (6MWD) were the main outcomes. Independent t-tests were used to compare pulmonary function between groups and the Pearson correlation coefficient was used to assess any relationship between lung volumes and the 6MWD in the stroke group. Results: Sixty-six participants (24 males in each group; 56.5 ± 15.5 years) were included. People with stroke presented significantly lower lung volumes when compared to the control group. The median of forced vital capacity (FVC) was 79% and peak expiratory flow was 64% of the reference value. The 6MWD was found to be weakly correlated with inspiratory reserve volume (r = 0.39, p = .03) and peak inspiratory flow (r = 0.35, p = .05). Conclusions: People with chronic stroke show decreased lung volumes when compared with healthy people and this likely impacts on their functional capacity.