Introducción.La pérdida generalizada de masa y fuerza muscular asociada al envejecimiento es causa de deterioro funcional y discapacidad física, especialmente en el anciano de edad avanzada. En este contexto, la función respiratoria puede verse gravemente comprometida, cuando al descenso fisiológico de la fuerza de la musculatura respiratoria (MR), se le suman la comorbilidad y la inmovilidad. Estudios previos han demostrado que el entrenamiento específico de la MR se acompaña de la mejora significativa de la fuerza y la resistencia de esta musculatura, tanto en sujetos sanos como en enfermos. Por lo tanto, puede tratarse de una intervención efectiva para mejorar y mantener las características de la MR, así como prevenir el deterioro clínico y funcional del anciano más vulnerable. Objetivo. Evaluar y comparar entre sí la efectividad de dos protocolos de entrenamiento específico de la MR en la mejora de su fuerza y resistencia, en el anciano institucionalizado con importante limitación funcional. Material y métodos.Setenta y un ancianos institucionalizados con incapacidad para deambular (90% mujeres;edadmedia ± Sx, 85 ± 6 años) fueron asignados aleatoriamente a un grupo control (n= 24) y dos grupos entrenados (grupo Threshold,n= 23; grupo Pranayama, n= 24). Los grupos experimentales siguieron un protocolo de entrenamiento supervisado, cinco días a la semana durante seis semanas consecutivas. Las principales variables de este estudio, las presiones respiratorias estáticas máximas (PImax y PEmax) y la ventilación máxima voluntaria (VMV), fueron medidas en cuatro momentos temporales (semanas 0, 4, 7 y 10) para cada uno de los tres grupos definidos. Resultados. Contrariamente a nuestra hipótesis, el entrenamiento mediante Threshold® IMT no reveló efecto significativo en la fuerza y la resistencia de la MR. Sin embargo, los ejercicios de ventilación controlada, descritos como Pranayama, reflejaron un aumento significativo de la fuerza de laMR sobre los grupos control y Threshold(PImax F6,204= 6,774, p< 0,001, η2= 0,166; PEmax F6,204= 4,257, p< 0,001, η2= 0,111). Adicionalmente, el Pranayama mostró un efecto significativamente mayor de la resistencia de la MR respecto al grupo control (VMV F6,204= 5,322, p< 0,001, η2= 0,135). Conclusión. El entrenamiento mediante Pranayama es una modalidad de ejercicio efectiva y bien tolerada por el anciano que no puede deambular autónomamente. Por lo tanto, es una alternativa beneficiosa para el mantenimiento y mejora de la fuerza y resistencia de la MR en el anciano con perdida significativa de movilidad y capacidad de ejercicio. / The global loss of muscle mass and strength associated with aging is a cause of functional impairment and disability, particularly in the frail elderly. Respiratory function can be severely compromised if there is a decrease of respiratory muscle (RM) strength complicated by the presence of comorbidities and physical immobility. Previous studies have shown that RM training is an effective method to increase RM strength, both in healthy people and patients. In this case, RM training may be regarded as a beneficial alternative to improve RM function, and thus prevent physical deterioration in this population. The purpose of this study was to assess and compare the effect of two specific RM training protocols on the RM strength and endurance in an elderly population, who were unable to engage in general exercise conditioning. The hypothesis was that RM training would improve RM strength and endurance in the experimental groups vs. control group, who did not participate in RM training. Methods. Seventy-one institutionalized elderlypeople with an inability to walk (90% female, age 85 ± 6 years) were randomly assigned to a control group (n=24), Threshold group (n=23) or Pranayama group (n=24). Both experimental groups performed a supervised RM training, 5 days/week for six consecutive weeks. The maximum inspiratory and expiratory pressures (MIP and MEP) and the maximum voluntary ventilation (MVV) were assessed at four time points in each of the three groups. Results. Contrary to our original hypothesis, Threshold® IMT did not reveal a significant effect on the RM strength and endurance, when compared to the outcomes in the control group. However, Pranayama exercises reflected a significant increase in RM strength, over the control and Threshold groups (MIP F6,204= 6,774, p< 0,001, 2= 0,166; MEP F6,204= 4,257, p< 0,001, 2= 0,111). Additionally, the Pranayama RM trainingwas significantlybetter in increasing RM endurance when compared to the MVVmeasured in the control group (MVV F6,204= 5,322, p< 0,001, 2= 0,135). Conclusion.Pranayama RM training is an effective and well-tolerated exercise regimen in the elderly population. Therefore, RM training is effective in improving RM strength and endurance in a functionally impaired elderly population.

Orientador: Wilson Nadruz Junior / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-11T18:42:20Z (GMT). No. of bitstreams: 1 Gemignani_Tiago_M.pdf: 1392345 bytes, checksum: 25697107f179a8a592c3843115eec95e (MD5) Previous issue date: 2008 / Resumo: A aterosclerose de artérias periféricas tipicamente afeta vasos dos membros inferiores, sugerindo que estímulos locais tenham função importante neste processo. O presente estudo avaliou os efeitos das mudanças posturais na tensão circunferencial das artérias poplítea e carótida e investigou a correlação entre a tensão circunferencial vascular local e a espessura íntima-média destas artérias. Cento e dezessete indivíduos não diabéticos, não hipertensos, não fumantes foram avaliados (48 homens e 69 mulheres). A pressão arterial foi mensurada em braço e panturilha dos pacientes, nas posições supina e ortostática. Análise com Eco-Doppler foi realizada em artérias carótida comum e poplítea após medida de pressão arterial. A tensão circunferencial foi calculada de acordo com a Lei de Laplace. Foi encontrado que a mudança da posição supina para a ortostática aumentou a tensão circunferencial poplítea, mas não em artérias carótidas. Análises de correlação parcial, ajustadas por idade e índice de massa corpórea, revelaram que os valores de tensão circunferencial média obtidos em posição supina e ortostática exibiram correlação similar com a espessura íntima-média carotídea, enquanto que a tensão circunferencial sistólica ortostática revelou correlação mais forte com a espessura íntima-média poplítea, que a tensão circunferencial obtida em posição supina. Estes resultados foram confirmados após análise de regressão múltipla incluindo idade, sexo, índice de massa corpórea e níveis de lípides e glicemia como variáveis independentes. Em conclusão, a tensão circunferencial ortostática foi melhor preditor hemodinâmico da espessura íntima-média poplítea do que a tensão circunferencial supina. Estes dados sugerem que a posição ereta seja um fator de risco potencial para aterosclerose poplítea devido ao aumento da sobrecarga hemodinâmica local. / Abstract: Atherosclerosis of peripheral arteries typically affects vessels of the lower limbs, suggesting that local hemodynamic stimuli play a role in this process. The present study evaluated the effects of body posture changes on carotid and popliteal circumferential wall tension (CWT) and investigated the relationship between local CWT and intima-media thickness (IMT) of these arteries. One hundred seventeen nondiabetic, nonhypertensive, nonsmoker subjects (48 men and 69 women) were evaluated. Blood pressure was measured in the arm and calf of subjects in supine and orthostatic positions. Echo-Doppler analysis evaluated the common carotid and popliteal arteries after blood pressure measurements. CWT was calculated according to Laplace's law. Changing from supine to orthostatic posture increased CWT in popliteal but not in carotid arteries. Partial correlation analysis controlled for age and body mass index revealed that supine and orthostatic CWT exhibited comparable correlation coefficients with carotid IMT, while orthostatic CWT displayed a stronger relationship with popliteal IMT than supine CWT. These results were further confirmed by multiple linear regression analysis including age, sex, body mass index, lipid fractions and glucose as independent variables. Orthostatic CWT is a better hemodynamic predictor of popliteal IMT in comparison to supine CWT. These data suggest that orthostatic posture may be a potential risk factor for popliteal atherosclerosis by increasing local hemodynamic burden. / Mestrado / Clinica Medica / Mestre em Clinica Medica

The abdominal aorta (AA) in man is a vulnerable artery prone to atherosclerosis as well as aneurysmatic dilation. The underlying aortic composition, mechanical properties as well as the mechanisms responsible for age-related changes and vascular disease are however largely unknown. The aims of this study were 1) to characterize the age- and gender-related changes of the aortic wall components in vivo, using a mechanical model based on ultrasound measurements of pulsatile aortic diameter changes combined with intra-arterial pressure; 2) to validate ultrasound measurements of diameter and intima-media thickness (IMT) of the AA in order to calculate wall stress; 3) to study the stress driven remodeling response of the aortic wall in healthy individuals and the influence of age and gender; and 4) to study wall stress and remodeling of the AA in diabetic patients in order to elucidate the protective influence of diabetes on abdominal aortic aneurysm formation. The stiffness of the isotropic material (mainly elastin) increased in males despite the known decrease in elastin content with age. Further, an exponential increase in stiffness of the anisotropic material (mainly collagen) in males at high physiological pressure was found. This might be due to changed isoforms of collagen and increased glycation with age. Females were less affected than males. The reproducibility of the ultrasound measurements of diameter and IMT in the AA was acceptable (CV; 4% and 11% respectively), making it possible to calculate circumferential aortic wall stress in vivo. The age-related remodeling of the arterial wall led to increased diameter, and compensatory thickening of the wall preventing the circumferential wall stress from increasing in the common carotid artery of males and females, and the AA of females. However, the compensatory increase in wall thickness was defect in the male AA, where stress increased with age. Pulsatile stress influenced the material parameters of the AA, leading to increased stiffness of anisotropic material (mainly collagen), whereas stiffness of isotropic material (mainly elastin) was unaffected. Patients with diabetes mellitus had increased aortic wall thickness than controls, generating less circumferential stress. This coincides with the known reduction of abdominal aortic aneurysms in diabetic patients and may act as a protective factor.

Carotid intima-media thickness (cIMT) is a valid measure of cardiovascular disease (CVD). Physical activity appears to improve cIMT, however, research is inconclusive. This study investigated the relationship between physical activity (physical activity rating (PA-R)) and cardiovascular fitness (predicted VO2max , perceived functional ability (PFA)) and cIMT. Data collected from 341 seniors (≥50 years) competing in the Huntsman World Senior Games (HWSG) included blood lipids, inflammatory makers, blood glucose, blood pressure (BP) and anthropometric measurements of obesity and central adiposity. Multiple regression analysis was used to determine correlations of measured variables with cIMT. Two of the fitness related variables, PFA (r ≈ 0.1359; p = 0.012) and predicted VO2max (r ≈ 0.1475; p = 0.007) were significantly correlated to cIMT without controlling for confounding factors, but lost significance when adjustments for other CVD risk factors were included. PAR (r ≈ 0.0869; p = 0.111) was not significantly correlated to cIMT. Regression analysis indicated that the most predictive variables of cIMT we investigate were: age (t = 7.166, p = 0.000), gender (t = 3.310, p = 0.001), BMI (t = 1.892, p = 0.05), SBP (t = 3.952, p = 0.000), total cholesterol (TC) (t = 4.184, p = 0.000) and triglycerides (TRG) (t ≈ 3.466, p = 0.000), our R2 = .299, thus indicating these 6 variables account for about 30% of the variance in cIMT in seniors competing at HWSG. Physical activity and cardiovascular fitness influence other CVD risk factors and consequently may have an indirect impact on cIMT.

Perivascular adipose (PVAT) has been hypothesized to influence arterial health, where an excess can lead to pathogenesis of atherosclerosis and other arterial pathologies. A novel assessment of carotid PVAT is the use of carotid extra media thickness (EMT) ultrasonography. Currently, there is a lack of research to demonstrate the relationship between carotid EMT and existing measures of arterial health, notably, central pulse wave velocity, and carotid distensibility and intimal media thickness. In the current cross sectional study, 81 participants of younger recreationally active (ages 23.2 ± 2.5 years), younger sedentary (ages 26.4 ± 7.2 years), older healthy (ages 70.3 ± 5.4 years) and older adults with coronary artery disease (CAD) (ages 67.9 ± 8.7 years) were recruited. Resting measures of central arterial stiffness was examined through the assessment of aPWV, while measures of local carotid stiffness were examined through carotid distensibility. Aortic PWV was calculated using an accepted direct distance method (80% of carotid to femoral direct distance) and time difference between the feet of the carotid and femoral waveforms. Carotid intima-media thickness (IMT), a measure of the inner arterial walls, and carotid extra media thickness (EMT), a measure of carotid PVAT, were assessed through B-mode ultrasound images and a semi-automated edge tracking software. Carotid EMT, IMT, and aPWV were significantly greater in older adults than in younger adults (p < 0.05). No difference in carotid EMT was found between younger recreationally active (0.47 ± .08 mm) and sedentary adults (0.46 ± .06 mm). There were also no differences in carotid EMT between the older healthy (0.58 ± .06 mm) and older adults with CAD (0.54 ± 0.08 mm). Carotid EMT was also significantly correlated with age (r =0 .500), waist circumference (r = 0.521), aPWV (r =0.431), carotid distensibility (r = -0.364 and IMT (r = 0.404). Despite significant correlations, carotid EMT was not an independent predictor of aPWV, carotid distensibility and IMT. Because of the lack of predictive power in measures of arterial stiffness and carotid IMT, there is a potential that carotid EMT may be an independent vascular disease marker. Future investigations should involve carotid EMT in longitudinal studies to evaluate the potential marker for a more comprehensive cardiovascular risk assessment. / Thesis / Master of Science (MSc)

Live simulations play an important role in allowing users to practice and develop skills they learn in training. Although live simulations are playing an increasingly important role in training, ways to improve them are not well understood or documented. In order to improve the efficacy of live simulation and maximize results from funds spent on training; this research examines the relationship between the affective variables of the participants and their performance in the live simulation. Prior to participating in the instructor development live simulation used in this study two training preference scales were administered to a group of trainees. These scales measured the trainees’ locus of control and immersion tendencies. During the live simulation the trainees’ performance was evaluated by a panel of expert observers. The trainees also self-reported their performance through the use of a self-rating instrument. Analysis of the data revealed significant positive correlations between the trainees’ internal locus of control and their performance in the simulation, both self-reported (p=0.026) and as reported by the expert observers (p=0.033). The correlation between immersion tendency scores and performance in the live simulation were mixed; while not always statistically significant they did reveal some slight positive correlation. This research did provide a number of lessons learned and implications for instructional and simulation developers wishing to employ live simulation in a training environment. These include performance of sub-populations within the greater population of subjects, consideration of roles assigned to participants, and the need to increase presence within the live simulation. Application of these lessons learned can reduce training costs and/or improve the effectiveness of live simulation in a training environment, this in turn can be of significant benefit to instructional and simulation designers. Additionally, understanding these relationships can lead iv to better assignments of roles or activities within live simulation and improve the transfer of experience from live simulation training to on the job performance. However, additional research needs to be conducted in order to make more conclusive statements regarding the most appropriate affective variable that would allow for predicting transfer of the simulated experience to the ‘real’ world, the individuals who would benefit most from live simulation, and to develop additional prescriptive methods for improving live simulation utilized in training environments.

Submitted by Rosivalda Pereira (mrs.pereira@ufma.br) on 2017-12-06T17:23:43Z No. of bitstreams: 1 NataliaMandarino.pdf: 1259793 bytes, checksum: 4c22457bb7148f23dd689ff0d6e19abc (MD5) / Made available in DSpace on 2017-12-06T17:23:43Z (GMT). No. of bitstreams: 1 NataliaMandarino.pdf: 1259793 bytes, checksum: 4c22457bb7148f23dd689ff0d6e19abc (MD5) Previous issue date: 2017-09-05 / FAPEMA / The role of vitamin D in the regulation of bone metabolism is already well established. However, in recent years, the role of vitamin D in extraskeletal health has been widely explored. In the cardiovascular area, vitamin D deficiency has been independently associated with the occurrence of myocardial infarction, stroke and cardiovascular death. The mechanisms to explain the association between hypovitaminosis D and cardiovascular disease are still not fully understood, and their association with atherosclerosis is postulated. However, studies attempting to correlate hypovitaminosis D with atherosclerosis markers have produced conflicting results, in the same way as small randomized trials of oral supplementation to evaluate intermediate outcomes, so there is currently considerable debate about whether hypovitaminosis D represents a new risk or would be just an inflammatory marker. In the first article, a comprehensive review was made of the role of vitamin D deficiency in the pathogenesis of cardiovascular disease, from basic aspects of its biosynthesis to the results of interventional studies, through its oral supplementation. The second article presents the results of a cross - sectional analysis of 382 individuals living in quilombola communities in Alcântara - MA, participants of the PREVRENAL cohort, presenting at least one cardiovascular risk factor, with a mean age of 57.79 (± 15.3) years and a slight predominance, in which the serum levels of 25-hydroxyvitamin D, the stable circulating form of the vitamin, were correlated with an established marker of subclinical atherosclerosis, carotid intima-media thickness, and other cardiovascular risk factors. Socio-demographic, lifestyle, anthropometric and clinical data were collected and biochemical tests were performed, including the dosage of 25-hydroxyvitamin D by means of the electrochemiluminescence assay. The urinary excretion of albumin was evaluated by means of the albumin / creatinine ratio in an isolated sample of urine. Hypovitaminosis D was defined as serum 25- hydroxyvitamin D levels <30 ng / mL. All participants underwent examination of the common carotid arteries by high-resolution ultrasonography to measure the intimamedia thickness, and the mean of the measurements on both sides was adopted. Serum levels of 25-hydroxyvitamin D were 50.4 (± 13.5) ng / mL, with a low prevalence of hypovitaminosis D (<5%). By simple linear correlation, there was a significant inverse association between 25-hydroxyvitamin D levels and carotid intima-media thickness (r = -0.174, p = 0.001). However, after multiple regression analysis, only the variables male gender, age, smoking, systolic blood pressure, fasting blood glucose and LDL-cholesterol remained significantly associated with carotid intima-media thickness. Levels of 25-hydroxyvitamin D were independently associated positively with HDL-cholesterol and inversely with urinary albumin excretion. In conclusion, in this Afrodescendant population, with a low prevalence of hypovitaminosis D, there was no independent association between serum 25- hydroxyvitamin D levels and carotid intima-media thickness, a finding that contradicts the hypothesis of its antiatherosclerotic role. On the other hand, its positive association with HDL-cholesterol and the inverse association with urinary albumin excretion, also considered as an independent predictor of cardiovascular events, does not allow the exclusion of cardiovascular protection actions of the vitamin in this population profile. / O papel da vitamina D na regulação do metabolismo ósseo já está bem estabelecido. Entretanto, nos últimos anos, o papel da vitamina D na saúde extraesquelética tem sido amplamente explorado. Na área cardiovascular, a deficiência de vitamina D tem sido associada de forma independente à ocorrência de infarto do miocárdio, acidente vascular cerebral e morte cardiovascular. Os mecanismos para explicar a associação entre hipovitaminose D e doença cardiovascular ainda não estão de todo esclarecidos, sendo postulada sua vinculação com a aterosclerose. No entanto, estudos procurando correlacionar hipovitaminose D com marcadores de aterosclerose têm produzido resultados conflitantes, da mesma forma que pequenos estudos randomizados de suplementação oral para avaliar desfechos intermediários, de modo que há atualmente considerável debate acerca de se a hipovitaminose D representa um novo fator de risco ou seria apenas um marcador inflamatório. No primeiro artigo, já publicado, procurou-se realizar uma revisão abrangente sobre o papel da deficiência de vitamina D na patogenia da doença cardiovascular, incluindo desde aspectos básicos de sua biossíntese até os resultados de estudos de intervenção, por meio de sua suplementação oral. O segundo artigo apresenta os resultados de uma análise transversal de 382 indivíduos habitantes de comunidades quilombolas em Alcântara - MA, participantes da coorte PREVRENAL, apresentando pelo menos um fator de risco cardiovascular, com média de idade de 57.79 (± 15.3) anos e discreto predomínio do sexo feminino, em que se procurou correlacionar os níveis séricos de 25-hidroxivitamina D, a forma circulante estável da vitamina, com um marcador estabelecido de aterosclerose subclinica, a espessura médio-intimal carotídea, e outros fatores de risco cardiovascular. Foram coletados dados sócio-demográficos, sobre estilo de vida, antropométricos e clínicos e realizados exames bioquímicos, incluindo a dosagem de 25-hidroxivitamina D, por meio do ensaio eletroquimioluminiscência. A excreção urinária de albumina foi avaliada por meio da razão albumina / creatinina em amostra isolada de urina. Hipovitaminose D foi definida como níveis séricos de 25-hidroxivitamina D <30 ng / mL. Todos os participantes foram submetidos a exame das artérias carótidas comuns por ultrassonografia de alta resolução para medida da espessura médio-intimal, sendo adotada a média das medidas de ambos os lados. A média dos níveis séricos de 25-hidroxivitamina D foi de 50.4 (± 13.5) ng / mL, observando-se uma baixa prevalência de hipovitaminose D (<5%). Por correlação linear simples, observou-se uma associação inversa significativa entre os níveis de 25-hidroxivitamina D e a espessura médio-intimal carotídea (r = -0.174, p = 0.001). Entretanto, após análise de regressão múltipla, apenas as variáveis sexo masculino, idade, tabagismo, pressão arterial sistólica, glicemia em jejum e LDL-colesterol permaneceram significativamente associadas com a espessura médio-intimal carotídea. Níveis de 25-hidroxivitamina D se associaram independentemente, de forma positiva com o HDL-colesterol, e inversa com a excreção urinária de albumina. Em conclusão, nesta população afrodescendente, com baixa prevalência de hipovitaminose D, não se observou uma associação independente entre os níveis séricos de 25- hidroxivitamina D e a espessura médio-intimal carotídea, achado que contraria a hipótese do seu papel antiaterosclerótico. Por outro lado, a sua associação positiva com o HDL-colesterol e inversa com a excreção urinária de albumina, também considerada um preditor independente de eventos cardiovasculares, não permite afastar ações de proteção cardiovascular da vitamina neste perfil populacional.

In 2018 the Utah Department of Transportation (UDOT) funded a study in which data were collected to evaluate performance measures for UDOT's Incident Management Team (IMT) program. After that study was completed, UDOT received funding to expand the size of its IMT program. Additionally, TransSuite, a data source used by the UDOT Traffic Operations Center to log incident-related data, was reconfigured to provide a higher quantity of performance measure data. This study made use of the new data source, in addition to Computer Aided Dispatch logs provided by the Utah Highway Patrol that were used in the first study, to collect performance measure data of the expanded program and measure the impacts of the IMT program expansion. Using these two datasets, a reanalyzed 2018 dataset and a new 2020 dataset, a comparison of performance measures was made. Performance measures studied included those defined as important by the Federal Highway Administration's Focus States Initiative in 2009, namely Roadway Clearance Time, Incident Clearance Time, and Response Time. These performance measures were calculated for IMT responders at 320 incidents in 2018 and 289 incidents in 2020. In addition, data regarding the affected volume associated with incidents, the excess travel time accumulated due to incidents, and the excess user cost associated with incident congestion were gathered. In 2018, 188 incidents were analyzed for these user impacts, and in 2020 144 incidents were analyzed. Statistical analyses were conducted to compare IMT performance between the two years and to determine relationships between performance measures and user impacts. The effects of the COVID-19 pandemic affected traffic volumes during this study, and statistical analyses were adjusted to account for volume differences between the two years. Results indicated that the expansion of the IMT program has allowed UDOT to respond faster to incidents, and respond to a larger quantity of incidents over a larger coverage area and in extended operating hours. Performance of the expanded IMT program has had significant effects in reducing incident-related congestion and its costs.

Bakgrund: Inspiratorisk muskelträning (IMT) har historiskt använts inom vården, men har på senare tid uppmärksammats mer inom idrottsvärlden. IMT kan förstärka andningsmuskulaturen som är förknippat med en förhöjd prestationsförmåga.Syftet med litteraturstudien är att sammanställa befintlig forskning och undersöka om IMT har en effekt på prestationsförmågan hos fotbollsspelare. Metod: Litteraturöversikten är utformad med hjälp av PRISMA Guidelines. Artikelsökningar gjordes på PubMed, SPORTDiscus och Sports Medicine &amp; Education Index i februari 2021. Totalt valdes sex artiklar utifrån framtagna inklusionskriterier. Artiklarna kvalitetsgranskades metodologiskt av båda författarna enligt PEDro skalan och Risk of Bias 2. Resultat: Analyserade studier inkluderade 62 deltagare i IMT-grupp, 27 IMT-sham och 51 i kontrollgrupp. Genomsnittliga studiekvalitéten klassificerade som ”måttlig” med en medelpoäng på 6 av 10. Samtliga studier visade på signifikant ökning av inspiratorisk muskelstyrka med en genomsnittlig ökning på 27.2% i maximal inspiratory pressure. Majoriteten av inkluderade studier kunde även visa på signifikant förbättring av i löpdistans efter IMT-intervention. Konklusion: IMT i kombination med traditionell fotbollsträning har en effekt på prestationsförmågan i form av inspiratorisk muskelstyrka och löpdistans. En ökad inspiratorisk muskelstyrka bidrar till att individen kan arbeta på en högre intensitet under en längre tid. IMT är därmed en effektiv, lätthanterlig och billig metod för att förbättra den individuella prestationsförmågan hos fotbollsspelare. Mekanismen bakom IMT antas vara en fördröjning av metaboreflexen. Framtida forskning behöver klargöra förklaringsmodellen och även ta fram optimala riktlinjer för användandet av IMT för att nå interventionens fulla utvecklingspotential.

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