scholarly journals Clinical responses following inspiratory muscle training in exercise-induced laryngeal obstruction

2021 ◽  
Author(s):  
Astrid Sandnes ◽  
Tiina Andersen ◽  
Hege Havstad Clemm ◽  
Magnus Hilland ◽  
John-Helge Heimdal ◽  
...  
Keyword(s):  
Inspiratory Muscle ◽  
Inspiratory Muscle Training ◽  
University Hospital ◽  
Control Group ◽  
Activity Levels ◽  
Muscle Training ◽  
Symptom Resolution ◽  
Laryngeal Obstruction ◽  
Clinical Responses ◽  
Exercise Induced

Abstract Purpose Exercise-induced laryngeal obstruction (EILO) is relatively common in young people. Treatment rests on poor evidence; however, inspiratory muscle training (IMT) has been proposed a promising strategy. We aimed to assess laryngeal outcomes shortly after IMT, and to compare self-reported symptoms with a control group 4–6 years later. Methods Two groups were retrospectively identified from the EILO-register at Haukeland University Hospital, Norway; one group had received only information and breathing advice (IBA), and another additionally IMT (IBA + IMT). At diagnosis, all participants performed continuous laryngoscopy during exercise (CLE), with findings split by glottic and supraglottic scores, and completed a questionnaire mapping exercise-related symptoms. After 2–4 weeks, the IBA + IMT-group was re-evaluated with CLE-test. After 4–6 years, both groups were re-assessed with a questionnaire. Results We identified 116 eligible patients from the EILO-register. Response rates after 4–6 years were 23/58 (40%) and 32/58 (55%) in the IBA and IBA + IMT-group, respectively. At diagnosis, both groups rated symptoms similarly, but laryngeal scores were higher in the IBA + IMT-group (P = 0.003). After 2–4 weeks, 23/32 in the IBA + IMT-group reported symptom improvements, associated with a decrease of mainly glottic scores (1.7–0.3; P < 0.001), contrasting unchanged scores in the 9/32 without symptom improvements. After 4–6 years, exercise-related symptoms and activity levels had decreased to similar levels in both groups, with no added benefit from IMT; however, full symptom resolution was reported by only 8/55 participants. Conclusion Self-reported EILO symptoms had improved after 4–6 years, irrespective of initial treatment. Full symptom resolution was rare, suggesting individual follow-up should be offered.

Laryngoscopy can guide inspiratory muscle training (IMT) in exercise induced laryngeal obstruction (EILO)

2021 ◽  
Author(s):  
Haakon Kvidaland ◽  
Sara-Petrine Veierød ◽  
Praveen Muralitharan ◽  
Petter Carlsen ◽  
Maria Vollsæter ◽  
...  
Keyword(s):  
Inspiratory Muscle ◽  
Inspiratory Muscle Training ◽  
Muscle Training ◽  
Laryngeal Obstruction ◽  
Exercise Induced

scholarly journals Exercise-induced laryngeal obstruction in athletes treated with inspiratory muscle training

2019 ◽  
Vol 5 (1) ◽  
pp. e000436 ◽  
Author(s):  
Astrid Sandnes ◽  
Tiina Andersen ◽  
Hege Havstad Clemm ◽  
Magnus Hilland ◽  
Maria Vollsæter ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Case Reports ◽  
Minute Ventilation ◽  
Vocal Folds ◽  
Inspiratory Muscle ◽  
Inspiratory Muscle Training ◽  
Peak Exercise ◽  
Muscle Training ◽  
Laryngeal Obstruction ◽  
Exercise Induced

BackgroundExercise-induced laryngeal obstruction (EILO) is common in athletes and presents with dyspnoea, chest tightness, inspiratory stridor and sometimes panic reactions. The evidence for conservative treatment is weak, but case reports suggest effects from inspiratory muscle training (IMT). We aimed to explore effects from IMT used in athletes with EILO.MethodTwenty-eight athletes, mean age 16.4 years, diagnosed with EILO at our clinic, participated in a 6-week treatment programme, using a resistive flow-dependent IMT device (Respifit S). Four athletes competed at international level, 13 at national and 11 at regional levels. Video-recorded continuous transnasal flexible laryngoscopy was performed from rest to peak exercise (continuous laryngoscopy exercise (CLE) test) and scored before and 2–4 weeks after the training period. Ergospirometric variables were obtained from this CLE set-up. Lung function was measured according to guidelines. Symptom scores and demographic variables were obtained from a questionnaire.ResultsAfter the treatment period, symptoms had decreased in 22/28 (79%) participants. Mean overall CLE score had improved after treatment (p<0.001), with the scores becoming normal in five athletes but worse in two. Most of the improvement was explained by changes at the glottic laryngeal level (p=0.009). Ergospirometric variables revealed significantly higher peak minute ventilation explained by higher tidal volumes and were otherwise unchanged.ConclusionThis explorative study underlines the heterogeneous treatment response of EILO and suggests that IMT may become an efficient conservative treatment tool in subgroups, possibly contributing to better control of the vocal folds. The signals from this study should be tested in future controlled interventional studies.

Effects of inspiratory muscle training on pulmonary function, respiratory muscle strength and functional capacity in patients with atrial fibrillation: a randomized controlled trial

2016 ◽  
Vol 30 (12) ◽  
pp. 1165-1174 ◽  
Author(s):  
Melih Zeren ◽  
Rengin Demir ◽  
Zerrin Yigit ◽  
Hulya N Gurses
Keyword(s):  
Atrial Fibrillation ◽  
Muscle Strength ◽  
Pulmonary Function ◽  
Functional Capacity ◽  
Respiratory Muscle ◽  
Inspiratory Muscle ◽  
Inspiratory Muscle Training ◽  
Control Group ◽  
Respiratory Muscle Strength ◽  
Muscle Training

Objective: To investigate the effects of inspiratory muscle training on pulmonary function, respiratory muscle strength and functional capacity in patients with atrial fibrillation. Design: Prospective randomized controlled single-blind study. Setting: Cardiology department of a university hospital. Subjects: A total of 38 patients with permanent atrial fibrillation were randomly allocated to either a treatment group ( n = 19; age 66.2 years (8.8)) or a control group ( n = 19; age 67.1 years (6.4)). Methods: The training group received inspiratory muscle training at 30% of maximal inspiratory pressure for 15 minutes twice a day, 7 days a week, for 12 weeks alongside the standard medical treatment. The control group received standard medical treatment only. Spirometry, maximal inspiratory and expiratory pressures and 6-minute walking distance was measured at the beginning and end of the study. Results: There was a significant increase in maximal inspiratory pressure (27.94 cmH2O (8.90)), maximal expiratory pressure (24.53 cmH2O (10.34)), forced vital capacity (10.29% (8.18) predicted), forced expiratory volume in one second (13.88% (13.42) predicted), forced expiratory flow 25%–75% (14.82% (12.44) predicted), peak expiratory flow (19.82% (15.62) predicted) and 6-minute walking distance (55.53 m (14.13)) in the training group ( p < 0.01). No significant changes occurred in the control group ( p > 0.05). Conclusion: Inspiratory muscle training can improve pulmonary function, respiratory muscle strength and functional capacity in patients with atrial fibrillation.

scholarly journals Effect of Additional Threshold Inspiratory Muscle Training Preoperative on Pulmonary Complication Post Heart Valve Replacement Surgery

2020 ◽  
Vol 9 (1) ◽  
pp. 19-28
Author(s):  
Erna Setiawati ◽  
Ronni Untung Handayanto ◽  
Sri Wahyudati
Keyword(s):  
Valve Replacement ◽  
Pulmonary Complication ◽  
Intervention Group ◽  
Inspiratory Muscle ◽  
Inspiratory Muscle Training ◽  
Control Group ◽  
Postoperative Pulmonary Complication ◽  
Muscle Training ◽  
Replacement Surgery ◽  
Valve Replacement Surgery

ABSTRACT Introduction: Cardiac surgery has been improved patient’s outcome with cardiac valve anomaly. There was 111 cardiac valve replacement surgery performed in Kariadi General Hospital Semarang in 2018.Postoperative pulmonary complication (PPC) is the most common complication in this procedure compared to cardiac complication which are thought caused by the disruption of normal respiratory function as a result from surgical and anesthetic procedure. Additional preoperative threshold inspiratory muscle training (Threshold IMT) has been considered as an ef fective intervention to reduce PPC. Methods: This is a quasi experimental study with main reason to know the role of Threshold IMT on PPC incidences. Subjects in the intervention group were given routine conventional rehabilitationexercises according to Clinical Practice Guide (PPK) with additional of Threshold IMT, which applied based on research protocols, while control group did convention al rehabilitation exercises only. Results: 18 subjects were divided into intervention group (n=9), and control group (n=9), PPC incidences (Intervention group n=2, control group n=7) were analyzed statistically using Chi-squared test andshowed significant differences (Fisher exact test p=0.02 with α=0.05). Conclusion: Additional of Threshold IMT preoperative may reduce the incidence of PPC on heart valve replacement surgery.Keywords: Postoperative pulmonary complication (PPC), Threshold inspiratory muscle training (Threshold IMT)

Effect of 4 weeks resistive inspiratory muscle training on respiratory functions in patients with tetraplegia during in-patient rehabilitation

2021 ◽  
Vol 12 (1) ◽  
pp. 536-543
Author(s):  
Gitanjali Sikka ◽  
Joginder Yadav ◽  
Roop Singh ◽  
Gupta K B
Keyword(s):  
Outcome Measures ◽  
T Test ◽  
Inspiratory Muscle ◽  
Inspiratory Muscle Training ◽  
Control Group ◽  
Muscle Training ◽  
Post Injury ◽  
Significant Difference ◽  
Cord Injury ◽  
And Control

There is reduction in lung compliance in first week after spinal cord injury (SCI) that deteriorates further and neuroprotective therapies like strength training of respiratory muscles should begin in first month after SCI  since both motor and sensory scores at baseline and their further recovery is maximum during this phase. Few studies on SCI subjects within first month of injury have supported use of resistive inspiratory muscle training (RIMT), but have advocated the need for further research in this patient population owing to pitfalls in these studies. The present study was a prospective randomized control trial being carried out to determine whether RIMT programme of four weeks duration is effective in improving respiratory functions and strength in motor complete cervical SCI patients (AIS grade A, B) during in-patient rehabilitation. Patients within first week of cervical SCI (C4-C7 level) were assigned to RIMT (48 patients) and Control (48 patients) group and completed 40 supervised training sessions over a period of four weeks. Outcome measures included: - Spirometry, inspiratory and expiratory muscle strength.  No significant differences of Chi-square test (P < 0.05) and unpaired “t” test (P < 0.05) were found between RIMT and Control group for all demographic and pre-training measurements. Following results were recorded after 2 weeks and 4 weeks of training on all outcome measures: - Highly significant difference  (P<0.01) within both groups with One–way ANOVA; Highly significant difference (P<0.01) with unpaired “t-test” between RIMT and control group. Cohen “d” effect sizes for RIMT vs. Control group were in large effect size zone i.e. greater than 0.8. The findings of present study show beneficial effect of RIMT on respiratory functions and strength in patients with tetraplegia in first month post injury and we propose that RIMT should be included early in acute phase rehabilitation of these patients.

scholarly journals Effects of a 10-Week Inspiratory Muscle Training Program on Lower-Extremity Mobility in People with Multiple Sclerosis

2011 ◽  
Vol 13 (1) ◽  
pp. 32-42 ◽  
Author(s):  
Lucinda Pfalzer ◽  
Donna Fry
Keyword(s):  
Multiple Sclerosis ◽  
Lower Extremity ◽  
Physical Performance ◽  
Intervention Group ◽  
Inspiratory Muscle ◽  
Inspiratory Muscle Training ◽  
Control Group ◽  
Muscle Training ◽  
Home Based ◽  
Edss Score

Pulmonary muscle weakness is common in ambulatory people with multiple sclerosis (MS) and may lead to deficits in mobility function. The purpose of this study was to examine the effect of a 10-week home-based exercise program using an inspiratory muscle threshold trainer (IMT) on the results of four lower-extremity physical performance tests in people with MS. The study design was a two-group (experimental-control), pretest-posttest study. Outcome measures consisted of pulmonary function measures including maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), and maximal voluntary ventilation (MVV), and the following lower-extremity physical performance measures: the 6-Minute Walk (6MW) distance, gait velocity (GV), the Sit-to-Stand Test (SST), the Functional Stair Test (FST), and a balance test (BAL). A total of 46 ambulatory participants (Expanded Disability Status Scale [EDSS] score, 2.0–6.5) with MS were randomly assigned to an intervention group (mean EDSS score, 4.1) that received 10 weeks of home-based inspiratory muscle training or a nontreatment control group (mean EDSS score, 3.2). Of the original 46 participants, 20 intervention group participants and 19 control group participants completed the study. Compared with the control group, the intervention group made significantly greater gains in inspiratory muscle strength (P = .003) and timed balance scores (P = .008). A nonsignificant improvement in 6MW distance (P = .086) was also noted in the IMT-trained group as compared with the control group. This is the first study directly linking improvement in respiratory function to improvement in physical performance function in people with mild-to-moderate disability due to MS.

The effects of five days of intensive preoperative inspiratory muscle training on postoperative complications and outcome in patients having cardiac surgery: a randomized controlled trial

2019 ◽  
Vol 33 (5) ◽  
pp. 913-922 ◽  
Author(s):  
Xiaoyu Chen ◽  
Lin Hou ◽  
Yuanyuan Zhang ◽  
Xiangjing Liu ◽  
Bohan Shao ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Intervention Group ◽  
Pulmonary Complications ◽  
Inspiratory Muscle ◽  
Inspiratory Muscle Training ◽  
Control Group ◽  
Postoperative Pulmonary Complications ◽  
Muscle Training ◽  
Randomized Controlled ◽  
Inspiratory Muscle Strength

Objective: To determine the prophylactic efficacy of short-term intensive preoperative inspiratory muscle training on the incidence of postoperative pulmonary complications in patients scheduled for cardiac surgery. Design: Single-blind, randomized controlled pilot study. Setting: TEDA International Cardiovascular Hospital, China. Subjects: In total, 197 subjects aged ⩾50 years scheduled for cardiac surgery were selected. Intervention: The intervention group ( n = 98) received five days of preoperative inspiratory muscle training on top of the usual care received by the patients in the control group ( n = 99). Main measures: The primary outcome variable was the occurrence of postoperative pulmonary complications. The secondary outcome variables were inspiratory muscle strength, lung function and length of hospitalization. Results: After cardiac surgery, a total of 10 (10.2%) of the 98 patients in the intervention group and 27 (27.3%) of 99 patients in the control group had postoperative pulmonary complications (risk ratio, 0.23; 95% confidence interval (CI), 0.09–0.58, P = 0.002). The study revealed that, compared with the control group, the intervention group had a significant increase in inspiratory muscle strength (by 10.48 cm H2O, P < 0.001), forced expiratory volume in the first second of expiration (FEV1) %predicted (by 3.75%, P = 0.030), forced vital capacity (FVC) %predicted (by 4.15%, P = 0.008) and maximal voluntary ventilation (MVV) %predicted (by 6.44%, P = 0.034). Length of hospital stay was 7.51 (2.83) days in the intervention group and 9.38 (3.10) days in the control group ( P = 0.039). Conclusion: A five-day intensive pattern of preoperative inspiratory muscle training reduced the incidence of postoperative pulmonary complications and duration of postoperative hospitalization in patients undergoing cardiac surgery.

scholarly journals The effects of inspiratory muscle training on plasma interleukin-6 concentration during cycling exercise and a volitional mimic of the exercise hyperpnea

2013 ◽  
Vol 115 (8) ◽  
pp. 1163-1172 ◽  
Author(s):  
Dean E. Mills ◽  
Michael A. Johnson ◽  
Martin J. McPhilimey ◽  
Neil C. Williams ◽  
Javier T. Gonzalez ◽  
...  
Keyword(s):  
Interleukin 6 ◽  
Respiratory Muscles ◽  
Inspiratory Muscle ◽  
Inspiratory Muscle Training ◽  
Muscle Training ◽  
Cycling Exercise ◽  
Main Effect ◽  
Exercise Hyperpnea ◽  
Exercise Induced ◽  
Diaphragm Fatigue

It is unknown whether the respiratory muscles contribute to exercise-induced increases in plasma interleukin-6 (IL-6) concentration, if this is related to diaphragm fatigue, and whether inspiratory muscle training (IMT) attenuates the plasma IL-6 response to whole body exercise and/or a volitional mimic of the exercise hyperpnea. Twelve healthy males were divided equally into an IMT or placebo (PLA) group, and before and after a 6-wk intervention they undertook, on separate days, 1 h of 1) passive rest, 2) cycling exercise at estimated maximal lactate steady state power (EX), and 3) volitional hyperpnea at rest, which mimicked the breathing and respiratory muscle recruitment patterns achieved during EX (HYPEX). Plasma IL-6 concentration remained unchanged during passive rest. The plasma IL-6 response to EX was reduced following IMT (main effect of intervention, P = 0.039) but not PLA ( P = 0.272). Plasma IL-6 concentration increased during HYPEX (main effect of time, P < 0.01) and was unchanged postintervention. There was no evidence of diaphragm fatigue (measured by phrenic nerve stimulation) following each trial. In conclusion, plasma IL-6 concentration is increased during EX and HYPEX and this occurred in the absence of diaphragm fatigue. Furthermore, IMT reduced the plasma IL-6 response to EX but not HYPEX. These findings suggest that the respiratory muscles contribute to exercise-induced increases in plasma IL-6 concentration in the absence of diaphragm fatigue and that IMT can reduce the magnitude of the response to exercise but not a volitional mimic of the exercise hyperpnea.

scholarly journals Congenital laryngomalacia is related to exercise-induced laryngeal obstruction in adolescence

2016 ◽  
Vol 101 (5) ◽  
pp. 443-448 ◽  
Author(s):  
Magnus Hilland ◽  
Ola Drange Røksund ◽  
Lorentz Sandvik ◽  
Øystein Haaland ◽  
Hans Jørgen Aarstad ◽  
...  
Keyword(s):  
Exercise Test ◽  
Quality Criteria ◽  
Later Life ◽  
University Hospital ◽  
Respiratory Morbidity ◽  
Control Group ◽  
Laryngeal Obstruction ◽  
Standard Quality ◽  
Exercise Induced ◽  
Laryngeal Anatomy

ObjectivesCongenital laryngomalacia (CLM) is the major cause of stridor in infants. Most cases are expected to resolve before 2 years of age, but long-term respiratory prospects are poorly described. We aimed to investigate if CLM was associated with altered laryngeal structure or function in later life.MethodsTwenty of 23 (87%) infants hospitalised at Haukeland University Hospital during 1990–2000 for CLM without comorbidities and matched controls were assessed at mean age 13 years. Past and current respiratory morbidity was recorded in a questionnaire, and spirometry performed according to standard quality criteria. Laryngoscopy was performed at rest and continuously throughout a maximal treadmill exercise test (continuous laryngoscopy exercise test (CLE-test)), and scored and classified in a blinded fashion according to preset criteria.ResultsIn the CLM group, laryngeal anatomy supporting CLM in infancy was described at rest in nine (45%) adolescents. Eleven (55%) reported breathing difficulties in relation to exercise, of whom 7 had similarities to CLM at rest and 10 had supraglottic obstruction during CLE-test. Overall, 6/20 had symptoms during exercise and similarities to CLM at rest and obstruction during CLE-test. In the control group, one adolescent reported breathing difficulty during exercise and two had laryngeal obstruction during CLE-test. The two groups differed significantly from each other regarding laryngoscopy scores, obtained at rest and during exercise (p=0.001 or less).ConclusionsCLM had left footprints that increased the risk of later exercise-induced symptoms and laryngeal obstruction. The findings underline the heterogeneity of childhood respiratory disease and the importance of considering early life factors.

scholarly journals Effects of Inspiratory Muscles Training Plus Rib Cage Mobilization on Chest Expansion, Inspiratory Accessory Muscles Activity and Pulmonary Function in Stroke Patients

2020 ◽  
Vol 10 (15) ◽  
pp. 5178
Author(s):  
Shin Jun Park
Keyword(s):  
Pulmonary Function ◽  
Muscle Activity ◽  
Inspiratory Muscle ◽  
Inspiratory Muscle Training ◽  
Control Group ◽  
Muscle Training ◽  
Rib Cage ◽  
Joint Mobilization ◽  
Chest Expansion ◽  
Inspiratory Muscles

After stroke, limited ribcage movement may lead to impaired respiratory function. Combining threshold inspiratory muscle training with rib cage joint mobilization has been shown to enhance the recovery of respiratory function in patients with stroke. The present study investigated whether the combination of rib cage joint mobilization and inspiratory muscle training would improve chest expansion, inspiratory muscle activity, and pulmonary function after stroke. Thirty stroke patients were recruited and randomly assigned to one of the two groups, namely 6-week rib cage joint mobilization with inspiratory muscle training (experimental group) or inspiratory muscle training alone (control group). Outcome measures included upper and lower chest expansion, activity of accessory inspiratory muscles (latissimus dorsi (LD) and upper trapezius (UT)), and pulmonary function (forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), and peak expiratory flow (PEF)). All evaluations were conducted at baseline and after 6 weeks of inspiratory muscle training. Significant increases were observed in upper and lower chest expansion, LD and UT muscle activity, FVC, FEV1, and PEF in both the groups. Upper and lower chest expansion and muscle activity of UT and LD were significantly higher in the experimental group than in the control group. No significant differences were observed in FVC, FEV1, and PEF between the groups. Inspiratory muscle training is effective in improving chest expansion, inspiratory muscle activity, and pulmonary function after stroke. The addition of rib cage joint mobilization further increases chest expansion and inspiratory muscle activity.

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