scholarly journals Inspiratory Muscle Training and the Perception of Dyspnea in Parkinson's Disease

2005 ◽  
Vol 32 (2) ◽  
pp. 213-217 ◽  
Author(s):  
Rivka Inzelberg ◽  
Nana Peleg ◽  
Puiu Nisipeanu ◽  
Rasmi Magadle ◽  
Ralph L. Carasso ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Muscle Strength ◽  
Respiratory Muscle ◽  
Inspiratory Muscle ◽  
Inspiratory Muscle Training ◽  
Muscle Performance ◽  
Training Period ◽  
Muscle Training ◽  
Pulmonary Functions

ABSTRACT:Background:Pulmonary and respiratory muscle function impairment are common in patients with Parkinson's disease (PD). Inspiratory muscle training may improve strength, dyspnea and functional capacity in healthy subjects and in those with chronic obstructive pulmonary disease. This study investigated the effect of specific inspiratory muscle training (SIMT) on pulmonary functions, inspiratory muscle performance, dyspnea and quality of life, in patients with PD.Patients and Methods:Twenty patients with PD (stage II and III Hoehn and Yahr scale) were recruited for the study and were divided into two groups: a) ten patients who received SIMT and b) ten patients who received sham training, for three months. Pulmonary functions, the respiratory muscle strength and endurance, the perception of dyspnea (POD) and the quality of life were studied before and within one week after the training period. All subjects trained daily, six times a week, each session consisting of 1/2 hour, for 12 weeks.Results:Following the training period, there was a significant improvement, in the training group but not in the control group, in the following parameters: inspiratory muscle strength, (PImax, increased from 62.0±8.2 to 78.0±7.5 cm of H2O (p<0.05), inspiratory muscle endurance (increased from 20.0±2.8 to 29.0±3.0 cm of H2O (p<0.05), and the POD (decreased from 17.9±3.2 to 14.0±2.4 units (p<0.05). There was a close correlation between the increase in the inspiratory muscle performance and the decrease in the POD.Conclusions:The inspiratory muscle performance may be improved by SIMT in patients with PD. This improvement is associated with a significant decrease in their POD.

scholarly journals Inspiratory muscle training in children and adolescents living with neuromuscular diseases: A pre-experimental study

2021 ◽  
Vol 77 (1) ◽  
Author(s):  
Anri Human ◽  
Brenda M. Morrow
Keyword(s):  
Quality Of Life ◽  
Muscle Strength ◽  
Respiratory Muscle ◽  
Neuromuscular Diseases ◽  
Inspiratory Muscle ◽  
Inspiratory Muscle Training ◽  
Muscle Training ◽  
Upper Limb Function ◽  
Inspiratory Muscle Strength

Background: Children with neuromuscular diseases (NMD) are at risk of morbidity and mortality because of progressive respiratory muscle weakness and ineffective cough. Inspiratory muscle training (IMT) aims to preserve or improve respiratory muscle strength, thereby reducing morbidity and improving health-related quality of life (HRQoL).Objectives: To describe the safety and feasibility of a 6-week IMT programme using an electronic threshold device (Powerbreathe®). Any adverse events and changes in functional ability, spirometry, peak expiratory cough flow (PECF), inspiratory muscle strength and HRQoL (Pediatric Quality of Life [PedsQL]) were recorded.Methods: A convenience sample of eight participants (n = 4 boys; median [interquartile range {IQR}] age: 12.21 [9.63–16.05] years) with various NMD were included in a pre-experimental, observational pre-test post-test feasibility study. Training consisted of 30 breaths, twice daily, 5 days a week, for 6 weeks.Results: There were significant pre- to post-intervention improvements in upper limb function and coordination (p = 0.03) and inspiratory muscle strength: maximum inspiratory mouth pressure (Pimax) (p = 0.01); strength-index (p = 0.02); peak inspiratory flow (PIF) (p = 0.02), with no evidence of change in spirometry, PECF or HRQoL. No adverse events occurred and participant satisfaction and adherence levels were high.Conclusion: Inspiratory muscle training (at an intensity of 30% Pimax) appears safe, feasible and acceptable, in a small sample of children and adolescents with NMD and was associated with improved inspiratory muscle strength, PIF and upper limb function and coordination.Clinical implications: Larger, longer-term randomised controlled trials are warranted to confirm the safety and efficacy of IMT as an adjunct respiratory management strategy in children with NMD.

Impact of respiratory muscle training on respiratory muscle strength, respiratory function and quality of life in individuals with tetraplegia: a randomised clinical trial

Thorax ◽  
2020 ◽  
Vol 75 (3) ◽  
pp. 279-288 ◽  
Author(s):  
Claire L Boswell-Ruys ◽  
Chaminda R H Lewis ◽  
Nirupama S Wijeysuriya ◽  
Rachel A McBain ◽  
Bonsan Bonne Lee ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Muscle Strength ◽  
Lung Function ◽  
Respiratory Muscle ◽  
Respiratory Health ◽  
Inspiratory Muscle ◽  
Respiratory Muscle Training ◽  
Muscle Training ◽  
Inspiratory Muscle Strength

BackgroundRespiratory complications remain a leading cause of morbidity and mortality in people with acute and chronic tetraplegia. Respiratory muscle weakness following spinal cord injury-induced tetraplegia impairs lung function and the ability to cough. In particular, inspiratory muscle strength has been identified as the best predictor of the likelihood of developing pneumonia in individuals with tetraplegia. We hypothesised that 6 weeks of progressive respiratory muscle training (RMT) increases respiratory muscle strength with improvements in lung function, quality of life and respiratory health.MethodsSixty-two adults with tetraplegia participated in a double-blind randomised controlled trial. Active or sham RMT was performed twice daily for 6 weeks. Inspiratory muscle strength, measured as maximal inspiratory pressure (PImax) was the primary outcome. Secondary outcomes included lung function, quality of life and respiratory health. Between-group comparisons were obtained with linear models adjusting for baseline values of the outcomes.ResultsAfter 6 weeks, there was a greater improvement in PImax in the active group than in the sham group (mean difference 11.5 cmH2O (95% CI 5.6 to 17.4), p<0.001) and respiratory symptoms were reduced (St George Respiratory Questionnaire mean difference 10.3 points (0.01–20.65), p=0.046). Significant improvements were observed in quality of life (EuroQol-Five Dimensional Visual Analogue Scale 14.9 points (1.9–27.9), p=0.023) and perceived breathlessness (Borg score 0.64 (0.11–1.17), p=0.021). There were no significant improvements in other measures of respiratory function (p=0.126–0.979).ConclusionsProgressive RMT increases inspiratory muscle strength in people with tetraplegia, by a magnitude which is likely to be clinically significant. Measurement of baseline PImax and provision of RMT to at-risk individuals may reduce respiratory complications after tetraplegia.Trial registration numberAustralian New Zealand Clinical Trials Registry (ACTRN 12612000929808).

Inspiratory muscle training improves pulmonary functions and respiratory muscle strength in healthy male smokers

2019 ◽  
Vol 264 ◽  
pp. 28-32 ◽  
Author(s):  
Özgür Bostanci ◽  
Hakan Mayda ◽  
Coşkun Yılmaz ◽  
Menderes Kabadayı ◽  
Ali Kerim Yılmaz ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Respiratory Muscle ◽  
Inspiratory Muscle ◽  
Inspiratory Muscle Training ◽  
Respiratory Muscle Strength ◽  
Healthy Male ◽  
Muscle Training ◽  
Pulmonary Functions

Inspiratory muscle training in severe spinal muscular atrophy: a case report

2019 ◽  
Vol 26 (4) ◽  
pp. 1-19
Author(s):  
Anri Human ◽  
Engela Honey ◽  
Brenda Morrow
Keyword(s):  
Quality Of Life ◽  
Muscle Strength ◽  
Muscular Atrophy ◽  
Inspiratory Muscle ◽  
Inspiratory Muscle Training ◽  
Health Related Quality ◽  
Muscle Training ◽  
Related Quality ◽  
Health Related

Background/Aims Inspiratory muscle training aims to preserve or improve respiratory muscle strength in children with neuromuscular diseases in order to prevent or minimise pulmonary morbidity. The aim of this study was to determine the effect of inspiratory muscle training on clinical outcomes and health-related quality of life in a child with advanced neuromuscular disease and severe pulmonary restriction. Methods A one patient pre-test post-test study design was implemented. General function, spirometry, peak expiratory cough flow and health-related quality of life were measured at baseline and after a 6-week inspiratory muscle training programme. Inspiratory muscle strength (maximal inspiratory mouth pressure and sniff nasal inspiratory pressure) was measured every 2 weeks. The patient used a tapered flow threshold inspiratory training device (POWERbreathe K3) at an intensity of ± 30% of maximal inspiratory mouth pressure twice a day, 5 days per week. Findings The non-ambulatory 10-year-old girl with type 2 spinal muscular atrophy initially had a forced vital capacity of 18% predicted and peak expiratory cough flow of 60 litres/minute. A substantial improvement was seen in inspiratory muscle strength between baseline and 4 weeks. Patient health-related quality of life improved and patient satisfaction was high, with a score of 9/10. The patient developed a lower respiratory tract infection towards the end of the inspiratory muscle training period. No other adverse events occurred. Conclusions Improved inspiratory muscle strength and health-related quality of life was associated with inspiratory muscle training in a child with advanced spinal muscular atrophy. Controlled clinical trials are recommended to determine the safety and efficacy of inspiratory muscle training in children with advanced spinal muscular atrophy and severe respiratory muscle weakness to inform clinical practice.

scholarly journals Does Mechanical Threshold Inspiratory Muscle Training Promote Recovery and Improve Outcomes in Ventilator-Dependent ICU Patients? The IMPROVE Randomised Trial.

2021 ◽  
Author(s):  
Bernie Bissett ◽  
I Anne Leditschke ◽  
Teresa Neeman ◽  
Margot Green ◽  
Vince Marzano ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Resistance Index ◽  
Training Group ◽  
Inspiratory Muscle ◽  
Inspiratory Muscle Training ◽  
Muscle Training ◽  
Icu Patients ◽  
Mechanical Threshold ◽  
Inspiratory Muscle Strength

Abstract Background: In ventilator-dependent ICU patients, inspiratory muscle training may improve inspiratory muscle strength and accelerate liberation from the ventilator, but optimal training parameters are yet to be established and little is known about the impact of inspiratory muscle training on quality of life or dyspnea. Thus we sough to ascertain whether inspiratory muscle training, commenced while ventilator-dependent, would improve outcomes for ICU patients invasively ventilated for 7 days or longer.Methods: In this randomized trial with assessor-blinding and intention-to-treat analysis, 70 participants (mechanically ventilated ≥7 days) were randomized to receive once- daily supervised high-intensity inspiratory muscle training with a mechanical threshold device in addition to usual care, or usual care (control). Primary outcomes were inspiratory muscle strength (maximum inspiratory pressure % predicted) and endurance (fatigue resistance index) at ventilator-liberation and 1 week later, and quality of life (SF-36v2, EQ-5D). Secondary outcomes included dyspnea, physical function, duration of ventilation and in-hospital mortality.Results: 33 participants were randomly allocated to the training group and 37 to control. There were no statistically significant differences in strength (maximum inspiratory pressure) (95% CI -7.4 to 14.0) or endurance (fatigue resistance index) (95% CI -0.003 to 0.436). Quality of life improved significantly more in the training group than control (EQ5D 17.2; 95% CI 1.3-33.0) (SF36-PCS 6.97; 96%CI 1.96-12.00). Only the training group demonstrated significant reductions in dyspnea (-1.5 at rest, -1.9 during exercise). There were no between-group differences in duration of ventilation or other measures. In-hospital mortality was higher in the control group than the training group (9 vs 4, 24% vs 12%, p=0.23).Conclusions: In ventilator-dependent patients, mechanical threshold loading inspiratory muscle training improves quality of life and dyspnea, even in the absence of strength improvements or acceleration of ventilator liberation. Trial registration: ACTRN12610001089022 https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12610001089022Trial protocol: http://bmjopen.bmj.com/content/2/2/e000813.full

scholarly journals Application of Inspiratory Muscle Training to Improve Physical Tolerance in Older Patients with Ischemic Heart Failure

2021 ◽  
Vol 18 (23) ◽  
pp. 12441
Author(s):  
Monika Piotrowska ◽  
Paulina Okrzymowska ◽  
Wojciech Kucharski ◽  
Krystyna Rożek-Piechura
Keyword(s):  
Heart Failure ◽  
Muscle Strength ◽  
Cardiac Rehabilitation ◽  
Exercise Tolerance ◽  
Respiratory Muscle ◽  
Inspiratory Muscle ◽  
Inspiratory Muscle Training ◽  
Respiratory Muscle Strength ◽  
Muscle Training ◽  
Patients With Heart Failure

Regardless of the management regime for heart failure (HF), there is strong evidence supporting the early implementation of exercise-based cardiac rehabilitation (CR). Respiratory therapy is considered to be an integral part of such secondary prevention protocols. The aim of the study was to evaluate the effect of inspiratory muscle training (IMT) on exercise tolerance and the functional parameters of the respiratory system in patients with heart failure involved in cardiac rehabilitation. The study included 90 patients with HF who took part in the second-stage 8-week cycle of cardiac rehabilitation (CR). They were randomly divided into three groups: Group I underwent CR and IMT; Group II only CR; and patients in Group III underwent only the IMT. Before and after the 8-week cycle, participants were assessed for exercise tolerance and the functional parameters of respiratory muscle strength. Significant statistical improvement concerned the majority of the hemodynamic parameters, lung function parameters, and respiratory muscle strength in the first group. Moreover, the enhancement in the exercise tolerance in the CR + IMT group was accompanied by a negligible change in the HRpeak. The results confirm that the addition of IMT to the standard rehabilitation process of patients with heart failure can increase the therapeutic effect while influencing some of the parameters measured by exercise electrocardiography and respiratory function.

Inspiratory muscle training does not improve clinical outcomes in 3-week COPD rehabilitation: results from a randomised controlled trial

2018 ◽  
Vol 51 (1) ◽  
pp. 1702000 ◽  
Author(s):  
Konrad Schultz ◽  
Danijel Jelusic ◽  
Michael Wittmann ◽  
Benjamin Krämer ◽  
Veronika Huber ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pulmonary Rehabilitation ◽  
Controlled Trial ◽  
Intervention Group ◽  
Inspiratory Muscle ◽  
Inspiratory Muscle Training ◽  
Chronic Obstructive ◽  
Muscle Training ◽  
Randomised Controlled

The value of inspiratory muscle training (IMT) in pulmonary rehabilitation in chronic obstructive pulmonary disease (COPD) is unclear. The RIMTCORE (Routine Inspiratory Muscle Training within COPD Rehabilitation) randomised controlled trial examined the effectiveness of IMT added to pulmonary rehabilitation.In total, 611 COPD patients (Global Initiative for Chronic Obstructive Lung Disease stage II–IV) received a 3-week inpatient pulmonary rehabilitation, of which 602 patients were included in the intention-to-treat analyses. The intervention group (n=300) received highly intensive IMT and the control group (n=302) received sham IMT. The primary outcome was maximal inspiratory pressure (PImax). The secondary outcomes were 6-min walk distance, dyspnoea, quality of life and lung function. Outcomes were assessed pre- and post-pulmonary rehabilitation. ANCOVA was used.The intervention group showed higher effects in PImax (p<0.001) and forced inspiratory volume in 1 s (p=0.013). All other outcomes in both study groups improved significantly, but without further between-group differences. Sex and pulmonary rehabilitation admission shortly after hospitalisation modified quality of life effects.IMT as an add-on to a 3-week pulmonary rehabilitation improves inspiratory muscle strength, but does not provide additional benefits in terms of exercise capacity, quality of life or dyspnoea. A general recommendation for COPD patients to add IMT to a 3-week pulmonary rehabilitation cannot be made.

Case Studies in Physiology: Cardiopulmonary exercise testing and inspiratory muscle training in a 59-year-old, four years after an extra-pleural pneumonectomy

2021 ◽  
Author(s):  
Reid A. Mitchell ◽  
Scott T. Apperely ◽  
Satvir S. Dhillon ◽  
Julia Zhang ◽  
Kyle G. Boyle ◽  
...  
Keyword(s):  
Case Report ◽  
Muscle Strength ◽  
Exercise Test ◽  
Respiratory Muscle ◽  
Cardiopulmonary Exercise Testing ◽  
Work Rate ◽  
Inspiratory Muscle ◽  
Inspiratory Muscle Training ◽  
Respiratory Muscle Strength ◽  
Muscle Training

This case report characterizes the physiological responses to incremental cycling and determines the effects of 12 weeks of inspiratory muscle training (IMT) on respiratory muscle strength, exercise capacity and dyspnea in a physically active 59-year-old female, four years after a left-sided extra-pleural pneumonectomy (EPP). On separate days, a symptom limited incremental exercise test and a constant work rate (CWR) test at 75% of peak work rate (WR) were completed, followed by 12 weeks of IMT and another CWR test. IMT consisted of two sessions of 30 repetitions twice daily for 5 days per week. Physiological and perceptual variables were measured throughout each exercise test. The participant had a total lung capacity that was 43% predicted post-EPP. A rapid and shallow breathing pattern was adopted throughout exercise, and the ratio of minute ventilation to carbon dioxide output was elevated for a given work rate. Oxygen uptake was 74%predicted and WR was 88%predicted. Following IMT, maximal inspiratory pressure improved by 36% (-27.1 cmH2O) and endurance time by 31s, with no observable changes in any submaximal or peak cardiorespiratory variables during exercise. The intensity and unpleasantness of dyspnea increased by 2 and 3 Borg 0-10 units, respectively, at the highest equivalent submaximal exercise time achieved on both tests. Despite having undergone a significant reduction in lung volume post-EPP, the participant achieved a relatively normal peak incremental WR, which may reflect a high level of physical conditioning. This case report also demonstrates that IMT can effectively increase respiratory muscle strength several years following EPP.

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