Walking training augments the effects of expiratory muscle training in Parkinson's disease

Objective: To compare the effects of an inspiratory versus and expiratory muscle-training program on voluntary and reflex peak cough flow in patients with Parkinson disease. Design: A randomized controlled study. Setting: Home-based training program. Participants: In all, 40 participants with diagnosis of Parkinson’s disease were initially recruited in the study and randomly allocated to three study groups. Of them, 31 participants completed the study protocol (control group, n = 10; inspiratory training group, n = 11; and expiratory training group, n = 10) Intervention: The inspiratory and expiratory group performed a home-based inspiratory and expiratory muscle-training program, respectively (five sets of five repetitions). Both groups trained six times a week for two months using a progressively increased resistance. The control group performed expiratory muscle training using the same protocol and a fixed resistance. Main measures: Spirometric indices, maximum inspiratory pressure, maximum expiratory pressure, and peak cough flow during voluntary and reflex cough were assessed before and at two months after training. Results: The magnitude of increase in maximum expiratory pressure ( d = 1.40) and voluntary peak cough flow ( d = 0.89) was greater for the expiratory muscle-training group in comparison to the control group. Reflex peak cough flow had a moderate effect ( d = 0.27) in the expiratory group in comparison to the control group. Slow vital capacity ( d = 0.13) and forced vital capacity ( d = 0.02) had trivial effects in the expiratory versus the control group. Conclusions: Two months of expiratory muscle-training program was more beneficial than inspiratory muscle-training program for improving maximum expiratory pressure and voluntary peak cough flow in patients with Parkinson’s disease.

Download Full-text

Detraining Effect on Pulmonary and Cardiovascular Autonomic Function and Functional Outcomes in Patients With Parkinson's Disease After Respiratory Muscle Training: An 18-Month Follow-Up Study

Frontiers in Neurology ◽

10.3389/fneur.2021.735847 ◽

2021 ◽

Vol 12 ◽

Author(s):

Chih-Cheng Huang ◽

Yun-Ru Lai ◽

Fu-An Wu ◽

Nai-Ying Kuo ◽

Ben-Chung Cheng ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Pulmonary Function ◽

Functional Outcomes ◽

Respiratory Muscle ◽

Autonomic Function ◽

Clinical Severity ◽

Respiratory Muscle Training ◽

Muscle Training ◽

Cardiovascular Autonomic Function

Background: The effect of 3-month respiratory muscle training (RMT) on pulmonary and autonomic function and functional outcomes has been demonstrated in patients with Parkinson's disease (PD); however, there is a paucity of information on the durability of the training effect. In this study, we monitored the pulmonary and cardiovascular autonomic function and clinical severity scales until 18 months after the cessation of RMT to elucidate the detraining effect after RMT.Methods: All patients with PD receiving RMT were assessed with clinical severity scales as well as pulmonary and autonomic function tests at four different stages (baseline on enrollment, immediately after 3 months of RMT, and 6 and 18 months after cessation of RMT). A control group of PD patients who did not receive RMT was also recruited for comparison. Pulmonary function parameters, including forced vital capacity (FVC), forced expiratory volume in one second (FEV1), maximum inspiratory pressure (MIP), and maximum expiratory pressure (MEP), were assessed. Cardiovascular autonomic function was assessed using measures including heart rate response to deep breathing (HRDB), Valsalva ratio, and baroreflex sensitivity. Clinical severity scores were also measured using the Hoehn and Yahr staging and the Unified Parkinson's Disease Rating Scale (UPDRS).Results: The results showed significant improvements in MIP, MEP, HRDB, and UPDRS immediately after RMT. Despite some decay, the improvements in pulmonary function (MIP and MEP) and functional outcomes (UPDRS) remained significant until 6 months of detraining (9 months after enrollment). However, the improvement in cardiovascular autonomic function (HRDB) was reversed after 6 months of detraining.Conclusions: Based on these findings, we recommend that RMT may be repeated after at least 6 months after previous session (9 months after enrollment) for patients with PD to maintain optimal therapeutic effects.

Download Full-text

Respiratory muscle training in patients with Parkinson's disease

http://isrctn.com/ ◽

10.1186/isrctn10301406 ◽

2018 ◽

Author(s):

Alvaro Reyes

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Respiratory Muscle ◽

Respiratory Muscle Training ◽

Muscle Training

Download Full-text

Effect of simultaneous application of postural techniques and expiratory muscle strength training on the enhancement of the swallowing function of patients with dysphagia caused by Parkinson’s disease

Journal of Physical Therapy Science ◽

10.1589/jpts.28.1840 ◽

2016 ◽

Vol 28 (6) ◽

pp. 1840-1843 ◽

Cited By ~ 6

Author(s):

Haewon Byeon

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Muscle Strength ◽

Strength Training ◽

Swallowing Function ◽

Simultaneous Application ◽

Expiratory Muscle ◽

Expiratory Muscle Strength Training

Download Full-text

Simultaneously Improved Pulmonary and Cardiovascular Autonomic Function and Short-Term Functional Outcomes in Patients with Parkinson’s Disease after Respiratory Muscle Training

Journal of Clinical Medicine ◽

10.3390/jcm9020316 ◽

2020 ◽

Vol 9 (2) ◽

pp. 316

Author(s):

Chih-Cheng Huang ◽

Yun-Ru Lai ◽

Fu-An Wu ◽

Nai-Ying Kuo ◽

Yuh-Chyn Tsai ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Pulmonary Function ◽

Functional Outcomes ◽

Respiratory Muscle ◽

Autonomic Function ◽

Respiratory Muscle Training ◽

Muscle Training ◽

Short Term ◽

Cardiovascular Autonomic Function

Both pulmonary function and autonomic function are impaired in patients with Parkinson’s diseases (PD). This study tested the hypothesis that respiratory muscle training (RMT) can not only improve pulmonary function, but also simultaneously improve cardiovascular autonomic function and short-term functional outcomes in patients with PD. Pulmonary function was measured by the forced vital capacity (FVC), forced expiratory volume in one second (FEV1), maximum inspiratory pressures (MIP), and maximum expiratory pressures (MEP). Cardiovascular autonomic function was measured by the heart rate response to deep breathing (HRDB), Valsalva ratio, baroreflex sensitivity, and spectral analysis. The functional and severity scores were measured by the Hoehn and Yahr stage and Unified Parkinson’s Disease Rating Scale (UPDRS). These measures were evaluated in patients with PD before and after 3 months of RMT, compared with a control group of PD patients without RMT. The results showed significant improvement of clinical scores (total UPDRS and UPDRS I, II and III) after RMT (p < 0.0001). Concerning pulmonary function, the parameters of MIP and MEP improved significantly. The parameters of cardiovascular function also improved after RMT, although only HRDB reached statistical significance. Based on the results of our study, RMT can not only improve both pulmonary and cardiovascular autonomic function, but can also improve short-term functional outcomes in patients with PD.

Download Full-text

Respiratory muscle training and vibrational therapy in patients with Parkinson’s disease

Revista Neurociências ◽

10.4181/rnc.2015.23.04.1097.07p ◽

2015 ◽

Vol 23 (04) ◽

pp. 479-485

Author(s):

Andreia Moreira ◽

Maria Luiza Galvão ◽

Hayslenne Araújo ◽

Adriana Silva ◽

Luciana Reis ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Respiratory Muscle ◽

Respiratory Muscle Training ◽

Muscle Training

Download Full-text

Effects of Inspiratory Muscle Training in Patients With Parkinson's Disease

Case Medical Research ◽

10.31525/ct1-nct04228887 ◽

2020 ◽

Author(s):

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Inspiratory Muscle ◽

Inspiratory Muscle Training ◽

Muscle Training

Download Full-text

Mechanisms for Successful Rehabilitation of Cough in Parkinson's Disease Using Expiratory Muscle Strength Training

Perspectives of the ASHA Special Interest Groups ◽

10.1044/persp2.sig13.93 ◽

2017 ◽

Vol 2 (13) ◽

pp. 93-102

Author(s):

Alyssa Huff ◽

Alyssa Brown ◽

Barbara K. Smith ◽

Teresa Pitts

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Muscle Strength ◽

Strength Training ◽

Speech Language Pathology ◽

Expiratory Muscle ◽

Language Pathology ◽

Maximum Expiratory Pressure ◽

Expiratory Muscle Strength Training ◽

The Relationship

Rehabilitation of cough is now moving under the purview of speech-language pathology as our understanding of the relationship between disorders of cough and swallow increases. The purpose of this review is to provide a guide in understanding the mechanisms of weak or disordered cough in Parkinson's disease, and mechanisms for why expiratory muscle strength training is an effective therapy. Additionally, this review provides resources for performing clinical evaluations of maximum expiratory pressure and dosage information for expiratory muscle strength training.

Download Full-text