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.

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 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 Influence of oxidative stress, diaphragm fatigue, and inspiratory muscle training on the plasma cytokine response to maximum sustainable voluntary ventilation

2014 ◽  
Vol 116 (8) ◽  
pp. 970-979 ◽  
Author(s):  
Dean E. Mills ◽  
Michael A. Johnson ◽  
Martin J. McPhilimey ◽  
Neil C. Williams ◽  
Javier T. Gonzalez ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Dna Damage ◽  
Respiratory Muscle ◽  
Minute Ventilation ◽  
Inspiratory Muscle ◽  
Inspiratory Muscle Training ◽  
Muscle Training ◽  
Muscle Work ◽  
Main Effect ◽  
Diaphragm Fatigue

The influence of oxidative stress, diaphragm fatigue, and inspiratory muscle training (IMT) on the cytokine response to maximum sustainable voluntary ventilation (MSVV) is unknown. 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 and ( 2) MSVV, whereby participants undertook volitional hyperpnea at rest that mimicked the breathing and respiratory muscle recruitment patterns commensurate with heavy cycling exercise. Plasma cytokines remained unchanged during passive rest. There was a main effect of time ( P < 0.01) for plasma interleukin-1β (IL-1β) and interleukin-6 (IL-6) concentrations and a strong trend ( P = 0.067) for plasma interleukin-1 receptor antagonist concentration during MSVV. Plasma IL-6 concentration was reduced after IMT by 27 ± 18% (main effect of intervention, P = 0.029), whereas there was no change after PLA ( P = 0.753). There was no increase in a systemic marker of oxidative stress [DNA damage in peripheral blood mononuclear cells (PBMC)], and diaphragm fatigue was not related to the increases in plasma IL-1β and IL-6 concentrations. A dose-response relationship was observed between respiratory muscle work and minute ventilation and increases in plasma IL-6 concentration. In conclusion, increases in plasma IL-1β and IL-6 concentrations during MSVV were not due to diaphragm fatigue or DNA damage in PBMC. Increases in plasma IL-6 concentration during MSVV are attenuated following IMT, and the plasma IL-6 response is dependent upon the level of respiratory muscle work and minute ventilation.

Does Inspiratory Muscle Training Reduce Exercise-Induced Arterial Hypoxemia in Female Rowers?

2007 ◽  
Vol 39 (Supplement) ◽  
pp. S149-S150
Author(s):  
Ioannis S. Vrabas ◽  
Christos S. Riganas ◽  
Nicholaos I. Benaxides ◽  
Konstantinos Mandroukas
Keyword(s):  
Inspiratory Muscle ◽  
Inspiratory Muscle Training ◽  
Muscle Training ◽  
Arterial Hypoxemia ◽  
Exercise Induced

The role of inspiratory muscle training in the management of asthma and exercise-induced bronchoconstriction

2016 ◽  
Vol 44 (4) ◽  
pp. 327-334 ◽  
Author(s):  
Ren-Jay Shei ◽  
Hunter L. R. Paris ◽  
Daniel P. Wilhite ◽  
Robert F. Chapman ◽  
Timothy D. Mickleborough
Keyword(s):  
Inspiratory Muscle ◽  
Inspiratory Muscle Training ◽  
Muscle Training ◽  
Exercise Induced

Inspiratory muscle training (IMT) in unilateral diaphragmatic dysfunction: case reports

2019 ◽  
Author(s):  
Mayra Caleffi Pereira ◽  
Sauwaluk Dacha ◽  
Dries Testelmans ◽  
Rik Gosselink ◽  
Daniel Langer
Keyword(s):  
Case Reports ◽  
Inspiratory Muscle ◽  
Inspiratory Muscle Training ◽  
Muscle Training ◽  
Diaphragmatic Dysfunction

scholarly journals Inspiratory Muscle Training in Children: Moderate Loads (60%) Are Safe and Promote an Increase in PIMAX

2020 ◽  
Author(s):  
Milena Siciliano Nascimento ◽  
Cristiane do Prado ◽  
Fernanda Ejzenberg ◽  
Simone Sayuri Kushida ◽  
Amanda Fontes ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Case Reports ◽  
Prolonged Mechanical Ventilation ◽  
Pediatric Population ◽  
Inspiratory Muscle ◽  
Inspiratory Muscle Training ◽  
Muscle Training ◽  
Occlusion Time ◽  
Weaning Failure ◽  
Significant Difference

Abstract Background: Weaning failure are complex outcomes as it involves some aspects including weakness of the respiratory muscles. Ventilator-induced diaphragmatic dysfunction has been described as one of the main complications of IMV. Inspiratory muscle training with moderate loads was described in adults as having excellent results in terms of disconnection from the IMV literature. On pediatric population there is still a scarcity of and most of it consists of descriptions of isolated case reports. Methods: This study aims at evaluating whether muscle training using moderate loads will cause an increase in maximal inspiratory pressure (PIMAX) in patients dependent on mechanical ventilation. This is a retrospective study conducted in 2 Pediatric Intensive Care Units from January 2016 to December 2017. All patients who underwent muscle training during the period of the study were included. PIMAX was measured using a manovacuometer. Three measurements were made with an occlusion time of 15 seconds and a recovery interval of 2 minutes between them. Muscle training was performed following the institutional protocol (4 sets of 6 repetitions with a load equivalent to 60% of PIMAX) 1x/day, 6 days a week, excluding the day of the measurement of PIMAX. Results: Six patients undergoing prolonged mechanical ventilation (average time of mechanical ventilation of 9647 hours) who underwent muscle training to disconnect mechanical ventilation were included. The measurements of PIMAX pre-training were compared to weeks 1 to 4. A significant difference on PIMAX was observed after the second week of training (p <0.001). Five patients progressed to IMV disconnection. Conclusion: Our study supports the performance of IMT using moderate loads (60%), with no risk of muscle fatigue as it resulted in a significant increase in PIMAX after 2 weeks of training, with positive outcomes regarding weaning from mechanical ventilation.

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