Efficacy of inspiratory muscle training on inspiratory muscle function, functional capacity, and quality of life in patients with asthma: A randomized controlled trial

2021 ◽  
pp. 026921552098404
Author(s):  
Susan Martins Lage ◽  
Danielle Aparecida Gomes Pereira ◽  
Anna Luísa Corradi Magalhães Nepomuceno ◽  
Anna Cláudia de Castro ◽  
Augusto Gonçalves Araújo ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Training Group ◽  
Inspiratory Muscle ◽  
Inspiratory Muscle Training ◽  
Inspiratory Pressure ◽  
Maximal Inspiratory Pressure ◽  
Muscle Training ◽  
Post Intervention ◽  
Randomized Controlled

Objective: To evaluate the efficacy of an inspiratory muscle training protocol on inspiratory muscle function, functional capacity, and quality of life in patients with asthma. Design: A single-blind, randomized controlled clinical trial. Setting: Community-based. Subjects: Patients with asthma, aged between 20 and 70 years old, non-smokers. Interventions: Participants were randomized into two groups: inspiratory muscle training group performed inspiratory muscle training 5 days a week for 8 weeks, consisting of six sets of 30 breaths per day with a training load ⩾50% of maximal inspiratory pressure, plus an educational program; the control group only received the educational program. Main measurements: Maximal inspiratory pressure, inspiratory muscle endurance, and the distance performed on the incremental shuttle walking test were assessed pre-intervention, post-intervention and at follow-up (3 months after the end of the intervention). The asthma quality of life questionnaire was applied pre and post-intervention. Results: Data from 39 participants were analyzed. Maximal inspiratory pressure in percentage of predicted and endurance test duration were significantly higher post-intervention in the inspiratory muscle training group (∆ post–pre: 50.8% vs 7.3% of predicted – P < 0.001 and ∆ post–pre: 207.9 seconds vs 2.7 seconds – P < 0.001, respectively). There was no significant difference in the incremental shuttle walking distance between groups (∆ post–pre: 30.9 m vs −8.1 m, P = 0.165). Quality of life was perceived as significantly better, without a difference between groups ( P > 0.05). Conclusions: About 8 weeks of inspiratory muscle training in patients with controlled asthma significantly increased inspiratory muscle strength and endurance.

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

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.

scholarly journals Adjunctive inspiratory muscle training for patients with COVID-19 (COVIDIMT): protocol for randomised controlled double-blind trial

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e049545
Author(s):  
Vinicius Maldaner ◽  
Jean Coutinho ◽  
Alfredo Nicodemos da Cruz Santana ◽  
Graziella F B Cipriano ◽  
Miriã Cândida Oliveira ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Exercise Capacity ◽  
Controlled Trial ◽  
Inspiratory Muscle ◽  
Inspiratory Muscle Training ◽  
Muscle Training ◽  
Number Of Patients ◽  
Psychosocial Counselling ◽  
Randomised Controlled

IntroductionA significant number of patients with COVID-19 may experience dyspnoea, anxiety, depression, pain, fatigue and physical impairment symptoms, raising the need for a multidisciplinary rehabilitation approach, especially for those with advanced age, obesity, comorbidities and organ failure. Traditional pulmonary rehabilitation (PR), including exercise training, psychosocial counselling and education, has been employed to improve pulmonary function, exercise capacity and quality of life in patients with COVID-19. However, the effects of inspiratory muscle training (IMT) in PR programmes remain unclear. This study aimed to determine whether the addition of a supervised IMT in a PR is more effective than PR itself in improving dyspnoea, health-related quality of life and exercise capacity in symptomatic patients with post-COVID-19.Methods and analysisThis parallel-group, assessor-blinded randomised controlled trial, powered for superiority, aimed to assess exercise capacity as the primary outcome. A total of 138 are being recruited at two PR centres in Brazil. Following baseline testing, participants will be randomised using concealed allocation, to receive either (1) standard PR with sham IMT or (2) standard PR added to IMT. Treatment effects or differences between the outcomes (at baseline, after 8 and 16 weeks, and after 6 months) of the study groups will be analysed using an ordinary two-way analysis of variance.Ethics and disseminationThis trial was approved by the Brazilian National Ethics Committee and obtained approval on 7 October 2020 (document number 4324069). The findings will be disseminated through publications in peer-reviewed journals and conference presentations.Trial registration numberNCT04595097.

Inspiratory Muscle Training: Improvement of Exercise Performance With Acute Hypoxic Exposure

2019 ◽  
Vol 14 (8) ◽  
pp. 1124-1131 ◽  
Author(s):  
Daniel G. Hursh ◽  
Marissa N. Baranauskas ◽  
Chad C. Wiggins ◽  
Shane Bielko ◽  
Timothy D. Mickleborough ◽  
...  
Keyword(s):  
Endurance Exercise ◽  
Exercise Performance ◽  
Perceived Exertion ◽  
Submaximal Exercise ◽  
Inspiratory Muscle ◽  
Inspiratory Muscle Training ◽  
Inspiratory Pressure ◽  
Hypoxic Exposure ◽  
Maximal Inspiratory Pressure ◽  
Muscle Training

Endurance exercise performance in hypoxia may be influenced by an ability to maintain high minute ventilation () in defense of reduced arterial oxyhemoglobin saturation. Inspiratory muscle training (IMT) has been used as an effective intervention to attenuate the negative physiological consequences associated with an increased , resulting in improved submaximal-exercise performance in normoxia. However, the efficacy of IMT on hypoxic exercise performance remains unresolved. Purpose: To determine whether chronic IMT improves submaximal-exercise performance with acute hypoxic exposure. Methods: A total of 14 endurance-trained men completed a 20-km cycling time trial (TT) in normobaric hypoxia (fraction of inspired oxygen [FiO2] = 0.16) before and after either 6 wk of an IMT protocol consisting of inspiratory loads equivalent to 80% of sustained maximal inspiratory pressure (n = 9) or a SHAM protocol (30% of sustained maximal inspiratory pressure; n = 5). Results: In the IMT group, 20-km TT performance significantly improved by 1.45 (2.0%), P = .03, after the 6-wk intervention. The significantly faster TT times were accompanied by a higher average (pre vs post: 99.3 [14.5] vs 109.9 [18.0] L·min−1, P = .01) and absolute oxygen uptake (pre vs post: 3.39 [0.52] vs 3.60 [0.58] L·min−1, P = .010), with no change in ratings of perceived exertion or dyspnea (P > .06). There were no changes in TT performance in the SHAM group (P = .45). Conclusion: These data suggest that performing 6 wk of IMT may benefit hypoxic endurance exercise performance lasting 30–40 min.

Do different loads in inspiratory muscle training alter maximal inspiratory pressure and ventilator weaning time?

2017 ◽  
Vol 42 ◽  
pp. 391
Author(s):  
Gisele Martins Leite dos Santos ◽  
João Victor Alvares Guzzo ◽  
Ivete Alonso Bredda Saad ◽  
Luciana Castilho de Figueiredo ◽  
Desanka Dragosavac ◽  
...  
Keyword(s):  
Ventilator Weaning ◽  
Inspiratory Muscle ◽  
Inspiratory Muscle Training ◽  
Inspiratory Pressure ◽  
Maximal Inspiratory Pressure ◽  
Muscle Training

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.

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