Inspiratory muscle training improves muscle oxygenation and efficiency of extradiaphragmatic inspiratory muscles in difficult to wean (DTW) patients

Background Most inspiratory muscle training (IMT) interventions in patients with chronic obstructive pulmonary disease (COPD) have been implemented as fully supervised daily training for 30 minutes with controlled training loads using mechanical threshold loading (MTL) devices. Recently, an electronic tapered flow resistive loading (TFRL) device was introduced that has a different loading profile and stores training data during IMT sessions. Objective The aim of this study was to compare the efficacy of a brief, largely unsupervised IMT protocol conducted using either traditional MTL or TFRL on inspiratory muscle function in patients with COPD. Design Twenty patients with inspiratory muscle weakness who were clinically stable and participating in a pulmonary rehabilitation program were randomly allocated to perform 8 weeks of either MTL IMT or TFRL IMT. Methods Participants performed 2 daily home-based IMT sessions of 30 breaths (3–5 minutes per session) at the highest tolerable intensity, supported by twice-weekly supervised sessions. Adherence, progression of training intensity, increases in maximal inspiratory mouth pressure (Pimax), and endurance capacity of inspiratory muscles (Tlim) were evaluated. Results More than 90% of IMT sessions were completed in both groups. The TFRL group tolerated higher loads during the final 3 weeks of the IMT program, with similar effort scores on the 10-Item Borg Category Ratio (CR-10) Scale, and achieved larger improvements in Pimax and Tlim than the MTL group. Limitations A limitation of the study was the absence of a study arm involving a sham IMT intervention. Conclusions The short and largely home-based IMT protocol significantly improved inspiratory muscle function in both groups and is an alternative to traditional IMT protocols in this population. Participants in the TFRL group tolerated higher training loads and achieved larger improvements in inspiratory muscle function than those in the MTL group.

Download Full-text

Eight Weeks of Inspiratory Muscle Training Improves Pulmonary Function in Disabled Swimmers—A Randomized Trial

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16101747 ◽

2019 ◽

Vol 16 (10) ◽

pp. 1747 ◽

Cited By ~ 2

Author(s):

Paulina Okrzymowska ◽

Monika Kurzaj ◽

Wojciech Seidel ◽

Krystyna Rożek-Piechura

Keyword(s):

Muscle Strength ◽

Respiratory Muscle ◽

Respiratory Muscles ◽

Lung Ventilation ◽

Inspiratory Muscle ◽

Inspiratory Muscle Training ◽

Respiratory Muscle Strength ◽

Muscle Training ◽

Swimming Training ◽

Inspiratory Muscles

Background: According to the literature, inspiratory muscle fatigue may increase after swimming training (ST). This study aimed to examine the efficacy of 8-week inspiratory muscular training (IMT) in disabled swimmers, combined with standard sports training, on selected parameters of lung ventilation and the function of respiratory muscles. Methods: A total of 16 disabled swimming division athletes from Wroclaw’s ‘Start’ Regional Sports Association qualified for the study. The subjects were randomly divided into two groups (ST and IMT). Both groups participated in swimming training for 8 weeks (8 times a week). The IMT group additionally participated in inspiratory muscle training (8 weeks). In all respondents, a functional lung test and the respiratory muscle strength was measured. Results: After 8 weeks of training, a significant increase in ventilation parameters and respiratory muscle strength was observed only in the IMT group. In ST group 1, a 20% improvement in the strength of inspiratory muscles was achieved. Conclusions: The inclusion of IMT is an important element that complements swimming training, allowing for greater increases in lung ventilation parameters and the strength of respiratory muscles in disabled swimmers.

Download Full-text

Design considerations for inspiratory muscle training systems

Proceedings of the Institution of Mechanical Engineers Part B Journal of Engineering Manufacture ◽

10.1243/095440503321148911 ◽

2003 ◽

Vol 217 (2) ◽

pp. 291-295 ◽

Cited By ~ 1

Author(s):

M P Caine ◽

T M Waller ◽

A Wilcox

Keyword(s):

Development Process ◽

Training Stimulus ◽

Inspiratory Muscle ◽

Inspiratory Muscle Training ◽

Muscle Training ◽

Training Systems ◽

Ambulatory Training ◽

Inspiratory Muscles ◽

Generating Capacity ◽

Elite Sports

Inspiratory muscle training can be used to strengthen the muscles employed when breathing in. This has been shown to benefit the exercise performance of a diverse group of users including elite sports people. Unfortunately, existing training devices do not provide an optimum training stimulus. The principal limitations of current devices are that they can only be used statically, i.e. not during exercise, and that the load they provide does not reflect the force generating capacity of the targeted muscle group. These limitations could be overcome if an ambulatory responsive loading technology were developed. Ambulatory training would allow users to ‘wear’ the training device while performing exercise, thereby ensuring that improvements to breathing are functionally relevant to the particular demands of a given sport or task. Responsive loading would ensure that the load applied to the inspiratory muscles is specific to the force-generating capacity of the inspiratory muscles during exercise. The purpose of the present project was to explore the feasibility of ambulatory responsive inspiratory muscle training. A series of potential design solutions were identified. This paper describes the design and development process undertaken and draws conclusions regarding the feasibility of ambulatory responsive inspiratory muscle training.

Download Full-text

The effects of inspiratory muscle training (IMT) with Tapered Flow Resistive Loading (TFRL) on breathing characteristics and inspiratory muscle oxygenation during weaning: a preliminary data analysis

10.1183/13993003.congress-2019.pa2201 ◽

2019 ◽

Author(s):

Zafeiris Louvaris ◽

Marine Van Hollebeke ◽

Beatrix Clerckx ◽

Johannes Muller ◽

Rik Gosselink ◽

...

Keyword(s):

Data Analysis ◽

Preliminary Data ◽

Inspiratory Muscle ◽

Muscle Oxygenation ◽

Inspiratory Muscle Training ◽

Muscle Training ◽

Resistive Loading

Download Full-text

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

Applied Sciences ◽

10.3390/app10155178 ◽

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.

Download Full-text

Effects of inspiratory muscle training on respiratory muscle electromyography and dyspnea during exercise in healthy men

Journal of Applied Physiology ◽

10.1152/japplphysiol.00046.2017 ◽

2017 ◽

Vol 122 (5) ◽

pp. 1267-1275 ◽

Cited By ~ 13

Author(s):

Andrew H. Ramsook ◽

Yannick Molgat-Seon ◽

Michele R. Schaeffer ◽

Sabrina S. Wilkie ◽

Pat G. Camp ◽

...

Keyword(s):

Respiratory Muscle ◽

Inspiratory Muscle ◽

Inspiratory Muscle Training ◽

Emg Activity ◽

Respiratory Drive ◽

Muscle Training ◽

Exertional Dyspnea ◽

Healthy Humans ◽

Inspiratory Muscles ◽

Pressure Threshold

Inspiratory muscle training (IMT) has consistently been shown to reduce exertional dyspnea in health and disease; however, the physiological mechanisms remain poorly understood. A growing body of literature suggests that dyspnea intensity can be explained largely by an awareness of increased neural respiratory drive, as measured indirectly using diaphragmatic electromyography (EMGdi). Accordingly, we sought to determine whether improvements in dyspnea following IMT can be explained by decreases in inspiratory muscle electromyography (EMG) activity. Twenty-five young, healthy, recreationally active men completed a detailed familiarization visit followed by two maximal incremental cycle exercise tests separated by 5 wk of randomly assigned pressure threshold IMT or sham control (SC) training. The IMT group ( n = 12) performed 30 inspiratory efforts twice daily against a 30-repetition maximum intensity. The SC group ( n = 13) performed a daily bout of 60 inspiratory efforts against 10% maximal inspiratory pressure (MIP), with no weekly adjustments. Dyspnea intensity was measured throughout exercise using the modified 0–10 Borg scale. Sternocleidomastoid and scalene EMG was measured using surface electrodes, whereas EMGdi was measured using a multipair esophageal electrode catheter. IMT significantly improved MIP (pre: −138 ± 45 vs. post: −160 ± 43 cmH2O, P < 0.01), whereas the SC intervention did not. Dyspnea was significantly reduced at the highest equivalent work rate (pre: 7.6 ± 2.5 vs. post: 6.8 ± 2.9 Borg units, P < 0.05), but not in the SC group, with no between-group interaction effects. There were no significant differences in respiratory muscle EMG during exercise in either group. Improvements in dyspnea intensity ratings following IMT in healthy humans cannot be explained by changes in the electrical activity of the inspiratory muscles. NEW & NOTEWORTHY Exertional dyspnea intensity is thought to reflect an increased awareness of neural respiratory drive, which is measured indirectly using diaphragmatic electromyography (EMGdi). We examined the effects of inspiratory muscle training (IMT) on dyspnea, EMGdi, and EMG of accessory inspiratory muscles. IMT significantly reduced submaximal dyspnea intensity ratings but did not change EMG of any inspiratory muscles. Improvements in exertional dyspnea following IMT may be the result of nonphysiological factors or physiological adaptations unrelated to neural respiratory drive.

Download Full-text

Inspiratory muscle training at sea level improves the strength of inspiratory muscles during load carriage in cold-hypoxia

Ergonomics ◽

10.1080/00140139.2020.1807613 ◽

2020 ◽

Vol 63 (12) ◽

pp. 1584-1598

Author(s):

K. L. Hinde ◽

C. Low ◽

R. Lloyd ◽

C. B. Cooke

Keyword(s):

Sea Level ◽

Load Carriage ◽

Inspiratory Muscle ◽

Inspiratory Muscle Training ◽

Muscle Training ◽

Inspiratory Muscles

Download Full-text

The Relationship among the Inspiratory Muscle Strength, the Perception of Dyspnea and Inhaled Beta2-Agonists in Patients with Asthma

Canadian Respiratory Journal ◽

10.1155/2002/746808 ◽

2002 ◽

Vol 9 (5) ◽

pp. 307-312 ◽

Cited By ~ 23

Author(s):

Paltiel Weiner ◽

Rasmi Magadle ◽

Marinella Beckerman ◽

Noa Berar-Yanay

Keyword(s):

Muscle Strength ◽

Inspiratory Muscle ◽

Inspiratory Muscle Training ◽

Maximal Inspiratory Pressure ◽

Muscle Training ◽

Moderate Asthma ◽

Inspiratory Muscles ◽

The Mean ◽

The Relationship ◽

Inspiratory Muscle Strength

BACKGROUND: It is well documented that the perception of dyspnea (POD), subjectively reported by patients, is related to the activity and strength of the inspiratory muscles, and influences the use of 'as needed' beta2-agonists.STUDY OBJECTIVE: To investigate the relationship among the increase in inspiratory muscle strength after specific inspiratory muscle training, beta2-agonist consumption and the POD in patients with persistent, mild to moderate asthma.METHODS: Inspiratory muscle strength, daily beta2-agonist consumption and the POD were measured in 30 patients with mild to moderate asthma. Patients were then randomly assigned to two groups: one group received specific inspiratory muscle training until an increase of more than 20 cm H2O was reached, and one group was a control group and received sham training. Inspiratory muscle strength, the POD and daily beta2-agonist consumption were assessed during and after the training period.RESULTS: There was no good correlation between the baseline maximal inspiratory pressure and the POD, or between the baseline maximal inspiratory pressure and the mean daily beta2-agonist consumption. However, there was a significant correlation between the POD and the mean daily beta2-agonist consumption. The increase in inspiratory muscle strength after the inspiratory muscle training was closely correlated with the decrease in the POD (P<0.001) and the decrease in beta2-agonist consumption (P<0.001).CONCLUSIONS: The present study shows that, in patients with mild to moderate, persistent asthma, there is a correlation between the POD and the mean daily beta2-agonist consumption. When the inspiratory muscles are strengthened, there is a significant decrease in the POD and in beta2-agonist consumption.

Download Full-text

The Effects of Inspiratory Muscle Training in Neuromuscular Disorders: Review Article

Indonesian Journal of Physical Medicine & Rehabilitation ◽

10.36803/ijpmr.v7i01.134 ◽

2019 ◽

Vol 7 (01) ◽

pp. 57

Author(s):

Okta Hariza ◽

Budiati Lasmitasari ◽

Siti Chandra Widjanantie ◽

Nury Nusdwinuringtyas

Keyword(s):

Neuromuscular Disorders ◽

Review Article ◽

Inspiratory Muscle ◽

Inspiratory Muscle Training ◽

Inspiratory Pressure ◽

Muscle Training ◽

Maximum Inspiratory Pressure ◽

Inspiratory Muscles ◽

Load Intensity ◽

Searching Method

Introduction: Progressive inspiratory muscles weakness in neuromuscular disorders (NMD) can lead to respiratory impairments, from restrictive lung to respiratory failure. Inspiratory muscle training (IMT) is an exercise with a device to increase inspiratory muscles strength and/or endurance. This article wasaimed to review the effect and prescription of IMT in NMD subjects.Methods: Searching method was done in PubMed and Google Scholar using keywords: “inspiratory muscle training” AND “neuromuscular disorders” AND “MIP” OR “PImax”.Results: Seven related studies were found. These studies shown that IMT increased inspiratory muscles strength and/or endurance in chronic progressive NMD. Most studies used threshold type. The intensities varied from 30% through 70% of maximum inspiratory pressure (MIP), minimum twice a day. Therepetition for strengthening was 10 times with 20-seconds rest between repetitions. Endurance trainings were done in 10 cycles of 1-minute breathing or for total 20 m inutes.Conclusion: Several evidences reported that IMT significantly improve strength and endurance of inspiratory muscles in chronic progressive NMD. It was effective in earlier phase of NMD. The minimum load intensity was 30% MIP.Keywords: Inspiratory muscle training (IMT), neuromuscular disorders (NMD), maximum inspiratory pressure (MIP)

Download Full-text