scholarly journals A role of tiotropium bromide in different methods of physical rehabilitation in patients with COPD

2007 ◽  
pp. 40-45
Author(s):  
N. N. Meshcheryakova ◽  
A. S. Belevsky
Keyword(s):  
Skeletal Muscle ◽  
Drug Therapy ◽  
Muscle Strength ◽  
Respiratory Muscle ◽  
Physical Rehabilitation ◽  
Tiotropium Bromide ◽  
Respiratory Muscle Training ◽  
Respiratory Muscle Strength ◽  
Muscle Training ◽  
Copd Patients

COPD is characterized not only by pulmonary pathology but also by systemic disorders leading to abrupt reduction in physical tolerance causing a significant decrease in the patients' quality of life (QoL). Training of upper and lower limb muscles along with breathing training, training of respiratory muscles using respiratory training devices and adequate drug therapy can improve physical tolerance of COPD patients. The aim of this work was to compare different methods of physical rehabilitation under the therapy with tiotropium bromide (TB). The study involved 45 patients with severe and very severe COPD (the mean age, 64.5 ±11.0 yrs) randomized into 3 groups: the 1st group patients took inhaled corticosteroids (ICS), short-acting b-agonists and TB, the 2nd group patients were treated with the same medications plus respiratory muscle training with Threshold IMT, PEP, and the 3rd group received the same medications plus skeletal muscle training. The study continued for 3 months and included 3 active visits with testing of lung function (LF) and respiratory muscle strength (Pi, Pe), 6-minute walking test (6-MWT), evaluation of QoL using the SF-36 questionnaire and of dyspnea using MRC scale. As a result, all groups have improved QoL, LF, respiratory muscle strength, and 6-minute walk distance after 3-month treatment. The best values of QoL and 6-MWT were seen in the 3rd group. The greatest improvement for the 2nd group patients was noted in LF and respiratory muscle strength. The 1st group also improved all the parameters. Therefore, we can not exclude the effect of TB on physical tolerance in COPD patients. We conclude that combined application of respiratory and skeletal muscle training and drug therapy including TB is the optimal treatment for COPD patients.

scholarly journals Effects of home-based respiratory muscle training in children and adolescents with chronic lung disease

2014 ◽  
Vol 40 (6) ◽  
pp. 626-633 ◽  
Author(s):  
Iván Rodríguez ◽  
Daniel Zenteno ◽  
Carlos Manterola
Keyword(s):  
Muscle Strength ◽  
Lung Disease ◽  
Children And Adolescents ◽  
Chronic Lung Disease ◽  
Respiratory Muscle ◽  
Respiratory Muscle Training ◽  
Respiratory Muscle Strength ◽  
Muscle Training ◽  
Home Based ◽  
Quasi Experimental

OBJECTIVE: Respiratory muscle weakness is a functional repercussion of chronic lung disease (CLD). The objective of this study was to assess the effects of home-based respiratory muscle training (RMT) in children and adolescents with CLD or neuromuscular disease (NMD). METHODS: This was a quasi-experimental study involving children and adolescents with CLD or NMD. Before and after 6 months of home-based RMT, we measured respiratory muscle strength (MIP and MEP), PEF, and peak cough flow (PCF). We made statistical comparisons between the pre-RMT and post-RMT values, as well as evaluating the correlation between the duration and effect of RMT. RESULTS: The study included 29 patients, with a mean age of 12 years (range, 5-17 years), of whom 18 (62.1%) were male. The CLD group comprised 11 patients (37.9%), and the NMD group comprised 18 (62.1%). The mean duration of the RMT was 60 weeks (range, 46-90 weeks) in the CLD group and 39 weeks (range, 24-89 weeks) in the NMD group. In comparison with the pre-RMT values, the post-RMT values for MIP and MEP were significantly higher in both groups, whereas those for PEF and PCF were significantly higher only in the NMD group. We found no correlation between the duration and the effect of RMT. CONCLUSIONS: Home-based RMT appears to be an effective strategy for increasing respiratory muscle strength in children and adolescents with CLD or NMD, although it increased the ability to cough effectively only in those with NMD.

scholarly journals The Retornus-2 study: impact of respiratory muscle training in subacute stroke patients with dysphagia, study protocol of a double-blind randomized controlled trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
A. Guillen-Sola ◽  
M. Messaggi-Sartor ◽  
C. Ramírez-Fuentes ◽  
E. Marco ◽  
E. Duarte
Keyword(s):  
Muscle Strength ◽  
Respiratory Muscle ◽  
Trial Registration ◽  
Respiratory Muscle Training ◽  
Secondary Outcome ◽  
Respiratory Muscle Strength ◽  
Muscle Training ◽  
Stroke Patients ◽  
Randomized Controlled ◽  
Subacute Stroke

Abstract Background Stroke can lead to varying degrees of oropharyngeal dysphagia, respiratory muscle dysfunction and even increase medical complications such as aspiration, malnutrition and death. Recent studies suggest that inspiratory and expiratory respiratory muscle training (IEMT) can improve swallowing efficacy and may reduce aspiration events. The main purpose of this study is to examine whether an 8-week IEMT programme can improve respiratory muscle strength and swallow dysfunction severity in subacute stroke patients with dysphagia. Methods Retornus-2 is a two-arm, prospectively registered, randomized controlled study with blinded assessors and the participation of fifty individuals who have suffered a stroke. The intervention group undergoes IEMT training consisting of 5 sets of 10 repetitions, three times a day for 8 weeks. Training loads increase weekly. The control group undergoes a sham-IEMT protocol. The primary outcome examines the efficacy of the IEMT protocol to increase respiratory muscle strength and reduce dysphagia severity. The secondary outcome assesses the longitudinal impact of dysphagia on body composition and nutritional assessment over a 6-month follow-up. Discussion IEMT induces an improvement in respiratory muscle strength and might be associated with relevant benefits in dysphagia patterns, as well as a reduction in the number of aspiration events confirmed by videofluoroscopy or fiberoptic endoscopic evaluation of swallowing. The description of the impact of swallowing impairment on nutritional status will help develop new strategies to face this known side-effect. Trial registration Clinicaltrials.gov NCT03021252. Registered on 10 January 2017. https://clinicaltrials.gov/ct2/results?cond=retornus+2&term=&cntry=ES&state=&city=&dist= WHO trial Registration data set: Due to heavy traffic generated by the COVID-19 outbreak, the ICTRP Search Portal does not respond. The portal recommends other registries such as clinicaltrials.gov. Protocol version: RETORNUS 2_ PROTOCOL_2.

Effect of Inspiratory muscle training in hypercapnic chronic obstructive pulmonary disease patients during acute care: a randomised clinical trial

2020 ◽  
pp. 1-10
Author(s):  
T. Saher ◽  
J.A. Moiz ◽  
P. Bhati ◽  
M.S. Ali ◽  
D. Talwar
Keyword(s):  
Respiratory Failure ◽  
Muscle Strength ◽  
Functional Capacity ◽  
Respiratory Muscle ◽  
Chronic Obstructive ◽  
Respiratory Muscle Strength ◽  
Muscle Training ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients

Weakness of respiratory muscles along with respiratory failure is a common finding in chronic obstructive pulmonary disease (COPD) patients which leads to dyspnoea and hence decreased functional capacity. Despite a sound theoretical rationale regarding the potential role of inspiratory muscles, the role of inspiratory muscle training (IMT) along with the conventional non-invasive ventilation (NIV) on important clinical outcomes has not been investigated in these patients during acute care. 34 hypercapnic stable COPD patients were randomly allocated to one of the interventions that lasted for 10 days: IMT with NIV (n=17), and NIV alone (n=17). IMT was administered 2 times in a day (15 min each time) by threshold loading at an intensity starting from 30% and progressed to 60% of their maximal inspiratory effort (PImax). NIV was given at an optimal pressure titrated for each patient for at least >8 h per day. Outcome measures (respiratory muscle strength, respiratory failure, dyspnoea, and functional capacity) were assessed before and after 10 days of intervention. Clinical characteristics and outcome variables of patients were similar between the groups at baseline. Addition of IMT led to a significantly greater increase in respiratory muscle strength (P=0.01), reduction in dyspnea (modified medical research council dyspnea scale, P=0.001); improved outcomes of respiratory failure (PaCO2, P=0.03; PaO2, P=0.002) and improved functional capacity (6 min walk distance, P=0.001) as compared to NIV alone. A short duration IMT program in addition to NIV was found to be effective in improving respiratory muscle strength, perception of dyspnoea, functional capacity and respiratory failure in hypercapnic COPD patients.

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