scholarly journals Exploring Pulmonary Rehabilitation Strategies for those with Respiratory Conditions

2021 ◽  
Author(s):  
◽  
Jessica L. McCreery
Keyword(s):  
Muscle Strength ◽  
Respiratory Disease ◽  
Psychological Health ◽  
Pulmonary Rehabilitation ◽  
Respiratory Muscle ◽  
Psychosocial Health ◽  
Chronic Respiratory Disease ◽  
Inspiratory Muscle ◽  
Respiratory Muscle Strength ◽  
Rehabilitation Strategies

Effective rehabilitation strategies are paramount to improve physiological and psychological health in pulmonary disease. The aim of this thesis was to investigate traditional and alternative pulmonary rehabilitation strategies in those with chronic respiratory disease. Chapter Four found that traditional pulmonary rehabilitation (PR) was physiologically and psychologically effective, regardless of respiratory disease, with socioeconomic status being a key determinant of adherence. Chapter Five investigated the feasibility and acceptability of IMT. Children aged 10.8 ± 0.8 years with Cystic Fibrosis (CF) enjoyed the IMT intervention, perceiving improvements in their physical ability and psychosocial health. The care team highlighted that future interventions needed to be longer and to monitor engagement and adherence. Chapter Six assessed the effectiveness of an alternative rehabilitation strategy, using a four-week inspiratory muscle training (IMT) intervention, on lung function and heart rate variability in children with CF aged 10.8 ± 1.1 years. There were significant and clinically meaningful increases in respiratory muscle strength, a clinically meaningful decrease in sympathetic modulation, and decreases in respiratory symptoms. Subsequently, utilising the formative, physiological and psychological findings derived from Chapters Five and Six, an eight-week IMT intervention with live biofeedback, performed at 80% maximal inspiratory pressure, three times a week was implemented, with an eight-week optional IMT top-up. Overall, Chapter Seven found that eight weeks of IMT elicited significant increases in respiratory muscle strength, aerobic capacity and in CF-specific questionnaire domains in children (11.0 ± 2.2 years) with CF, which were maintained following the eight-week top-up period. Chapter Eight demonstrated significant improvements in inspiratory muscle strength and endurance after eight weeks, with sustained improvements in physiological health after 16-weeks in adults with bronchiectasis (64.5 ± 10.3 years). CF and bronchiectasis participants demonstrated high levels of adherence and reported competency and autonomy. Overall, IMT may be an effective and feasible alternative to pulmonary rehabilitation.

scholarly journals The Effect of a High-Intensity PrO2Fit Inspiratory Muscle Training Intervention on Physiological and Psychological Health in Adults with Bronchiectasis: A Mixed-Methods Study

2021 ◽  
Vol 18 (6) ◽  
pp. 3051
Author(s):  
Jessica L. McCreery ◽  
Kelly A. Mackintosh ◽  
Rebekah Mills-Bennett ◽  
Melitta A. McNarry
Keyword(s):  
Muscle Strength ◽  
Exercise Capacity ◽  
Psychological Health ◽  
Respiratory Muscle ◽  
Inspiratory Muscle ◽  
Inspiratory Muscle Training ◽  
Respiratory Muscle Strength ◽  
Muscle Training ◽  
Physical Ability ◽  
Healthy Participants

Bronchiectasis is characterised by airflow obstruction and hyperinflation resulting in respiratory muscle weakness, and decreased exercise capacity. Inspiratory muscle training (IMT) is potentially an alternative treatment strategy to enhance respiratory muscle strength and endurance. Therefore, the aim was to investigate the effects of IMT on those with bronchiectasis. Eighteen participants (10 bronchiectasis) took part in an eight-week, three times a week IMT programme at 80% sustained maximal inspiratory pressure (SMIP). Lung function, respiratory muscle strength and endurance, exercise capacity, physical activity and self-determination theory measures were taken. Participants also took part in a semi-structured interview to assess their perceptions and experience of an IMT intervention. After eight weeks of IMT, bronchiectasis and healthy participants exhibited significant increases in MIP (27% vs. 32%, respectively), SMIP (16% vs. 17%, respectively) and inspiratory duration (36% vs. 30%, respectively). Healthy participants exhibited further improvements in peak expiratory flow and maximal oxygen consumption. Bronchiectasis participants reported high levels of perceived competence and motivation, reporting higher adherence and improved physical ability. Eight weeks of IMT increased inspiratory muscle strength and endurance in those with bronchiectasis. IMT also had a positive effect on perceived competency and autonomy, with bronchiectasis participants reporting improved physical ability and motivation, and high adherence.

scholarly journals Application of Inspiratory Muscle Training to Improve Physical Tolerance in Older Patients with Ischemic Heart Failure

2021 ◽  
Vol 18 (23) ◽  
pp. 12441
Author(s):  
Monika Piotrowska ◽  
Paulina Okrzymowska ◽  
Wojciech Kucharski ◽  
Krystyna Rożek-Piechura
Keyword(s):  
Heart Failure ◽  
Muscle Strength ◽  
Cardiac Rehabilitation ◽  
Exercise Tolerance ◽  
Respiratory Muscle ◽  
Inspiratory Muscle ◽  
Inspiratory Muscle Training ◽  
Respiratory Muscle Strength ◽  
Muscle Training ◽  
Patients With Heart Failure

Regardless of the management regime for heart failure (HF), there is strong evidence supporting the early implementation of exercise-based cardiac rehabilitation (CR). Respiratory therapy is considered to be an integral part of such secondary prevention protocols. The aim of the study was to evaluate the effect of inspiratory muscle training (IMT) on exercise tolerance and the functional parameters of the respiratory system in patients with heart failure involved in cardiac rehabilitation. The study included 90 patients with HF who took part in the second-stage 8-week cycle of cardiac rehabilitation (CR). They were randomly divided into three groups: Group I underwent CR and IMT; Group II only CR; and patients in Group III underwent only the IMT. Before and after the 8-week cycle, participants were assessed for exercise tolerance and the functional parameters of respiratory muscle strength. Significant statistical improvement concerned the majority of the hemodynamic parameters, lung function parameters, and respiratory muscle strength in the first group. Moreover, the enhancement in the exercise tolerance in the CR + IMT group was accompanied by a negligible change in the HRpeak. The results confirm that the addition of IMT to the standard rehabilitation process of patients with heart failure can increase the therapeutic effect while influencing some of the parameters measured by exercise electrocardiography and respiratory function.

Case Studies in Physiology: Cardiopulmonary exercise testing and inspiratory muscle training in a 59-year-old, four years after an extra-pleural pneumonectomy

2021 ◽  
Author(s):  
Reid A. Mitchell ◽  
Scott T. Apperely ◽  
Satvir S. Dhillon ◽  
Julia Zhang ◽  
Kyle G. Boyle ◽  
...  
Keyword(s):  
Case Report ◽  
Muscle Strength ◽  
Exercise Test ◽  
Respiratory Muscle ◽  
Cardiopulmonary Exercise Testing ◽  
Work Rate ◽  
Inspiratory Muscle ◽  
Inspiratory Muscle Training ◽  
Respiratory Muscle Strength ◽  
Muscle Training

This case report characterizes the physiological responses to incremental cycling and determines the effects of 12 weeks of inspiratory muscle training (IMT) on respiratory muscle strength, exercise capacity and dyspnea in a physically active 59-year-old female, four years after a left-sided extra-pleural pneumonectomy (EPP). On separate days, a symptom limited incremental exercise test and a constant work rate (CWR) test at 75% of peak work rate (WR) were completed, followed by 12 weeks of IMT and another CWR test. IMT consisted of two sessions of 30 repetitions twice daily for 5 days per week. Physiological and perceptual variables were measured throughout each exercise test. The participant had a total lung capacity that was 43% predicted post-EPP. A rapid and shallow breathing pattern was adopted throughout exercise, and the ratio of minute ventilation to carbon dioxide output was elevated for a given work rate. Oxygen uptake was 74%predicted and WR was 88%predicted. Following IMT, maximal inspiratory pressure improved by 36% (-27.1 cmH2O) and endurance time by 31s, with no observable changes in any submaximal or peak cardiorespiratory variables during exercise. The intensity and unpleasantness of dyspnea increased by 2 and 3 Borg 0-10 units, respectively, at the highest equivalent submaximal exercise time achieved on both tests. Despite having undergone a significant reduction in lung volume post-EPP, the participant achieved a relatively normal peak incremental WR, which may reflect a high level of physical conditioning. This case report also demonstrates that IMT can effectively increase respiratory muscle strength several years following EPP.

Effects of inspiratory muscle training on pulmonary function, respiratory muscle strength and functional capacity in patients with atrial fibrillation: a randomized controlled trial

2016 ◽  
Vol 30 (12) ◽  
pp. 1165-1174 ◽  
Author(s):  
Melih Zeren ◽  
Rengin Demir ◽  
Zerrin Yigit ◽  
Hulya N Gurses
Keyword(s):  
Atrial Fibrillation ◽  
Muscle Strength ◽  
Pulmonary Function ◽  
Functional Capacity ◽  
Respiratory Muscle ◽  
Inspiratory Muscle ◽  
Inspiratory Muscle Training ◽  
Control Group ◽  
Respiratory Muscle Strength ◽  
Muscle Training

Objective: To investigate the effects of inspiratory muscle training on pulmonary function, respiratory muscle strength and functional capacity in patients with atrial fibrillation. Design: Prospective randomized controlled single-blind study. Setting: Cardiology department of a university hospital. Subjects: A total of 38 patients with permanent atrial fibrillation were randomly allocated to either a treatment group ( n = 19; age 66.2 years (8.8)) or a control group ( n = 19; age 67.1 years (6.4)). Methods: The training group received inspiratory muscle training at 30% of maximal inspiratory pressure for 15 minutes twice a day, 7 days a week, for 12 weeks alongside the standard medical treatment. The control group received standard medical treatment only. Spirometry, maximal inspiratory and expiratory pressures and 6-minute walking distance was measured at the beginning and end of the study. Results: There was a significant increase in maximal inspiratory pressure (27.94 cmH2O (8.90)), maximal expiratory pressure (24.53 cmH2O (10.34)), forced vital capacity (10.29% (8.18) predicted), forced expiratory volume in one second (13.88% (13.42) predicted), forced expiratory flow 25%–75% (14.82% (12.44) predicted), peak expiratory flow (19.82% (15.62) predicted) and 6-minute walking distance (55.53 m (14.13)) in the training group ( p < 0.01). No significant changes occurred in the control group ( p > 0.05). Conclusion: Inspiratory muscle training can improve pulmonary function, respiratory muscle strength and functional capacity in patients with atrial fibrillation.

scholarly journals Inspiratory critical pressure - new methodology for evaluating and training the inspiratory musculature for recreational cyclists: study protocol for a randomized control trial

2019 ◽  
Author(s):  
Patricia Rehder-Santos ◽  
Vinicius Minatel ◽  
Juliana Cristina Milan-Mattos ◽  
Étore De Favari Signini ◽  
Raphael Martins de Abreu ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Physical Performance ◽  
Respiratory Muscle ◽  
Critical Pressure ◽  
Statistical Tests ◽  
Training Load ◽  
Load Test ◽  
Inspiratory Muscle ◽  
Muscle Endurance ◽  
Respiratory Muscle Strength

Abstract Background: Inspiratory muscle training (IMT) has brought great benefits in terms of improving physical performance in healthy individuals. However, there is no consensus regarding the best training load being in most cases the maximal inspiratory pressure (MIP) is used, mainly the intensity of 60% of MIP. So, the prescription of an IMT protocol that considers respiratory muscle strength and endurance may bring additional benefits to commonly used protocols, since the respiratory muscles that differ from other muscles because of their greater muscular resistance. Thus, IMT using inspiratory critical pressure (PThC) can be an alternative as the calculation of PThC considers these characteristics. Therefore, the aim of this study is to propose a new IMT protocol to determine the best training load for recreational cyclists. Methods: Thirty recreational cyclists (between 20-40 years) will be randomized into the SHAM Group (SG), the PThC Group (PCG) and the 60% of MIP Group (60G), according to age and aerobic functional capacity. All participants will undergo the following evaluations: pulmonary function test (PFT), respiratory muscle strength test (RMS), cardiopulmonary test (CPET), incremental respiratory muscle endurance test (iRME) [maximal sustained respiratory pressure for 1 minute (PThMAX)] and constant load test (CLT) (95%, 100% and 105% of PThMÁX) using a linear load inspiratory resistor (PowerBreathe K5). The PThC will be calculated from the inspiratory muscle endurance time (TLIM) and inspiratory loads of each CLT. The IMT will last 11 weeks (3 times/week and 1 hour/session). The session will consist of 5-minute warm-ups (50% of the training load) and 3 sets of 15-minute breaths (100% of the training load), with a 1-minute interval between them. RMS, iRME, CLT and CPET will be performed beforehand, at week 3 and 7 (to adjust the training load) and after training. PFT will be performed before and after training. The data will be analyzed using specific statistical tests (parametric or non-parametric) according to the data distribution and their respective variances. The p <0.05 will be established. Discussions: It is expected that the results of this study will enable the training performed with PThC to be used by health professionals as a new tool to evaluate and prescribe IMT. Clinical Trial: ClinicalTrial.gov, ID Number NCT02984189. Registered on December 6, 2016, https://clinicaltrials.gov/ct2/show/NCT02984189. Keywords: Physical Exercise, Physiotherapy, Physical Performance, Critical Power, Respiratory Muscle

scholarly journals Effectiveness of Inspiratory Muscle Training on Respiratory Muscle Strength in Patients Undergoing Cardiac Surgeries: A Systematic Review With Meta-Analysis

2021 ◽  
Vol 45 (4) ◽  
pp. 264-273
Author(s):  
Fiona Verdine Dsouza ◽  
Sampath Kumar Amaravadi ◽  
Stephen Rajan Samuel ◽  
Harish Raghavan ◽  
Nagaraja Ravishankar
Keyword(s):  
Cardiac Surgery ◽  
Muscle Strength ◽  
Pulmonary Function ◽  
Functional Capacity ◽  
Respiratory Muscle ◽  
Meta Analysis ◽  
Inspiratory Muscle ◽  
Inspiratory Muscle Training ◽  
Respiratory Muscle Strength ◽  
Muscle Training

To determine the effect of inspiratory muscle training (IMT) on pulmonary function, respiratory muscle strength (RMS), and functional capacity in patients undergoing cardiac surgery. The PubMed, PEDro, CINAHL, Web of Science, CENTRAL, and EMBASE databases were searched from inception to June 2020. Randomized controlled trials (RCTs) that evaluated patients who underwent cardiac surgery were included in this review. Meta-analysis performed using a random-effects model showed that the mean difference in forced vital capacity, forced expiratory volume in 1 second, 6-minute walk distance, and RMS was 3.47% (95% confidence interval [CI], 0.57 to 6.36), 5.80% (95% CI, 2.03 to 9.56), 78.05 m (95% CI, 60.92 to 95.18), and 4.8 cmH2O (95% CI, -4.00 to 13.4), respectively. There is strong evidence that IMT improves inspiratory muscle strength, pulmonary function, and functional capacity, and reduces the length of hospital stay in patients undergoing cardiac surgery.

scholarly journals Static and dynamic evaluation of respiratory muscle strength in asthmatic children and adolescents

2020 ◽  
Vol 20 (4) ◽  
pp. 1009-1016
Author(s):  
Jean Aretakis Cordeiro ◽  
Caroline Palácio Silva ◽  
Murillo Carlos Amorim Britto ◽  
Lívia Barboza Andrade
Keyword(s):  
Muscle Strength ◽  
Children And Adolescents ◽  
Respiratory Muscle ◽  
Inspiratory Muscle ◽  
Healthy Controls ◽  
Respiratory Muscle Strength ◽  
Positive Correlation ◽  
The Mean ◽  
Predicted Values ◽  
Inspiratory Muscle Strength

Abstract Objectives: to evaluate static and dynamic respiratory muscle strength in children and adolescents with asthma. Methods: cross-sectional study, involving 80 children and adolescents, 40 with asthma and 40 healthy controls. Biological and clinical characteristics were analyzed. The analysis of the dynamic inspiratory muscle strength was obtained using the KH5 device of the POWERbreathe® line, while the static evaluation was performed using an analog manova-cuometer. Results: the mean obtained from the S-Index was higher in the control group compared to asthmatics (p = 0.026). There was no statistical difference between MIP values for asthmatics and predicted values (p = 0.056). The MEP results showed a significant difference between the mean of the cases and the predicted values (p = 0.000). There was a positive correlation between height and S-Index (p = 0.002 and r = 0.438). Conclusion: the present study demonstrated that the static inspiratory muscle strength (PImáx) of children and adolescents with asthma in comparison with the values predicted in the literature does not differ, however, when submitted to dynamic assessment (S-Index), it presents higher values in healthy controls. In addition, the S-Index showed a positive correlation with the child's height.

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