scholarly journals Time to Move Beyond a “One-Size Fits All” Approach to Inspiratory Muscle Training

2022 ◽  
Vol 12 ◽  
Author(s):  
Ren-Jay Shei ◽  
Hunter L. Paris ◽  
Abigail S. Sogard ◽  
Timothy D. Mickleborough
Keyword(s):  
Respiratory Muscle ◽  
Individual Characteristics ◽  
Inspiratory Muscle ◽  
Inspiratory Muscle Training ◽  
Muscle Training ◽  
Respiratory Muscle Weakness ◽  
Personalized Approach ◽  
Study Participants ◽  
And Training

Inspiratory muscle training (IMT) has been studied as a rehabilitation tool and ergogenic aid in clinical, athletic, and healthy populations. This technique aims to improve respiratory muscle strength and endurance, which has been seen to enhance respiratory pressure generation, respiratory muscle weakness, exercise capacity, and quality of life. However, the effects of IMT have been discrepant between populations, with some studies showing improvements with IMT and others not. This may be due to the use of standardized IMT protocols which are uniformly applied to all study participants without considering individual characteristics and training needs. As such, we suggest that research on IMT veer away from a standardized, one-size-fits-all intervention, and instead utilize specific IMT training protocols. In particular, a more personalized approach to an individual’s training prescription based upon goals, needs, and desired outcomes of the patient or athlete. In order for the coach or practitioner to adjust and personalize a given IMT prescription for an individual, factors, such as frequency, duration, and modality will be influenced, thus inevitably affecting overall training load and adaptations for a projected outcome. Therefore, by integrating specific methods based on optimization, periodization, and personalization, further studies may overcome previous discrepancies within IMT research.

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.

scholarly journals Inspiratory Muscle Training and the Perception of Dyspnea in Parkinson's Disease

2005 ◽  
Vol 32 (2) ◽  
pp. 213-217 ◽  
Author(s):  
Rivka Inzelberg ◽  
Nana Peleg ◽  
Puiu Nisipeanu ◽  
Rasmi Magadle ◽  
Ralph L. Carasso ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Muscle Strength ◽  
Respiratory Muscle ◽  
Inspiratory Muscle ◽  
Inspiratory Muscle Training ◽  
Muscle Performance ◽  
Training Period ◽  
Muscle Training ◽  
Pulmonary Functions

ABSTRACT:Background:Pulmonary and respiratory muscle function impairment are common in patients with Parkinson's disease (PD). Inspiratory muscle training may improve strength, dyspnea and functional capacity in healthy subjects and in those with chronic obstructive pulmonary disease. This study investigated the effect of specific inspiratory muscle training (SIMT) on pulmonary functions, inspiratory muscle performance, dyspnea and quality of life, in patients with PD.Patients and Methods:Twenty patients with PD (stage II and III Hoehn and Yahr scale) were recruited for the study and were divided into two groups: a) ten patients who received SIMT and b) ten patients who received sham training, for three months. Pulmonary functions, the respiratory muscle strength and endurance, the perception of dyspnea (POD) and the quality of life were studied before and within one week after the training period. All subjects trained daily, six times a week, each session consisting of 1/2 hour, for 12 weeks.Results:Following the training period, there was a significant improvement, in the training group but not in the control group, in the following parameters: inspiratory muscle strength, (PImax, increased from 62.0±8.2 to 78.0±7.5 cm of H2O (p<0.05), inspiratory muscle endurance (increased from 20.0±2.8 to 29.0±3.0 cm of H2O (p<0.05), and the POD (decreased from 17.9±3.2 to 14.0±2.4 units (p<0.05). There was a close correlation between the increase in the inspiratory muscle performance and the decrease in the POD.Conclusions:The inspiratory muscle performance may be improved by SIMT in patients with PD. This improvement is associated with a significant decrease in their POD.

Effects of inspiratory muscle training after lung transplantation in children

2021 ◽  
Vol 14 (7) ◽  
pp. e241114
Author(s):  
Takayoshi Yamaga ◽  
Shuhei Yamamoto ◽  
Yasunari Sakai ◽  
Takashi Ichiyama
Keyword(s):  
Lung Transplantation ◽  
Pulmonary Rehabilitation ◽  
Respiratory Function ◽  
Respiratory Muscle ◽  
Vital Capacity ◽  
Inspiratory Muscle ◽  
Inspiratory Muscle Training ◽  
Maximal Inspiratory Pressure ◽  
Muscle Training ◽  
Respiratory Muscle Weakness

Pulmonary rehabilitation is a cornerstone of management for patients after lung transplantation (LT), but the benefits of inspiratory muscle training (IMT) after LT in children are unclear. Therefore, we examined whether IMT can improve respiratory function and dyspnoea in a paediatric patient after LT.The patient was a 13-year-old boy who underwent double LT. However, mild physical activity such as walking triggered dyspnoea for the patient. The patient underwent IMT with the intensity of approximately 30% of his maximal inspiratory pressure (MIP) for 2 months.The patient’s MIP was increased by approximately 60% after 2 months, and his forced vital capacity as a percent of the predicted normal value increased from 74.6% to 83.4%, with improvement of dyspnoea.IMT may help improve dyspnoea after LT in children with respiratory muscle weakness and a decline in respiratory function.

scholarly journals Effects of Inspiratory Muscle Training and Calisthenics-and-Breathing Exercises in COPD With and Without Respiratory Muscle Weakness

2015 ◽  
Vol 61 (1) ◽  
pp. 50-60 ◽  
Author(s):  
R. P. Basso-Vanelli ◽  
V. A. P. Di Lorenzo ◽  
I. G. Labadessa ◽  
E. M. G. Regueiro ◽  
M. Jamami ◽  
...  
Keyword(s):  
Muscle Weakness ◽  
Respiratory Muscle ◽  
Inspiratory Muscle ◽  
Inspiratory Muscle Training ◽  
Muscle Training ◽  
Respiratory Muscle Weakness ◽  
Breathing Exercises

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

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.

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.

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.

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