Respiratory muscle training and vibrational therapy in patients with Parkinson’s disease

Background: The effect of 3-month respiratory muscle training (RMT) on pulmonary and autonomic function and functional outcomes has been demonstrated in patients with Parkinson's disease (PD); however, there is a paucity of information on the durability of the training effect. In this study, we monitored the pulmonary and cardiovascular autonomic function and clinical severity scales until 18 months after the cessation of RMT to elucidate the detraining effect after RMT.Methods: All patients with PD receiving RMT were assessed with clinical severity scales as well as pulmonary and autonomic function tests at four different stages (baseline on enrollment, immediately after 3 months of RMT, and 6 and 18 months after cessation of RMT). A control group of PD patients who did not receive RMT was also recruited for comparison. Pulmonary function parameters, including forced vital capacity (FVC), forced expiratory volume in one second (FEV1), maximum inspiratory pressure (MIP), and maximum expiratory pressure (MEP), were assessed. Cardiovascular autonomic function was assessed using measures including heart rate response to deep breathing (HRDB), Valsalva ratio, and baroreflex sensitivity. Clinical severity scores were also measured using the Hoehn and Yahr staging and the Unified Parkinson's Disease Rating Scale (UPDRS).Results: The results showed significant improvements in MIP, MEP, HRDB, and UPDRS immediately after RMT. Despite some decay, the improvements in pulmonary function (MIP and MEP) and functional outcomes (UPDRS) remained significant until 6 months of detraining (9 months after enrollment). However, the improvement in cardiovascular autonomic function (HRDB) was reversed after 6 months of detraining.Conclusions: Based on these findings, we recommend that RMT may be repeated after at least 6 months after previous session (9 months after enrollment) for patients with PD to maintain optimal therapeutic effects.

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Respiratory muscle training in patients with Parkinson's disease

http://isrctn.com/ ◽

10.1186/isrctn10301406 ◽

2018 ◽

Author(s):

Alvaro Reyes

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Respiratory Muscle ◽

Respiratory Muscle Training ◽

Muscle Training

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Simultaneously Improved Pulmonary and Cardiovascular Autonomic Function and Short-Term Functional Outcomes in Patients with Parkinson’s Disease after Respiratory Muscle Training

Journal of Clinical Medicine ◽

10.3390/jcm9020316 ◽

2020 ◽

Vol 9 (2) ◽

pp. 316

Author(s):

Chih-Cheng Huang ◽

Yun-Ru Lai ◽

Fu-An Wu ◽

Nai-Ying Kuo ◽

Yuh-Chyn Tsai ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Pulmonary Function ◽

Functional Outcomes ◽

Respiratory Muscle ◽

Autonomic Function ◽

Respiratory Muscle Training ◽

Muscle Training ◽

Short Term ◽

Cardiovascular Autonomic Function

Both pulmonary function and autonomic function are impaired in patients with Parkinson’s diseases (PD). This study tested the hypothesis that respiratory muscle training (RMT) can not only improve pulmonary function, but also simultaneously improve cardiovascular autonomic function and short-term functional outcomes in patients with PD. Pulmonary function was measured by the forced vital capacity (FVC), forced expiratory volume in one second (FEV1), maximum inspiratory pressures (MIP), and maximum expiratory pressures (MEP). Cardiovascular autonomic function was measured by the heart rate response to deep breathing (HRDB), Valsalva ratio, baroreflex sensitivity, and spectral analysis. The functional and severity scores were measured by the Hoehn and Yahr stage and Unified Parkinson’s Disease Rating Scale (UPDRS). These measures were evaluated in patients with PD before and after 3 months of RMT, compared with a control group of PD patients without RMT. The results showed significant improvement of clinical scores (total UPDRS and UPDRS I, II and III) after RMT (p < 0.0001). Concerning pulmonary function, the parameters of MIP and MEP improved significantly. The parameters of cardiovascular function also improved after RMT, although only HRDB reached statistical significance. Based on the results of our study, RMT can not only improve both pulmonary and cardiovascular autonomic function, but can also improve short-term functional outcomes in patients with PD.

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The Effects of Respiratory Muscle Training on Phonatory Measures in Individuals with Parkinson's Disease

Journal of Voice ◽

10.1016/j.jvoice.2019.05.001 ◽

2020 ◽

Vol 34 (6) ◽

pp. 894-902 ◽

Cited By ~ 5

Author(s):

Alvaro Reyes ◽

Adrián Castillo ◽

Javiera Castillo ◽

Isabel Cornejo ◽

Travis Cruickshank

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Respiratory Muscle ◽

Respiratory Muscle Training ◽

Muscle Training

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Should respiratory muscle training be part of the treatment of Parkinson’s disease? A systematic review of randomized controlled trials

Clinical Rehabilitation ◽

10.1177/0269215519896054 ◽

2019 ◽

Vol 34 (4) ◽

pp. 429-437

Author(s):

Miguel Ángel Rodríguez ◽

Irene Crespo ◽

Miguel del Valle ◽

Hugo Olmedillas

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Randomized Controlled Trials ◽

Respiratory Muscle ◽

Respiratory Muscle Training ◽

Controlled Trials ◽

Muscle Training ◽

Swallowing Function ◽

Randomized Controlled ◽

Training Programmes

Objective: To determine the effectiveness of respiratory muscle training in persons with Parkinson’s disease. Data sources: PubMed/MEDLINE, EMBASE, Web of Science, Scopus and PEDro electronic databases were searched until 15 November 2019. Reference lists of included studies were hand-searched. Methods: Randomized controlled trials assessing the effects of respiratory muscle training programmes (both inspiratory and expiratory) in patients with Parkinson’s disease were included. Two reviewers independently identified eligible studies and extracted data. Method quality was appraised with the PEDro scale. Results: Five papers including three randomized controlled trials with a total of 111 patients were identified. Method appraisal showed a mean score of 5 in the PEDro scale. One study analysed inspiratory muscle training, one expiratory muscle training and two established a comparison between both of them. Statistically positive results were found in maximal inspiratory pressure ( P < 0.05 and d = 0.76), maximal expiratory pressure ( P < 0.01 and d = 1.40), perception of dyspnoea ( P < 0.01), swallowing function ( d = 0.55) and phonatory measures, without significant differences in spirometric indices. Conclusions: Respiratory muscle training may be an effective alternative for improving respiratory muscle strength, swallowing function and phonatory parameters in subjects with Parkinson’s disease. Nevertheless, the lack of primary studies about this type of training prevents obtaining robust evidence.

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