Abstract
Inspiratory muscle training (IMT) enhances velocity of inspiratory muscle contraction and modifies inspiratory and expiratory time. This study aimed to examine the impact of high-intensity IMT (H-IMT) on exercise capacity in bronchiectasis. Forty-five patients were included. Lung function, respiratory muscle strength and endurance, exercise capacity, dyspnoea, fatigue and quality of life (QOL) were evaluated. Patients were randomized into two groups: H-IMT and control groups. Twenty-three patients underwent H-IMT for 8 weeks, using threshold loading with a target workload of maximal inspiratory pressure (MIP) of at least 70%, with 3-min cycles (as 2-min training: 1-min rest intervals) for 21 min. There was a total period of 14 min of loaded breathing and 7 min of recovery. The control group (n = 22) underwent low-intensity IMT at 10% of the initial MIP and was maintained at the same intensity until the end of the training. After training, both MIP and maximal expiratory pressure (MEP) and the incremental shuttle walk distance were increased in the H-IMT group compared with the control group (P < 0.05). There was a significant difference in constant threshold load, time and pressure-time units in the H-IMT group (P < 0.05) but not in the control group (P > 0.05). A significant decrease was found in fatigue in both groups (P < 0.05). The Leicester Cough Questionnaire social score for the H-IMT group decreased significantly after the treatment (P < 0.05). The H-IMT increased exercise capacity in patients with non-cystic fibrosis bronchiectasis. It has also positive effects on respiratory muscle strength and endurance, and social aspects of QOL.
Highlights
Bronchiectasis is a chronic lung disease with major symptoms of cough, excessive secretions, dyspnoea, exercise intolerance and fatigue.[1,2]Inspiratory muscle weakness may lead to muscle load and capacity discordance, and thereby, dyspnoea, decreased exercise tolerance, hypoventilation and respiratory failure
The present randomized controlled study contributes to the literature about the impact of highintensity inspiratory muscle training (H-Inspiratory muscle training (IMT)) in bronchiectasis
We showed that high-intensity IMT (H-IMT) increased respiratory muscle strength and endurance, exercise capacity and social aspects of quality of life in patients with non-cystic fibrosis bronchiectasis
Summary
Bronchiectasis is a chronic lung disease with major symptoms of cough, excessive secretions, dyspnoea, exercise intolerance and fatigue.[1,2]Inspiratory muscle weakness may lead to muscle load and capacity discordance, and thereby, dyspnoea, decreased exercise tolerance, hypoventilation and respiratory failure. Inspiratory muscle training weakness.[6] Inspiratory muscle training (IMT) using a threshold device can enhance velocity of inspiratory muscle contraction, decreased inspiratory time and increase exhalation time and allow more time for lung emptying.[5] In bronchiectasis, one study combining IMT with whole-body exercise training (ExT) revealed that IMT has no additional effects on maximum inspiratory pressure (MIP), whereas the impact of ExT was sustained.[1] The IMT improved both inspiratory and expiratory muscle strengths without any impact on pulmonary function, quality of life (QOL) or exercise capacity.[5]. Conclusion: The H-IMT increased exercise capacity in patients with non-cystic fibrosis bronchiectasis It has positive effects on respiratory muscle strength and endurance, and social aspects of QOL
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