Role Of Endurance And Inspiratory Resistive Diaphragmatic Breathing Training In Improving Asthmatic Symptomology

Abstract

The growing incidence and costs of asthma has resulted in a considerable financial- and health-burden that demands alternative and more cost-effective pulmonary rehabilitation treatment options. PURPOSE: To compare endurance training (ET), inspiratory resistive diaphragmatic breathing training (IDT) and combined endurance and inspiratory resistive diaphragmatic breathing training (ET+IDT) on asthmatic symptomology. METHODS: Eighty-eight inactive, moderate-persistent asthmatics were assigned to either a control group (CG) (n = 22), ET group (n = 22), IDT group (n = 22) or ET+IDT group (n = 22). The forced vital capacity (FVC), forced expiratory volume in one second (FEV1), forced expiratory volume in one second/forced vital capacity ratio (FEV1/FVC), peak expiratory flow (PEF), maximal voluntary ventilation (MVV), maximal oxygen consumption (VO2max) and medication usage was assessed pre- and post-training. The ET patients walked/jogged at 60% of their individual age-predicted maximal heart rate, IDT patients performed both inspiratory resistive breathing and diaphragmatic breathing for three sets of five to 10 repetitions at a 1:2 second inspiration to expiration ratio, three sets of 10 to 15 repetitions at a 2:4 ratio and three sets of 15 to 20 repetitions at a 3:6 ratio. The ET+IDT patients performed 15 minutes of walking/jogging and diaphragmatic breathing for two sets of each of the repetitions and ratios utilized by the IDT group. RESULTS: ET, IDT and ET+IDT significantly (P<0.05) increased FVC, FEV1 and PEF, while significantly decreasing medication usage. IDT and ET+IDT were effective at increasing FEV1/FVC. VO2max and MVV increased significantly following ET and ET+IDT training. Post-hoc analysis revealed that the ET+IDT was the most effective at improving VO2max, FVC, FEV1, FEV1/FVC, PEF and MVV. CONCLUSIONS: These findings support the inclusion of ET+IDT for moderate-persistent asthmatics to improve asthmatic symptomology due to ET+IDT's low risk and cost while allowing a patient to gain the unique benefits of both modes of exercise.