Abstract
ABSTRACT This study aims to assess the effect of short-time low frequency inspiratory muscle trainer (Threshold IMT) on inspiratory muscle strength and electromyographic activity of the sternocleidomastoid (SCM) muscle in people with chronic obstructive pulmonary disease (COPD). People with COPD participating in a lung rehabilitation program were allocated to a control or inspiratory muscle training (IMT) group. The control group participated in the usual rehabilitation, whereas the other group received IMT (performed with a load of 50% maximal inspiratory pressure (MIP) adjusted weekly). Both interventions lasted for 2 months. Outcomes included electromyographic analysis of the SCM and MIP. In total, ten participants were allocated to each group. The IMT group presented an increase in absolute (p<0.001) and predicted (p<0.001) values of MIP and also in pre- and post-intervention variation between groups (p=0.003 and p=0.008, respectively). Such differences were not found in the control group. The SCM muscle activity decreased in the IMT post intragroup evaluation (p=0.008). IMT provided a reduction of the electromyographic activity of SCM in COPD patients, also increasing inspiratory muscle strength in the study participants.
Highlights
Chronic obstructive pulmonary disease (COPD) is a systemic condition characterized by airflow limitation, being not fully reversible[1]
Two participants from the inspiratory muscle training (IMT) group were lost to follow-up due to an acute worsening of the condition and lack of treatment adherence (Figure 1)
This study showed that inspiratory muscle training at 50% of the maximal inspiratory pressure with weekly adjustments of short-time low frequency training significantly increased maximal inspiratory pressure
Summary
Chronic obstructive pulmonary disease (COPD) is a systemic condition characterized by airflow limitation, being not fully reversible[1]. Structural changes in the thoracic cage caused by the overload of diaphragm increase the resistance to fatigue[3,4,5]. It does not increase inspiratory pressure, leading to accessory muscle activation to compensate the increase in ventilation demand[3], including the activation of the scalene and sternocleidomastoid (SCM) muscles[3]. The diagnosis of respiratory muscles disorders is commonly confirmed by respiratory muscle strength tests, using maximal respiratory pressure[6] This method only enables a global assessment, without differentiating the muscle groups involved[6]. Surface electromyography (EMG) is a non-invasive technique that allows differentiation of muscle activity generated in different muscle groups, assessing muscle activation by electric signals, and it has been used under different conditions[4,5,6,7]
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