Abstract
Expiratory muscle strength training (EMST) is a rehabilitative program that has been tested for outcomes related to respiratory muscle strength, cough, swallow, and voice function in healthy young adult, elderly individuals, and in patients with progressive neurodegenerative disease. Because EMST has been used in patient care, the associated cardiovascular responses during EMST are of importance. This study investigated the changes in systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), and oxygen saturation (SpO2) during one session of EMST in healthy, young adults as a preliminary study of device safety. Thirty-one participants completed a single session of 25 trials with the EMST device. Valsalva maneuvers were performed at the beginning and at the end of the EMST trials for task comparison. The SBP, DBP, HR, and SpO2 were recorded at the baseline and after completing the following tasks: a Valsalva maneuver, 12 trials using the EMST device, 13 trials using the EMST device, and 5 min of rest following the EMST session. A mixed linear model tested for changes across the six time points. The results indicated no significant change of SBP, DBP, HR, or SpO2 during or following the EMST trials or after performing the Valsalva maneuver. The results suggest that EMST does not elicit significant fluctuations of blood pressure, HR, and SpO2 in healthy young adults even when considering the effects of covariates on the outcomes measures.
Highlights
Expiratory muscle strength training (EMST) improves expiratory muscle force generating capacity to increase maximum expiratory driving pressure (MEP)
body mass index (BMI) had a significant effect on systolic blood pressure (SBP) (F = 6.37; df = 1,176; p = 0.0125), with SBP increasing with BMI
The results showed no significant changes in blood pressure (BP), heart rate (HR), and SpO2 during and following a session of 25 EMST trials with the EMST device set at 75% MEP, suggesting little impact on BP, HR, and SpO2 for the cohort enrolled in the study This outcome supports the hypothesis that EMST would not induce major fluctuations in cardiovascular response primarily because of the brief and repetitive expiratory effort durations of the task
Summary
Expiratory muscle strength training (EMST) improves expiratory muscle force generating capacity to increase maximum expiratory driving pressure (MEP). Studies provide evidence of the benefits of EMST as a treatment for increasing MEP generation in those with Parkinson’s disease, multiple sclerosis, (Chiara et al, 2006), as well as both sedentary and healthy elderly individuals (Baker et al, 2005; Kim et al, 2009), wind instrumentalists (Sapienza et al, 2002), professional voice users (Wingate et al, 2007), and healthy young adults (Baker et al, 2005). It has been proposed that EMST could assist in improving respiratory function and reducing pulmonary complications in persons post stroke (Kim and Sapienza, 2005; Harraf et al, 2008). Since a majority of stroke patients are at risk of developing cardiovascular disease and suffer from hypertension (Harraf et al, 2008), it is important to assess the cardiovascular responses to EMST prior to the application of the program with this patient group
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