The Effect of a High-Intensity PrO2Fit Inspiratory Muscle Training Intervention on Physiological and Psychological Health in Adults with Bronchiectasis: A Mixed-Methods Study.

Jessica L Mccreery,Rebekah Mills-Bennett,Kelly A Mackintosh,Melitta A Mcnarry

doi:10.3390/ijerph18063051

Abstract

Bronchiectasis is characterised by airflow obstruction and hyperinflation resulting in respiratory muscle weakness, and decreased exercise capacity. Inspiratory muscle training (IMT) is potentially an alternative treatment strategy to enhance respiratory muscle strength and endurance. Therefore, the aim was to investigate the effects of IMT on those with bronchiectasis. Eighteen participants (10 bronchiectasis) took part in an eight-week, three times a week IMT programme at 80% sustained maximal inspiratory pressure (SMIP). Lung function, respiratory muscle strength and endurance, exercise capacity, physical activity and self-determination theory measures were taken. Participants also took part in a semi-structured interview to assess their perceptions and experience of an IMT intervention. After eight weeks of IMT, bronchiectasis and healthy participants exhibited significant increases in MIP (27% vs. 32%, respectively), SMIP (16% vs. 17%, respectively) and inspiratory duration (36% vs. 30%, respectively). Healthy participants exhibited further improvements in peak expiratory flow and maximal oxygen consumption. Bronchiectasis participants reported high levels of perceived competence and motivation, reporting higher adherence and improved physical ability. Eight weeks of IMT increased inspiratory muscle strength and endurance in those with bronchiectasis. IMT also had a positive effect on perceived competency and autonomy, with bronchiectasis participants reporting improved physical ability and motivation, and high adherence.

Highlights

The healthy participants were younger than those with bronchiectasis who were characterised by a higher body mass index (BMI) at baseline (Table 1)
This study revealed that an eight-week, home-based Inspiratory muscle training (IMT) programme elicited significant and clinically meaningful increases in inspiratory muscle strength and endurance in both bronchiectasis and healthy participants, with healthy participants significantly enhancing expiratory flow and exercise capacity
As bronchiectasis is associated with respiratory muscle weakness [5,6,7], the clinically meaningful improvement in MIP observed after eight weeks of IMT in the current study is of clinical importance

Summary

Introduction

Excessive secretions, dyspnoea, exercise intolerance and fatigue [4,5]. These symptoms may, at least in part, be attributable to respiratory muscle weakness reported in those with bronchiectasis [5,6,7,8], which may lead to discord between respiratory muscle load and capacity [6]. Decreased respiratory muscle strength is associated with less productive coughing and decreased removal of airway secretions [8,9]. Effective strategies to target and resolve respiratory muscle weakness are needed for those with bronchiectasis

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Conclusion