Effects Of Respiratory Muscle Training Research Articles

The effect of respiratory muscle training on children and adolescents with cystic fibrosis: a systematic review and meta-analysis

BackgroundCystic fibrosis is a chronic genetic disease that can affect the function of the respiratory system. Previous reviews of the effects of respiratory muscle training in people with cystic fibrosis are uncertain and do not consider the effect of age on disease progression. This systematic review aims to determine the effectiveness of respiratory muscle training in the clinical outcomes of children and adolescents with cystic fibrosis.MethodsUp to July 2023, electronic databases and clinical trial registries were searched. Controlled clinical trials comparing respiratory muscle training with sham intervention or no intervention in children and adolescents with cystic fibrosis. The primary outcomes were respiratory muscle strength, respiratory muscle endurance, lung function, and cough. Secondary outcomes included exercise capacity, quality of life and adverse events. Two review authors independently extracted data and assessed study quality using the Cochrane Risk of Bias Tool 2. The certainty of the evidence was assessed according to the GRADE approach. Meta-analyses where possible; otherwise, take a qualitative approach.ResultsSix studies with a total of 151 participants met the inclusion criteria for this review. Two of the six included studies were published in abstract form only, limiting the available information. Four studies were parallel studies and two were cross-over designs. There were significant differences in the methods and quality of the methodology included in the studies. The pooled data showed no difference in respiratory muscle strength, lung function, and exercise capacity between the treatment and control groups. However, subgroup analyses suggest that inspiratory muscle training is beneficial in increasing maximal inspiratory pressure, and qualitative analyses suggest that respiratory muscle training may benefit respiratory muscle endurance without any adverse effects.ConclusionsThis systematic review and meta-analysis indicate that although the level of evidence indicating the benefits of respiratory muscle training is low, its clinical significance suggests that we further study the methodological quality to determine the effectiveness of training.Trial registrationThe protocol for this review was recorded in the International Prospective Register of Systematic Reviews (PROSPERO) under registration number CRD42023441829.

The Effect of Respiratory Muscle Training on Swallowing Function in Patients With Stroke: A Systematic Review and Meta-Analysis.

The improvement of swallowing function after stroke is a significant challenge faced by patients and health care professionals. However, the current evidence synthesis of the effects of respiratory muscle training (RMT) on swallowing function is limited. To assess the effectiveness of RMT on swallowing recovery in patients undergoing stroke. The CKNI, WanFang Data, PubMed, CINAHL, Web of Science, Embase, MEDLINE, and Cochrane Library databases were searched for studies evaluating RMT interventions' effect on swallowing outcomes. Risks of bias were evaluated using the approach recommended by the Cochrane Collaboration tool and a summary of findings table was generated using the GRADE approach. Outcomes were synthesized using a random-effects meta-analysis model. RMT interventions reduced the risk of aspiration (SMD = 1.19; 95% CI, 0.53-1.84), the recovery process of water swallowing function (RR = 1.22; 95% CI, 1.05-1.42), and the activity of the swallowing muscles (SMD = 2.91; 95% CI, 2.22-3.61). However, there was no significant effect of RMT on the functional level of oral intake (SMD = 0.70; 95% CI, -0.03 to 1.42). RMT can be regarded as an innovative, auxiliary means in the near future to better manage and improve swallowing function, given its improving effect on work outcomes in this review.

Effect of respiratory muscle training in patients with stable chronic obstructive pulmonary disease: A systematic review and meta-analysis

ObjectivesChronic obstructive pulmonary disease (COPD) is a prevalent respiratory disorder characterized by progressive airflow limitation. This meta-analysis aims to evaluate the effectiveness of respiratory muscle training (RMT) on key pulmonary function parameters, inspiratory muscle strength and quality of life in patients with stable COPD. MethodsA comprehensive search was conducted in the databases including PubMed, Cochrane, Web of Science, Embase, and ClinicalTrials.gov, from their inception to June 12, 2023. Randomized controlled trials (RCTs) evaluating the impact of RMT on stable COPD were included for meta-analysis. ResultsIn total, 12 RCTs involving 453 participants were included in the meta-analysis. RMT demonstrated a significant increase in maximal inspiratory pressure (PImax, MD, 95% CI: 14.34, 8.17 to 20.51, P < 0.001) but not on maximal expiratory pressure (PEmax). No significant improvement was observed in 6-Min walk test (6MWT), dyspnea, forced expiratory volume in 1 s (FEV1), forced vital capacity ratio (FVC) and quality of life between RMT and control groups. However, subgroup analysis revealed a significant negative effect of RMT alone on FEV1/FVC (MD, 95% CI: 2.59, −5.11 to −0.06, P = 0.04). When RMT was combined with other interventions, improvements in FEV1/FVC and FEV1 were found, although not statistically significant. ConclusionRMT can effectively improve maximal inspiratory pressure in stable COPD patients, but the effect is slight in improving lung function, dyspnea and quality of life. It is recommended to combine with other treatment strategies to comprehensively improve the prognosis of COPD patients.

Implications for respiratory muscle training in patients with stroke-associated pneumonia: a meta-analysis

Purpose To evaluate the effect of respiratory muscle training on improving lung function in patients with stroke-associated pneumonia. Materials and methods A systematic retrieval was conducted using the databases of the Cochrane Library, PubMed, the Web of Science, Embase, ProQuest, and others. Studies involving patients who received respiratory muscle training with/without a breathing trainer and those who adopted routine post-stroke rehabilitation training were included in the systematic review. The statistical analysis was performed using RevMan 5.3 software. Results Fourteen studies were included involving 850 patients with stroke. According to the results of the meta-analysis, compared with the control group, there were statistically significant differences in forced vital capacity (FVC) measurements (mean difference (MD) = 0.93, p < 0.0001) and improvement values for FEV1/FVC (MD = 0.65, p < 0.00001) in the experimental group. The FEV1 value was higher in the experimental group than in the control group (MD = 5.89, p < 0.0001). Furthermore, respiratory muscle training was superior to routine rehabilitation training for improving the PImax of patients with stroke (MD = 9.20, p < 0.0001). The patients had better respiratory tolerance after respiratory muscle training intervention (MD = 73.40, p < 0.0001). Conclusions The implementation of respiratory muscle training can improve FVC and FEV lung function indicators, inspiratory muscle strength and the 6-min walk test results in patients with stroke.

Respiratory Muscle Training and Its Impact on Balance and Gait in Patients with Severe COPD.

Background and Objectives: Improving extrapulmonary symptoms in COPD through respiratory muscle training can help alleviate the burden of respiratory symptoms, reduce fatigue, and improve exercise capacity in patients with COPD. This, in turn, can enhance physical activity, balance, and gait, ultimately improving the overall quality of life for individuals with COPD. This study aimed to investigate the effects of respiratory muscle training on balance and gait in patients with moderate to severe COPD. Materials and Methods: We included 65 patients with moderate to severe COPD randomly assigned to either the pulmonary rehabilitation protocol group (PR) or the pulmonary rehabilitation and inspiratory muscle training group (PR + IMT) for three weeks. Patients performed a spirometry, maximal inspiratory and expiratory pressure (MIP/MEP), 6 min walking test (6MWT), activities-specific balance confidence (ABC) scale questionnaire, Berg Balance Scale (BBS), timed up and go test (TUG), and single-leg stance test (SLS). Results: Rehabilitation had a notable impact on MIP in Group 2 (PR + IMT), with a highly significant difference between pre- and post-rehabilitation distributions (p < 0.0001). At the same time, Group 1 (PR-only) showed no significant changes (p = 0.27). In Group 1 (Control), pre- and post-rehabilitation comparisons reveal slight non-significant changes for SLS EO (p = 0.16), ABC (p = 0.07), TUG (p = 0.06), and BBS (p = 0.13). In contrast, in Group 2 (Cases), there are significant improvements in all variables after rehabilitation compared to the pre-rehabilitation values: SLS EO (p < 0.0001), ABC (p < 0.0001), TUG (p < 0.0001), and BBS (p < 0.0001). Conclusions: Our research demonstrated that respiratory muscle training significantly positively impacts balance and gait performance among patients with moderate to severe COPD compared to a control group.

The effect of respiratory muscle training on respiratory muscle strength, diaphragm thickness/mobility, and exercise capacity in patients with systemic lupus erythematosus and associated shrinking lung syndrome.

Systemic lupus erythematosus (SLE) is a chronic autoimmune disorder that can impact any organ in the body. The pathophysiology of shrinking lung syndrome (SLS), a rare pulmonary complication of SLE, remains unknown. The objective of the current case series was to investigate the effects of inspiratory muscle training (IMT) on diaphragm thickness/mobility, respiratory muscle strength, peripheral muscle thickness/strength, and functional exercise capacity in patients with SLE and associated SLS. Three patients with SLE were included in the case series. Respiratory muscle strength, peripheral muscle strength, peripheral muscle thickness, diaphragm muscle thickness, diaphragm muscle mobility, functional exercise capacity, and pulmonary function test were assessed. A significant improvement has been determined in respiratory muscle strength, functional exercise capacity, peripheral muscle strength, peripheral muscle thickness, diaphragm muscle thickness, and diaphragm muscle mobility. This is the first case series showing the beneficial effects of IMT on respiratory muscle strength, diaphragm thickness/mobility, peripheral muscle thickness/strength, and exercise capacity in patients with SLE.

Review of effects of respiratory muscle training on athlete performance

For a long time, the respiratory system plays an important role in athletes' training and competition, and its quality directly affects the athletes' competitive level and state. In particular, after the COVID-19 pandemic, many athletes have experienced a significant decline in respiratory function due to viral infection, which has led to a renewed understanding of the importance of respiratory function in athlete training. Furthermore, respiratory muscle training can be a key to improving respiratory function. This paper will review the effects of respiratory muscle training on athlete performance by means of comparative analysis. After analyzing and organizing 36 articles, it can be concluded that different functions of respiratory muscles can improve the sports performance of different types of athletes. Among them, the exercise of inspiratory muscles is the most important, even for athletes infected with COVID-19.

Preoperative respiratory muscle training reduces the risk of pulmonary complications and the length of hospital stay after cardiac surgery: a systematic review

QuestionsWhat is the effect of preoperative respiratory muscle training (RMT) on the incidence of postoperative pulmonary complications (PPCs) after open cardiac surgery? What is the effect of RMT on the duration of mechanical ventilation, postoperative length of stay and respiratory muscle strength? DesignSystematic review of randomised trials with meta-analysis. ParticipantsAdults undergoing elective open cardiac surgery. InterventionThe experimental groups received preoperative RMT and the comparison groups received no intervention. Outcome measuresThe primary outcomes were PPCs, length of hospital stay, respiratory muscle strength, oxygenation and duration of mechanical ventilation. The methodological quality of studies was assessed using the PEDro scale and the overall certainty of the evidence was assessed using the GRADE approach. ResultsEight trials involving 696 participants were included. Compared with the control group, the respiratory training group had fewer PPCs (RR 0.51, 95% CI 0.38 to 0.70), less pneumonia (RR 0.44, 95% CI 0.25 to 0.78), shorter hospital stay (MD −1.7 days, 95% CI −2.4 to −1.1) and higher maximal inspiratory pressure values at the end of the training protocol (MD 12 cmH2O, 95% CI 8 to 16). The mechanical ventilation time was similar in both groups. The quality of evidence was high for pneumonia, length of hospital stay and maximal inspiratory pressure. ConclusionPreoperative RMT reduced the risk of PPCs and pneumonia after cardiac surgery. The training also improved the maximal inspiratory pressure and reduced hospital stay. The effects on PPCs were large enough to warrant use of RMT in this population. RegistrationCRD42021227779

Effectiveness of respiratory muscle training on pulmonary function and quality of life in cotton industry workers

Cotton sector workers are more likely to be exposed to the dust of cotton, leading to acute and chronic respiratory diseases, including chest tightness, bronchoconstriction, and occupational pulmonary disease. Physical exercise includes strengthening inspiratory muscles and training a larger muscle group, crucial to increase pulmonary function, exercise capacity, and cardiorespiratory endurance. To assess whether inspiratory muscle training (IMT) with aerobic exercise provides additional benefits in cotton workers to increase lung function and quality of life. A single-blinded interventional study performed at Angle Fibres Pvt. Ltd. cotton industry. One hundred (100) male workers based on enclosure criteria were randomly included and equally alienated into group A: Experimental (IMT + Aerobic Exercise) and group B: Control (Aerobic Exercise). Both groups received the supervised treatment four times each week for four weeks. Pulmonary function and excellence of life were measured at baseline, 4 weeks and 1 year follow-up. An Independent t-test was used for baseline comparisons. Repeated measures Multivariate ANOVA was applied for statistical analysis within and between group comparisons. No significant difference existed at the baseline. All the outcomes in each group demonstrated statistically significant differences. Among both groups, there was a statistically significance difference (p&lt;0.05) in experimental group outcome measures FVC (p=0.03), FEV1 (p=0.02), FEV1/FVC (p=0.04) PEFR (p=0.01) and SGRQ score (p=0.03). In addition to aerobic exercise, respiratory muscle training is essential to pulmonary rehabilitation for improving lung function and quality of life for those employed in this cotton industry.

Effects of Sprint-Interval and Endurance Respiratory Muscle Training on Post-Cycling Inspiratory and Quadriceps Fatigue.

We investigated whether a 4-week period of respiratory muscle endurance training (RMET) or respiratory muscle sprint interval training (RMSIT) would lead to an attenuation of inspiratory muscle and quadriceps fatigue following a bout of high-intensity cycling compared to a placebo intervention (PLAT), as predicted by the respiratory metaboreflex model. 33 active, young healthy adults performed either RMET, RMSIT, or PLAT. Changes in inspiratory muscle and quadriceps twitches in response to a cycling test at 90% of peak work capacity were assessed before and after training. Electromyographical (EMG) activity and deoxyhemoglobin (HHb, via near-infrared spectroscopy) of the quadriceps and inspiratory muscles were also monitored during the cycling test, along with cardiorespiratory and perceptual variables. At pre-training, cycling reduced the twitch force of the inspiratory muscles (86 ± 11% baseline) and quadriceps (66 ± 16% baseline). Training did not attenuate the drop in twitch force of the inspiratory muscles (PLAT, -3.5 ± 4.9 percent-points (p.p.); RMET 2.7 ± 11.3 p.p.; RMSIT, 4.1 ± 8.5 p.p., group-training interaction P = 0.394) or quadriceps (PLAT, 3.8 ± 18.6 p.p.; RMET -2.6 ± 14.0 p.p., RMSIT, 5.2 ± 9.8 p.p., group-training interaction P = 0.432). EMG activity and HHb levels during cycling did not change after training for either group. Only RMSIT showed a within-group decrease in the perception of respiratory exertion with training. Four weeks of RMET or RMSIT did not attenuate the development of exercise-induced inspiratory or quadriceps fatigue. The ergogenic effects of RMT during whole-body exercise might be related to an attenuation of perceptual responses.

The acute effect of respiratory muscle training on microcirculation in patients with chronic heart failure

Background: Patients with chronic heart failure (CHF) present microcirculation alterations and vascular endothelial dysfunction. Exercise training programs have been shown to improve the functional status of these patients, however less is known yet about the acute systemic effect of exercise on peripheral muscle microcirculation. The aim of the present study was to investigate the acute effect of a respiratory muscle exercise bout on the microcirculation of non-exercising muscles (systemic effect). Materials and Methods: Thirty-four (30♂/4♀) stable CHF patients, with a mean age of61.4±9.2 years, ejection fraction (EF): 33.9±7.8%, maximal inspiratory pressure (MIP): 78.2±27.1 cmH2O, VO2max: 17.5±4.05 ml/kg/min, VE/VCO2 slope: 32.7±6.4 and a New York Heart Association classification (NYHA) ≥ ΙΙ participated in the study. Microcirculatory assessment was performed at rest and immediately after the respiratory exercise program (5 sets/10 repetitions, training load: 60% of MIP). Basal tissue oxygen saturation (StO2),oxygen consumption rate (OCR) and reperfusion rate (RR) were measured utilizing near-infrared spectroscopy(NIRS) at the thenar muscle along with the vascular occlusion test (VOT). Results: RR (%/min), following the release of vascular occlusion, as well as OCR (%/min) increased after the respiratory exercise program (from 3.4±1.6 to 3.9±1.7, p=0.007, and from 12.7±3.8 to 13.2±3.9, p=0.021 respectively), whereas the corresponding basal StO2values difference did not reach the level of statistical significance (from 85.5±6.4. to 84.7±6.2, p=0.065). Conclusions: In the present study, concerning patients with CHF, after an acute respiratory exercise bout, dynamic microcirculatory indices assessed by NIRS in peripheral, non-exercising muscles, were significantly altered.

Effect of respiratory muscle training in asthma: A systematic review and meta-analysis.

The last systematic review about respiratory muscle training (RMT) in people with asthma was published almost 10 years ago. Since then, several works have been published. To review the effect of RMT in people with asthma. We conducted a systematic review of research included up to September 2021 in PubMed/MEDLINE, PEDro, Scopus, Web of Science, CINAHL, LILACS, Cochrane Central Register of Controlled Trials and ClinicalTrials.gov. We included randomized controlled trials and quasi-experimental studies assessing the effect of RMT on respiratory muscle function, rescue medication, asthma-related symptoms, lung function, exercise capacity, healthcare use, health-related quality of life (HRQoL) and adverse effects in people with asthma. Risk of bias and methodological quality were assessed with the Cochrane Risk of Bias assessment tool and the PEDro scale. Meta-analysis was performed whenever possible; otherwise a qualitative approach was followed. Eleven studies (270 participants) were included, 10 with only adults and were included in the meta-analysis. Inspiratory muscle training (IMT) had beneficial effects on maximal inspiratory pressure (PImax: mean difference [MD] 21.95 cmH2O [95% confidence interval [CI] 15.05; 28.85]), with no changes in maximal expiratory pressure (MD 14.97 cmH2O [95%CI -5.65; 35.59]), lung function (forced expiratory volume in 1 sec: MD 0.06 [95%CI -0.14; 0.26] L; force vital capacity: MD 0.39 [95%CI -0.24; 1.02] L) and exercise capacity (standard mean difference [SMD] 1.73 [95%CI -0.61; 4.08]). Subgroup analysis revealed that IMT load >50% PImax and duration >6 weeks were beneficial for exercise capacity. The qualitative analysis suggested that IMT may have benefits on respiratory muscle endurance, rescue medication and exertional dyspnoea, with no adverse effects. This systematic review and meta-analysis showed a significant increase in PImax after IMT in adults with asthma and reinforced the relevance of the dose-response principle of training. More evidence is needed to clarify the effect of IMT in respiratory muscle endurance, rescue medication, exercise capacity, healthcare use and HRQoL. PROSPERO International Prospective Register of Systematic Reviews CRD42020221939; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=221939.

The RESISTANT study (Respiratory Muscle Training in Patients with Spinal Muscular Atrophy): study protocol for a randomized controlled trial

BackgroundSpinal Muscular Atrophy (SMA) is characterized by progressive and predominantly proximal and axial muscle atrophy and weakness. Respiratory muscle weakness results in impaired cough with recurrent respiratory tract infections, nocturnal hypoventilation, and may ultimately lead to fatal respiratory failure in the most severely affected patients. Treatment strategies to either slow down the decline or improve respiratory muscle function are wanting.ObjectiveThe aim of this study is to assess the feasibility and efficacy of respiratory muscle training (RMT) in patients with SMA and respiratory muscle weakness.MethodsThe effect of RMT in patients with SMA, aged ≥ 8 years with respiratory muscle weakness (maximum inspiratory mouth pressure [PImax] ≤ 80 Centimeters of Water Column [cmH2O]), will be investigated with a single blinded randomized sham-controlled trial consisting of a 4-month training period followed by an 8-month open label extension phase.InterventionThe RMT program will consist of a home-based, individualized training program involving 30-breathing cycles through an inspiratory and expiratory muscle training device. Patients will be instructed to perform 10 training sessions over 5–7 days per week. In the active training group, the inspiratory and expiratory threshold will be adjusted to perceived exertion (measured on a Borg scale). The sham-control group will initially receive RMT at the same frequency but against a constant, non-therapeutic resistance. After four months the sham-control group will undergo the same intervention as the active training group (i.e., delayed intervention). Individual adherence to the RMT protocol will be reviewed every two weeks by telephone/video call with a physiotherapist.Main study parameters/endpointsWe hypothesize that the RMT program will be feasible (good adherence and good acceptability) and improve inspiratory muscle strength (primary outcome measure) and expiratory muscle strength (key secondary outcome measure) as well as lung function, patient reported breathing difficulties, respiratory infections, and health related quality of life (additional secondary outcome measures, respectively) in patients with SMA.DiscussionRMT is expected to have positive effects on respiratory muscle strength in patients with SMA. Integrating RMT with recently introduced genetic therapies for SMA may improve respiratory muscle strength in this patient population.Trial registrationRetrospectively registered at clinicaltrial.gov: NCT05632666.

Effectiveness of Respiratory Muscle Training in Adults With Pulmonary Hypertension. A Systematic Review and Meta-Analysis.

Patients with pulmonary hypertension (PH) may have impaired exercise capacity and quality of life; this may possibly be due to the early onset of dyspnoea associated with respiratory muscle weakness. Respiratory muscle training could improve the condition of these patients, so this study aimed to determine, through a systematic review and meta-analysis, the effectiveness of respiratory muscle training in adult patients with PH. Medline, Embase, CENTRAL, clinical trial registries databases, and grey literature and reference lists of reviews related to the objective were searched up to March 2022. Controlled clinical trials comparing the effectiveness of respiratory muscle training with sham or no intervention in adults with PH were included. Records were independently screened by two authors. The primary outcomes were maximal and functional exercise capacity, quality of life, and dyspnoea. The secondary outcomes were respiratory muscle strength, physical activity, lung function, and adverse events. Two authors independently extracted data and the study quality was assessed using the Cochrane risk-of-bias tool 2 (RoB 2). The certainty of the evidence was assessed according to the GRADE approach. A total of 5,524 records were screened, and seven randomised clinical trials (RCTs) (257 participants) were included. It was uncertain whether inspiratory muscle training (IMT), compared with sham IMT or no intervention, increased the distance walked in the 6-minute walk test (6MWT) (MD, 39 m; 95% CI, 20.72-57.39; I2=27%; four RCTs; very low certainty of evidence) and slightly decreased the perceived sensation of dyspnoea (MD, 0.5 points on the mMRC scale; 95% CI, -0.87 to -0.13; I2=0%; two RCTs; very low certainty of evidence). In addition, it was uncertain whether IMT had no effect on the emotional (SMD,-0.34; 95% CI, -1.06 to 0.38; I2=64%; three RCTs; very low certainty of evidence) and physical (SMD,0.06; 95% CI, -0.41 to 0.52; I2=16%; three RCTs; very low certainty of evidence) component of quality of life. It is uncertain whether IMT increases functional exercise capacity and slightly decreases the sensation of dyspnoea. In addition, it is uncertain whether IMT does not affect the quality of life. More RCTs and with a better methodological design are needed to increase the certainty of the evidence and determine the real effect of this intervention.

Effectiveness of Respiratory Muscle Training Interventions in Patients with Spinal Cord Injury; A Literature Review

Spinal Cord Injury (SCI) level tinggi dapat menyebabkan gangguan pada pernapasan yang dapat mengancam nyawa pasien. One of the interventions that can be given to individuals with SCI in reducing complications of respiratory problems is Respiratory Muscle Training (RMT). Respiratory Muscle Training (RMT) is a technique that aims to improve the function of the respiratory muscles through specific exercises. This study determined the effectiveness of respiratory muscle training in spinal cord injury patients with respiratory problems. This literature review used several databases such as Google Scholar, Pubmed, Ebsco, Sciencedirect, CINAHL, and SAGE with inclusion criteria Articles published less than five years (2018-2022), English, Full text, Systematic review/meta-analysis/RCT. The results indicate that this RMT intervention's effectiveness on respiratory muscles and lung function depends on the characteristics of SCI patients. There were six articles used for the review of this paper. The results show that this respiratory muscle training intervention's effectiveness impacts respiratory muscles and lung function depending on the characteristics of the spinal cord injury patient himself. Furthermore, the results suggest that this RMT intervention's efficacy on respiratory muscle and lung function depends on the features of the SCI patient.

Editor's Message: Changing of the Guard.

Editor's Message: Changing of the Guard.

목척수손상환자의 호흡근훈련의 효과

Purpose: This systematic review was designed to analyze studies examining the effects of respiratory muscle training on cervical spinal cord injury.&#x0D; Methods: Randomized controlled trials on the rehabilitation of patients with cervical spinal cord injury were searched using four databases: Physiotherapy Evidence Database (PEDro), PubMed, and Google Scholar. Five studies were selected according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, and the PEDro scale was used for qualitative analysis. For rehabilitation, a protocol including respiratory training and physical activity was selected.&#x0D; Results: Of the 135 studies identified in the 2019-2022 period, three were finally selected. All studies performed respiratory muscle training for 30-40 min a day, 5 days a week, for 6-12 weeks. Performing a meta-analysis was difficult because of differences in the study design, and all studies reported significant improvement in respiratory function compared with that in the control group.&#x0D; Conclusion: The literature on various respiratory muscle training for cervical spinal cord injury is scarce. However, it is confirmed that respiratory muscle training has a positive effect on not only respiratory function but also neuroplasticity, cardiovascular autonomic function, and quality of life in patients with cervical spinal cord injury.

Effect of respiratory muscle training using Ultrabreathe device on pulmonary function in Duchenne Muscular Dystrophy through telephysiotherapy

Background. Duchenne Muscular Dystrophy (DMD), an X linked disorder resulting in respiratory insufficiency, caused by progressive respiratory muscle weakness particularly in diaphragm. During this pandemic, Telerehabilitation played a major role among patients, especially disabled children. OBJECTIVE: To find out the effect on the pulmonary function in DMD children by training the respiratory muscles by telephysiotherapy. Methodology. Non Experimental design, Case series- pre and post test type. Convenient sampling, sample size was 5. Boys and girls between 9 and 16 years of age were included in the study. Procedure. 5 subjects were selected based on the inclusion and exclusion criteria and were trained for one minute with minimum resistance using ultrabreathe through Telephysiotherapy which is repeated for 3 times in a session with a rest period of 20–30 seconds for six weeks. Outcome measure. Pulmonary Function test. Results. The results of this study shows increased mean value of post test Tidal volume, Forced Vital Capacity, Inspiratory time/Respiration time and Tidal Volume / Inspiration time compared with pre test, whereas other parameters like Duration of Inspiration, Total Lung Volume, Inspiratory Capacity, Forced Expiratory Volume1 does not increased. Conclusion This study concluded that the Duchenne Muscular Dystrophy children improved in Tidal Volume, Forced Vital Capacity, Tidal Volume/Inspiration Time, and Inspiration Time/Respiration Time whereas all other parameters such as Duration of Inspiration, Total lung volume, Inspiratory capacity and Forced Expiratory volume1 maintained after 6 weeks of respiratory muscles training with ultrabreathe device.

Therapeutic Effects of Respiratory Muscle Training in Patients with Chronic Obstructive Pulmonary Disease

<h3>Research Objectives</h3> To investigate the improvement of cognition, lung function, clinical scores, and diaphragmatic muscle performance after respiratory muscle training in populations of chronic obstructive pulmonary disease (COPD) comorbid with mild cognitive impairment. <h3>Design</h3> This is a prospective randomized study with eight weeks of intervention. <h3>Setting</h3> Participants were recruited from a tertiary referral center, and they were instructed to perform training at home with telephonic supervision every week. <h3>Participants</h3> The inclusion criteria included: (1) a diagnosis of COPD, and (2) an mini mental state examination (MMSE) score between 23 and 27. The exclusion criteria were: (1) being unable to follow respiratory muscle training instructions or complete the questionnaires of our study due to cognitive impairment; (2) difficulty in completing cardiopulmonary exercise testing (CPET) due to high-risk cardiopulmonary diseases or orthopedic conditions; (3) a body mass index (BMI) of ≥30. Finally, 28 patients received both inspiratory and expiratory muscle training and 20 patients received inspiratory muscle training only. <h3>Interventions</h3> Participants were randomized into the full training (inspiratory plus expiratory muscle training) or the simple training group (inspiratory muscle training only) for a total of eight weeks. <h3>Main Outcome Measures</h3> Diaphragmatic thickness fraction and excursion examined through ultrasound; scores of MMSE, the COPD assessment test (CAT) and modified Medical Research Council (mMRC) scale; percentage of predicted FVC, FEV1, FEV1/FVC, DLCO, and DLCO/VA examined by pulmonary function test; dead space fraction (Vd/Vt) and minute ventilation to CO2 output (VE/VCO2) slope examined by CPET; and distance walked and changes in oxygen saturation and perceived exertion during six-minute walking test. <h3>Results</h3> Respiratory muscle training significantly improved the diaphragmatic thickness fraction and excursion, lung functions, MMSE, CAT and mMRC scores. The difference between the full training and simple training group was not significant. Patients with FEV1>30% had more improvement in diaphragmatic thickness than those with FEV1< 30%. <h3>Conclusions</h3> Expiratory muscle training could provide no further benefit to inspiratory muscle training. Additional study recruiting more patients with FEV< 30% could better validate our study results in clinical settings. <h3>Author(s) Disclosures</h3> Nothing to be disclosed.

The Additive Effectiveness of Inspiratory Muscle Training on Glottic Closure and Subjective Voice Outcomes of Patients With Benign Lesion After Hyaluronic Acid Laryngoplasty

ObjectivesFor patients with glottic insufficiency disease, injection laryngoplasty is a rapid and efficient management option that complements voice therapy. Some studies have indicated that respiratory muscle training may also show promise in patients with voice disorders. However, the effect of respiratory muscle training in patients with glottic insufficiency was reported to be limited, and whether it provides additional benefit after standard management requires further evaluation. We aimed to investigate the effectiveness of inspiratory muscle training on glottis closure and patient-reported voice quality in glottic insufficiency patients who had been treated with hyaluronic acid injection. Study DesignRetrospective observational study. MethodsWe included 46 patients with glottic insufficiency who had undergone hyaluronic acid injection. Twenty of them had undergone inspiratory muscle training during three months. We measured patients’ changes in glottic status according to the normalized glottal gap area and bowing index, as well as voice quality of life according to the voice handicap index 10 and the voice outcome survey, before and after training. ResultsPatients who underwent inspiratory muscle training had higher odds of experiencing better improvement in all scores. The range of odds ratios ranged from 2.5 to 6.3 for changes in scores, and from 3.8 to 22.2 for changes in score percentages. Of note, the effect of training on percentage changes in the normalized glottal gap area score was significant (P= 0.0127) after adjustment for the duration of vocal disease, body mass index and BMI, and history of gastroesophageal reflux disease. ConclusionsInspiratory muscle training can improve the glottal gap after injection laryngoplasty, and may be applied in clinical practice.