Influence Of Inspiratory Muscle Training Research Articles

Influence of Inspiratory Muscle Training on Respiratory Functions among Uncontrolled Asthmatics

Background: Specific breathing exercises are reported to improve quality of life and reduce symptoms; although no significant benefit on lung function or reduction of exacerbation risk. Additionally, inspiratory muscle training (IMT) aims to increase diaphragm and inspiratory muscle endurance. In this regard, IMT has been studied in uncontrolled asthma patients to investigate its effect on respiratory symptoms and pulmonary functions. Methods: Twenty-one uncontrolled and partially controlled asthmatic patients were included in the study. Asthma control test (ACT), asthma quality of life questionnaire (AQLQ), and spirometric evaluations were performed. The study population was randomized into two groups. The standard care group (n=10) received standard medical treatment while the intervention (n=11) group practiced a portable threshold IMT device following standard medical treatment. Results: The study was completed by 15 patients due to 6 lost follow up (one intervention group and 5 standard care) and one asthma exacerbation. We have found that the intervention group tended to have increased pulmonary function test parameters and AQLQ scores, moreover; MIP values and ACT scores have statistically significant increases after IMT(p=0.01, p=0.02 respectively). Conclusion: Add-on IMT to standard medical treatment could improve asthma control by strengthening inspiratory muscles in uncontrolled asthmatic patients. IMT could be considered in the non-pharmacological treatments of uncontrolled asthmatic patients. Despite the limited number of patients, this study revealed that IMT might have positive outcomes for uncontrolled asthma patients.

Influence of Inspiratory Muscle Training of Various Intensities on the Physical Performance of Long-Distance Runners.

The aim of this study was to assess the efficacy of inspiratory muscle training (IMT) at different intensities on the pulmonary function and physiological adaptations of long-distance runners undergoing sports training. This study involved 25 long-distance runners. The subjects were randomly divided into three groups depending on the type of IMT applied: POWERbreathe device (group 1), Threshold IMT device (group 2), and a control group. The following lung variables were evaluated: vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in one second (FEV1) and peak expiratory flow (PEF). Respiratory muscle strength was assessed by maximum inspiratory pressure (PImax) and maximum expiratory pressure (PEmax). Spiroergometric measures included: heart rate (HR), oxygen uptake (VO2max), carbon dioxide production (VCO2max), maximum ventilation (VE) and respiratory exchange rate (RER), which were measured breath by breath using a gas analyser (VYNTUS CPX). Group 1, which used the POWERbreathe device, showed significant increases in all assessed physiological and physical performance variables. In group 2, which used the Threshold device, only VO2max, VE and tRER ventilation were significantly increased to a similar level as that observed in group 1. In the control group, we only observed a significant reduction in saturation. The use of IMT with a higher intensity resulted in significant improvements in all tested variables of lung ventilation and respiratory muscle strength. Also, after training, lactate accumulation was significantly decreased. Physiological characteristics (VO2max/kg) and muscle respiratory strength variables were significantly improved in the group that used the POWERbreathe device after 8 weeks of training.

Chronic Influence of Inspiratory Muscle Training at Different Intensities on the Serum Metabolome.

This study investigated the chronic effect of inspiratory muscle training (IMT) on the human serum metabolome in healthy male recreational cyclists. Using a randomized, parallel group design, twenty-eight participants were randomized to three IMT groups: low intensity (LI, n = 7); moderate intensity (MI, n = 10); and high intensity (HI, n = 11). The IMT was performed for 11 weeks. Another group of participants under the same conditions, who did not perform the IMT but participated in all procedures, was included as controls (CG, n = 6). Blood samples were collected one week before and after 11 weeks of IMT and analyzed for metabolite shifts using 1H NMR. Statistical analysis included a 4 (group) × 2 (time) repeated measures ANOVA using the general linear model (GLM), and multivariate principal component analysis (PCA). Untargeted metabolomics analysis of serum samples identified 22 metabolites, including amino acids, lipids, and tricarboxylic acid cycle intermediates. Metabolites shifts did not differ between groups, indicating that IMT at three intensity levels did not alter the serum metabolome relative to the control group. These results reveal novel insights into the metabolic effects of the IMT and are consistent with the results from other studies showing negligible chronic alterations in the serum metabolome in response to physical training.

Influence of Inspiratory Muscle Training on Sympatho‐excitation in Healthy Young Adults

Inspiratory muscle training (IMT) lowers blood pressure in healthy young adults and adults with obstructive sleep apnea (Vranish & Bailey, 2015; 2016). Importantly, in healthy young adults, 6 weeks IMT also is associated with significant declines in systemic vascular resistance (Delucia et al. 2017). In light of these outcomes, in the current study we test the hypothesis that 6 weeks IMT reduces sympathetic outflow. Accordingly, we recruited healthy college‐aged students and randomly allocated them to either IMT or to Sham training groups. At intake (Week 1) and study completion (Week 6) we recorded MSNA as subjects performed sympatho‐excitatory challenges as follows: Valsalva maneuver, Mueller maneuver, submaximal grip test, cold pressor test, and mental stress tests (Stroop and mental arithmetic). Additionally, we performed weekly (blinded) assessments of systolic and diastolic blood pressures (SBP and DBP), and assessed maximal inspiratory pressure and respiratory function. Our preliminary results indicate subjects in the IMT group have lowered systolic (114.3 ± 3.4 mmHg vs. 106.7 ± 1.8 mmHg, p=0.0115) and diastolic (68.39 ± 1.58 mmHg vs. 63.5 ± 0.97 mmHg, p=0.0413) blood pressures relative to Sham trained subjects (SBP 114.7 ± 2.94 mmHg vs. 108.9 ± 1.34 mmHg and DBP 72.47 ± 3.29 mmHg vs. 69.99 ± 1.75 mmHg). Consistent with our hypothesis, preliminary analyses highlight lowered sympathetic burst frequency in the IMT group during Valsalva maneuvers (Week 1:15 ± 2.2 bursts per 15 seconds vs. Week 6: 11 ± 1.5 bursts per 15 seconds) as compared to Sham trained subjects (Week 1:12.13 ± 1.48 bursts per 15 seconds vs. Week 6:11.63 ± 0.83 bursts per 15 seconds). Data collection is ongoing however, our early findings show a reduction in sympathetic outflow during respiratory challenges which may underpin declines in peripheral resistance and blood pressure seen in healthy young adults following IMT.Support or Funding InformationThis work was supported by start up monies awarded to EFB.This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

The influence of inspiratory muscle training combined with the Pilates method on lung function in elderly women: A randomized controlled trial

OBJECTIVE:Aging is progressive, and its effects on the respiratory system include changes in the composition of the connective tissues of the lung that influence thoracic and lung compliance. The Powerbreathe® K5 is a device used for inspiratory muscle training with resistance adapted to the level of the inspiratory muscles to be trained. The Pilates method promotes muscle rebalancing exercises that emphasize the powerhouse. The aim of this study was to evaluate the influence of inspiratory muscle training combined with the Pilates method on lung function in elderly women.METHODS:The participants were aged sixty years or older, were active women with no recent fractures, and were not gait device users. They were randomly divided into a Pilates with inspiratory training group (n=11), a Pilates group (n=11) and a control group (n=9). Spirometry, manovacuometry, a six-minute walk test, an abdominal curl-up test, and pulmonary variables were assessed before and after twenty intervention sessions. RESULTS:The intervention led to an increase in maximal inspiratory muscle strength and pressure and power pulmonary variables (p<0.0001), maximal expiratory muscle strength (p<0.0014), six-minute walk test performance (p<0.01), and abdominal curl-up test performance (p<0.00001). The control group showed no differences in the analyzed variables (p>0.05).CONCLUSION:The results of this study suggest inspiratory muscle training associated with the Pilates method provides an improvement in the lung function and physical conditioning of elderly patients.

Influence of Inspiratory Muscle Training on Ventilatory Efficiency and Cycling Performance in Normoxia and Hypoxia.

The aim of this study was to analyse the influence of inspiratory muscle training (IMT) on ventilatory efficiency, in normoxia and hypoxia, and to investigate the relationship between ventilatory efficiency and cycling performance. Sixteen sport students (23.05 ± 4.7 years; 175.11 ± 7.1 cm; 67.0 ± 19.4 kg; 46.4 ± 8.7 ml·kg−1·min−1) were randomly assigned to an inspiratory muscle training group (IMTG) and a control group (CG). The IMTG performed two training sessions/day [30 inspiratory breaths, 50% peak inspiratory pressure (Pimax), 5 days/week, 6-weeks]. Before and after the training period subjects carried out an incremental exercise test to exhaustion with gas analysis, lung function testing, and a cycling time trial test in hypoxia and normoxia. Simulated hypoxia (FiO2 = 16.45%), significantly altered the ventilatory efficiency response in all subjects (p < 0.05). Pimax increased significantly in the IMTG whereas no changes occurred in the CG (time × group, p < 0.05). Within group analyses showed that the IMTG improved ventilatory efficiency (VE/VCO2 slope; EqCO2VT2) in hypoxia (p < 0.05) and cycling time trial performance [WTTmax (W); WTTmean (W); PTF(W)] (p < 0.05) in hypoxia and normoxia. Significant correlations were not found in hypoxia nor normoxia found between ventilatory efficiency parameters (VE/VCO2 slope; LEqCO2; EqCO2VT2) and time trial performance. On the contrary the oxygen uptake efficiency slope (OUES) was highly correlated with cycling time trial performance (r = 0.89; r = 0.82; p < 0.001) under both conditions. Even though no interaction effect was found, the within group analysis may suggest that IMT reduces the negative effects of hypoxia on ventilatory efficiency. In addition, the data suggest that OUES plays an important role in submaximal cycling performance.

The influence of inspiratory muscle training on lung function in female basketball players - a randomized controlled trial

Inspiratory muscle fatigue may inhibit healthy athletes to achieve maximum performance, compromising blood flow and perfusion on locomotor muscles. Recent studies have showed irregular influence of inspiratory muscle training (IMT) on resting lung function. It was hypothesized that a 4-week IMT protocol would improve pulmonary function of basketball players. Twenty-one female basketball players were randomly assigned to an experimental group (EG) (n=11) or a control group (CG) (n=10). Pre- and post-forced expiratory volume in first second (FEV1), forced vital capacity (FVC) and peak expiratory flow (PEF) were assessed with spirometry in the beginning of the sport's season, at the first day of protocol and four weeks after. The EG (22.00±5.00 years) was submitted to IMT using a threshold, 5 times a week, for a 4-week protocol (30 maximal repetitions (RM) against a pressure threshold load equivalent to 50% of maximal inspiratory pressure), while the CG (18.50±5.75 years) was not subjected to any intervention during the same period. Baseline sociodemographic and anthropometric characteristics were not significantly different with the exception of age (p=0.036). No significant differences were found in baseline pulmonary volumes (0.173≤p≤0.848) neither in predicted pulmonary variables (0.223≤p≤0.654). Significant increase on FEV1, FVC and PEF was found in the EG post-protocol (p<0.001). In the CG, an improvement of PEF was found (p=0.042). This type of specific inspiratory training appears to improve pulmonary function. Results suggest that the applied IMT protocol is effective. Further research is needed to assess the sustainability of the findings and to conclude the short and long term effects of IMT on basketball players.

Corrigendum.

dos Santos Silva M, Ramos LR, Tufik S, Togeiro SM, Lopes GS. Influence of Inspiratory Muscle Training on Changes in Fasting Hyperglycemia in the Older Adult: The Epidoso Project. J Diabetes Sci Technol. 2015;9:1352-1353.(Original DOI: 10.1177/1932296815599006)In the above article, published in Journal of Diabetes Science and Technology on July 2015, has incorrectly informed that professor Dr Guiomar Silva Lopes is related to the Preventine Medicine Department of Federal University of São Paulo. In fact, on the date of its submission and publication, the aforementioned professor was a member of Nursing Department of Federal University of São Paulo.

Influence of inspiratory muscle training on weaning patients from mechanical ventilation: a systematic review

Abstract Introduction: The inability of respiratory muscles to generate force and endurance is recognized as an important cause of failure in weaning patients from invasive mechanical ventilation (IMV). Thus, inspiratory muscle training (IMT) might be an interesting treatment option for patients with prolonged IMV weaning. Objective: The aim of this systematic literature review was to evaluate the effectiveness of inspiratory muscle training in weaning patients from mechanical ventilation and to identify the most effective type of training for this particular purpose. Methods: We searched PubMed, LILACS, PEDro and Web of Science for randomized clinical trials published in English or Portuguese from January 1990 until March 2015. Results: Eighty-nine studies were identified of which five were selected. A total of 267 patients participated in the five randomized clinical trials analyzed here. IMV duration before onset of training varied greatly among subjects. Three studies performed IMT using a threshold device and two studies used adjustments of ventilator pressure sensitivity. Four studies have shown that IMT resulted in a significant increase in inspiratory maximal pressure. Only two studies, however, have reported that IMT resulted in higher success rates in weaning patients from IMV. One study has found that patients showed a shorter ventilator weaning duration after IMT. Conclusion: IMT using pressure threshold devices results in increased inspiratory muscle strength and can therefore be considered a more effective treatment option and with the potential to optimize ventilator weaning success in patients at risk of prolonged IMV.

Influence of Inspiratory Muscle Training on Changes in Sleep Architecture in Older Adult - Epidoso Projects

Background: Senescence is accompanied by changes in sleep parameters including fragmentation and increased abnormal respiratory events (apneas/hypopneas obstructive and central) with hypoxemia. Objective: This project aims to investigate the influence of inspiratory muscle training through the Threshold® on sleep disorders. Methods: The study involved the participation of 38 older adult volunteers of both genders with sleep disorders confirmed by polysomnography. Chosen patients underwent laboratory evaluation, cardiorespiratory assessment and evaluation of sleep, forming two groups: control group (Threshold® unloaded) and experimental groups (Threshold® loaded). The study lasted 8 weeks and frequency of 7 times per week, lasting 60 minutes each session. Results: Showed a decrease in the fragmentation sleep and apnea/hypopnea index. Conclusion: These results made us suggest that inspiratory muscle training can be a good help in the treatment of sleep-related breathing disorders.

The influence of inspiratory muscle training on diaphragmatic mobility, pulmonary function and maximum respiratory pressures in morbidly obese individuals: a pilot study

Purpose: To investigate whether 12 week inspiratory muscle training (IMT) has any impact on pulmonary function, maximum respiratory pressures and diaphragmatic mobility (DM) in morbidly obese subjects. Method: Thirty-one morbidly obese individuals were assessed. Volunteers were randomised into two groups. The IMT group (n = 16) followed an IMT protocol for 12 weeks, with a training load of 30% of maximal inspiratory pressure (PImax). The control group (CG) (n = 15) followed the same protocol but without inspiratory load. Results: A total of 14 subjects performed IMT for 12 weeks. Significant increases in PImax (−86.86 ± −20.70 cmH2O versus −106.43 ± −32.97 cmH2O, p < 0.05) and maximal voluntary ventilation (97.84 ± 37.06 L/min versus 115.17 ± 34.17 L/min, p < 0.05) were observed in the IMT group when compared to baseline. However, only FIV1 significantly differed between the IMT group and the CG after the 12 week protocol (3.35 ± 0.96 L versus 2.22 ± 1.07 L, respectively; p < 0.05). No significant differences were found in DM after the IMT protocol was performed. Conclusion: IMT improved PImax and altered the FIV1. These results suggest that the improvements in muscular respiratory efficiency were insufficient to mobilise the diaphragm and modify ventilation mechanics. Pre-operative IMT may be a valuable approach in obese patients for preventing post-operative pulmonary complications. http://clinicaltrials.org -- NCT01449643 -- The Influence of IMT on Diaphragmatic Mobility in Morbidly Obese.Implications for Rehabilitation Morbid ObesityMorbid obesity is a disabling condition that has a serious negative impact on lung function, respiratory muscle function and quality of life.Inspiratory Muscle Training (IMT) is a technique which aims to improve pulmonary expansion and to prevent post surgery complications on morbid obese individuals.This study shows significantly increased on maximal inspiratory pressure, maximal voluntary ventilation and promoted changes on spirometric variables after IMT.

Influence of Prior Activity (Warm-Up) and Inspiratory Muscle Training upon Between- and Within-Day Reliability of Maximal Inspiratory Pressure Measurement

Background: A specific inspiratory muscle ‘warm-up’ (IWU) prior to assessment of maximal inspiratory mouth pressure (PI_max) may reduce the number of measurements required to obtain reproducible, representative estimates of PI_max. The influence of inspiratory muscle training (IMT) upon this phenomenon is unknown. Objective: Compare the impact of an IWU on the between- and within-day reliability of PI_max before and after IMT. Method: Eight participants were assessed on 4 separate occasions: 2 trials preceded IMT and 2 followed it. At each assessment, the highest of 3 initial efforts was recorded as the pre-IWU value (PI). The highest of 9 subsequent efforts that followed 2 sets of 30 breaths at 40% PI was recorded as PI_max. Following 4 weeks of IMT, the trials were repeated. Results: IWU increased PI by 11–17% (p ≤ 0.01), irrespective of IMT status. After IWU, 5–6 efforts were required to determine PI_max, irrespective of IMT status. PI_max was similar between the 2 trials before IMT and the 2 trials after IMT (p ≥ 0.05), and was 21% higher after IMT (p ≤ 0.01). The coefficient of variation was excellent before and after IWU, both before (1.9 and 0.6%, respectively) and after IMT (1.1 and 0.3%, respectively). Limits of agreement and sample sizes for effect sizes ≤10% were substantially smaller after IWU in all trials. Conclusions: (1) IWU enhances the between-day reliability of PI_max measurement, and this is unaffected by IMT, and (2) judgements regarding acceptability in relation to PI_max reliability should be made in relation to analytical goals and we present data to facilitate this.

Effects of inspiratory muscle training on respiratory function and repetitive sprint performance in wheelchair basketball players

BackgroundThere is considerable evidence that respiratory muscle training improves pulmonary function, quality of life and exercise performance in healthy athletic populations. The benefits for wheelchair athletes are less well understood....

Rehabilitacja oddechowa chorych z idiopatycznym śródmiąższowym włóknieniem płuc za pomocą programu z ćwiczeniami mięśni wdechowych

Evaluation of effectiveness of pulmonary rehabilitation in patients with idiopathic pulmonary fibrosis (IPF) has not yet been presented in medical literature. The objective of the study is to analyze the influence of inspiratory muscle training on dyspnea (oxygen cost diagram [OCD], baseline dyspnea index [BDI]), quality of life (SF-36), results of 6 MWT (distance, dyspnea in Borg's scale), maximal inspiratory pressure (MIP), and lung function tests (IC, TLC, VC, FEV1, DLCO(SB), DLCO/VA) in patients with IPF. Investigations were conducted before, after 6 and 12 weeks of pulmonary rehabilitation performed in 2 groups of patients: study group (GB)--16 patients--with inspiratory muscle training added to general body conditioning and in control group (GK)--14 patients--who performed only general body conditioning. After 12 weeks of rehabilitation in SG we noticed the significant decrease of dyspnoea before (p = 0.028) and after (p = 0.012) 6 MWT, increase of distance in 6 MWT (p = 0.001), increase of MIP (p = 0.006), decrease of dyspnoea in BDI (p = 0.001) and improvement of quality of life (SF-36/PCS; p = 0.030) in comparison to baseline values. In the GK we observed increase of distance in 6MWT (p = 0.001) and improvement in quality of life (SF-36/PCS; p = 0.016). No improvement in sensation of dyspnea during 6MWT, BDI and MIP was noticed in the GK. Adding inspiratory muscle training increases effectiveness of pulmonary rehabilitation in IPF patients.