Inspiratory Muscle Training Group Research Articles

Daily inspiratory muscle training lowers blood pressure and vascular resistance in healthy men and women.

What is the central question of this study? What impact does inspiratory muscle training have on systemic vascular resistance, cardiac output and baroreflex sensitivity in adult men and women? What is the main finding and its importance? Inspiratory muscle training exerts favorable effects on blood pressure, vascular resistance and perception of stress. This exercise format is well-tolerated and equally effective whether implemented in men or women. Previous work has shown that inspiratory muscle training (IMT) lowers blood pressure after a mere 6weeks, identifying IMT as a potential therapeutic intervention to prevent or treat hypertension. Here, we explore the effects of IMT on respiratory muscle strength and select cardiovascular parameters in recreationally active men and women. Subjects were randomly assigned to IMT (n=12, 75% maximal inspiratory pressure) or sham training (n=13, 15% maximal inspiratory pressure) groups and underwent a 6-week intervention comprising 30breathsday-1 , 5daysweek-1 . Pre- and post-training measures included maximal inspiratory pressure and resting measures of blood pressure, cardiac output, heart rate, spontaneous cardiac baroreflex sensitivity and systemic vascular resistance. We evaluated psychological and sleep status via administration of the Cohen-Hoberman inventory of physical symptoms and the Epworth sleepiness scale. Male and female subjects in the IMT group showed declines in systolic/diastolic blood pressures (-4.3/-3.9mmHg, P<0.025) and systemic vascular resistance (-3.5mmHgminl-1 , P=0.008) at week 6. There was no effect of IMT on cardiac output (P=0.722), heart rate (P=0.795) or spontaneous cardiac baroreflex sensitivity (P=0.776). The IMT subjects also reported fewer stress-related symptoms (pre- versus post-training, 12.5±8.5 versus 7.2±9.7, P=0.025). Based on these results, we suggest that a short course of IMT confers significant respiratory and cardiovascular improvements and parallel (modest) psychological benefits in healthy men and women.

Effects of inspiratory muscle training on dyspnoea in severe COPD patients during pulmonary rehabilitation: controlled randomised trial.

The benefit of inspiratory muscle training (IMT) combined with a pulmonary rehabilitation programme (PRP) is uncertain. We aimed to demonstrate that, in severe and very severe chronic obstructive pulmonary disease (COPD) patients, IMT performed during a PRP is associated with an improvement of dyspnoea.In a single-blind randomised controlled trial, 150 severe or very severe COPD patients were allocated to follow PRP+IMT versus PRP alone. The evaluations were performed at inclusion and after 4 weeks. The primary outcome was the change in dyspnoea using the Multidimensional Dyspnoea Profile questionnaire at the end of a 6-min walk test (6MWT) at 4 weeks. Secondary outcomes were changes in dyspnoea using the Borg (end of the 6MWT) and modified Medical Research Council scales and in functional parameters (maximal inspiratory pressure (PImax), inspiratory capacity, 6MWT and quality of life). All analyses were performed on an intention-to-treat basis.Dyspnoea decreased significantly in both groups; however, the improvement of dyspnoea was not statistically different between the two groups. We only found a statistically significant greater increase of PImax after IMT+PRP than after PRP alone.In this trial including severe or very severe COPD patients, we did not find a significant benefit of IMT during PRP+IMT as compared to PRP alone on dyspnoea, despite a significantly higher improvement of PImax in the IMT group.

Corticoterapia vs. corticoterapia con inmunosupresores en el tratamiento de la fase aguda del síndrome de Vogt-Koyanagi-Harada

IntroductionVogt-Koyanagi-Harada disease is a multisystem disorder characterized by a bilateral granulomatous panuveitis. Multiple therapeutic regimens have been used to control inflammation in acute uveitic stage to prevent irreversible visual loss. The purpose of this paper is to compare the effect, on functional and anatomic outcomes, of early treatment with standard corticotherapy vs. corticotherapy plus immunosuppressive (IMT) therapy in acute Vogt-Koyanagi-Harada disease (Group A vs Group B). MethodsA retrospective chart review of patients with Vogt-Koyanagi-Harada disease, with an evolution time of 2 weeks or less, who attended the Inflammatory Eye Disease Clinic, from 2001 to 2015. Data collected included demographic information, presenting features, treatment and improvement in visual acuity (VA). ResultsSixteen charts were reviewed; 15 females (93.75%). Mean age: 30.81±10.53 years, follow-up time (months): 54.94±43.43. Ten patients (66.6%) had IMT, azathioprine, methotrexate and cyclophosphamide.In group A, initial VA<20/200 in 66.7%; final VA was ≥20/40 in 9 eyes (75%). In group B, initial VA<20/200 in 65%; final VA≥20/40 in 15 eyes (75%). In group A, VA improved faster at one and 3 months (ANOVA P<.057). Clinical characteristics in convalescent stage and complications were similar.Anterior chamber recurrences occurred in both groups and posterior pole recurrences were observed in group A. Time to first recurrence was similar (P<.279).Frequency of recurrence was 2.33±1.80 vs 1.5±0.79 (P<.01). At recurrence 15 patients were still having oral steroids, nine in group A, 6 in Group B. In group A, prednisone was given during more time: mean 15.17±12.08 months, and time to reach to 10mg dose was longer: 8.60±11.7 (P<.008 and P<.046). ConclusionsAdding IMT as first line therapy to corticosteroids, do not matter significantly in terms of final VA or development of visually significant complications. In the IMT plus corticosteroids group number of recurrences was significantly lower, and a steroid sparing effect was evident.

Impact of Weekly Swimming Training Distance on the Ergogenicity of Inspiratory Muscle Training in Well-Trained Youth Swimmers

Lomax, M, Kapus, J, Brown, PI, and Faghy, M. Impact of weekly swimming training distance on the ergogenicity of inspiratory muscle training in well-trained youth swimmers. J Strength Cond Res 33(8): 2185-2193, 2019-The aim of this study was to examine the impact of weekly swimming training distance on the ergogenicity of inspiratory muscle training (IMT). Thirty-three youth swimmers were recruited and separated into a LOW and HIGH group based on weekly training distance (≤31 km·wk and >41 km·wk, respectively). The LOW and HIGH groups were further subdivided into control and IMT groups for a 6-week IMT intervention giving a total of 4 groups: LOWcon, LOWIMT, HIGHcon, and HIGHIMT. Before and after the intervention period, swimmers completed maximal effort 100- and 200-m front crawl swims, with maximal inspiratory and expiratory mouth pressures (PImax and PEmax, respectively) assessed before and after each swim. Inspiratory muscle training increased PImax (but not PEmax) by 36% in LOWIMT and HIGHIMT groups (p ≤ 0.05), but 100- and 200-m swims were faster only in the LOWIMT group (3 and 7% respectively, p ≤ 0.05). Performance benefits only occurred in those training up to 31 km·wk and indicate that the ergogenicity of IMT is affected by weekly training distance. Consequently, training distances are important considerations, among others, when deciding whether or not to supplement swimming training with IMT.

Safety and efficacy of inspiratory muscle training for preventing adverse outcomes in patients at risk of prolonged hospitalisation

BackgroundThe early institution of inspiratory muscle training on hospitalised patients with no established respiratory deficits could prevent in-hospital adverse outcomes that are directly or indirectly associated to the loss of respiratory muscle mass inherent to a prolonged hospital stay. The objective of the clinical trial is to assess the impact of inspiratory muscle training on hospital inpatient complications.MethodsThis is a double-blind randomised controlled trial. Subjects in the intervention group underwent an inspiratory muscle training loaded with 50% maximum inspiratory pressure twice daily for 4 weeks from study enrolment. Patients were randomly assigned to an inspiratory muscle training group or a sham inspiratory muscle training group. All patients received conventional physiotherapy interventions. Baseline and post-intervention respiratory and peripheral muscle strength, functionality (performance of activities of daily living), length of hospital stay, and death were evaluated. Clinical outcomes were assessed until hospital discharge. This study was approved by the Institutional Hospital Ethics Committee (03/2014).ResultsThirty-one patients assigned to the inspiratory muscle training group and 34 to the sham inspiratory muscle training group were analysed. Patients in the inspiratory muscle training group had a shorter mean length of hospital stay (35.3 ± 2.7 vs. 41.8 ± 3.5 days, p < 0.01) and a lower risk of endotracheal intubation (relative risk (RR) = 0.36; 95% confidence interval (CI) 0.27–0.97; p = 0.03) as well as muscle weakness (RR = 0.36; 95% CI 0.19–0.98; p = 0.02) and mortality (RR = 0.23; 95% CI 0.2–0.94; p = 0.04). The risk of adverse events did not differ significantly between groups.ConclusionInspiratory muscle training was a protective factor against endotracheal intubation, muscle weakness, and mortality.Trial registrationClinicalTrials.gov, ID: NCT02459444. Registered on 19 May 2015.

Effectiveness of inspiratory muscle training on sleep and functional capacity to exercise in obstructive sleep apnea: a randomized controlled trial.

The aim of this study was to evaluate the effectiveness of inspiratory muscle training (IMT) on sleep and functional capacity to exercise in subjects with obstructive sleep apnea (OSA). This is a controlled, randomized, double-blind study conducted in 16 OSA patients divided into two groups: training (IMT: n=8) and placebo-IMT (P-IMT: n=8). IMT was conducted during 12weeks with a moderate load (50-60% of maximal inspiratory pressure-MIP), while P-IMT used a load <20% of MPI. Total daily IMT time for both groups was 30min, 7days per week, twice a day. There was no difference comparing IMT to P-IMT group after training for lung function (p>0.05) and respiratory muscle strength (p>0.05). Maximal oxygen uptake (VO2Max) was not significantly different between IMT and P-IMT group (mean difference -1.76, confidence interval (CI) -7.93 to 4.41, p=0.71). The same was observed for the other ventilatory and cardiometabolic variables measured (p>0.05). A significant improvement in sleep quality was found when Pittsburgh Sleep Quality Index (PSQI) values of IMT and P-IMT group after training were compared (mean difference: 3.7, confidence interval 95% (CI95%) 0.6 to 6.9, p=0.02) but no significant changes were seen in daytime sleepiness between both groups after the intervention (mean difference: 3.4, CI 95%: -3.3 to 10.0; p=0.29). According to these results, 12weeks of moderate load IMT resulted in improved sleep quality, but there were no significant repercussions on functional capacity to exercise or excessive daytime sleepiness.

Short-term high-intensity rehabilitation in radically treated lung cancer: a three-armed randomized controlled trial.

The feasibility and practicality of preoperative rehabilitation (PR) programs remains quite controversial in the treatment of lung cancer (LC). This study explored whether a short-term high-intensity rehabilitation program could improve postoperative outcomes compared to those achieved with conventional inspiratory muscle training (IMT). A three-armed randomized controlled trial comparing the two training modalities and routine care was conducted in surgical LC patients. Patient groups received one of three treatment regimens: (I) high-intensity pulmonary rehabilitation (PR) that combined IMT with conventional resistance training (CRT) (combined PR group); (II) conventional PR (single IMT group); or (III) routine preoperative preparation (control group). The primary endpoint was a change in the occurrence of post-operative pulmonary complications (PPCs) that occurred within 30 days after surgery, while secondary endpoints included changes in length of hospital stay, quality of life (QoL) scores, 6-min walk distance (6-MWD) and peak expiratory flow (PEF). A total of 90 enrolled patients were randomized into three groups with a computer-based 1:1:1 ratio. The intention-to-treat analysis of the study revealed that, compared with the Control Group, the Combined PR Group had a significant increase in ∆6-MWD (by 32.67 m, P=0.002), ∆PEF (by 14.3 L/min, P=0.001), ∆global scores (by 3.7, P=0.035); and a reduced ∆average total hospital stay (by 3.2 d, P=0.001) and ∆postoperative stay (by 3.6 d, P=0.001). With regard to PPC rate, the Combined PR Group had a somewhat lower PPC severity (grade II-V) compared to the Control Group. This hospital-based short-term program of PR combining high-intensity IMT with CRT was significantly superior to the conventional IMT program, indicating that this approach would be a feasible strategy for treating LC patients, especially those waiting operations with surgery-related risk factors.

Effects of inspiratory muscle training in professional women football players: a randomized sham-controlled trial

ABSTRACTThis study was conducted to determine the effects of inspiratory muscle training (IMT) on respiratory and peripheral muscles oxygenation during a maximal exercise tolerance test and on repeated-sprint ability (RSA) performance in professional women football players. Eighteen athletes were randomly assigned to one of the following groups: SHAM (n = 8) or IMT (n = 10). After a maximal incremental exercise test, all participants performed (on a different day) a time-to-exhaustion (Tlim) test. Peripheral and respiratory muscles oxygenation by near-infrared spectroscopy, breath-by-breath ventilatory and metabolic variables, and blood lactate concentration were measured. The RSA test was performed on a grass field. After a 6 week intervention, all athletes were reevaluated. Both groups showed increases in inspiratory muscles strength, exercise tolerance and RSA performance, however only the IMT group presented lower deoxyhemoglobin and total hemoglobin blood concentrations on intercostal muscles concomitantly to an increased oxyhemoglobin and total hemoglobin blood concentrations on vastus lateralis muscle during Tlim. In conclusion, these results may indicate the potential role of IMT to attenuate inspiratory muscles metaboreflex and consequently improve oxygen and blood supply to limb muscles during high-intensity exercise, with a potential impact on inspiratory muscle strength, exercise tolerance and sprints performance in professional women football players.

Inspiratory Muscle Training Improves Intercostal and Forearm Muscle Oxygenation in Patients With Chronic Heart Failure: Evidence of the Origin of the Respiratory Metaboreflex

BackgroundThe impact of inspiratory muscle training (IMT) on respiratory and peripheral muscle oxygenation and perfusion during inspiratory muscle fatigue in patients with chronic heart failure (HF) has not been established. Methods and ResultsTwenty-six patients with chronic HF were randomly assigned to either 8 weeks of IMT or a control group. Inspiratory fatigue was induced by means of a progressive inspiratory resistive loading protocol until there was an inability to sustain inspiratory pressure, when the inspiratory muscle metaboreflex should be activated. The main outcomes were intercostal and forearm muscle oxygen saturation and deoxygenation as measured by means of near-infrared spectroscopy (NIRS) and blood lactate levels. Inspiratory muscle strength was increased by 78% (P < .001) after 8 weeks of participation in the IMT group. IMT attenuated the reduction of oxygen saturation in intercostal and forearm muscles and the increase in blood lactate during respiratory fatigue (P < .001 and P < .05, respectively). These changes were different from the control group (P < .01, P < .05, and P < .05, respectively). After 8 weeks, similar increases in oxygen consumption, mean arterial pressure, heart rate, stroke volume, and cardiac output were observed in both groups during respiratory fatigue. ConclusionsThis randomized controlled clinical trial demonstrates that IMT attenuates the respiratory muscle oxygen demand-delivery mismatch during respiratory fatigue in patients with chronic HF.

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 effect of the inspiratory muscle training on functional ability in stroke patients.

[Purpose] This study was to find out an inspiratory muscle training (IMT) program therapeutic effects on stroke patients’ functional ability. [Subjects and Methods] Twenty stroke patients were assigned to one of two groups: inspiratory muscle training (n=10), and control (n=10), randomization. The inspiratory muscle training participants undertook an exercise program for 30 minute per times, 5 times a week for 6 weeks. The investigator measured the patients’ trunk impairment scale (TIS) and 6 minute walking test (6MW) for functional ability before and after IMT. [Results] The TIS appeared some significant differences in both groups before and after the training. The 6MW test showed some significant differences in the inspiratory muscle training group, but didn’t show any significant difference in the control group. And the differences in both groups after depending the inspiratory muscle training were significantly found in the tests of TIS and 6MW test [Conclusion] The results showed that the inspiratory muscle training in stroke patients are correlated with the trunk stability and locomotion ability, suggesting that physical therapist must take into consideration the inspiratory muscle training, as well as functional training to improve physical function in stroke patients.

Inspiratory muscle training during rehabilitation in successfully weaned hypercapnic patients with COPD

BackgroundThis study is aimed to evaluate the effect of inspiratory muscle training (IMT) added to rehabilitation in patients with chronic obstructive pulmonary disease (COPD) who remain hypercapnic and use non-invasive ventilation after successful weaning. MethodsPatients received rehabilitation and were randomized to inspiratory muscle or sham training for 4 weeks. The primary outcome was distance walked within 6 min. Secondary outcomes were inspiratory muscle strength, endurance, lung function, and blood gas levels. ResultsTwenty-nine patients participated in this study. Walking distance of the sham group increased from 93 ± 52 m at baseline to 196 ± 85 m at week 4 (p = 0.019, 95% CI: 11–196 m). Patients in the IMT group significantly improved their walking distance from 94 ± 32 to 290 ± 75 m (p < 0.0001 [107–286 m]; p = 0.04 [3–186 m] for between-group comparison). Patients in the IMT group increased their maximal inspiratory pressure from −35 ± 8 to −55 ± 11 cmH2O (p = 0.001; −6 to −33 cmH2O), while the increase in the sham group failed to reach significance (−29 ± 10 to −37 ± 13 cmH2O [−22 to 6 cmH2O]). Inspiratory power increased from 9.6 ± 5.4 to 20.7 ± 9.7 joules/min (2.6–19.5 joules/min, p = 0.003) in the IMT group, while no significant change occurred in the sham group (7.6 ± 4.2 joules/min at study entry and 11.1 ± 6.9 joules/min [−5.2–12.3 joules/min] at study end). ConclusionsRehabilitation of successfully weaned patients with COPD and persistent hypercapnia significantly improves functional exercise capacity. Additional IMT significantly enhances functional exercise capacity and increases respiratory muscle strength and power.

Inspiratory muscle training in stroke patients with congestive heart failure: A CONSORT-compliant prospective randomized single-blind controlled trial.

BackgroundCardiopulmonary function can be adversely affected after a cerebrovascular accident in patients with congestive heart failure (CHF). The aim of this study was to investigate the efficacy and feasibility of inspiratory muscle training (IMT) for stroke patients with CHF.MethodsA prospective randomized single-blind controlled trial was conducted in a single tertiary medical center in southern Taiwan between May 2011 and July 2015. Forty-one patients were enrolled, of whom 21 completed the study (IMT group n = 11 and control group n = 10). Both groups participated in a conventional stroke rehabilitation program. Patients in the IMT group received an additional IMT program beginning with an intensity of 30% maximal inspiratory pressure (MIP), then increased by 2cmH2O each week for 30 minutes daily for at least 5 days a week for 10 weeks. MIP, maximal expiratory pressure, spirometry, resting oxyhemoglobin saturation, modified Borg Scale, Fatigue Assessment Scale, and Barthel Index were assessed in each patient.ResultsThere were significant differences from baseline in MIP (P = 0.008), percent predicted forced vital capacity (P = 0.033), forced expiratory volume in 1 second (FEV1) (P = 0.008), percent predicted FEV1 (P = 0.008), and Barthel Index (P = 0.012) in the IMT group, and Barthel Index (P = 0.027) in the control group. There were significant differences between groups in MIP (20.91 ± 19.73 vs −9.00 ± 26.01, adjusted P value = 0.023) and Barthel Index (24.55 ± 22.30 vs 7.50 ± 8.25, adjusted P value = 0.044).ConclusionThe 10-week IMT was feasible and effective in improving inspiratory force and activities of daily living for the stroke patients with CHF.

Effects Of Inspiratory Muscle Training On Inspiratory And Locomotor Muscle Hemodynamics During Exercise In Men

High levels of respiratory muscle work may elicit a redistribution of blood flow from the locomotor to the respiratory muscles during exercise. It is unknown if specific inspiratory muscle training (IMT) can attenuate this response during high-intensity, whole-body exercise. PURPOSE: To examine the hemodynamic responses of multiple inspiratory muscles and the vastus lateralis (VL) during incremental cycling before and after 5 weeks of IMT. METHODS: After a comprehensive familiarization visit, 25 recreationally active healthy men (mean±SD; age=24±4; maximal aerobic power (V[Combining Dot Above]O2max)=52±10 ml·kg-1·min-1) completed two maximal incremental cycle exercise tests (25W/2min steps) separated by 5 weeks of pressure threshold IMT or sham-control training (SC). The IMT group (n=12) performed 30 inspiratory efforts twice daily against a minimum resistance of 50% of maximum inspiratory pressure (MIP), adjusted weekly. The SC (n=13) group performed a daily bout of 60 inspiratory efforts against 10% MIP using the same device with no weekly adjustments. During the incremental cycle tests, participants were instrumented with NIRS optodes on the sternocleidomastoid (SCM), parasternal intercostals (PIC), 7th intercostal space (7IC), and VL to measure changes in oxygenated, deoxygenated, and total hemoglobin (tHb) concentrations. RESULTS: The IMT and SC groups were well matched for age, height, mass, and V[Combining Dot Above]O2max. There was a significant increase in MIP in the IMT group (mean±SD, 135±44 vs. 159±35 cmH2O, p<0.05) but not in the SC group (134±39 vs. 134±44 cmH2O, p>0.05). No differences were detected when comparing pre vs. post-IMT for any NIRS derived variables at relative percentages of maximal work rate (20, 40, 60, 80,100%) for any muscle in both the IMT and SC groups. The tHb (muscle blood volume) at the highest equivalent absolute work rate achieved by an individual on each test in the IMT group (pre vs. post-IMT) was 3±15 vs. 1±25, 1±9 vs. 2±11, -6±12 vs. -6±12, and 12±10 vs. 11±9[INCREMENT]μM whereas the SC group was 2±11 vs. 3±6, 1±9 vs. 4±8, -6±6 vs. -6±8, and 12±8 vs. 9±10[INCREMENT]μM in the SCM, PIC, 7IC, and VL, respectively (all p>0.05). CONCLUSION: Five weeks of pressure-threshold IMT had no effect on respiratory or locomotor muscle hemodynamics during incremental cycle exercise in healthy recreationally active men. Supported NSERC

Effect of Inspiratory Muscle Training versus Breathing Exercise Training to Enhance the Sprint Performance and PiMax on Wheelchair Athletes with Spinal Cord Injury

Background and purpose: Spinal cord injury can be one of the most fatal experience for the individuals who sustains it, as it not only endows one with devastating effects of disability but as well renders significant effects on personal, social as well as economic aspects of a person’s life. Wheelchair basketball is a sport which requires efficient respiratory capacity or function to sustain in the game for prolonged period of time. In higher thoracic Spinal Cord Injury, respiratory function reduces and due to fatigue patient becomes dyspneic easily even after small workout. Objective: To evaluate the effectiveness of Inspiratory muscle trainer (power breathe) and breathing exercise on sprint timing and maximum inspiratory capacity or pressure inside the lungs. Methodology: Samples of 45 subjects with upper thoracic (T1-T6 level) wheelchair basketball athletes was recruited and were randomly divided into three groups: IMT, breathing exercise and control. Baseline scores of PiMax and sprint time were assessed using inspiratory monometer apparatus and 20m shuttle test respectively. Six weeks training was given to both the experimental groups and post intervention scores were measured after every 2 weeks. Results: Highly significant differences in IMT and breathing exercise groups were observed (p=0.005). However, at last week of training improvement was not so significant in IMT group. Significant differences were found within and between groups. Conclusion: Our data indicates that IMT and Breathing exercise have a significant effect on PiMax, sprint and dyspnea in recreational wheelchair basketball players by assessing through Borg scale of perceived exertion.

Time-dependent flow velocity measurement using two-dimensional color Doppler flow imaging and evaluation by Hagen-Poiseuille equation.

This paper aims to develop a technique to assess velocity flow profile and wall shear stress (WSS) spatial distribution across a vessel phantom representing an artery. Upon confirming the reliability of the technique, it was then used on a set of carotid arteries from a cohort of human subjects. We implemented color Doppler flow imaging (CDFI) for measurement of velocity profile in the artery cross section. Two dimensional instantaneous and time-dependent flow velocity and WSS vector fields were measured and their waveforms of peak velocities based on the technique were compared with WSS values generated by Hagen-Poiseuille equation. Seventy-five patients with intima-media thickening were prospectively enrolled and were divided into an IMT group. At the same time, another 75 healthy volunteers were enrolled as the control group. All the subjects were scanned and the DICOM files were imported into our in-house program. Next, we determine the velocity profile of carotid arteries in a set of 150 human subjects and compared them again. The peak velocities by the CDFI and Hagen-Poiseuille equation techniques were compared and statistically evaluated. The amounts of deviation for the two measured WSS profiles were performed and we demonstrated that they are not significantly different. At two different flow settings with peak flow velocity of 0.1, 0.5 (×10(-11)) m/s, the obtained WSS were 0.021 ± 0.04, 0.038 ± 0.05 m/s, respectively. For the patient population study, the mean WSS value calculated by Hagen-Poiseuille equation was 2.98 ± 0.15 dyne/cm(2), while it was 2.31 ± 0.14 dyne/cm(2) by our CDFI analysis program. The difference was not statistically significant (t = -1.057, P = 0.259). Similar to the Hagen-Poiseuille equation, a negative linear correlation was also found between the calculated WSS and intima-media thickness (P = 0.000). Using CDFI analysis, we found that the WSS distribution at the middle of the proximal plaque shoulder was larger than the top of the shoulder. CDFI can assess the velocity and WSS profile accurately and efficiently and may be used for clinical diagnosis of cardiovascular conditions.

Systematic Review of Inspiratory Muscle Training After Cerebrovascular Accident.

This systematic review examines levels of evidence and recommendation grades of various therapeutic interventions of inspiratory muscle training in people who have had a stroke. Benefits from different levels of force and resistance in respiratory muscles are shown in this population. This review was conducted following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) directives and was completed in November 2014. The search limits were studies published in English between 2004 and 2014. Relevant studies were searched for in MEDLINE, PEDro, OAIster, Scopus, PsycINFO, Web of Knowledge, CINAHL, SPORTDiscus, DOAJ, Cochrane, Embase, Academic Search Complete, Fuente Académica, and MedicLatina. Initially, 20 articles were identified. After analyzing all primary documents, 14 studies were excluded. Only 6 studies were relevant to this review. Three different types of interventions were found (maximum inspiratory training, controlled training, and nonintervention) in 3 different groups. One specific study compared 3 inspiratory muscle training groups with a group of breathing exercises (diaphragmatic exercises with pursed lips) and a control group. Future long-term studies with larger sample sizes are needed. It is necessary to apply respiratory muscle training as a service of the national health system and to consider its inclusion in the conventional neurological program.

Training the inspiratory muscles improves running performance when carrying a 25 kg thoracic load in a backpack

Load carriage (LC) exercise in physically demanding occupations is typically characterised by periods of low-intensity steady-state exercise and short duration, high-intensity exercise while carrying an external mass in a backpack; this form of exercise is also known as LC exercise. This induces inspiratory muscle fatigue and reduces whole-body performance. Accordingly we investigated the effect of inspiratory muscle training (IMT, 50% maximal inspiratory muscle pressure (PImax) twice daily for six week) upon running time-trial performance with thoracic LC. Nineteen healthy males formed a pressure threshold IMT (n = 10) or placebo control group (PLA; n = 9) and performed 60 min LC exercise (6.5 km h–1) followed by a 2.4 km running time trial (LCTT) either side of a double-blind six week intervention. Prior to the intervention, PImax was reduced relative to baseline, post-LC and post-LCTT in both groups (pooled data: 13 ± 7% and 16 ± 8%, respectively, p < .05) and similar changes were observed post-PLA. Post-IMT only, resting PImax increased +31% (p < .05) and relative to pre-IMT was greater post-LC (+19%) and post-LCTT (+18%, p < .05), however, the relative reduction in PImax at each time point was unchanged (13 ± 11% and 17 ± 9%, respectively, p > .05). In IMT only, heart rate and perceptual responses were reduced post-LC (p < .05). Time-trial performance was unchanged post-PLA and improved 8 ± 4% after IMT (p < .05). In summary, when wearing a 25 kg backpack, IMT attenuated the cardiovascular and perceptual responses to steady-state exercise and improved high-intensity time-trial performance which we attribute in part to reduced relative work intensity of the inspiratory muscles due to improved inspiratory muscle strength. These findings have real-world implications for occupational contexts.

Respiratory muscle training in children and adults with neuromuscular disease

Respiratory muscle training in children and adults with neuromuscular disease

Inspiratory muscle training in patients with diabetic autonomic neuropathy: a randomized clinical trial.

We evaluated the effects of an 8-week inspiratory muscle training (IMT, n=5) or placebo IMT (P-IMT, n=5) on maximal respiratory pressures, pulmonary function, functional capacity, and cardiac autonomic control in patients with type 2 diabetes and diabetic autonomic neuropathy (DAN). The IMT group had a greater increase in maximum inspiratory pressure as compared to P-IMT (p<0.05). The IMT improved inspiratory muscle strength in patients with DAN.