Respiratory muscle function is compromised in children recovering from chest wall burns, which potentially leads to more impact on exercise capacity and quality of life. This study investigates the ...effects of an inspiratory muscle training intervention accompanied with a pulmonary rehabilitation program on respiratory muscle strength, lung function, functional capacity, and quality of life in chest burned children.
Forty children with burns, aged from 10 to 18 years old and total body surface area of 30% to 50%, were randomly allocated to the inspiratory muscle training group (IMT- G: n = 20) or control group (CG: n = 20). They received IMT plus pulmonary rehabilitation or pulmonary rehabilitation with sham IMT, respectively for eight weeks. The outcomes were the respiratory muscle strength measured by maximum inspiratory pressure (MIP) and maximum expiratory pressure (MEP); lung functions (FEV1, FVC and FEV1/FVC ratio); functional capacity as well as Pediatric Quality of Life to measure physical and psychosocial functioning. outcome measures were assessed at before and after intervention (after eight weeks).
Based on the pre-intervention assessments, we found no significant difference between both groups (p > 0.05). Significant post-intervention differences were reported between both groups in MIP (P = .003), MEP (P = .017), FVC (P = .001), FEV1 (P = .007), FEV1/FVC ratio (P = .028), functional capacity (P = .003), physical domain of QoL (P = .006) and psychological domain of QoL (P = .002) in favor of the IMT group.
Eight weeks of inspiratory muscle training combined with pulmonary rehabilitation program improved children with chest burns' respiratory muscles strength, lung functions, functional capacity, and quality of life. Inspiratory muscle training may be employed in burn rehabilitation programs. It is a safe and effective therapy in chest burned children.
•Inspiratory muscle training with pulmonary rehab improved respiratory muscle strength, lung functions.•Quality of life significantly improved with inspiratory muscle training.•Inspiratory muscle training can be used in burn rehab programs as a safe and effective therapy.
: To evaluate the effects of an inspiratory muscle training (IMT) program on dyspnea during activities of daily living, inspiratory muscle function, functional capacity, and quality of life in ...patients with advanced lung disease (ALD).
: Pre-post interventional study in which patients with ALD from the Advanced Lung Disease and Pre Lung Transplantation Ambulatory Clinic were included. Patients performed home-based high-intensity interval IMT for 8 weeks (two sessions per day, daily). In each session, patients performed two sets of 30 breaths, with a 2-min rest between sets. Dyspnea during activities of daily life, primary outcome - assessed by the London Chest Activity of Daily Living scale-LCADL, inspiratory muscle function (MIP and endurance test), distance on the 6-min walking test 6MWD, and quality of life (St George Respiratory Questionnaire SGRQ) were measured pre-IMT, post-IMT, and 3 months after the intervention (follow-up).
: Dyspnea during activities of daily living significantly decreased after 8 weeks of IMT (LCADL
= 31.5 IQR = 23-37.25, LCADL
= 26 IQR = 20.75-32, LCADL
= 30.5 IQR = 20-35;
< .03). After IMT, there was an improvement in inspiratory muscle strength (
< .001) and endurance (
< .001). Functional capacity evaluated using the 6MWD increased but did not reach significance (
= .79) There was also a significant improvement in quality of life, as demonstrated by the SGRQ (
< .004).
: Our results suggest that IMT was able to reduce dyspnea during activities of daily living, as well as improve inspiratory muscle function, and quality of life in patients with ADL, and these benefits were sustained for 3 months.
Purpose. The aim of the study was to determine if an 8-week-long endurance fitness training with elastic belts would increase the strength-endurance of the inspiratory muscles and lung function ...characteristics, and to assess whether these changes were consistent with an increase in aerobic power and exercise capacity in healthy young women. Methods. Twenty-two females aged 20-25 years were randomly allocated into 2 groups. The experimental group preformed 8-week-long exercises on stationary bikes with an elastic belt on the lower part of the chest. The control group underwent the same workout, without elastic belts. Vital capacity, forced vital capacity, maximal voluntary ventilation, maximal inspiratory and expiratory pressure, sustained maximal inspiratory pressure, physical activity status, and perceived exertion scores were measured. In the incremental exercise test, work capacity and maximal oxygen uptake were assessed. Tidal volume, minute ventilation (VE), oxygen uptake (VO 2 ), VE/VO 2 , heart rate (HR), and VO 2 /HR were continuously monitored. The cycle performance at the power of the ventilatory threshold was evaluated on the following day. Results. The fitness training with elastic belts significantly improved the strength and strength-endurance of the inspiratory muscles, the functional cardio-respiratory capabilities, and aerobic work output. In the control group, the studied parameters were not significantly increased. Conclusions. Applying elastic belts to fitness endurance exercises improves the strength and strength-endurance of inspiratory muscles, cardio-respiratory capabilities, and aerobic power, which additionally raises aerobic work output in fitness training of young women.
Dans le cadre d’un programme de réhabilitation respiratoire (PRR) chez les patients atteints de BPCO, les sociétés savantes recommandent d’inclure un entrainement des muscles inspiratoires (EMI) chez ...les patients présentant une diminution objective de la force des muscles inspiratoires. Cette recommandation fait suite à une méta-analyse qui suggère qu’un EMI serait bénéfique lorsque la pression inspiratoire (PI) maximale est inferieure a 60 cm H2O.L’entraînement des muscles améliore la force et l’endurance des muscles inspiratoires, la capacité d’exercice et la dyspnée. Dans la dernière méta-analyse, les auteurs précisent que, dans le cadre d’un PRR, il n’est pas certain que l’EMI améliore davantage la dyspnée par rapport à un PRR seul.La question de départ est la suivante : est-ce que l’EMI au cours d’un PRR permet de diminuer davantage la dyspnée qu’un PRR seul ?Dans la première étude contrôlée randomisée, nous montrons que dans le cadre d’un PRR, l’EMI n’améliore pas davantage la dyspnée, chez des patients avec une force des muscles inspiratoires normale. Cependant, une analyse en sous-groupe tend à montrer que chez les patients plus sévèrement atteints (VEMS<50% théorique), l’EMI permettrait une amélioration plus importante de la dyspnée.La deuxième étude est le plus important essai contrôle randomise à propos de l’effet de l’EMI sur la dyspnée dans le cadre d’un PRR. Dans cette étude trois outils différents sont utilisés afin d’évaluer la dyspnée des patients, dont le questionnaire multidimensionnel MDP. Nous montrons que l’EMI ajoute a un PRR n’apporte pas une amélioration significativement plus importante de la dyspnée en comparaison a un PRR seul. Ainsi l’intérêt clinique de l’EMI dans le cadre d’un PRR semble remis en cause.
During a pulmonary rehabilitation program (PRP) in COPD patients, French and international respiratory societies recommend to include inspiratory muscles training (IMT) in patients with an objective inspiratory muscles weakness. This recommendation follows upon a meta-analysis which suggests that IMT would be beneficial when the maximal Inspiratory pressure (PImax) is lower than 60 cm H2O. IMT improves the strength and the endurance of the inspiratory muscles, the exercise capacity and the dyspnea. In the last meta-analysis, the authors specifies that, when IMT is associated to a PRP, it is not certain that IMT improves more the dyspnea compared with a PRP alone.The initial question of this work is: does IMT during a PRP allow decreasing more the dyspnea than a PRP alone?In the first randomized controlled trial, we show that during a PRP, IMT in COPD patients with normal inspiratory muscles strength does not improve more the dyspnea, compared to a PRP alone. However, an analysis in sub-groups tends to show that in severe or very severe COPD patients (VEMS < 50 % of predictive value), IMT would allow a higher improvement of the dyspnea.The second study is the most important randomized controlled trial about the effect of IMT on the dyspnea during pulmonary rehabilitation. In this study we used three different tools to estimate the dyspnea of the patients, of which the multidimensional Dyspnea Profile questionnaire (MDP). We show that IMT added to a PRP does not improve significantly more dyspnea compared to a PRP alone. So the clinical interest of IMT during a PRP seems questionnable.
Aim: To evaluate the effects of an inspiratory muscle training (IMT) program on dyspnea during activities of daily living, inspiratory muscle function, functional capacity, and quality of life in ...patients with advanced lung disease (ALD).
Methods: Pre-post interventional study in which patients with ALD from the Advanced Lung Disease and Pre Lung Transplantation Ambulatory Clinic were included. Patients performed home-based high-intensity interval IMT for 8 weeks (two sessions per day, daily). In each session, patients performed two sets of 30 breaths, with a 2-min rest between sets. Dyspnea during activities of daily life, primary outcome - assessed by the London Chest Activity of Daily Living scale-LCADL, inspiratory muscle function (MIP and endurance test), distance on the 6-min walking test 6MWD, and quality of life (St George Respiratory Questionnaire SGRQ) were measured pre-IMT, post-IMT, and 3 months after the intervention (follow-up).
Results: Dyspnea during activities of daily living significantly decreased after 8 weeks of IMT (LCADL
pre
= 31.5 IQR = 23-37.25, LCADL
post
= 26 IQR = 20.75-32, LCADL
follow-up
= 30.5 IQR = 20-35; p < .03). After IMT, there was an improvement in inspiratory muscle strength (p < .001) and endurance (p < .001). Functional capacity evaluated using the 6MWD increased but did not reach significance (p = .79) There was also a significant improvement in quality of life, as demonstrated by the SGRQ (p < .004).
Conclusions: Our results suggest that IMT was able to reduce dyspnea during activities of daily living, as well as improve inspiratory muscle function, and quality of life in patients with ADL, and these benefits were sustained for 3 months.
Patients suffering from long COVID may exhibit autonomic dysregulation. However, the association between autonomic dysregulation and exercise intolerance and the impact of therapeutic interventions ...on its modulation remains unclear. This study investigated the relationship between heart rate recovery at the first minute (HRR1), a proxy for autonomic imbalance, and exercise intolerance in patients with long COVID. Additionally, the study aimed to assess the effects of a 12-week home-based inspiratory muscle training program on autonomic modulation in this patient population.
This study is a post hoc subanalysis of a randomized trial in which 26 patients with long COVID were randomly assigned to receive either a 12-week inspiratory muscle training program or usual care alone (NCT05279430). The data were analyzed using Pearson's correlation and linear mixed regression analysis.
The mean age was 50.4 ± 12.2 years, and 11 (42.3%) were women. Baseline HRR1 was significantly correlated with maximal functional capacity (peakVO2) (r = 0.402, P = .041). Patients with lower baseline HRR1 (≤22 bpm) exhibited higher resting heart rates and lower peakVO2. Inspiratory muscle training led to a more substantial increase in peakVO2 in patients with lower HRR1 at baseline (P = .019). Additionally, a significant improvement in HRR1 was observed in the IMT group compared to the usual care group after 12-week (Δ +9.39, 95% CI = 2.4-16.4, P = .010).
Lower baseline HRR1 is associated with exercise intolerance in long COVID patients and may serve as a valuable criterion for identifying individuals likely to benefit more from a home-based inspiratory muscle training program.
Enhancing lung function can significantly improve daily life functionality for children with cerebral palsy, leading to increased interest in respiratory physiotherapy training devices in clinical ...practice. This study aims to evaluate the efficacy of devices (inspiratory muscle training and feedback devices) for improving pulmonary function through various respiratory parameters.
A systematic review with meta-analysis of randomized clinical trials was conducted in seven databases up until May 2023. The included studies focused on training inspiratory muscle function using specific devices (inspiratory muscle training and feedback devices) in children with cerebral palsy. The main outcomes were maximum expiratory pressure and maximum inspiratory pressure. Secondary outcomes included forced vital capacity, forced expiratory volume in 1 s, peak expiratory flow, and the Tiffenau index. The effects of respiratory treatment were calculated through the estimation of the effect size and its 95% confidence intervals. The risk of bias in the included studies was assessed using the Cochrane Collaboration's tool for assessing the risk of bias (RoB2).
Nine studies were included in the systematic review with meta-analysis, involving a total of 321 children aged between 6 and 18 years after secondary analyses were conducted. Feedback devices were found to be more effective in improving maximum expiratory pressure (effect size −0.604; confidence interval −1.368 to 0.161), peak expiratory flow, forced expiratory volume in 1 s, and forced vital capacity. Inspiratory muscle training devices yielded better effectiveness in improving maximum inspiratory pressure (effect size −0.500; confidence interval −1.259 to 0.259), the Tiffeneau index, and quality of life.
Both devices showed potential in improving pulmonary function in children with cerebral palsy. Further high-quality clinical trials are needed to determine the optimal dosage and the most beneficial device type for each pulmonary function parameter.
•Inspiratory muscle training (IMT) devices and feedback devices (ISE) enhanced pulmonary function in cerebral palsy children.•IMT devices improved FEV1/FVC.•ISE devices improved FEV1.•The use of each device must be adjusted to the objectives of each subject.
To the best of our knowledge, no studies have evaluated the effects of inspiratory muscle training (IMT) on recovered COVID-19 patients after weaning from mechanical ventilation. Therefore, this ...study assessed the efficacy of IMT on recovered COVID-19 patients following mechanical ventilation.
Forty-two recovered COVID-19 patients (33 men and 9 women) weaned from mechanical ventilation with a mean age of 48.05 ± 8.85 years were enrolled in this pilot control clinical study. Twenty-one patients were equipped to 2-week IMT (IMT group) and 21 matched peers were recruited as a control (control group). Forced vital capacity (FVC%), forced expiratory volume in 1 second (FEV1%), dyspnea severity index (DSI), quality of life (QOL), and six-minute walk test (6-MWT) were assessed initially before starting the study intervention and immediately after intervention.
Significant interaction effects were observed in the IMT when compared to control group, FVC% (F = 5.31, P = .041, ηP2 = 0.13), FEV1% (F = 4.91, P = .043, ηP2 = 0.12), DSI (F = 4.56, P = .032, ηP2 = 0.15), QOL (F = 6.14, P = .021, ηP2 = 0.17), and 6-MWT (F = 9.34, P = .028, ηP2 = 0.16). Within-group analysis showed a significant improvement in the IMT group (FVC%, P = .047, FEV1%, P = .039, DSI, P = .001, QOL, P < .001, and 6-MWT, P < .001), whereas the control group displayed nonsignificant changes (P > .05).
A 2-week IMT improves pulmonary functions, dyspnea, functional performance, and QOL in recovered intensive care unit (ICU) COVID-19 patients after consecutive weaning from mechanical ventilation. IMT program should be encouraged in the COVID-19 management protocol, specifically with ICU patients.
PURPOSE Respiratory function can be adversely affected after a cerebrovascular accident. This study aimed to determine whether inspiratory muscle training (IMT) changes the respiration and balance ...abilities of patients with stroke. METHODS Twelve patients with stroke were randomly assigned to the study (n=6) and control (n=6) groups. The study and control groups received IMT and general physical therapy, respectively for 6 weeks, five times a week for 30 min/day. Inspiratory and expiratory functions and balance were measured pre- and post-evaluation. RESULTS After IMT intervention, the weight distribution ratio (WDR) for balance ability measurement was significantly decreased (p<.05), and the maximum inspiratory pressure (MIP), maximum inspiratory flow rate (MIFR), maximum inspiratory capacity (MIC), peak expiratory flow (PEF), forced expiratory volume in 1 second (FEV1), and limits of stability (LOS) were significantly increased in the study group (p<.05). A comparison of the study and control groups revealed statistically significant differences in MIP (p<0.01), MIFR (p<.01), MIC (p<.05), PEF (p<.05), FEV1 (p<.05), WDR (p<.01), and LOS (p<.05). CONCLUSIONS This study suggests that IMT is a useful and effective exercise intervention for patients with stroke.
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