Inspiratory Muscle Training

Purpose Cystic Fibrosis (CF) is a multisystem disease associated with symptoms such as dyspnoea, tachycardia and tachyp-nea that may be related to changes in autonomic function and sensitive to improvement following inspiratory muscle training (IMT). The aim of the present study was to investigate the effect of IMT on heart rate variability (HRV) and respiratory function in children. Methods Five CF and five matched controls (40% boys) performed a 4-weeks IMT programme, involving 30 breaths, twice a day. Weeks 1-2 of training were set at 40% of a participant's maximal strength index (S.Index), with week's 3-4 set at 50%. Participants wore an ActiHeart for three consecutive days at baseline and post-intervention and indices of HRV were derived. Standard measures of lung function were obtained along with health-related quality of life (HRQoL) using the CF-specific questionnaire (CFQ-R). Results IMT elicited clinically meaningful increases in respiratory muscle strength and respiratory symptom domain scores, but no improvements in respiratory volume, irrespective of group. Similarly, no significant improvements were found in HRQoL despite 62.5% of the population increased their HRQoL score. Post-intervention, CF participants showed a clinically meaningful decrease in the very low frequency (VLF) domain. Conclusion These results may indicate clinically meaningful changes in HRV and inspiratory muscle strength following a 4-week IMT intervention, although a more powerful study is required to draw further conclusions. Indeed, the trends for improved HRQoL support the need for such studies to ascertain the potential therapeutic role of IMT in those with CF.

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

This study investigated the relationship between the intensity of an inspiratory muscle training programme and its effect on respiratory muscle strength, exercising heart rate, and ratings of perceived exertion. A total of 66 subjects were randomly assigned to one of three groups. One group trained at 100% of maximum inspiratory pressure (MIP) for 6 weeks (MAX, n=22). A second group performed 6 weeks of inspiratory muscle training at 80% of MIP (SUB, n=21) and a third control group received no inspiratory training (CON, n=23). Both the MAX and SUB training groups improved MIP relative to the control group [32 (19) cmH2O, P=0.01; 37 (25) cmH2O, P=0.001, respectively]. A significant decrease in heart rate [−6 (9) beats min−1, P=0.02] and rating of perceived exertion [−0.5 (1.4), P=0.04] was observed for the MAX group only. It is concluded that 6 weeks of both MAX and SUB training were sufficient to improve inspiratory muscle strength. However, exercising heart rate and perceived exertion decreased with MAX training only.

Objectives: This study aimed to elucidate the outcome of an Inspiratory Muscle Training (IMT) rehabilitation intervention on the lung function, functional mobilization, balance, and peripheral muscle strength of the paretic side in patients with subacute stroke.
Methods: This double-blind, randomized controlled trial study was conducted on patients with stable subacute stroke. For 8 weeks, the intervention group (n=16) received 40% intensity IMT while the control group (n=16) received 10% intensity IMT. We assessed the patients’ lung function (spirometer) before and after the intervention, as well as their pulmonary muscle strength (micro-respiratory pressure meter [RPM]), quadriceps strength (handheld dynamometer), grip strength (Jamar), walking speed (10-m walk test), balance (Berg Balance Scale [BBS]), and functional mobilization (sit-to-stand test).
Results: There were significant differences between the intervention group and the control group after IMT for forced vital capacity (FVC)% (P<0.01; d=3.20), forced expiratory volume in the first second (FEV1)/FVC (P<0.001; d=2.55), FEV1% (P<0.001; d=5.10), walking speed (P<0.05; d=1.62), hand grip (P<0.001; d=2.45), quadriceps strength (P<0.001; d=4.18), functional mobilization (P<0.01; d=2.41), and maximal inspiratory mouth pressure (P<0.001; d=1.62), but no significant changes were seen in balance (P=0.304; d=0.57).
Discussion: IMT improved lung function, functional mobilization, handgrip strength, and quadriceps strength on the paretic side of subacute stroke patients and is expected to improve functional status and allow the patient to participate in social activities. IMT exercise can be included in the rehabilitation program for subacute stroke patients.

Purpose of this study was to find out the effects of Inspiratory muscle Strength training in obese individuals with Inspiratory
muscle weakness. We conducted 4 weeks Experimental study for 47 obese  subjects  with  Inspiratory  muscle  weakness  randomised  into  two  groups  based  on  the selection criteria. Group A –Experimental group (25 subjects) and Group B – Control group (22 subjects).  Informed  consent  obtained  from  all  participants.  Outcome  measures  were  modified Borg  scale  to  record  dyspnea  and  quality  of  life  questionnaire  using  Nottingham  extended activities  of  daily  living,  Maximum  voluntary  ventilation,  Forced  Expiratory  Volume  in  one second  and  Forced  vital  capacity  performed  using  Spirometer  were  tested  at  baseline  and  after intervention.  Inspiratory  muscle  training  using  Incentive  spirometer  was  performed  as  an
intervention.  Participants Age  and  BMI  were  similar  for  both  the  groups.  Experimental  group showed
significant differences  in  improving  Maximum  voluntary  ventilation, Forced expiratory volume  in  one  second,  Forced  vital  capacity.  Reduce  in  dyspnea  was    reported  in  experimental group and improved quality of life.

To evaluate the effectiveness of a home-based inspiratory muscle training (IMT) programme using multiple inspiratory muscle tests. Sixty-eight patients (37 M) with moderate to severe chronic obstructive pulmonary disease (COPD) (Mean [SD], FEV1 36.1 [13.6]% pred.; FEV1/FVC 35.7 [11.2]%) were randomised into an experimental or control group and trained with a threshold loading device at intensity &gt;30% maximum inspiratory pressure (PImax) or &lt;15% PImax, respectively, for 7 weeks. Thirty-nine patients (23 M) completed the study. The following measures were assessed pre- and post-IMT: PImax, sniff inspiratory nasal pressure (SNIP), diaphragm contractility (Pdi,tw), incremental shuttle walk test (ISWT), respiratory muscle endurance (RME), chronic respiratory disease questionnaire (CRDQ), the hospital anxiety and depression scale (HADS) and the SF-36. Between-group changes were assessed using one-way analysis of variance (ANOVA). PImax and perception of well-being improved significa...

Paradoxical vocal fold dysfunction (PVFD) with high effort exercise can result in disruptions to ventilation, dyspnea, inspiratory stridor, elevated heart rate, and syncope. This single subject study experimentally tested an inspiratory muscle strength training (IMST) program with behavioral therapy on a 15-year-old male crew member. Outcome variables were maximum inspiratory pressure (MIP), and dyspnea ratings. Following 5 weeks of IMST, MIP increased by 93% from baseline function while dyspnea ratings substantially decreased. Outcome included successful competition with his high-school crew team, a task he was previously unable to complete. Discussion focuses on IMST combined with traditional approaches of voice therapy for treating PVFD.

Introduction: 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&#x27;s scale), maximal inspiratory pressure (MIP), and lung function tests (IC, TLC, VC, FEV1, DLCOSB, DLCO/VA) in patients with IPF. Material and methods: 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. Results: After 12 weeks of rehabilitation in SG we noticed the significant decrease of dyspnoea before (p = 0.028) and after (p = 0....