[Pulmonary rehabilitation in patients with idiopathic pulmonary fibrosis with inspiratory muscle training].
Pneumonol Alergol Pol. 2008;76(3):131-41. PMID: 18843927
Dariusz Jastrzebski, Jerzy Kozielski, Aleksandra Zebrowska
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's scale), maximal inspiratory pressure (MIP), and lung function tests (IC, TLC, VC, FEV1, DLCO(SB), 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 = 0.012) 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. CONCLUSION: Adding inspiratory muscle training increases effectiveness of pulmonary rehabilitation in IPF patients.
Article Published Date : Jan 01, 2008
Inspiratory muscle training in adults with chronic obstructive pulmonary disease: a systematic review.
Respir Med. 2005 Nov;99(11):1440-58. PMID: 15894478
E Lynne Geddes, W Darlene Reid, Jean Crowe, Kelly O'Brien, Dina Brooks
The purpose of this study was to conduct a systematic review to determine the effect of inspiratory muscle training (IMT) on inspiratory muscle strength and endurance, exercise capacity, dyspnea and quality of life for adults with chronic obstructive pulmonary disease (COPD). A systematic review of the literature was conducted according the Cochrane Collaboration protocol using Medline and CINAHL. Nineteen of 274 extracted articles met the inclusion criteria and addressed comparisons of interest which included: IMT versus sham; IMT versus no intervention; low- versus high-intensity IMT; and two different modes of IMT. Thirteen meta-analyses were reported. Results indicate that targeted resistive or threshold IMT was associated with significant improvements in some outcomes of inspiratory muscle strength (PI(max) (cm H2O)) and endurance (Inspiratory Threshold Loading (kPa)), exercise capacity (Borg Scale for Respiratory Effort (modified Borg scale), Work Rate maximum (Watts)), and dyspnea (Transition Dyspnea Index), whereas IMT without a target or not using threshold training did not show improvement in these variables. There was no conclusive evidence regarding quality of life measures. IMT is effective for adults with COPD when using threshold or targeted devices that control or provide a target for training intensity.
Article Published Date : Nov 01, 2005
[Effect of specific inspiratory muscle training on dyspnea and exercise tolerance in congestive heart failure].
Harefuah. 1999 May 16;136(10):774-7, 843. PMID: 10955110
P Weiner, J Waizman, R Magadle, N Berar-Yanay, B Pelled
It has been shown that the inspiratory muscles of patients with congestive heart failure (CHF) are weaker than normal. This weakness may contribute to dyspnea and limit exercise capacity. But respiratory muscles can be trained for increase in both strength and endurance. This study was designed to evaluate the effect of specific inspiratory muscle training (SIMT) on muscular performance, lung function, dyspnea and exercise capacity in moderate heart failure. 10 patients with CHF (NYHA functional class II-III) received 1/2 hour of SIMT daily, 6 times/week, for 3 months. They started breathing at a resistance 15% of their Pimax for 1 week and the resistance was then increased incrementally to 60%. Spirometry, inspiratory muscle strength and endurance, and the 12-minute walk test were performed before and after the training period. All showed an increase in inspiratory muscle strength and endurance. This was associated with a small but significant increase in FVC, a significant increase in the distance walked (458 +/- 29 to 562 +/- 32 m, p < 0.01), and improvement in the dyspnea index score. SIMT resulted in increased inspiratory muscle strength and endurance. This increase was associated with decreased dyspnea and an increase in submaximal exercise capacity. SIMT may prove to be useful complementary therapy in CHF.
Article Published Date : May 16, 1999
Inspiratory muscle training in adults with chronic obstructive pulmonary disease: an update of a systematic review.
Am J Obstet Gynecol. 1993 Sep;169(3):483-9. PMID: 18708282
E Lynne Geddes, Kelly O'Brien, W Darlene Reid, Dina Brooks, Jean Crowe
The purpose was to update an original systematic review to determine the effect of inspiratory muscle training (IMT) on inspiratory muscle strength and endurance, exercise capacity, dyspnea and quality of life for adults with chronic obstructive pulmonary disease (COPD). The original MEDLINE and CINAHL search to August 2003 was updated to January 2007 and EMBASE was searched from inception to January 2007. Randomized controlled trials, published in English, with adults with stable COPD, comparing IMT to sham IMT or no intervention, low versus high intensity IMT, and different modes of IMT were included. Nineteen of 274 articles in the original search met the inclusion criteria. The updated search revealed 17 additional articles; 6 met the inclusion criteria, all of which compared targeted, threshold or normocapneic hyperventilation IMT to sham IMT. An update of the sub-group analysis comparing IMT versus sham IMT was performed with 10 studies from original review and 6 from the update. Sixteen meta-analyses are reported. Results demonstrated significant improvements in inspiratory muscle strength (PI(max), PI(max) % predicted, peak inspiratory flow rate), inspiratory muscle endurance (RMET, inspiratory threshold loading, MVV), exercise capacity (Ve(max), Borg Score for Respiratory Effort, 6MWT), Transitional Dyspnea Index (focal score, functional impairment, magnitude of task, magnitude of effort), and the Chronic Respiratory Disease Questionnaire (quality of life). Results suggest that targeted, threshold or normocapneic hyperventilation IMT significantly increases inspiratory muscle strength and endurance, improves outcomes of exercise capacity and one measure of quality of life, and decreases dyspnea for adults with stable COPD.
Article Published Date : Sep 01, 1993
Therapeutic Actions EXERCISE Inspiratory Muscle Training
A systematic review of the impact of preoperative exercise for patients with abdominal aortic aneurysms.
J Vasc Surg. 2019 Jan 01;:
Authors: Wee IJY, Choong AMTL
BACKGROUND: Abdominal aortic aneurysm (AAA) surgery carries significant risk of morbidity and mortality. Preoperative exercise may improve the physical fitness capacity of patients with AAA, as well as postoperative outcomes.
METHODS: A systematic review was performed in accordance to the PRISMA guidelines. An electronic search was performed on Medline, EMBASE, and the Cochrane Library for relevant studies. A methodologic assessment of included studies was conducted using the Physiotherapy Evidence Database scale.
RESULTS: Seven studies (six randomized, controlled trials and one retrospective cohort study) were included. The overall quality of studies was assessed to range from fair to good. Three studies included patients with an AAA without indication for surgery, and four other studies included patients with an AAA awaiting surgical repair. One study implemented an inspiratory muscle training program, five studies implemented a continuous moderate-intensity exercise regimen, and one study implemented a high-intensity interval training program. Overall compliance with the exercise regimen was high (94% in those not awaiting surgery; 75.8%-82.3% in those awaiting surgery). In patients not awaiting surgery, preoperative exercise may improve physical fitness parameters including ventilator threshold (P = .016 at 12 weeks; P = .09 at 12 months), anaerobic threshold (10% increase; P = .007), but not peak VO2 (P = .183 at 12 weeks; 0.29 at 12 months). In patients awaiting surgery, one study demonstrated a statistically significant improvement in peak VO2 consumption (difference of 1.6 mL/kg/min; P = .004) and anaerobic threshold (difference of 1.9 mL/kg/min; P = .012) for patients who exercised. In terms of postoperative outcomes, exercise may decrease the risk of cardiac, renal, and respiratory complications, albeit only in those who underwent open surgery. Only patients who underwent endovascular repair had a shorter length of hospital stay when preoperative exercise was conducted.
CONCLUSIONS: Despite the encouraging evidence of preoperative exercise on patients with an AAA, it remains premature to recommend it as a preoperative intervention. Given the heterogeneity of reported outcomes, future studies should consider conducting well-designed randomized, controlled trials with standardized reporting outcomes and definitions.
PMID: 30606665 [PubMed - as supplied by publisher]