There is no conclusive evidence in this review to support or refute inspiratory muscle training for asthma. The evidence was limited by the small number of trials with few participants together with the risk of bias. More well conducted randomised controlled trials are needed. Future trials should investigate the following outcomes: lung function, exacerbation rate, asthma symptoms, hospital admissions, use of medications and days off work or school. Inspiratory muscle training should also be assessed in people with more severe asthma and conducted in children with asthma.

Results show that both forms of low-intensity physical exercise benefit patients with moderate and very severe COPD. The AG exhibited additional benefits in physical ability, indicating a new therapeutic modality targeting patients with COPD.

BACKGROUND:The aim of the present study was to assess how volume-oriented incentive spirometry applied to patients after a stroke modifies the total and compartmental chest wall volume variations, including both the right and left hemithoraces, compared with controls. METHODS: Twenty poststroke patients and 20 age-matched healthy subjects were studied by optoelectronic plethysmography during spontaneous quiet breathing (QB), during incentive spirometry, and during the recovery period after incentive spirometry. RESULTS: Incentive spirometry was associated with an increased chest wall volume measured at the pulmonary rib cage, abdominal rib cage and abdominal compartment (P ‫؍‬ .001) and under 3 conditions (P < .001). Compared with healthy control subjects, the tidal volume (V T ) of the subjects with stroke was 24.7, 18.0, and 14.7% lower during QB, incentive spirometry, and postincentive spirometry, respectively. Under all 3 conditions, the contribution of the abdominal compartment to V T was greater in the stroke subjects (54.1, 43.2, and 48.9%) than in the control subjects (43.7, 40.8, and 46.1%, P ‫؍‬ .039). In the vast majority of subjects (13/20 and 18/20 during QB and incentive spirometry, respectively), abdominal expansion precedes rib cage expansion during inspiration. Greater asymmetry between the right and left hemithoracic expansions occurred in stroke subjects compared with control subjects, but it decreased during QB (62.5%, P ‫؍‬ .002), during incentive spirometry (19.7%), and postincentive spirometry (67.6%, P ‫؍‬ .14). CONCLUSIONS: Incentive spirometry promotes increased expansion in all compartments of the chest wall and reduces asymmetric expansion between the right and left parts of the pulmonary rib cage; therefore, it should be considered as a tool for rehabilitation.

No abstract

OBJETIVO: Avaliar o efeito do treinamento muscular inspiratório em crianças com leucemia aguda. MÉTODOS: Trata-se de um estudo quase experimental com grupo controle. Quatorze pacientes com diagnóstico de leucemia aguda e idade entre cinco e 14 anos foram submetidos à avaliação da mobilidade torácica e da força muscular respiratória e divididos em dois grupos (A e B). Os pacientes do grupo A realizaram treinamento muscular inspiratório domiciliar por 15 minutos, duas vezes por dia, durante dez semanas, através do aparelho Threshold®, com carga de 30% da pressão inspiratória máxima, reajustada após reavaliações semanais. O grupo B (controle) realizou uma avaliação das pressões respiratórias máximas inicialmente e após dez semanas. Os dados foram analisados com o SPSS 15.0. Aplicou-se o teste t para analisar as diferenças entre as pressões inspiratória máxima e expiratória máxima entre os dois grupos e o teste de correlação de Pearson para analisar associações das medidas de pressão inspiratória e pressão expiratória com as diferentes cargas utilizadas. RESULTADOS: Constatou-se ganho significativo de 35% nas pressões inspiratória máxima e expiratória máxima no grupo A ao término do treinamento. Houve correlação positiva entre os níveis de carga utilizada e a pressão inspiratória máxima (p<0,0001) e a pressão expiratória máxima (p=0,0001). CONCLUSÕES: O treinamento muscular inspiratório pode ser eficaz no ganho de força muscular em crianças em tratamento de leucemia aguda.