The effects of respiratory muscle training on peak cough flow in patients with Parkinson’s disease: a randomized controlled study

Reyes, Álvaro; Castillo, Adrián; Castillo, Javiera; Cornejo, Isabel

doi:10.1177/0269215518774832

Cited by 48 publications

(66 citation statements)

References 27 publications

(49 reference statements)

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“…For example, Sapienza et al [23] showed a 27% increase of MEP from pre-to post-EMST after four weeks of training. In contrast, Reyes et al found an increase of MEP of only 8.5% after 8 weeks EMST [25]. There are several possible explanations for the differences in the magnitude of the effects in the included studies.…”

Section: Discussionmentioning

confidence: 77%

“…In the first RCT, twelve weeks of IMST training significantly increased MIP by 25.8%, inspiratory muscle endurance by 45% and perception of dyspnea decreased by 27.8% compared to the control group (n = 20) [29]. The second RCT showed a moderate Cohen's d effect size between IMST and control group on MIP (d = 0.76) after two months of IMST training [25]. In the same RCT, two months of IMST (5 sets, 5 repetitions, 6 days/week on 50% MEP) showed large effect sizes for peak subglottic pressure (d = 1.32), peak sound pressure level (d = 1.27) and maximum phonation time (d = 1.26) when compared to the control group.…”

Section: Inspiratory Muscle Strength Trainingmentioning

confidence: 96%

“…Attempts were made to keep the participants blinded (by using sham devices) for at least the intervention. Blinding of outcome assessment was guaranteed in all studies, except for the two papers of Reyes et al [25,30]. Although in both papers of Reyes et al, the attempts to ascertain blinding of the personnel that provided instructions for training was unclear, we decided to rate all six RCTs for low risk of bias on the criterion 'blinding of participants and personnel'.…”

Section: Other Interventionsmentioning

confidence: 99%

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The Effects of Respiratory Training in Parkinson’s Disease: A Systematic Review

Dongen

Kalf

Wees³

et al. 2020

JPD

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Background: Signs of respiratory dysfunction can be present already early in the course of Parkinson’s disease (PD). Respiratory training could alleviate this, but its effectiveness is not well understood. Objective: The purpose of this systematic review is to review the efficacy of different respiratory training interventions in PD. Methods: A search strategy was performed in four databases: PubMed, Physiotherapy Evidence Database (PEDro), Cochrane Library, and Cumulative Index to Nursing and Allied Health Literature (CINAHL). Methodological quality of original full-text articles was assessed using the Cochrane Risk of Bias tool for randomized controlled trials (RCTs) and the Risk Of Bias In Non-randomized Studies of Interventions (ROBINS-I) tool for the controlled trials (CTs). Levels of evidence were rated by the Grading of Recommendation Assessment, Development and Evaluation (GRADE) approach. Results: Six papers reporting on four randomized controlled trials and another four controlled trials were included. Positive effects were reported for inspiratory muscle strength training (IMST), expiratory muscle strength training (EMST), air stacking, breath-stacking, incentive spirometry and postural training on respiratory muscle strength, swallowing safety, phonatory aspects and chest wall volumes. Best methodological quality was found for breath-stacking and incentive spirometry. Best levels of evidence were found for EMST, IMST and EMST plus air stacking. Conclusion: Respiratory training shows positive effects and should be considered when people with PD experience respiratory dysfunction. Future studies should focus on standardizing both training devices, instruments to measure outcomes and intervention protocols to further increase the level of evidence.

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Section: Discussionmentioning

confidence: 77%

Section: Inspiratory Muscle Strength Trainingmentioning

confidence: 96%

Section: Other Interventionsmentioning

confidence: 99%

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The Effects of Respiratory Training in Parkinson’s Disease: A Systematic Review

Dongen

Kalf

Wees³

et al. 2020

JPD

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“…Results showed that those PD patients receiving RMT had significant improvement not only in pulmonary function, but also in functional scores and cardiovascular autonomic function. The effects of RMT in patients with PD have been validated in several previous reports [18][19][20][31][32][33]. However, these studies only evaluated certain domains of function, such as respiratory or cough function, speech function (or phonation), swallowing function, or quality of life.…”

Section: Discussionmentioning

confidence: 98%

Simultaneously Improved Pulmonary and Cardiovascular Autonomic Function and Short-Term Functional Outcomes in Patients with Parkinson’s Disease after Respiratory Muscle Training

Huang

Lai

et al. 2020

JCM

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Both pulmonary function and autonomic function are impaired in patients with Parkinson’s diseases (PD). This study tested the hypothesis that respiratory muscle training (RMT) can not only improve pulmonary function, but also simultaneously improve cardiovascular autonomic function and short-term functional outcomes in patients with PD. Pulmonary function was measured by the forced vital capacity (FVC), forced expiratory volume in one second (FEV1), maximum inspiratory pressures (MIP), and maximum expiratory pressures (MEP). Cardiovascular autonomic function was measured by the heart rate response to deep breathing (HRDB), Valsalva ratio, baroreflex sensitivity, and spectral analysis. The functional and severity scores were measured by the Hoehn and Yahr stage and Unified Parkinson’s Disease Rating Scale (UPDRS). These measures were evaluated in patients with PD before and after 3 months of RMT, compared with a control group of PD patients without RMT. The results showed significant improvement of clinical scores (total UPDRS and UPDRS I, II and III) after RMT (p < 0.0001). Concerning pulmonary function, the parameters of MIP and MEP improved significantly. The parameters of cardiovascular function also improved after RMT, although only HRDB reached statistical significance. Based on the results of our study, RMT can not only improve both pulmonary and cardiovascular autonomic function, but can also improve short-term functional outcomes in patients with PD.

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“…Köseoğlu et al [37] zeigten bereits positive Effekte einer pulmonalen Rehabilitation auf die Lungenfunktion bei Patienten mit Parkinson auf. Neuere Untersuchungen zu diesem Thema fokussieren sich jedoch zunehmend auf ein gezieltes Training der exspiratorischen und/oder inspiratorischen Atemmuskulatur [38,39].…”

Section: Datenanalyse Und -Darstellungunclassified

Reflektorische Atemtherapie bei Patienten mit idiopathischem Parkinson-Syndrom – Einarmige Pilotstudie

et al. 2019

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Zusammenfassung Hintergrund Beim idiopathischen Parkinson Syndrom (IPS) handelt es sich um die häufigste neurologische Erkrankung in Deutschland. Die Patienten haben ein erhöhtes Risiko, sekundär eine Störung der Lungenfunktion zu entwickeln. Die reflektorische Atemtherapie ist eine spezielle Form der Atemtherapie zur Behandlung von Lungenfunktionsstörungen. Ziel Das Ziel dieser Pilotstudie war, die Anwendbarkeit der reflektorischen Atemtherapie bei Patienten mit IPS zu untersuchen. Methode In der einarmigen interventionellen Pilotstudie erhielten die Probanden in der 3-wöchigen Interventionsphase 2 Behandlungen reflektorische Atemtherapie pro Woche. Die Verlaufsdokumentation erfolgte anhand des Parkinson’s Disease Questionnaire (PDQ) 39, der Spirometrie und des 6-Minuten-Gehtests. Zudem wurden die Zufriedenheit und der Studienabbruch der Studienteilnehmer erfasst und die Daten deskriptiv ausgewertet. Ergebnisse Insgesamt wurden 10 Probanden eingeschlossen. Bei 9 Teilnehmern konnte die Therapie durchgeführt werden. Bei der Verlaufsdokumentation zeigten sich für eine Mehrheit der Patienten gleichbleibende bis positive Entwicklungen der krankheitsbezogenen Lebensqualität und der Gehstrecke. Die Zufriedenheit lag bei 9,44 (± 0,69) von 10 Punkten. Sowohl Drop-outs als auch Lost-to-Follow-up wurden erfasst. Schlussfolgerung Bei Patienten mit IPS ist die reflektorische Atemtherapie eine ergänzende Behandlungsmethode. Die erfassten klinischen Daten können als Anhaltspunkte für nachfolgende wissenschaftliche Studien dienen.

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The effects of respiratory muscle training on peak cough flow in patients with Parkinson’s disease: a randomized controlled study

Abstract: Two months of expiratory muscle-training program was more beneficial than inspiratory muscle-training program for improving maximum expiratory pressure and voluntary peak cough flow in patients with Parkinson's disease.

Cited by 48 publications

References 27 publications

The Effects of Respiratory Training in Parkinson’s Disease: A Systematic Review

The Effects of Respiratory Training in Parkinson’s Disease: A Systematic Review

Simultaneously Improved Pulmonary and Cardiovascular Autonomic Function and Short-Term Functional Outcomes in Patients with Parkinson’s Disease after Respiratory Muscle Training

Reflektorische Atemtherapie bei Patienten mit idiopathischem Parkinson-Syndrom – Einarmige Pilotstudie

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