Effects of inspiratory muscle training and breathing exercises in children with asthma: a systematic review

Abstract

Introduction: Asthma is characterized by a narrowing and inflammation of the bronchi, with symptoms of dyspnea, fatigue and exercise limitation. Physical therapy includes inspiratory muscle training and breathing exercises, given that an increase in inspiratory muscle strength and resistance can improve the symptoms of the disease.
 Objective: To describe the effects of inspiratory muscle training (IMT) and breathing exercises in children with asthma.
 Methods: This is a systematic review of the literature using the Cochrane, PubMed Scopus e Web of Science databases. The following descriptors were used: asthma, inspiratory muscle training, breathing exercises and child in Portuguese, English and Spanish. Two independent evaluators screened studies that used breathing exercises and IMT in children with asthma.
 Results: Of a total of 312 titles, eight studies were included, of which six are randomized clinical trials and two are observational studies All the studies included breathing exercises, with the objective of adjusting breathing patterns and pulmonary ventilation, reducing pulmonary hyperinflation, bronchospasm and sensation of dyspnea. However, as these exercises were not performed solely, the effects of this intervention could not be verified. Two studies performed IMT and showed an increase in maximal respiratory pressure.
 Conclusion: Breathing exercises are widely used in clinical practice as part of the management of asthma in children; however it is not possible to measure the effects in this population. IMT seems to improve inspiratory and expiratory muscle strength, but its indication in the pediatric population is not a standard procedure.

12-Week Inspiratory Muscle Training Improves Respiratory Muscle Strength in Adult Patients with Stable Asthma: A Randomized Controlled Trial

“…Similarly, IMT was reported to cause significant increases in respiratory muscle strength for 6 weeks [ 36 ] and 12 weeks [ 40 ]. A meta-analysis was carried out in favor of increasing PImax during IMT, but PEmax results were controversial [ 4 ]. There are three possible explanations.…”

“…Breathing exercises (BTE) and inspiratory muscle training (IMT) are nonpharmacological interventions that improve asthma control. Both exercises have been widely used and are low cost, easy to apply, safe, and considered important adjuncts for asthma treatment [ 4 ]. BTE have been routinely used by professionals to control the hyperventilation symptoms of asthma and often appear in educational programs as self-monitoring techniques, which aim to adapt asthma patients to an appropriate breathing pattern with a longer expiration and a lower respiratory rate and thereby reduce hyperventilation and hyperinflation [ 5 ].…”

“…The expected role of IMT and its potential role in patients with asthma include an increase in diaphragm thickness and strength, a decrease in exertional dyspnea, and a decrease in the oxygen cost of breathing [ 8 ]. There is evidence that IMT also provides benefits, such as pulmonary function, respiratory muscle strength and endurance, levels of functional capacity, physical activity, and HRQoL, as well as reduced emotional disorders, and the use of medical services [ 4 , 9 ]. The addition of IMT, even when applied for a short period, had better rehabilitative effects than respiratory exercise alone [ 10 ].…”

Effect of Threshold Inspiratory Muscle Training on Functional Fitness and Respiratory Muscle Strength Compared to Incentive Spirometry in Children and Adolescents With Obesity: A Randomized Controlled Trial

“…Many studies of threshold IMT (15)(16)(17) and IS (18,19) training among obese adults reported substantial improvement in 6-min walk test (6-MWT) distance, inspiratory muscle strength, and spirometry. In children and adolescents, studies of the effect of threshold IMT (20)(21)(22)(23)(24)(25)(26)(27) and IS (28)(29)(30) on pulmonary function were conducted in other diseases, including neuromuscular disease (NMD), cerebral palsy (CP), asthma, and cystic fibrosis (CF). To our knowledge, no study has investigated the effect of threshold IMT and IS on functional fitness, RMS, and spirometry in children and adolescents with obesity.…”

Decision making in adolescents: a multifaceted construct

“…Topics such as the effect of interdisciplinary intervention on insulin resistance indicators in overweight adolescents 25 and the use of surface electromyography as a measure of physical therapy outcome in children with cerebral palsy 26 are presented in this volume. This publication also contains the comparison of click and ce-chirp stimuli in hearing screening in the neonatal life cycle stage 27 and the effects of inspiratory muscle training and breathing exercises in children with asthma 28 , close the themes related to the life cycle of childhood and adolescence.…”