Effects of Inspiratory Muscle Training on Heart Rate Variability in Children with Cystic Fibrosis: A Pilot Study

Abstract

Purpose Cystic Fibrosis (CF) is a multisystem disease associated with symptoms such as dyspnoea, tachycardia and tachypnea 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.

Entrenamiento muscular respiratorio en el paciente pediátrico con enfermedad respiratoria crónica

“…En niños con enfermedades neuromusculares, el entrenamiento de los músculos respiratorios incrementa la potencia y resistencia de los músculos inspiratorios (Gozal & Thiriet, 1999;Torres-Castro et al, 2013) y la fuerza de los músculos espiratorios (Rodríguez et al, 2014); así mismo, en los infantes con bronquiectasias se identificó que entrenamiento de los músculos inspiratorios mejora la fuerza de los músculos respiratorios, la función pulmonar (Gurses et al, 2013), la resistencia muscular respiratoria, la capacidad de ejercicio y mejoró los aspectos sociales de la calidad de vida (Ozalp et al, 2018). En el caso de los pacientes con fibrosis quística que han recibido entrenamiento muscular respiratorio se evidencio mejoría en la tolerancia al ejercicio (Sawyer & Clanton, 1993) y en la potencia muscular inspiratoria (Sawyer & Clanton, 1993;McCreery et al, 2021). No obstante, se requieren más estudios que incluyan las diversas patologías respiratorias crónicas que permitan establecer los mecanismos y los posibles beneficios del entrenamiento muscular respiratorio a corto y largo plazo sobre variables clínicas de la función pulmonar, la fuerza y resistencia muscular respiratoria, la disnea, la percepción de esfuerzo, la tolerancia al ejercicio y componentes de la calidad de vida.…”

Effect of Inspiratory Muscle Training on Exercise Capacity, Dyspnea and Cardiac Autonomic Function in Individuals with Chronic Obstructive Pulmonary Disease: A Study Protocol

“…COPD has cardiac autonomic dysfunction due to the imbalance in the sympatheticparasympathetic function synchrony (18). The literature documents the beneficial effect of IMT on cardiac autonomic function (13,(19)(20)(21). Evidence regarding the effect of IMT on cardiac autonomic function is increasing but lacks consensus.…”

Editorial

“…Brain health is a particularly relevant topic and novel research by Logan et al demonstrates that wearing a collar to provide mild bilateral compression of the jugular vein has the potential to help protect the brain of female high-school soccer players [5]. Pilot work by McNarry et al shows that inspiratory muscle training can increase inspiratory muscle strength and lead to clinically meaningful change in the heart rate variability of children with cystic fibrosis [6], further supporting the concept that "exercise is medicine". Training youth athletes will always also have a focus on improving physical performance.…”