Effects of respiratory muscle training on parasympathetic activity in diabetes mellitus

Abstract

This study verified the effects of respiratory muscle training (RMT) on hemodynamics, heart rate (HR) variability, and muscle morphology in rats with streptozotocin-induced diabetes mellitus (DM). Thirty-six male Wistar rats were randomized into 4 groups and 34 completed the study: i) sham-sedentary (Sham-ST; n=9); ii) sham-RMT (Sham-RMT; n=9); iii) DM-sedentary (DM-ST; n=8); and iv) DM-RMT (DM-RMT; n=8). Hemodynamics were assessed by central cannulation, and R-R intervals were measured by electrocardiogram. In addition, the effects of RMT on the cross-sectional area of the diaphragm, anterior tibial, and soleus muscles were analyzed. The induction of DM by streptozotocin resulted in weight loss, hyperglycemia, reduced blood pressure, and attenuated left ventricular contraction and relaxation (Po0.05). We also observed a decrease in root mean square of successive differences between adjacent RR intervals (RMSSD) index and in the cross-sectional area of the muscles assessed, specifically the diaphragm, soleus, and anterior tibial muscles in diabetic rats (Po0.05). Interestingly, RMT led to an increase in RMSSD in rats with DM (Po0.05). The induction of DM produced profound deleterious changes in the diaphragmatic and peripheral muscles, as well as impairments in cardiovascular hemodynamics and autonomic control. Nevertheless, RMT may beneficially attenuate autonomic changes and improve parasympathetic modulation.

Effects of Inspiratory Muscle Training in Type 2 Diabetes: A Systematic Review

“…Patients with T2DM and autonomic dysfunction have impaired nerve blood supply, in other words, nerve conduction affected with consequent neuropathy, being more impaired than those without nerve injury [ 31 , 32 ] . Regarding autonomic modulation, one study by our group showed that IMT improved autonomic function in diabetic patients [ 33 ] with increased parasympathetic activity. In healthy individuals, the use of IMT with a load of 30% MIP provides an increase in vagal modulation, while higher loads can determine a predominance of sympathetic modulation [ 34 , 35 ] .…”