Exercise Training 3—exercise Training in Pulmonary Rehabilitation

Abstract

Gårdsvägen 4, 169 70 Solna Printed byAll previously published papers were reproduced with permission from the publisher.Published by Karolinska Institutet.© Malin Nygren-Bonnier, 2008 ISBN 978-91-7357-533-1 Life begins when we inhale our first breath and ends when we exhale our last To my family ABSTRACT Introduction and aims:The technique of glossopharyngeal breathing was introduced already in the 1950's, but today, few health professionals are aware of its uses. The technique is performed by using the glossopharyngeal muscles to piston boluses of air into the lungs. Is has been used by patients to improve ventilation and cough function and by breath-hold divers to prolong their period of time under water. The aims of the present thesis were to determine whether healthy women, elite swimmers, people with cervical spinal cord injury (CSCI) and children with spinal muscular atrophy (SMA) type II were able to learn glossopharyngeal pistoning for lung insufflation (GI) and if so, to describe and evaluate the immediate and long-term effects after a training period of GI on pulmonary function and chest expansion. Methods: In Study I 26 healthy women were recruited; 16 were randomly assigned to the training group (TG) and nine to the control group (CG). In Study II 26 elite swimmers were recruited, 16 men and 10 women. In Study III 25 participants with CSCI were recruited, 20 men and five women. In Study IV 11 children with SMA type II were recruited, eight boys and three girls. All participants performed 10-15 cycles of GI, three to four times a week for five to eight weeks. Pulmonary function tests and chest expansion were measured before and after the training period and also three months after training completed. Results: All of the healthy participants in Study I and II, with the exception of one woman, were able to learn GI. Five of the participants with CSCI and six of the children with SMA type II were not able to perform the technique. The participants in all studies who did learn GI were able to exceed their vital capacity (VC) by 23% and to increase their chest expansion. The men with CSCI had a higher glossopharyngeal insufflation volume (GIV) than the male swimmers in relation to their VC and their chest expansion was also improved in relation to their normal chest expansion. VC increased in the TG compared to the CG in Study I, p<0.01. VC increased for the female swimmers and chest expansion increased for all the swimmers after the training period. Most of the pulmonary function variables and chest expansion increased in participants with CSCI. Some pulmonary function variables tended to improve in the children with SMA type II and chest expansion tended to increase at the level of the processus xiphoideus. Some of the participants reported temporary symptoms when performing the technique, such as dizziness, tension in the chest and some participants even fainted. The improvements in VC persisted three months after training completed. Conclusions: Nearly all of the healthy participants, most of the...