Inspiratory Muscle Training in Patients with Chronic Obstructive Pulmonary Disease

Abstract

The present study was aimed at evaluating the effects of a specific inspiratory muscle training protocol on the structure of inspiratory muscles in patients with chronic obstructive pulmonary disease. Fourteen patients (males, FEV1, 24 +/- 7% predicted) were randomized to either inspiratory muscle or sham training groups. Supervised breathing using a threshold inspiratory device was performed 30 minutes per day, five times a week, for 5 consecutive weeks. The inspiratory training group was subjected to inspiratory loading equivalent to 40 to 50% of their maximal inspiratory pressure. Biopsies from external intercostal muscles and vastus lateralis (control muscle) were taken before and after the training period. Muscle samples were processed for morphometric analyses using monoclonal antibodies against myosin heavy chain isoforms I and II. Increases in both the strength and endurance of the inspiratory muscles were observed in the inspiratory training group. This improvement was associated with increases in the proportion of type I fibers (by approximately 38%, p < 0.05) and in the size of type II fibers (by approximately 21%, p < 0.05) in the external intercostal muscles. No changes were observed in the control muscle. The study demonstrates that inspiratory training induces a specific functional improvement of the inspiratory muscles and adaptive changes in the structure of external intercostal muscles.

Treinamento muscular inspiratório e exercícios respiratórios em crianças asmáticas

“…Previous studies have shown that such interventions lead to improvements in physical conditioning and muscle strength of children with asthma, as was confirmed in our study. (20) The results of the present study are in agreement with those of studies involving adults diagnosed with obstructive diseases, (2,8,9,21,22) showing improvements in respiratory muscle strength, with consequent clinical improvement, after specific IMT.…”

Methods to increase muscle tonus of upper airway to treat snoring: systematic review

“…Improvement of muscle tonus by physical training has been shown on several studies, and they were based on exercises for endurance and strength properties. This improvement was associated with increases in the proportion of Type I fiber and in the size of Type II fiber, demonstrated by muscle biopsy samples [42][43][44][45][46][47][48][49][50][51][52][53] . Methods to increase muscle tonus of the stomatognathic system are based on gain of endurance and strength properties either, so we considered this option as a possibility to increase the proportion of fiber Type I, resulting in decrease of snoring and clinical symptoms.…”

“…We know much more now about the pathogenesis of snoring and obstrutive sleep apnea (OSA), and some studies brought us evidences that the muscles in the pharynx are affected, showing fiber desproportion [38][39][40][41] . Based on such information, would be interesting to search for studies that have treated patients aiming to interfere with a diseased upper airway through out any sort of physical intervention to increase muscle tonus [42][43][44][45][46][47][48][49][50][51][52][53] . The aim of this systematic review is to evaluate if methods to increase muscle tonus of the upper airway is effective and safe for treatment of snoring based on accepted scientific evidence.…”

Avaliação clínica da capacidade do exercício em pacientes com doença pulmonar obstrutiva crônica

“…These measurements serve for the evaluation of maximum strength. Currently, only one device for evaluating respiratory muscle endurance is available commercially, even though this is the property that is most susceptible to changes following specific training programs 56 . It is now known that identifying the strength of the respiratory muscles, and particularly the strength of the inspiratory muscles, is of fundamental importance in determining whether inspiratory muscle training (IMT) should be included in rehabilitation programs.…”