Respiratory muscle training for cystic fibrosis

Hilton, Nathan; Solís-Moya, Arturo

doi:10.1002/14651858.cd006112.pub4

Cited by 15 publications

(28 citation statements)

References 36 publications

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“…In addition, respiratory exercises, such as respiratory muscle training and chest physiotherapy, have short-term effects in terms of increasing mucus transport and airway clearance. 9,10 Although both general and respiratory exercises are recommended by clinical guidelines of CF, 11 nonadherence to prescribed interventions is common in chronic diseases. 12 Multiple therapies with an exhaustive treatment routine, in addition to the lack of curative treatment, 13 may be an aggravating factor to non-adherence to exercises in CF, which is associated with increased risk of hospitalization, longer hospital stays, and pulmonary exacerbations.…”

Section: Introductionmentioning

confidence: 99%

Adherence and barriers to general and respiratory exercises in cystic fibrosis

Santuzzi

Liberato

Morau

et al. 2020

Pediatric Pulmonology

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Objectives To investigate the adherence and the self‐reported barriers to general and respiratory exercises reported by individuals with cystic fibrosis (CF). Study Design An exploratory, experimental study. Methods Community‐dwelling individuals aged 16 years and over, diagnosed with CF, who were accompanied in referral centers were included. Information regarding adherence to exercises was obtained by a questionnaire and reported as a ratio between prescribed exercises and self‐reported adherence. The weekly frequency was used to verify adherence to exercise initiation, and the amount of session duration concluded was used to verify adherence to exercise duration. Values above 0.70 were considered as high adherence. Eight demographic and clinical factors were examined to explore their relationships with adherence, and the barriers to exercises were also collected by questionnaire. Results Thirty‐four participants met the inclusion criteria. Overall, adherence to exercise initiation was 0.40 (standard deviation [SD] = 0.3) for general exercises and 0.63 (SD = 0.4) for respiratory exercises. Adherence to exercise duration was 0.76 (SD = 0.4) for general exercises and 0.73 (SD = 0.4) for respiratory exercises. Forced vital capacity (r = 0.39; P = .02) was associated with adherence to the duration of general exercises, and body mass index (r = −0.33; P = .05) was associated with adherence to the duration of respiratory exercises. The main reported barriers were lack of interest, motivation and time, tiredness, noncommitment, and do not recognize the benefits of exercises. Conclusions Individuals with CF minded completing the sessions of prescribed exercises once they have initiated it, but most of the days they did not practice general or respiratory exercises.

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Section: Introductionmentioning

confidence: 99%

Adherence and barriers to general and respiratory exercises in cystic fibrosis

Santuzzi

Liberato

Morau

et al. 2020

Pediatric Pulmonology

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“…These two adaptations jointly facilitate the ability to walk at a certain intensity for a long time without decreasing the SpO 2 . On the other hand, it is also known that IMT improves the strength of the inspiratory musculature, allowing lung pathology patients to overcome and "train" pulmonary compliance [35,37]. This allows patients to maintain a larger alveolar gas exchange surface, as there is a better expansion of lungs, and to maintain a higher VE at a high intensity of exercise.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Combined Training in Idiopathic Pulmonary Fibrosis: A Case Study

Orellana

Santalla

2020

IJERPH

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A supervised combined training program was applied to a sedentary 56-year-old man with idiopathic pulmonary fibrosis (IPF) along three years, until lung transplantation. It included: (a) aerobic continuous (CT) and interval training (IT), (b) high load resistance training (RT) and (c) inspiratory muscle training (IMT). IT and IMT were applied for two years, while CT and RT could be maintained until transplantation using supplemental oxygen. Maximal inspiratory pressure (MIP) kept above 180 cm H2O and forced vital capacity (FVC) remained stable until lung transplantation. Peak oxygen uptake VO2 increased during 1.5 years before its decline, staying above the poor prognosis level two years. Finally, the patient maintained his walking capacity and independence for 2 years, before the decline due to the disease. After receiving a two-lung transplant, the patient remained intubated for 12 h, left the intensive care unit after 3.5 days and was discharged after 18 days (average values: 48 h, 7–10 days and 25–35 days, respectively). These results show that systematic and supervised combined training can be safety applied in an IPF patient to maintain functionality and quality of life. In addition, we show that RT can be maintained for as long as necessary without complications.

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“…The apparent limited utility of IMT to translate to clinically meaningful outcomes must be interpreted in the context of multiple methodological limitations and the obvious paucity of available studies. Indeed, the most recent Cochrane review only identified nine reports eligible for inclusion [20]. Whilst the overall conclusion of this review appears to be appropriate based on the available evidence, several parameters that may underpin the equivocal findings were not adequately discussed, such as the methods utilized to quantify respiratory muscle function [36].…”

Section: Current State Of Imt In Cfmentioning

confidence: 99%

“…Strategies to enhance respiratory muscle function in the presence of a load/capacity imbalance and to counteract the disease-related decline in pulmonary function have been suggested, with one potential strategy being IMT [20, 21]. While specific loading protocols vary, IMT typically utilizes either a pressure or volume load on the inspiratory muscles to provide a stimulus to elicit a training response [22], similar to that observed in response to training peripheral musculature.…”

Section: Introductionmentioning

confidence: 99%

“…Indeed, IMT has been shown to be an effective ergogenic aid to enhance exercise performance in healthy adults [23–26] and has been investigated as a therapeutic intervention to improve clinical and functional outcomes in a variety of health conditions including asthma, chronic obstructive pulmonary disease (COPD), heart failure, and stroke [27–33]. However, the applicability of IMT as a therapeutic strategy in those with CF remains equivocal [20]. Nonetheless, whilst recent reviews have provided a comprehensive summary of the current evidence base, little attention has been given to the methodological limitations associated with this evidence, which largely confounds its interpretation and should temper any conclusions.…”

Section: Introductionmentioning

confidence: 99%

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Inspiration for the Future: The Role of Inspiratory Muscle Training in Cystic Fibrosis

et al. 2019

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Cystic fibrosis (CF) is an inherited, multi-system, life-limiting disease characterized by a progressive decline in lung function, which accounts for the majority of CF-related morbidity and mortality. Inspiratory muscle training (IMT) has been proposed as a rehabilitative strategy to treat respiratory impairments associated with CF. However, despite evidence of therapeutic benefits in healthy and other clinical populations, the routine application of IMT in CF can neither be supported nor refuted due to the paucity of methodologically rigorous research. Specifically, the interpretation of available studies regarding the efficacy of IMT in CF is hampered by methodological threats to internal and external validity. As such, it is important to highlight the inherent risk of bias that differences in patient characteristics, IMT protocols, and outcome measurements present when synthesizing this literature prior to making final clinical judgments. Future studies are required to identify the characteristics of individuals who may respond to IMT and determine whether the controlled application of IMT can elicit meaningful improvements in physiological and patient-centered clinical outcomes. Given the equivocal evidence regarding its efficacy, IMT should be utilized on a case-by-case basis with sound clinical reasoning, rather than simply dismissed, until a rigorous evidence-based consensus has been reached.

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Respiratory muscle training for cystic fibrosis

Cited by 15 publications

References 36 publications

Adherence and barriers to general and respiratory exercises in cystic fibrosis

Adherence and barriers to general and respiratory exercises in cystic fibrosis

Long-Term Combined Training in Idiopathic Pulmonary Fibrosis: A Case Study

Inspiration for the Future: The Role of Inspiratory Muscle Training in Cystic Fibrosis

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