Training of the respiratory muscles in individuals with tetraplegia

Uijl, Sabine G.; Houtman, S.; Folgering, H.T.M.; Hopman, Maria T. E.

doi:10.1038/sj.sc.3100887

Cited by 50 publications

(57 citation statements)

References 22 publications

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“…(1,8) Several studies have demonstrated that the inspiratory muscles of quadriplegic patients can be trained by increasing MIP, inspiratory muscle endurance, lung volume and capacity. (6,(8)(9)(10)(11)(12)(13)(14)(15)(16) Those studies have used different methods for overloading inspiratory muscles, such as the use of threshold trainers, resistive trainers or abdominal weights, as well as normocapnic hyperpnea and training protocols involving high or unknown loads. (11)(12)(13) Some studies have included a control group, (2,11,16,17) whereas others have included only a training group or compared the type of training used with that of another protocol.…”

Section: Methodsmentioning

confidence: 99%

Treinamento de músculos inspiratórios em pacientes com quadriplegia

et al. 2010

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Objective: To determine whether inspiratory muscle training can increase strength and endurance of these muscles in quadriplegic patients. Methods: Eight quadriplegic patients (7 males and 1 female) with injury to the lower cervical spine (segments C4-C7) were submitted to inspiratory muscle training with a threshold inspiratory muscle trainer adjusted to 30% of MIP. The training sessions were carried out with the patients in a sitting position, 5 days a week for 8 weeks. Endurance time, MIP, MEP and FVC were determined at baseline, week 4 and week 8. Results: In comparison with the mean baseline value, there was an increase in MIP, measured in the sitting position, at weeks 4 and 8 (−83.0 ± 18.9 cmH 2 O vs. −104.0 ± 19.4 cmH 2 O and −111.3 ± 22.7 cmH 2 O). There was an increase in MEP, also in the sitting position, at week 4 (from 36.8 ± 8.1 to 42.6 ± 8.8 cmH 2 O). There was an improvement in FVC at week 4 (from 2.1 ± 0.8 to 2.5 ± 0.6 L, representing an increase of 24 ± 22%). Although there was an increase in endurance (sitting) at week 8, the difference was not significant in comparison with the baseline value (29.8 ± 21.0 vs. 35.9 ± 15.5 min, an increase of 173 ± 233%). Conclusions: Quadriplegic patients can benefit from training at low loads (30% of MIP), which can improve inspiratory muscle strength, FVC and expiratory muscle performance.Keywords: Respiratory mechanics; Quadriplegia; Breathing exercises. ResumoObjetivo: Determinar se o treinamento de músculos inspiratórios pode aumentar a força e endurance desses músculos em pacientes com quadriplegia. Métodos: Oito pacientes quadriplégicos (7 homens e 1 mulher) com lesão medular cervical entre C4 e C7 foram submetidos ao treinamento de músculos inspiratórios utilizando-se um resistor de carga linear ajustado em 30% da PImáx. As sessões de treinamento foram realizadas com os pacientes sentados 5 vezes por semana por 8 semanas. Tempo de endurance, PImáx, PEmáx e CVF foram medidos antes do treinamento e nas semanas 4 e 8. Resultados: Em comparação ao valor basal médio, houve um aumento da PImáx, mensurada na posição sentada, nas semanas 4 e 8 (−83,0 ± 18,9 cmH 2 O vs. −104,0 ± 19,4 e −111,3 ± 22,7 cmH 2 O). Houve aumento da PEmáx, também na posição sentada, na semana 4 (de 36,8 ± 8,1 a 42,6 ± 8,8 cmH 2 O). Houve uma melhora na FVC na 4ª semana (de 2,1 ± 0,8 a 2,5 ± 0,6 L, representando um incremento de 24 ± 22%).O tempo de endurance (sentado) não apresentou um aumento significativo entre o momento basal e a semana 8 (29,8 ± 21,0 min vs. 35,9 ± 15,5 min; aumento de 173 ± 233%). Conclusões: Pacientes com quadriplegia podem se beneficiar com o treinamento com baixas cargas (30% da PImáx), com melhora da força dos músculos inspiratórios, CVF e efetividade dos músculos expiratórios.

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Section: Methodsmentioning

confidence: 99%

Treinamento de músculos inspiratórios em pacientes com quadriplegia

et al. 2010

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“…2,3 The most important pulmonary function change is a nonparenchymatous pulmonary restriction, 4,5 owing to weakness or paralysis of respiratory muscles. 6,7 Maximal static mouth respiratory pressures are used in the evaluation of respiratory muscle strength. 8 Studies in patients with spinal cord lesions are infrequent, but point to a reduction over wide range in these parameters.…”

Section: Introductionmentioning

confidence: 99%

Maximal static mouth respiratory pressure in spinal cord injured patients: correlation with motor level

2006

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Study design: Transversal. Objectives: The few studies concerning maximal static mouth respiratory pressures in patients with spinal cord lesions suggest a marked reduction. We studied the correlation of these parameters with the motor level of injury. Setting: Rehabilitation Center, Brası´lia/DF, Brazil. Methods: One hundred and thirty-one patients with traumatic spinal cord injury (C4-L3) were recruited. The participants were assessed by standard spirometry and maximal static mouth respiratory pressure. Results: Forced vital capacity was most reduced in tetraplegics (subgroup C4-C5, 49%725 predicted) and increase successively for each descending subgroup (C6-C8, 61%722 predicted; T1-T6, 70%715 predicted), becoming normal in low paraplegia (T7-L3, 84%715 predicted). There is no evidence of an obstructive disturbance throughout all groups. The lowest average percent predicted of maximal static inspiratory pressure (MIP) was in the subgroup C4-C5 (50%723). The average percent predicted of maximal static expiratory pressure (MEP) improved from 19%714 in the C4-C5 subgroup to 51%719 for T7-L3 subgroup. The average percent predicted of all participants for MIP was 74%730 and for MEP was 37%721. In patients with complete motor lesion, the correlation with the level of injury was stronger for MEP (r ¼ 0.81, Po0.0001; r 2 ¼ 0.65) than for MIP (r ¼ 0.62, P ¼ 0.004; r 2 ¼ 0.38). No correlation was found among incomplete motor lesion patients. Conclusions: The linear regression equations for the relationship of percent predicted MIP or MEP to level of injury are applicable only to complete motor lesions and may be useful to establish normative association between them.

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“…Some studies in people with CSCI show that RMT can improve ventilatory function. 139,140 In a review article of Van Houtte et al 141 they reported that RMT tended to improve expiratory muscle strength, VC and RV.…”

Section: Resultsmentioning

confidence: 99%

Exercise Training 3—exercise Training in Pulmonary Rehabilitation

2002

Cardiopulmonary Physiotherapy

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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...

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Training of the respiratory muscles in individuals with tetraplegia

Cited by 50 publications

References 22 publications

Treinamento de músculos inspiratórios em pacientes com quadriplegia

Treinamento de músculos inspiratórios em pacientes com quadriplegia

Maximal static mouth respiratory pressure in spinal cord injured patients: correlation with motor level

Exercise Training 3—exercise Training in Pulmonary Rehabilitation

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