Benefits of combining inspiratory muscle with ‘whole muscle’ training in children with CF

The British Journal of Sports Medicine has just published details online (16th May) of a randomised trial that looked at assessing the effects of an 8-week combined ‘whole muscle’ (resistance + aerobic) and inspiratory muscle training on lung volume, inspiratory muscle strength and cardiorespiratory fitness, and dynamic muscle strength, body composition and quality of life in children with cystic fibrosis.

The trial concluded that the 8-week training programme induced significant benefits in important health phenotypes, and that inspiratory muscle training was an easily applicable intervention that could be included, along with supervised exercise training, in the standard care of these patients.

Here’s the Original Article, the Abstract for which can be found online at the British Journal of Sports Medicine.

Benefits of combining inspiratory muscle with ‘whole muscle’ training in children with cystic fibrosis: a randomised controlled trial

Authors:

Elena Santana-Sosa1, Laura Gonzalez-Saiz1, Iris F Groeneveld2, José R Villa-Asensi3, María I Barrio Gómez de Aguero3, Steven J Fleck4, Luis M López-Mojares1, Margarita Pérez1, Alejandro Lucia1,5

Author Affiliations:

1 School of Doctorate Studies and Research, Universidad Europea de Madrid, Spain

2 Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands

3 Department of Pneumology, Hospital ‘Nino Jesus’ of Madrid, Madrid, Spain

4 Department of Health, Exercise Science and Sport Management, University of Wisconsin-Parkside, Kenosha, Wisconsin, USA

5 Instituto de Investigación i+12, Madrid, Spain

Correspondence to:

Dr Alejandro Lucia, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid 28670, Spain; alejandro.lucia@uem.es

Abstract

Background
The purpose of this study (randomised controlled trial) was to assess the effects of an 8-week combined ‘whole muscle’ (resistance+aerobic) and inspiratory muscle training (IMT) on lung volume, inspiratory muscle strength (PImax) and cardiorespiratory fitness (VO2 peak) (primary outcomes), and dynamic muscle strength, body composition and quality of life in paediatric outpatients with CF (cystic fibrosis, secondary outcomes). We also determined the effects of a detraining period.

Methods
Participants were randomly allocated with a block on gender to a control (standard therapy) or intervention group (initial n=10 (6 boys) in each group; age 10±1 and 11±1 years). The latter group performed a combined programme (IMT (2 sessions/day) and aerobic+strength exercises (3 days/week, in-hospital)) that was followed by a 4-week detraining period. All participants were evaluated at baseline, post-training and detraining.

Results
Adherence to the training programme averaged 97.5%±1.7%. There was a significant interaction (group×time) effect for PImax, VO2peak and five-repetition maximum strength (leg-press, bench-press, seated-row) (all (p<0.001), and also for %fat (p<0.023) and %fat-free mass (p=0.001), with training exerting a significant beneficial effect only in the intervention group, which was maintained after detraining for PImax and leg-press.

Conclusion
The relatively short-term (8-week) training programme used here induced significant benefits in important health phenotypes of paediatric patients with CF. IMT is an easily applicable intervention that could be included, together with supervised exercise training in the standard care of these patients.

In another study, Improved Pulmonary Function and Exercise Tolerance With Inspiratory Muscle Conditioning in Children With Cystic Fibrosis, published in the Chest Journal (November 1993, Vol 104, No. 5) the effect of inspiratory muscle conditioning in children with cystic fibrosis was also documented, with findings indicating that the experimental group that trained at a high pressure load (> or = 29 cm H2O) showed significant increases in inspiratory muscle strength, vital capacity, total lung capacity, and exercise tolerance in comparison to the control group. The study suggested that IMT may provide some benefit to the young CF population with respect to functional status. “…the results are promising and may potentially be useful as an adjunct to well-established physical therapy regimens in this patient group.”

If you’re already using POWERbreathe to help with symptoms of cystic fibrosis, then please leave a comment here or on the POWERbreathe Forum as we’d love to hear from you. You can also read a POWERbreathe blog from Evan Scully who was diagnosed with CF at the age of just 6-months, about his first experience of using POWERbreathe.

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