Other Medical Conditions

Breathing Effort in other Medical Conditions 

Any condition that prevents normal physical activity can lead to inspiratory muscle weakness, and in addition to asthma and Chronic Obstructive Pulmonary Disease (COPD), Inspiratory Muscle Training (IMT), such as with POWERbreathe, has been found to be helpful for managing other medical conditions, including chronic heart failure, postoperative pulmonary complications and inspiratory stridor.

• Breathing Training

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  • Specific Inspiratory Muscle Training (IMT) of the muscles we use to breathe, such as with POWERbreathe, has been demonstrated to increase their strength, resistance to fatigue and reduce breathlessness, as well as being helpful in managing medical conditions including: 

    • Chronic heart failure and heart disease 
    • Neuromuscular disease
    • Parkinson's disease
    • Prior-polio
    • Spinal cord injury
    • Sleep apnoea and snoring (Heijdra et al., 1996)
    • Exercise-induced paradoxical vocal fold motion
    • Muscular dystrophy
    • Multiple Sclerosis
    • Voice and speech disorders
    • Postoperative pulmonary complications
    • Restrictive thoracic disease
    • Severe chronic pulmonary hypertension
    • Inspiratory stridor 
    • Duchenne muscular dystrophy
    • Tetraplegia
    • Myasthenia gravis
    • Bronchiectasis
    • Chronic hemodialysis

• Medical Conditions

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    Heart Failure & Disease 

    A study concluded that Inspiratory Muscle Training (IMT) using an incremental endurance test, successfully increases both inspiratory strength and endurance, alleviates dyspnea and improves functional status in chronic heart failure¹.

    And another study concluded that in patients with chronic heart failure and inspiratory muscle weakness, Inspiratory Muscle Training (IMT) results in marked improvement in inspiratory muscle strength, as well as improvement in functional capacity, ventilatory response to exercise, recovery oxygen uptake kinetics, and quality of life².

    Neuromuscular Disease 

    One study concluded: Inspiratory Muscle Training may potentially strengthen the inspiratory muscles and slow the decline in respiratory function in patients with ALS/MND³. 

    And another study concluded: With Inspiratory Muscle Training, respiratory muscle function can be improved in the long term of up to 2 years⁴.

    Parkinson’s Disease

    A study concluded that inspiratory muscle performance may be improved by specific Inspiratory Muscle Training in patients with Parkinson’s Disease. This improvement is associated with a significant decrease in their perception of dyspnoea (difficult or laboured breathing; shortness of breath)⁵.

    Prior-Polio 

    A study concluded that Inspiratory Muscle Training and close supervision can increase respiratory muscle endurance and improve well-being in patients with prior polio who use part-time assisted ventilation⁶.

    Spinal Cord Injury 

    A study concluded Resistive Inspiratory Muscle Training (RIMT) can improve ventilatory function, respiratory endurance, and the perceived difficulty of breathing in patients with complete cervical spinal cord injury within half a year after trauma⁷. 

    Muscular Dystrophy 

    A study concluded that respiratory muscle strength is enhanced by training in the patients with muscular dystrophy who are ambulatory, but inspiratory and/or expiratory training effect is specific to the trained muscles. The techniques that improve the strength of respiratory muscles should be included in the physiotherapy management of patients with muscular dystrophy⁸.

    Multiple Sclerosis 

    A study concluded that Inspiratory Muscle Training (IMT) significantly increased inspiratory muscle strength and resulted in generalized improvements in expiratory pulmonary function in persons with Multiple Sclerosis who have minimal to moderate disability. Future studies are needed that focus on the long-term effects of IMT with increased resistance and the impact it has on increasing pulmonary function and functional performance⁹.

    Postoperative pulmonary complications

    A study concluded that preoperative Inspiratory Muscle Training (IMT) reduced the incidence of Postoperative pulmonary complications and duration of postoperative hospitalization in patients at high risk of developing a pulmonary complication undergoing CABG surgery¹⁰.

    Another study concluded that Inspiratory Muscle Training (IMT) for 2-4 weeks before coronary artery bypass graft surgery was well tolerated by patients at risk of postoperative pulmonary complications and prevented the occurrence of atelectasis in these patients. A larger randomized clinical trial is warranted¹¹.

    Restrictive thoracic disease 

    A study concluded: In patients with restrictive thoracic disorders and noninvasive positive-pressure ventilation (NPPV), Respiratory Muscle Training (RMT) improved inspiratory muscle strength. Exercise performance and health-related quality of life (HRQOL) were improved when the 2 groups were compared. Respiratory Muscle Training (RMT) was practicable and safe despite severe respiratory impairment. Further evaluation, including different training intensities and modalities, seems warranted¹².

    Severe chronic pulmonary hypertension 

    A study indicated that respiratory and physical training could be a promising adjunct to medical treatment in severe pulmonary hypertension. The effects add to the beneficial results of modern medical treatment¹³.

    Inspiratory Stridor

    A study showed that Inspiratory Muscle Training (IMT) is a suitable cost-effective intervention for athletes who present with inspiratory stridor¹⁴.

    Duchenne muscular dystrophy 

    A study concluded that specific Inspiratory Muscle Training (IMT) improves respiratory muscle endurance in Duchenne muscular dystrophy and the effectiveness of training appears to be dependent on the quantity of training¹⁵.

    Another study concluded that a specific inspiratory muscle training is useful in the early stage of Duchenne muscular dystrophy¹⁶.

    Tetraplegia 

    A case report evaluated the effect of a year-long respiratory intervention, which included inspiratory muscle training and positive expiratory pressure therapy, for a person with C3-C4 tetraplegia. The intervention improved both inspiratory muscle force and pulmonary function values. Respiratory infections, frequency of suctioning and physiotherapy treatment time decreased progressively throughout the intervention. There were no admissions to the acute care hospital after the interventions began. This intervention improved the participant's health and well being and reduced costs to the health care system¹⁷.

    Results of another study indicated that training of the respiratory muscles results in an enhanced endurance capacity of these muscles and a concomitant increase in the aerobic exercise performance¹⁸.

    And in another study findings suggest that Resistive Inspiratory Muscle Training (RIMT) can enhance the respiratory muscle strength and endurance of chronic tetraplegia and further ameliorate the sleep-induced breathing disorder. Therefore, RIMT is suggested as a home program for patients with sleep-disordered breathing¹⁹.

    Myasthenia gravis 

    A study concluded that the partial home program of interval-based Inspiratory Muscle Training (IMT) associated with breathing retraining (BR) is feasible and effective in patients with generalized Myasthenia gravis. Improvements in respiratory muscle strength, chest wall mobility, respiratory pattern, and respiratory endurance were observed²⁰.

    Another study concluded that specific inspiratory threshold loading training alone, or combined with specific expiratory training, markedly improved respiratory muscle strength and endurance in patients with Myasthenia gravis. This improvement in respiratory muscle performance was associated with improved lung function and decreased dyspnea. Respiratory muscle training may prove useful as a complementary therapy with the aim of reducing dyspnea symptoms, delay the breathing crisis and the need for mechanical ventilation in patients with Myasthenia gravis²¹.

    Bronchiectasis

    A study concluded that pulmonary rehabilitation is effective in improving exercise tolerance in bronchiectasis but there is no additional advantage of simultaneous Inspiratory Muscle Training (IMT). IMT may, however, be important in the longevity of the training effects²².

    Chronic hemodialysis 

    A study concluded that, following Specific Inspiratory Muscle Training (SIMT), inspiratory muscle performance improved significantly and was associated with improved functional capacity, but not in the control group. We conclude that patients with chronic renal failure undergoing maintenance hemodialysis have reduced inspiratory muscle performance, and specific inspiratory muscle training improves functional capacity²³.

    All references can be found in Research.

     

• Research

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  • ¹ Inspiratory muscle training using an incremental endurance test alleviates dyspnea and improves functional status in patients with chronic heart failure

    ² Inspiratory muscle training in patients with heart failure and inspiratory muscle weakness: a randomized trial

    ³ INSPIRATIonAL--INSPIRAtory muscle training in amyotrophic lateral sclerosis

    ⁴ 2 Years' experience with inspiratory muscle training in patients with neuromuscular disorders

    ⁵ Inspiratory muscle training and the perception of dyspnea in Parkinson's disease

    ⁶ Inspiratory muscle training in patients with prior polio who use part-time assisted ventilation

    ⁷ Resistive inspiratory muscle training: Its effectiveness in patients with acute complete cervical cord injury

    ⁸ Comparison study of chest physiotherapy home training programmes on respiratory functions in patients with muscular dystrophy

    ⁹ Randomized Control Trial of Effects of a 10-Week Inspiratory Muscle Training Program on Measures of Pulmonary Function in Persons with Multiple Sclerosis

    ¹⁰ Preoperative Intensive Inspiratory Muscle Training to Prevent Postoperative Pulmonary Complications in High-Risk Patients Undergoing CABG Surgery
    A Randomized Clinical Trial

    ¹¹ Feasibility of preoperative inspiratory muscle training in patients undergoing coronary artery bypass surgery with a high risk of postoperative pulmonary complications: a randomized controlled pilot study

    ¹² Respiratory muscle training in restrictive thoracic disease: a randomized controlled trial

    ¹³ Exercise and Respiratory Training Improve Exercise Capacity and Quality of Life in Patients With Severe Chronic Pulmonary Hypertension

    ¹⁴ Inspiratory muscle training: a simple cost-effective treatment for inspiratory stridor

    ¹⁵ Dose-dependent effect of individualized respiratory muscle training in children with Duchenne muscular dystrophy

    ¹⁶ Inspiratory muscle training in patients with Duchenne muscular dystrophy

    ¹⁷ Respiratory training for a person with C3-C4 tetraplegia

    ¹⁸ Training of the respiratory muscles in individuals with tetraplegia

    ¹⁹ Resistive inspiratory muscle training in sleep-disordered breathing of traumatic tetraplegia

    ²⁰ Effects of 8-week, interval-based inspiratory muscle training and breathing retraining in patients with generalized myasthenia gravis

    ²¹ Respiratory muscle training in patients with moderate to severe myasthenia gravis

    ²² Exercise training and inspiratory muscle training in patients with bronchiectasis

    ²³ [Specific inspiratory muscle training in chronic hemodialysis]