Reliability of K-Series for Assessing Pulmonary Function in Post-Stroke Patients

STUDY:

Reliability of an Electronic Inspiratory Loading Device for Assessing Pulmonary Function in Post-Stroke Patients

Kyeong-Bong Lee, Min-Kyu Kim, Ju-Ri Jeong, Wan-Hee Lee

This recently published clinical research undertaken at the Graduate School of Physical Therapy, Sahmyook University, Seoul, Republic of Korea, was to examine the inter- and intra-rater reliability of an electronic inspiratory loading device for the assessment of pulmonary functions: maximum inspiratory pressure, peak inspiratory flow, and vital capacity.

Maximum inspiratory pressure, peak inspiratory flow, and vital capacity for pulmonary functions were assessed using an electronic inspiratory loading device – the POWERbreathe K5 with Breathe-Link Live Feedback software.

Conclusions:

After assessment the researchers concluded, “The intra- and inter-examiner reliability of the pulmonary function measurements, maximum inspiratory pressure, peak inspiratory flow, and vital capacity, for the post-stroke patients was very high. The results suggest that the electronic inspiratory loading device would be useful for clinical rehabilitative assessment of pulmonary function.”

Read the full research paper, Reliability of an Electronic Inspiratory Loading Device for Assessing Pulmonary Function in Post-Stroke Patients

IMT in mechanical ventilation: suitable protocols and endpoints

RESEARCH:

Inspiratory muscle training in mechanical ventilation: suitable protocols and endpoints, the key to clear results – a critical review

Silva, Paulo Eugênio

This research from Faculdade de Educação Física, Universidade de Brasília looked into whether Inspiratory Muscle Training (IMT) led to a shorter duration of mechanical ventilation, improved weaning success, or improved survival.

The purpose of this critical review was to determine:

1. What is the ideal prescription of IMT for patients on MV?
2. What is the best time to measure treatment effect?
3. Which kind of device should be used to IMT?
4. What are the best endpoints to evaluate the effects of IMT on the process of discontinuing from MV?

Which kind of device should be used to IMT? POWERbreathe K-Series.

“The biggest challenge in the training of mechanically ventilated patients is the use of conventional devices to impose loads on the respiratory muscles. When training starts, the patient must be disconnected from the ventilator and the respiratory monitoring is lost.”

“A new class of device is now available that is possible to monitor respiratory variables during the training. One example of this is the POWERbreathe K-Series (POWERbreathe-HaB UK) an electronic K-device with feedback software that helps professionals to understand what is happening with patients during their training. This device provides automatically processed information on external inspiratory work. Moreover, power and breathing patterns during loaded breathing tasks is shown, thus the onset of fatigue can be detected earlier.”

“POWERbreathe K-Series was externally evaluated by Belgian researchers and they concluded that the K-Series technology provides automatically processed and valid estimates of physical units of energy during loaded breathing tasks. Recently, de Souza et al. published a case report showing good results using the same technology to train a prolonged mechanically ventilated patient.”

“Another great advantage of this kind of technology is the capacity of load adjustment (1 cmH2O per 1 cmH2O) reaching 3 to 200 cmH2O. Beyond that, the device can adjust the load dynamically, imposing higher load at the beginning of inspirations and lower load close to vital capacity. Thus, a greater range of motion can be reached improving the effectiveness of the training.”

CONCLUSION:

“This review demonstrated the necessity of new RCTs despite of some well designed RCTs have already been published. Many evidences point out that a high intensity training with loads ≥ 50% of MIP in 5 to 6 sets, aiming to reach thirty breathes, one or twice a day, seven days per week is a suitable protocol to improve performance on mechanical ventilation. Patients must be trained at least for two weeks in order to IMT promotes clinically significant effects. It is possible, that outcomes such as the onset of weaning process, duration and success on the weaning, have higher correlation with IMT.” “In conclusion, IMT on mechanically ventilated patients seems to be a promissory treatment despite controversial results. RCTs should be carried out to verify the efficacy of the high intensity training during a suitable period of training using electronic kinetic devices in mechanically ventilated patients.”

Read Inspiratory muscle training in mechanical ventilation: suitable protocols and endpoints, the key to clear results – a critical review

Effects of Inspiratory Muscle Training in older adults

RESEARCH:

The Effects of Inspiratory Muscle Training in Older Adults
Mills D, Johnson M, Barnett Y, Smith W, Sharpe G

This research, published in Medicine & Science in Sports & Exercise (April 2015 – Volume 47 – Issue 4 – p 691–697) concluded that Inspiratory Muscle Training (IMT) elicits some positive changes in inspiratory muscle function and structure in healthy older adults…

PURPOSE:
“Declining inspiratory muscle function and structure and systemic low-level inflammation and oxidative stress may contribute to morbidity and mortality during normal ageing. Therefore, we examined the effects of inspiratory muscle training (IMT) in older adults on inspiratory muscle function and structure and systemic inflammation and oxidative stress, and reexamined the reported positive effects of IMT on respiratory muscle strength, inspiratory muscle endurance, spirometry, exercise performance, physical activity levels (PAL), and quality of life (QoL).”

CONCLUSION:
“These novel data indicate that in healthy older adults, IMT elicits some positive changes in inspiratory muscle function and structure but neither attenuates systemic inflammation and oxidative stress nor improves exercise performance, PAL, or QoL.”

Read The Effects of Inspiratory Muscle Training in Older Adults

Discover POWERbreathe used in Research here >

Effects of IMT on Resistance to Fatigue of Respiratory Muscles in Exercise

EliteVelo Kalas Sportswear Cycling Race Team by Richard Fox Photography

EliteVelo Kalas Sportswear Cycling Race Team using POWERbreathe Plus IMT (above)
PHOTO: Richard Fox Photography

STUDY:

Effects of Inspiratory Muscle Training on Resistance to Fatigue of Respiratory Muscles During Exhaustive Exercise
M. O. Segizbaeva, N. N. Timofeev, Zh. A. Donina, E. N. Kur’yanovich, N. P. Aleksandrova

This study, published in Body Metabolism and Exercise – Advances in Experimental Medicine and Biology (Volume 840, 2015, pp 35-43) concluded that IMT elicits resistance to the development of inspiratory muscles fatigue during high-intensity exercise.

PURPOSE:

To assess the effect of inspiratory muscle training (IMT) on resistance to fatigue of the diaphragm, parasternal, sternocleidomastoid and scalene muscles in healthy humans during exhaustive exercise.

The sternocleidomastoid muscle flexes the neck and helps with the oblique rotation of the head. Also, the muscle helps in forced inspiration while breathing, and it raises the sternum. As for forced inspiration, the muscle also works in concert with the scalene muscles in the neck. The scalene muscles are lateral vertebral muscles that begin at the first and second ribs and pass up into the sides of the neck. There are three of these muscles. (SOURCE: Healthline.com)

CONCLUSION:

“The study found that in healthy subjects, IMT results in significant increase in MIP (+18 %), a delay of inspiratory muscle fatigue during exhaustive exercise, and a significant improvement in maximal work performance. We conclude that the IMT elicits resistance to the development of inspiratory muscles fatigue during high-intensity exercise.”

Read Effects of Inspiratory Muscle Training on Resistance to Fatigue of Respiratory Muscles During Exhaustive Exercise

Check out more Inspiratory Muscle Training Research here >

Discover POWERbreathe used in Research here >

Effect of IMT on exercise performance – September 6 2013

A research article, published online ahead of print (6 September 2013), has revealed evidence that prior-induced inspiratory muscle fatigue (IMF) reduces exercise performance, likely as a result of the increased quadriceps muscle fatigue (QMF).

Research Abstract:

Effect of inspiratory muscle fatigue on exercise performance taking into account the fatigue-induced excess respiratory drive

The study investigated “whether prior-induced IMF would affect subsequent cycling performance via increased quadriceps muscle fatigue (QMF) alone and whether fatigue-induced excess ventilation would contribute to this impairment.”

It concluded “Thus, prior-induced IMF reduces exercise performance likely as a result of the increased QMF and thus greater perception of exertion independent of the excess respiratory drive when cycling with fatigued inspiratory muscles.”

Andrew Jones, Professor of Applied Physiology at Exeter University and endurance sports training, physiology and nutrition expert, has interpreted this to mean “High rates of ventilation over long periods fatigue the diaphragm – more cardiac output directed there rather than to legs.”

Read the Abstract online.

Read more research regarding breathing training for cyclists on our Cycling page.