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 trauma1.
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.
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
- 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
- Myasthenia gravis
- Chronic hemodialysis
- Low back pain
“The effect of respiratory muscle endurance training (RMET) on respiratory muscle (RM) function, dyspnoea and exercise performance was evaluated in spinal cord injury athletes.”
“Respiratory muscle endurance training (RMET) can improve respiratory muscle function, reduce the perception of dyspnoea but modifies only slightly exercise performance in spinal cord injury athletes.”
“Injury to the cervical and upper thoracic spinal cord disrupts function of inspiratory and expiratory muscles, as reflected by reduction in spirometric and lung volume parameters and static mouth pressures. In association, subjects with tetraplegia have decreased chest wall and lung compliance, increased abdominal wall compliance, and rib cage stiffness with paradoxical chest wall movements, all of which contribute to an increase in the work of breathing.”
Grupo GNAP in Salvador – Bahia offers specialised care in neurological rehabilitation, offering rehabilitation to their spinal cord injury patients that is efficient and motivating.
Respiratory approach to the neurological patient
GNAP believes that the treatment of neurological patients should not be limited to a motor or sensory approach of the limbs and trunk only, but also to their respiratory ability, because in many patient cases a reduction in functional performance limitations is associated with their respiratory ability.
To verify this, using the POWERbreathe K5 with Breathe-Link Live Feedback Software, they assess the patient’s respiratory ability by asking them to perform specific tasks, after which they identify issues and begin a course of POWERbreathe Inspiratory Muscle Training to help them improve not only their respiratory function but in turn their functional performance.
We’d like to thank Mateus Esquivel, Departamento De Fisioterapia Sbc Bahia and Fabio Carvalho, Physical therapist, expert in physical therapy neurofuncionnal and MBA in Business Management (FGV) from GNAP for bringing this important and encouraging work to our attention. Thank you!
Published by the American Physical Therapy Association 2014.
Karin Postma, Janneke A. Haisma, Maria T.E. Hopman, Michael P. Bergen, Henk J. Stam and Johannes B. Bussmann
“To assess immediate and long-term effects of Resistive Inspiratory Muscle Training (RIMT) in persons with Spinal Cord Injury (SCI).”
“Persons were randomized to the RIMT-group or the control-group. All persons received usual rehabilitation care. In addition, persons in the intervention group performed RIMT with a threshold trainer.”
“RIMT has a positive short-term effect on inspiratory muscle function in persons with SCI who have impaired pulmonary function during inpatient rehabilitation.”
View list of published research that used POWERbreathe as the IMT intervention of choice in POWERbreathe in Research.
Find more published research on our Inspiratory Muscle Training Research blog.
An Intervention Review by the Cochrane Injuries Group has been published on The Cochrane Library that looked at Respiratory Muscle Training for Cervical Spinal Cord Injury (SCI).
This systematic review was needed to determine the effectiveness of Respiratory Muscle Training (either inspiratory or expiratory muscle training) on pulmonary function, dyspnoea, respiratory complications, respiratory muscle strength, and quality of life for people with cervical spinal cord injury.
David Berlowitz, Jeanette Tamplin
Editorial Group: Cochrane Injuries Group
Published Online: 19 JUL 2013
Authors’ Conclusions – Implications for practice
The results of this review suggest that respiratory muscle training (RMT) can improve vital capacity and respiratory muscle strength (maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP)) for people with cervical spinal cord injury (SCI).
The Plain Language Summary -‘Training the muscles used for breathing after a spinal cord injury’:
“After an injury at a high point on the spinal cord (a cervical injury), the muscles responsible for breathing are paralysed or weakened. This weakness reduces the volume of the lungs (lung capacity), the ability to take a deep breath and cough, and puts them at greater risk of lung infection. Just like other muscles of the body, it is possible to train the breathing (respiratory) muscles to be stronger; however, it is not clear if such training is effective for people with a cervical spinal cord injury. This review compared any type of respiratory muscle training with standard care or sham treatments. We reviewed 11 studies (including 212 people with cervical spinal cord injury) and suggested that for people with cervical spinal cord injury there is a small beneficial effect of respiratory muscle training on lung volume and on the strength of the muscles used to take a breath in and to breathe air out and cough. No effect was seen on the maximum amount of air that can be pushed out in one breath, or shortness of breath. An insufficient number of studies had examined the effect of respiratory muscle training on the frequency of lung infections or quality of life, so we could not assess these outcomes in the review. We identified no adverse effects of training the breathing muscles for people with a cervical spinal cord injury.”