Impact Of IMT In Patients With COPD: What Is The Evidence?

“Meta-analysis including 32 randomised controlled trials on the effects of inspiratory muscle training (IMT) in chronic obstructive pulmonary disease (COPD) patients was performed.”

Conclusion:

“In conclusion, IMT is an effective treatment modality in COPD patients to improve respiratory muscle strength and endurance, resulting in reductions of dyspnoea and improvement in functional exercise capacity and health-related quality of life. Patients with more advanced muscle weakness seem to be better responders, especially when considering IMT in addition to general exercise training.”

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Effect of Inspiratory Muscle Training on Exercise Tolerance in Asthmatic Individuals

“The aim of this study was to determine the effects of inspiratory muscle training (IMT) on exercise tolerance, inspiratory muscle fatigue, and the perception of dyspnea in asthmatic individuals.”

Conclusion:

“This study has shown that 6 wk of IMT in individuals with mild to moderate asthma significantly increased inspiratory muscle strength, reduced inspiratory muscle fatigue, improved exercise tolerance, and reduced the perception of dyspnea during cycling exercise at È70% V ̇O2max to the limit of tolerance. These data suggest that IMT may be a helpful adjunct to asthma management and has the potential to improve participation and adherence to exercise training in this group. However, it should also be noted that the perception of breathlessness is also an important signal of bronchoconstriction, and thus, caution should be exercised if this symptom is abnormally low.”

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Attenuated Inspiratory Muscle Metaboreflex In Endurance-Trained Individuals

“The inspiratory metaboreflex is activated during loaded breathing to task failure and induces sympathetic activation and peripheral vasoconstriction that may limit exercise performance. Inspiratory muscle training appears to attenuate the inspiratory metaboreflex in healthy subjects. Since whole body aerobic exercise training improves breathing endurance and inspiratory muscle strength, we hypothesized that endurance-trained individuals would demonstrate a blunted inspiratory muscle metaboreflex in comparison to sedentary individuals.”

Conclusion:

“Data demonstrate that endurance-trained individuals have an attenuated inspiratory muscle metaboreflex.”

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Type 2 Diabetes

‘Inspiratory Muscle Training In Type 2 Diabetes With Inspiratory Muscle Weakness’

“Patients with type 2 diabetes mellitus may present weakness of the inspiratory muscles. This study tested the hypothesis that inspiratory muscle training (IMT) could improve inspiratory muscle strength, pulmonary function, functional capacity, and autonomic modulation in patients with type 2 diabetes and weakness of the inspiratory muscles.”

Conclusion:

“Patients with type 2 diabetes may frequently present inspiratory muscle weakness. In these patients, IMT improves inspiratory muscle function with no consequences in functional capacity or autonomic modulation.”

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Effects of High-Intensity Inspiratory Muscle Training Following a Near-Fatal Gunshot Wound

“Severe injuries sustained during combat may classify individuals as undeployable for active service. It is imperative that every effort is made to optimize physical function following such injuries.”

“In this case, a 38-year-old man sustained a gunshot wound during armed combat. The bullet entered via the left axilla and exited from the right side of the abdomen, resulting in severe thoracic and abdominal injuries. The main goals of therapy were to reduce dyspnea on exertion and to enable return to full work duties. A program of high-intensity, interval-based threshold inspiratory muscle training (IMT) was undertaken.”

Conclusion:

“Given that IMT was introduced 12 months following the injury, at which point progress had reached a plateau with other rehabilitation strategies, it seems reasonable to attribute the increased maximum forced inspiratory flow recorded at rest and change in the locus of symptom limitation during exercise from the dyspnea to leg fatigue to the introduction of IMT. These data should be seen as hypothesis-generating.”

Clinical Implications and Future Research:

“The flow-volume loops recorded during the CPET allowed us to identify inefficiencies in breathing strategy and respiratory mechanics that were responsible for this patient’s intolerable dyspnea during exercise. Notably, the measurement of Pimax was of no diagnostic value and was used only to prescribe the initial load for IMT. These findings suggest that static measures of the pressure-generating capacity of the inspiratory pump muscles convey little information about how they operate under dynamic conditions such as exercise. In this patient, chest fluoroscopy and the CPET with flow-volume loops provided the most useful diagnostic information. A program of high-intensity IMT should be considered for individuals who demonstrate inspiratory flows during exercise that approximate the maximum inspiratory flow recorded at rest. Further study is needed to confirm the role of IMT in people with diaphragm injury.”

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Inspiratory Muscles Strength Training In Recreational Athletes

Entraînement de la force des muscles inspiratoires chez le sujet sportif amateur

“Respiratory muscles strength and endurance influence athletic performance. Besides conventional spirometry, sniff test, inspiratory and expiratory maximal pressures can directly assess respiratory muscle strength. Respiratory muscles can be train through a device offering inspiratory and expiratory resistance.”

Conclusion:

A specific training of inspiratory muscles (Powerbreathe® Sports performance) increases the power of these muscles (voluntary and non-invasive tests).

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