Effects of inspiratory muscle training in advanced multiple sclerosis.


Journal

Multiple sclerosis and related disorders
ISSN: 2211-0356
Titre abrégé: Mult Scler Relat Disord
Pays: Netherlands
ID NLM: 101580247

Informations de publication

Date de publication:
Jan 2020
Historique:
received: 10 04 2019
revised: 22 10 2019
accepted: 31 10 2019
pubmed: 11 11 2019
medline: 20 11 2020
entrez: 11 11 2019
Statut: ppublish

Résumé

Respiratory training using Threshold Inspiratory Muscle Trainer (IMT) has not been examined adequately in multiple sclerosis (MS). The primary objective in this study of persons with advanced MS was to investigate the training effect of IMT. The secondary objective was to evaluate the retention of IMT benefits. This study was a repeated measures within-subject design (before-after trial).. Participants were recruited from a long-term care facility specialized in progressive neurologic conditions. Thirty-six non-ambulatory persons with advanced MS volunteered. Inspiratory muscle exercise using the threshold IMT were performed daily for 10 weeks at 3 sets of 15 repetitions per day. Resistance was progressed weekly based on perceived rate of exertion and symptoms. Primary outcome measures were maximum inspiratory pressure (MIP) and maximum expiratory pressure (MEP) that were measured at baseline, after 5 and 10 weeks of IMT exercises (training period), and at 4 and 8 weeks after the IMT training ended (retention). Linear mixed-effect regression models with time (i.e. weeks from baseline) as the fixed factor and participants as the random effect factor were applied separately to test each hypothesis. Effect size was calculated using partial eta square (η2p). Two-tailed significance level was p < 0.05. Participants were 60.5 ± 8.6 years old. Expanded Disability Status Scale was 8.5 ± 0.4. Baseline MIP were 25.9 ± 16.4 cmH2O (33.2% %± 19.8% of predicted values) and MEP were 23.5 ± 15.7 cmH2O (25.8% %± 14.4% of predicted values). Compared to the baseline, MIP increased significantly to 30.1 ± 17.9 cmH2O (38.9% %± 22.4% of predicted values) and 30.6 ± 17.6 cmH2O (39.6% %± 22.3% of predicted values) after 5 (p < 0.05) and 10 weeks (p < 0.05) of IMT exercises. MIP improvements were retained in an 8-week washout period. MEP did not differ significantly by time. In persons with advanced MS, 10-week IMT training increased inspiratory muscle strength. This study is the first to demonstrate the retention of benefits following daily IMT exercises at 8 weeks after training ended.

Sections du résumé

BACKGROUND BACKGROUND
Respiratory training using Threshold Inspiratory Muscle Trainer (IMT) has not been examined adequately in multiple sclerosis (MS). The primary objective in this study of persons with advanced MS was to investigate the training effect of IMT. The secondary objective was to evaluate the retention of IMT benefits.
METHODS METHODS
This study was a repeated measures within-subject design (before-after trial).. Participants were recruited from a long-term care facility specialized in progressive neurologic conditions. Thirty-six non-ambulatory persons with advanced MS volunteered. Inspiratory muscle exercise using the threshold IMT were performed daily for 10 weeks at 3 sets of 15 repetitions per day. Resistance was progressed weekly based on perceived rate of exertion and symptoms. Primary outcome measures were maximum inspiratory pressure (MIP) and maximum expiratory pressure (MEP) that were measured at baseline, after 5 and 10 weeks of IMT exercises (training period), and at 4 and 8 weeks after the IMT training ended (retention). Linear mixed-effect regression models with time (i.e. weeks from baseline) as the fixed factor and participants as the random effect factor were applied separately to test each hypothesis. Effect size was calculated using partial eta square (η2p). Two-tailed significance level was p < 0.05.
RESULTS RESULTS
Participants were 60.5 ± 8.6 years old. Expanded Disability Status Scale was 8.5 ± 0.4. Baseline MIP were 25.9 ± 16.4 cmH2O (33.2% %± 19.8% of predicted values) and MEP were 23.5 ± 15.7 cmH2O (25.8% %± 14.4% of predicted values). Compared to the baseline, MIP increased significantly to 30.1 ± 17.9 cmH2O (38.9% %± 22.4% of predicted values) and 30.6 ± 17.6 cmH2O (39.6% %± 22.3% of predicted values) after 5 (p < 0.05) and 10 weeks (p < 0.05) of IMT exercises. MIP improvements were retained in an 8-week washout period. MEP did not differ significantly by time.
CONCLUSION CONCLUSIONS
In persons with advanced MS, 10-week IMT training increased inspiratory muscle strength. This study is the first to demonstrate the retention of benefits following daily IMT exercises at 8 weeks after training ended.

Identifiants

pubmed: 31707233
pii: S2211-0348(19)30481-X
doi: 10.1016/j.msard.2019.101492
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

101492

Informations de copyright

Copyright © 2019 Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest The authors declared no conflict of interest.

Auteurs

Min H Huang (MH)

Physical Therapy Department, College of Health Sciences, University of Michigan-Flint, 2157 William S. White Building, 303 E. Kearsley Street, Flint, MI 48502-1950, USA. Electronic address: mhhuang@umich.edu.

Donna Fry (D)

College of Health Sciences, University of Michigan-Flint, 3180 William S. White Building, 303 E. Kearsley Street, Flint, MI 48502-1950, USA.

Lisa Doyle (L)

Doctor of Physical Therapy Program, Franklin Pierce University, 670 North Commercial Street, Center Tower, Third Floor, Manchester, NH 03101, USA.

Alexander Burnham (A)

The Boston Home, 2049 Dorchester Ave., Boston, MA 02124, USA.

Nathan Houston (N)

Doctor of Physical Therapy Program, Franklin Pierce University, 670 North Commercial Street, Center Tower, Third Floor, Manchester, NH 03101, USA.

Keelin Shea (K)

Doctor of Physical Therapy Program, Franklin Pierce University, 670 North Commercial Street, Center Tower, Third Floor, Manchester, NH 03101, USA.

Hannah Smith (H)

Doctor of Physical Therapy Program, Franklin Pierce University, 670 North Commercial Street, Center Tower, Third Floor, Manchester, NH 03101, USA.

Lauren Wiske (L)

Doctor of Physical Therapy Program, Franklin Pierce University, 670 North Commercial Street, Center Tower, Third Floor, Manchester, NH 03101, USA.

Jessica Goode (J)

Doctor of Physical Therapy Program, Franklin Pierce University, 670 North Commercial Street, Center Tower, Third Floor, Manchester, NH 03101, USA.

Elizabeth Khitrik (E)

Doctor of Physical Therapy Program, Franklin Pierce University, 670 North Commercial Street, Center Tower, Third Floor, Manchester, NH 03101, USA.

Mackenzie Kolanda (M)

Doctor of Physical Therapy Program, Franklin Pierce University, 670 North Commercial Street, Center Tower, Third Floor, Manchester, NH 03101, USA.

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Classifications MeSH