Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Hacettepe University, Ankara, Turkey.
School of Physiotherapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey.
Respirology. 2019 Mar;24(3):246-253. doi: 10.1111/resp.13397. Epub 2018 Sep 12.
Inspiratory muscle training (IMT) enhances velocity of inspiratory muscle contraction and modifies inspiratory and expiratory time. This study aimed to examine the impact of high-intensity IMT (H-IMT) on exercise capacity in bronchiectasis.
Forty-five patients were included. Lung function, respiratory muscle strength and endurance, exercise capacity, dyspnoea, fatigue and quality of life (QOL) were evaluated. Patients were randomized into two groups: H-IMT and control groups. Twenty-three patients underwent H-IMT for 8 weeks, using threshold loading with a target workload of maximal inspiratory pressure (MIP) of at least 70%, with 3-min cycles (as 2-min training: 1-min rest intervals) for 21 min. There was a total period of 14 min of loaded breathing and 7 min of recovery. The control group (n = 22) underwent low-intensity IMT at 10% of the initial MIP and was maintained at the same intensity until the end of the training.
After training, both MIP and maximal expiratory pressure (MEP) and the incremental shuttle walk distance were increased in the H-IMT group compared with the control group (P < 0.05). There was a significant difference in constant threshold load, time and pressure-time units in the H-IMT group (P < 0.05) but not in the control group (P > 0.05). A significant decrease was found in fatigue in both groups (P < 0.05). The Leicester Cough Questionnaire social score for the H-IMT group decreased significantly after the treatment (P < 0.05).
The H-IMT increased exercise capacity in patients with non-cystic fibrosis bronchiectasis. It has also positive effects on respiratory muscle strength and endurance, and social aspects of QOL.
吸气肌训练(IMT)可增强吸气肌收缩速度,并改变吸气和呼气时间。本研究旨在探讨高强度 IMT(H-IMT)对支气管扩张症患者运动能力的影响。
共纳入 45 例患者。评估了肺功能、呼吸肌力量和耐力、运动能力、呼吸困难、疲劳和生活质量(QOL)。患者被随机分为两组:H-IMT 组和对照组。23 例患者接受 H-IMT 治疗 8 周,采用阈负荷,目标工作负荷为最大吸气压力(MIP)至少 70%,3 分钟周期(2 分钟训练:1 分钟休息间隔),共 21 分钟。总负荷呼吸时间为 14 分钟,恢复时间为 7 分钟。对照组(n=22)接受初始 MIP 的 10%的低强度 IMT,并保持相同强度直到训练结束。
与对照组相比,H-IMT 组训练后 MIP 和最大呼气压力(MEP)以及递增式穿梭步行距离均增加(P<0.05)。H-IMT 组的恒定阈负荷、时间和压力-时间单位均有显著差异(P<0.05),而对照组无显著差异(P>0.05)。两组的疲劳感均显著降低(P<0.05)。H-IMT 组的莱斯特咳嗽问卷社会评分在治疗后显著下降(P<0.05)。
H-IMT 可提高非囊性纤维化支气管扩张症患者的运动能力。它对呼吸肌力量和耐力以及 QOL 的社会方面也有积极影响。