Inspiratory Muscle Training Improves Lung Function and Exercise Capacity in Adults With Cystic Fibrosis

• Published in: Chest Vol. 126; no. 2; pp. 405 - 411
• Main Authors: Enright, Stephanie, Chatham, Ken, Ionescu, Alina A., Unnithan, Viswanath B., Shale, Dennis J.
• Format: Journal Article
• Language: English
• Published: Northbrook, IL Elsevier Inc 01.08.2004; American College of Chest Physicians
• Subjects: Adult; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Body Composition; Breathing Exercises; Cardiology. Vascular system; Cystic fibrosis; Cystic Fibrosis - physiopathology; Cystic Fibrosis - therapy; Diaphragm - diagnostic imaging; Diaphragm - physiopathology; diaphragm thickness; Exercise; exercise tolerance; Exercise Tolerance - physiology; Female; Functional Residual Capacity; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Liver. Biliary tract. Portal circulation. Exocrine pancreas; Lung - physiopathology; lung volumes; Male; Medical sciences; Motor Activity; Muscle function; Muscle strength; Musculoskeletal system; Other diseases. Semiology; Physical fitness; Pneumology; respiratory muscle training; Surveys and Questionnaires; Total Lung Capacity; Ultrasonic imaging; Ultrasonography; Workloads; SPimax; CF; CRDQ; IMF; TDIcont; RV; diaphragm thickness; TLC; RME; VC; IMT; METS; Pimax; FRC; LBM; TDIrel; exercise tolerance; RMS; TFco; respiratory muscle training; lung volumes; PWC; TR; Human; Physical exercise; Respiratory disease; Tolerance; Metabolic diseases; Cystic fibrosis; diaphragm thickness: exercise tolerance; Respiratory system; Genetic disease; Thickness; Lung volume; Lung function; Respiratory muscle; Capacity; Digestive diseases; Adult; Anesthesia; Exercise tolerance test; Circulatory system; Diaphragm; Cardiology; Pancreatic disease
• ISSN: 0012-3692; 1931-3543
• DOI: 10.1378/chest.126.2.405

To investigate the effects of high-intensity inspiratory muscle training (IMT) on inspiratory muscle function (IMF), diaphragm thickness, lung function, physical work capacity (PWC), and psychosocial status in patients with cystic fibrosis (CF). Twenty-nine adult patients with CF were randomly assigned to three groups. Two groups were required to complete an 8-week program of IMT in which the training intensity was set at either 80% of maximal effort (group 1; 9 patients) or 20% of maximal effort (group 2; 10 patients). A third group of patients did not participate in any form of training and acted as a control group (group 3; 10 patients). In all patients, baseline and postintervention measures of IMF were determined by maximal inspiratory pressure (Pimax), and sustained Pimax (SPimax); pulmonary function, body composition, and physical activity status were also determined. In addition, diaphragm thickness was measured at functional residual capacity (FRC) and total lung capacity (TLC) [TDIcont], and the diaphragm thickening ratio (TR) was calculated (TR = thickness during Pimax at FRC/mean thickness at FRC). Subjects also completed an incremental cycle ergometer test to exhaustion and two symptom-related questionnaires, prior to and following training. Following training, significant increases in Pimax and SPimax (p < 0.05), TDIcont (p < 0.05), TR (p < 0.05), vital capacity (p < 0.05), TLC (p < 0.05), and PWC (p < 0.05) were identified, and decreases in anxiety scores (p < 0.05) and depression scores (p < 0.01) were noted in group 1 patients compared to group 3 patients. Group 2 patients significantly improved Pimax and SPimax (both p < 0.05) only with respect to group 3 patients. No significant differences were observed in group 3 patients. An 8-week program of high-intensity IMT resulted in significant benefits for CF patients, which included increased IMF and thickness of the diaphragm (during contraction), improved lung volumes, increased PWC, and improved psychosocial status.