Reproducibility of inspiratory muscle endurance testing using PowerBreathe for COPD patients

Comparison of respiratory functions, muscle strength, and physical activity among children with primary ciliary dyskinesia with and without Kartagener's syndrome and healthy controls

INTRODUCTION

Kartagener's syndrome (KS), consisting of bronchiectasis, situs inversus totalis, and sinusitis, is a subtype of primary ciliary dyskinesia (PCD). The presence of KS may affect respiratory and physical functions.

PURPOSE

This study aimed to compare respiratory functions, exercise capacity, muscle strength, and physical activity levels among children with PCD with/without KS and healthy peers.

METHODS

Fifteen patients with KS, 23 with PCD without KS, and 27 controls were compared. Pulmonary function, functional exercise capacity (6-minute walk test - 6MWT), maximal inspiratory, expiratory (MIP, MEP), and skeletal muscle strength, inspiratory muscle endurance (IME), and physical activity level were evaluated.

RESULTS

The forced expiratory volume in one second (FEV1) % (p = .009), forced expiratory flow from 25%-75% (FEF25-75%) % (p = .001), MIP (p = .034), MEP (p = .003), 6MWT distance (p = .001), and daily steps (p = .034) were significantly different among the groups. Quadriceps femoris (QF) muscle strength and IME were similar in groups (p ˃ .05). FEV1% (p = .002), FEF25-75% % (p = .001), MIP (p = .027), MEP (p = .001), and 6MWT distance (p = .003) in patients with KS; 6MWT distance (p = .003) in patients with PCD without KS was significantly lower than controls.

CONCLUSION

The presence of KS affects pulmonary function, respiratory muscle strength, and physical activity more. Exercise capacity and physical activity levels are decreased, inspiratory muscle endurance and QF muscle strength are preserved in patients with KS and PCD without KS. Kartagener's syndrome further impairs pulmonary and extrapulmonary outcomes; the reasons should be investigated, and the necessity of rehabilitation approaches that will prevent deterioration come to the fore.

Improving respiratory muscle strength and health status in burn patients: a randomized controlled trial

PURPOSE

Pulmonary complications are among the major disadvantages of burns. The present study aimed to determine the effect of inspiratory muscle training on respiratory muscle strength and health status in burned patients.

METHODS

The current randomized clinical trial was conducted on 64 burned patients in Burn Center of Imam Reza Hospital, Mashhad, Iran. In the intervention group, a Powerbreathe device (KH1 digital model) was used twice a day for 10 days, accompanied by the routine procedures and in the control group, only chest physiotherapy and incentive spirometer were used.

RESULTS

Before the intervention, the mean scores of respiratory muscle strength were 38.8 ± 10.1 and 35.8 ± 9.0 in the Powerbreathe group and control group, respectively (p = .206). After the intervention, the mean score of respiratory muscle strength of Powerbreathe group was 49.2 ± 11.8 and in the control group was 39.3 ± 8.5 (p < 0.001). Moreover, the mean scores of health status before the intervention in the burned patients were 66.3 ± 14.8 and 63.0 ± 17.3 in the Powerbreathe group and control group, respectively (p = 0.550). In the post-intervention phase, the mean health status score of the burned patients in the intervention and control groups were measured at 75.9 ± 14.1 and 66.7 ± 15.9, respectively (p = 0.019).

CONCLUSION

It seems that inspiratory muscle training improves respiratory muscle strength and health status in the burned patients. Therefore, the use of Powerbreathe is recommended for the prevention and improvement of pulmonary complications in patients with chest burns.

Sustainable inspiratory pressure and incremental threshold loading for respiratory muscle endurance in chronic obstructive pulmonary disease: A pilot study

INTRODUCTION

A prolonged mismatch between the demand for respiratory muscle work and the capacity to meet that demand in chronic obstructive pulmonary disease (COPD) can result in symptoms of dyspnea and the development of muscle fatigue.

OBJECTIVES

The purpose of this study was to compare two different respiratory muscle endurance assessment methods of sustainable inspiratory pressure (SIP) and incremental threshold loading (ITL) in COPD.

METHODS

Thirty-four patients diagnosed with COPD were included in the study. Physical and demographic characteristics of the subjects were recorded. Pulmonary function testing (PFT), modified Medical Research Council (MMRC) dyspnea scale, COPD assessment test, inspiratory and expiratory muscle strength (MIP and MEP, respectively) measurement and six-minute walk test (6MWT) were used to assess subjects. Two different respiratory muscle endurance tests (SIP and ITL) were performed within 48 hours apart, and each test was repeated two times on the same day.

RESULTS

There was no correlation between the SIP and ITL tests (r = 0.069, P = .699). According to the test-retest reliability analysis, both tests were reproducible (ICC = 0.843; P < .001 for SIP, ICC = 0.905; P < .001 for ITL). Finding no differences between repeated tests showed that tests are not affected by learning effect.

CONCLUSION

The SIP and ITL tests are used for the same purpose but have different characteristics. Regarding the relationship between the other parameters and tests, the ITL is well tolerated and reflects the differences in respiratory muscle endurance better.