None listed
Conditions
Brief summary
Depending on the respiratory system’s efficiency, increased work of breathing may restrict the body’s capacity to perform exercise, leading to respiratory muscle fatigue and perceived dyspnoea. Physiotherapeutic approaches aimed at solving problems resulting from respiratory muscle dysfunction or insufficient performance may include different strategies, depending on the background of the problem and the nature of the mechanical disorder, as well as the effect to be achieved. One of the means to improve the function and structure of the respiratory muscles is Inspiratory Muscle Training (IMT). IMT refers to resistance exercise aimed at inspiratory muscles strength increase due to muscles adapting to overcome the resistance provided during inspiration. The use of accessible and reliable methods of inspiratory muscles' structure and function assessment with particular emphasis on the diaphragm, may facilitate the implementation of adequately tailored IMT and ongoing monitoring of the progress and effectiveness of the program. A variety of static and dynamic techniques are available to assess respiratory muscles. It seems that the most optimal method is ultrasound imaging, which provides direct, fast, and non-invasive real-time visualization, even in bedside conditions. The aim of the study will be to assess the parameters describing the function of the inspiratory muscles for the purpose of planning and monitoring the strength training of the inspiratory muscles. Additionaly, the objective will be to compare 2 methods of strength training of the inspiratory muscles and to assess their short-term and long-term effectiveness. We assume that IMT can lead to a comparable improvement in all respiratory muscle function outcome measures assessed. We also hypothesize that it may be possible to achieve similar results regarding respiratory muscle function parameters with the use of the two methods of training introduced.
Interventions
The intervention is 8-week Inspiratory Muscle Training (IMT). The study involves 3 arms: Arm 1, a group training with pressure threshold loading device; Arm 2, a group training with the use of elastic bands; Arm 3, a group performing a sham-training program.
Intervention is conducted by physiotherapists experienced in delivering such form of training. The research physiotherapists in this study require no additional training.
2 supervized introductory sessions are held initially in a week prio
The intervention is 8-week Inspiratory Muscle Training (IMT). The study involves 3 arms: Arm 1, a group training with pressure threshold loading device; Arm 2, a group training with the use of elastic bands; Arm 3, a group performing a sham-training program. Intervention is conducted by physiotherapists experienced in delivering such form of training. The research physiotherapists in this study require no additional training. 2 supervized introductory sessions are held initially in a week prior to training to take patients through an example session of their home-based training. The proper positioning, technique of breathing, and use of the device is demonstrated. The sessions are conducted in one day interval and the duration of each is 30 minutes. They are administrated in groups of five. After introductory training sessions the participants perform home-based unsupervized training. A number of 30 breaths at a rate of 15 breaths per minute, 2 times a day, 5 times a week is performed in a sitting position with back support. Quick and forceful inspirations against the resistance, from the level of residual volume until total lung capacity is achieved is required. Training loads are between 60-80% of 1 Repetition Maximum. The baseline loading of 60% is set. The progression in loading involves 10% increase, when the participant exceedes the workload for 2 repetitions over the number set, at 2 consecutive training sessions. Arm 1 performs IMT with the use of Powerbreathe device of medium resistance (Powerbreathe Classic, Powerbreathe International Ltd., Southam, UK). The Powerbreathe Classic is a respiratory training tool that is designed to improve breathing strength by providing resistance to the inhalation. It involves a handheld device with an adjustable resistance valve that the user inhales through. To use the device, the participant places the mouthpiece in their mouth and inhales against the resistance according to the predetermined training scheme. The level of resistance is a percentage of MIP measured with the use of Powerbreathe tapered flow resistive loading device (Powerbreathe KH2, Powerbreathe International Ltd., Southam, UK) and increased depending on the current strength. Arm 2 performs IMT with the use of elastic bands (Thera-Band, Akron, USA). The bands are positioned around the chest at the level of diaphragm attachment. The resistance is adjusted according to the percentages of elongation and resistance ranges provided by the manufacturer. The initial level of resistance is a percentage of 1RM measured with the use of elastic band. Adherence is monitored by the diary kept by participants and by weekly motivational calls provided by physiotherapists.
Sponsors
Agnieszka Lewinska
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Educational / counselling / training
Masking
Blinded (masking used) (Subject, Investigator)
Eligibility
Sex/Gender
All
Age
18 Years to 40 Years
Healthy volunteers
Yes
Inclusion criteria
age 18 or over; written informed consent; active swimmer.
Exclusion criteria
contraindications for US imaging; present respiratory tract infection; interventions targeting respiratory muscle function in the past 12 months; a history of spontaneous pneumothorax; pulmonary hypertension; ruptured eardrum or any other condition of the ear.
Outcome results
None listed