Background \& Objective: Inspiratory muscle training (IMT) is known to improve strength and endurance of inspiratory muscles. However, clinical beneficial effects of IMT for patients with chronic respiratory disease remain inconclusive. The purposes of the study are to investigate in patients with chronic respiratory disease: (Year 1) main (diaphragm) and accessory inspiratory muscle (sternocleidomastoid muscle) activation pattern during various IMT loading using group-based trajectory modeling (GBTM); and (Year 2) effectiveness of individualized IMT program (based on results of Year 1) on clinical outcomes. Methods: (Year 1) Patients with chronic respiratory disease with inspiratory muscle weakness will be recruited for the study. Patients will perform 3 inspiratory loading tests (15%, 30%, and 50% of maximum inspiratory pressures) on 3 separate days with the sequence will be randomized. Surface electromyography (EMG) of diaphragm and sternocleidomastoid muscle will be used to use inspiratory muscle activation during various conditions. Other outcomes include maximum inspiratory pressure, and functional exercise capacity will be measured. Inspiratory muscle activation will be used for GBTM analysis. Patient will then be trained with individualized IMT program based on the GBTM analysis input form results of Year 1.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
1
Patients will perform 3 inspiratory loading tests (15%, 30%, and 50% of maximum inspiratory pressures) on 3 separate days with the sequence will be randomized. Patient will then be trained with individualized IMT program based on the results of 3 inspiratory loading tests.
School & Graduate Institute of Physical Therapy, College of Medicine, NTU
Taipei, Taiwan
Diaphragm and Sternocleidomastoid muscle activation
Root mean square values during different conditions
Time frame: through the completion of the inspiratory loading tests condition; it would take about 3 minutes
The mean median frequency of diaphragm and sternocleidomastoid muscle
The power spectrum is divided into two equal areas of the frequency value by median frequency to exam muscle fatigability
Time frame: In five minute after the completion of the loaded inspiratory muscle test condition
Pulmonary function
Forced expiratory volume in one second, forced vital capacity, residual volume, total lung capacity
Time frame: About five minutes to complete
Maximal inspiratory pressure test
Maximal inspiratory pressure
Time frame: About three minutes to complete
Functional exercise capacity using the six-minute walk test
The six-minute walk test is commonly performed to evaluate functional exercise capacity. The six-minute walk test was performed according to the guidelines, and the distance walked in the test presented as functional exercise capacity
Time frame: The six-minute walk test needs six minute to complete the test
Heart rate
Heart rate is measured at rest, during six-minute walk test
Time frame: The six-minute walk test needs six minute to complete the test
Blood pressure
systolic and diastolic pressure are measured at rest, after six-minute walk test
Time frame: Before and immediately after the six-minute walk test;it takes less than one minute to measure blood pressure
Perceived dyspnea
Rating of perceived dyspnea is measured by using Borg scale at rest, during six-minute walk test, inspiratory loading tests. The most widely used tool is the "Borg scale", with rating ranges from 0 (nothing at all) to 10 (extremely dyspnea).
Time frame: It takes less than one minute to evaluate perceived dyspnea
Oxygen saturation
Oxygen saturation is continuously monitored by pulse oximetry throughout six-minute walk test, inspiratory loading tests
Time frame: The six-minute walk test needs six minute to complete the test; through the completion of the inspiratory loading tests condition; it would take about 3 minutes
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