Inspiratory-Expiratory Muscle Training Improved Respiratory Muscle Strength in Dialysis Patients: A Pilot Randomised Trial.

IF 1.8 Q3 RESPIRATORY SYSTEM Advances in respiratory medicine Pub Date : 2023-02-10 DOI:10.3390/arm91010009
Nicola Lamberti, Giovanni Piva, Yuri Battaglia, Michele Franchi, Matteo Pizzolato, Antonio Argentoni, Giorgio Gandolfi, Giulia Gozzi, Margherita Lembo, Pietro Lavisci, Alda Storari, Natascia Rinaldo, Fabio Manfredini, Annalisa Cogo
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Abstract

End-stage kidney disease (ESKD) exposes patients to progressive physical deconditioning involving the respiratory muscles. The aim of this pilot randomized controlled trial was to determine the feasibility and effectiveness of low-intensity respiratory muscle training (RMT) learned at the hospital and performed at home. A group of ESKD patients (n = 22) were randomized into RMT or usual care (control group, CON) in a 1:1 ratio. The respiratory training was performed at home with an inspiratory-expiratory system for a total of 5 min of breathing exercises in a precise rhythm (8 breaths per minute) interspersed with 1 min of rest, two times per day on nondialysis days for a total of 4 weeks, with the air resistance progressively increasing. Outcome measures were carried out every 4 weeks for 3 consecutive months, with the training executed from the 5th to the 8th week. Primary outcomes were maximal inspiratory and expiratory pressure (MIP, MEP), while secondary outcomes were lung capacity (FEV1, FVC, MVV). Nineteen patients without baseline between-group differences completed the trial (T: n = 10; Age: 63 ± 10; Males: n = 12). Both MIP and MEP significantly improved at the end of training in the T group only, with a significant difference of MEP of 23 cmH2O in favor of the RMT group (p = 0.008). No significant variations were obtained for FVC, FEV1 or MVV in either group, but there was a greater decreasing trend over time for the CON group, particularly for FVC (t = -2.00; p = 0.046). Low-fatiguing home-based RMT, with a simple device involving both inspiratory and expiratory muscles, may significantly increase respiratory muscle strength.

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吸气-呼气肌训练改善透析患者的呼吸肌力量:一项随机试验。
终末期肾脏疾病(ESKD)使患者暴露于累及呼吸肌的进行性身体机能丧失。本试验的目的是确定低强度呼吸肌训练(RMT)在医院学习和在家进行的可行性和有效性。一组ESKD患者(n = 22)按1:1的比例随机分为RMT组或常规治疗组(对照组,CON)。呼吸训练在家中进行,采用吸气-呼气系统,以精确的节奏(每分钟8次呼吸)进行共5分钟的呼吸练习,穿插1分钟休息,在非透析日每天2次,共4周,空气阻力逐渐增加。结果测量每4周进行一次,连续3个月,第5 ~ 8周进行培训。主要指标为最大吸气和呼气压(MIP, MEP),次要指标为肺活量(FEV1, FVC, MVV)。19例无基线组间差异的患者完成了试验(T: n = 10;年龄:63±10岁;男性:n = 12)。在训练结束时,仅T组的MIP和MEP均有显著改善,RMT组的MEP显著差异为23 cmH2O (p = 0.008)。两组的FVC、FEV1和MVV均无显著变化,但CON组随着时间的推移有更大的下降趋势,尤其是FVC (t = -2.00;P = 0.046)。低疲劳的家庭RMT,使用一个简单的装置,包括吸气和呼气肌,可以显着增加呼吸肌力量。
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来源期刊
Advances in respiratory medicine
Advances in respiratory medicine RESPIRATORY SYSTEM-
CiteScore
2.60
自引率
0.00%
发文量
90
期刊介绍: "Advances in Respiratory Medicine" is a new international title for "Pneumonologia i Alergologia Polska", edited bimonthly and addressed to respiratory professionals. The Journal contains peer-reviewed original research papers, short communications, case-reports, recommendations of the Polish Respiratory Society concerning the diagnosis and treatment of lung diseases, editorials, postgraduate education articles, letters and book reviews in the field of pneumonology, allergology, oncology, immunology and infectious diseases. "Advances in Respiratory Medicine" is an open access, official journal of Polish Society of Lung Diseases, Polish Society of Allergology and National Research Institute of Tuberculosis and Lung Diseases.
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