Inspiratory Muscle Training: Integrative Review of Use in Conditions Other Than COPD
| Autor: | Cynthia A. Padula, Evelyn M. J. Yeaw |
|---|---|
| Rok vydání: | 2007 |
| Předmět: |
Respiratory Therapy
Weakness medicine.medical_specialty Cystic Fibrosis Quadriplegia Breathing Exercises Perioperative Care Pulmonary Disease Chronic Obstructive Work of breathing Physical medicine and rehabilitation Patient Education as Topic Quality of life medicine Respiratory muscle Humans Coronary Artery Bypass Asthma Heart Failure COPD Evidence-Based Medicine business.industry Airway Resistance Patient Selection Neuromuscular Diseases General Medicine medicine.disease Respiratory Muscles Bronchiectasis Treatment Outcome Inhalation Research Design Heart failure Physical therapy Breathing medicine.symptom Respiratory Insufficiency business Ventilator Weaning |
| Zdroj: | Research and Theory for Nursing Practice. 21:98-118 |
| ISSN: | 1945-7286 1541-6577 |
| DOI: | 10.1891/088971807780852039 |
| Popis: | Inspiratory muscle training (IM training) is a technique that is designed to improve the performance of the respiratory muscles (RMs) that may be impaired in a variety of conditions. Interest in IM training has expanded over the past two decades, and IM training has been used in an increasingly wide range of clinical conditions. However, the benefits of IM training continue to be debated, primarily because of methodological limitations of studies conducted to date. The focus of this article is to provide a critical review of IM training research in conditions other than chronic obstructive pulmonary disease for which it has been used, including asthma, bronchiectasis, cystic fibrosis, pre- and postsurgery, ventilator weaning, neuromuscular diseases, and chronic heart failure. Emphasis is placed on what has been learned, remaining questions, future applications, and significance to practice. Keywords: inspiratory muscle training; respiratory muscle weakness; dyspnea; respiratory muscle training Respiratory as well as other diseases can adversely affect respiratory muscle (RM) function (Tobin, Laghi, & Jubran, 1998), and RM weakness has been increasingly recognized as a confounding and complicating factor in a wide range of diseases (Syllabo, 1998). Weakness of the inspiratory muscles (IMs) predisposes to RM fatigue and contributes to perceived dyspnea (McConnell & Romer, 2004). Interventions aimed at preventing or treating RM dysfunction and its accompanying symptoms have the potential to significantly impact respiratory and perhaps overall functioning. Most interventions have focused on decreasing the work of breathing, such as with pharmacologic agents, and on optimizing functional status, as with general body conditioning (Larson & Kim, 1987). IM training represents a technique that is designed to directly affect functioning and improve performance of the RMs, which are skeletal in structure and thus amenable to training. IM training is a capacity- targeted strategy that has the potential to diminish or stop the downward spiral associated with dyspnea, resulting in reduced functioning (Larson & Leidy, 1998), and the associated decrease in health-related quality of life. Interest in IM training as a means to treat RM dysfunction has grown over the past two decades, and it has been used in an increasingly wide range of clinical situations, but benefits continue to be debated. One of the predominant reasons is related to methodological concerns of the studies conducted to date. Emphasis in this critical analysis will be placed on what has been learned, questions that remain, future applications, and significance to practice. REVIEW OF IM TRAINING RESEARCH: STUDY IDENTIFICATION AND SELECTION The databases used for selection of the literature included CINAHL, Dissertation Abstracts, and Medline, from the time period 1966 through April 2006. Key words used in the search were inspiratory muscle training, inspiratory resistive training, respiratory muscle training, threshold loading, inspiratory muscle training, and specific condition (i.e., chronic obstructive pulmonary disease [COPD]). Articles not written in English were excluded, as were those related to expiratory muscle training alone. In addition, studies focusing only on physical rehabilitation without IM training were excluded. Studies for selection included those that used inspiratory resistive (IR) training and measured maximal inspiratory pressure (PI^sub max^) as an outcome. BRIEF OVERVIEW: IR TRAINING IR training can be performed with either a nonlinear resistive device or a threshold loading device (Larson, Covey, & Corbridge, 2002). With the former, resistance is progressively increased by the person inspiring through progressively smaller orifices. A significant disadvantage of this method is that a change in breathing pattern can alter the amount of resistance; people often compensate and make breathing less strenuous by taking slower breaths, thus decreasing resistance (Breslin, 1996-1997). … |
| Databáze: | OpenAIRE |
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