title: Effect of inspiratory muscle training in patients with multiple sclerosis.
abstract: OBJECTIVE
  To evaluate whether inspiratory muscle training (IMT) improves inspiratory muscle strength, respiratory capacity, fatigue, and subjective perception of physical endurance in patients with advanced multiple sclerosis (MS).
  
  
  METHODS
  Randomized controlled trial.
  
  
  METHODS
  Outpatient clinic in Sweden.
  
  
  METHODS
  Fifteen severely disabled patients with MS, randomized to a training or control group.
  
  
  METHODS
  Seven patients trained with a Threshold inspiratory muscle trainer, twice every other day, with 3 sets of 10 loaded inspirations (40%-60% of patients' maximal inspiratory pressure [Pimax]) over a 10-week period.
  
  
  METHODS
  Spirometry, Pimax, maximal expiratory pressure (Pemax), clinical assessments, and questionnaires on the patients' fatigue severity and physical endurance were evaluated.
  
  
  RESULTS
  After training, the Pimax (P<.008) and Pemax (P<.02) increased in the training group. The improvement in Pimax after 10 weeks of training was higher than the improvement in the control group (P<.01) and was maintained 1 month after the training period ended. The training affected neither respiratory function nor the patients' symptoms.
  
  
  CONCLUSIONS
  IMT had a beneficial effect on inspiratory muscle strength in patients with MS and is recommended as a complement to ordinary physical training.
authors.affiliation: Neurotec Department, Division of Physiotherapy, Karoliniska Institutet, Stockholm, Sweden.
authors.forename: Brita
authors.initials: B
authors.lastname: Klefbeck
authors.forename: Jallal
authors.initials: J
authors.lastname: Hamrah Nedjad
mesh_terms: D000328:Adult; D001945:Breathing Exercises; D004185:Disability Evaluation; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008297:Male; D008448:Maximal Expiratory Flow Rate; D008875:Middle Aged; D020528:Multiple Sclerosis, Chronic Progressive / Q000150:complications*; D010366:Peak Expiratory Flow Rate; D010807:Physical Endurance; D012131:Respiratory Insufficiency / Q000209:etiology* / Q000503:physiopathology / Q000534:rehabilitation*; D012132:Respiratory Muscles / Q000503:physiopathology*; D012720:Severity of Illness Index; D013147:Spirometry; D011795:Surveys and Questionnaires; D013548:Sweden; D016896:Treatment Outcome; D014797:Vital Capacity