Inspiratory muscle training improves lung function and exercise capacity in adults with cystic fibrosis.
OBJECTIVE
To investigate the effects of high-intensity inspiratory muscle training (IMT) on inspiratory muscle function (IMF), diaphragm thickness, lung function, physical work capacity (PWC), and psychosocial status in patients with cystic fibrosis (CF).


METHODS
Twenty-nine adult patients with CF were randomly assigned to three groups. Two groups were required to complete an 8-week program of IMT in which the training intensity was set at either 80% of maximal effort (group 1; 9 patients) or 20% of maximal effort (group 2; 10 patients). A third group of patients did not participate in any form of training and acted as a control group (group 3; 10 patients).


METHODS
In all patients, baseline and postintervention measures of IMF were determined by maximal inspiratory pressure (Pimax), and sustained Pimax (SPimax); pulmonary function, body composition, and physical activity status were also determined. In addition, diaphragm thickness was measured at functional residual capacity (FRC) and total lung capacity (TLC) [TDIcont], and the diaphragm thickening ratio (TR) was calculated (TR = thickness during Pimax at FRC/mean thickness at FRC). Subjects also completed an incremental cycle ergometer test to exhaustion and two symptom-related questionnaires, prior to and following training.


RESULTS
Following training, significant increases in Pimax and SPimax (p < 0.05), TDIcont (p < 0.05), TR (p < 0.05), vital capacity (p < 0.05), TLC (p < 0.05), and PWC (p < 0.05) were identified, and decreases in anxiety scores (p < 0.05) and depression scores (p < 0.01) were noted in group 1 patients compared to group 3 patients. Group 2 patients significantly improved Pimax and SPimax (both p < 0.05) only with respect to group 3 patients. No significant differences were observed in group 3 patients.


CONCLUSIONS
An 8-week program of high-intensity IMT resulted in significant benefits for CF patients, which included increased IMF and thickness of the diaphragm (during contraction), improved lung volumes, increased PWC, and improved psychosocial status.
School of Health Care Professions, University of Salford, Manchester, UK. s.enright@salford.ac.uk
Stephanie
S
Enright
Ken
K
Chatham
Alina A
AA
Ionescu
Viswanath B
VB
Unnithan
Dennis J
DJ
Shale
D000328:Adult; D001823:Body Composition; D001945:Breathing Exercises; D003550:Cystic Fibrosis / Q000503:physiopathology / Q000628:therapy*; D003964:Diaphragm / Q000000981:diagnostic imaging / Q000503:physiopathology; D017079:Exercise Tolerance / Q000502:physiology*; D005260:Female; D005652:Functional Residual Capacity; D006801:Humans; D008168:Lung / Q000503:physiopathology*; D008297:Male; D009043:Motor Activity; D011795:Surveys and Questionnaires; D014109:Total Lung Capacity; D014463:Ultrasonography