title: Respiratory muscle training in restrictive thoracic disease: a randomized controlled trial.
abstract: OBJECTIVE
  To investigate the effects of respiratory muscle training (RMT) in patients with restrictive thoracic disorders and intermittent noninvasive positive-pressure ventilation (NPPV).
  
  
  METHODS
  Prospective randomized controlled trial.
  
  
  METHODS
  Home-based RMT, with assessment in a primary care pulmonary center.
  
  
  METHODS
  Thirty patients with restrictive thoracic disorders; 28 patients completed the trial.
  
  
  METHODS
  Three months of RMT by isocapnic hyperpnea or sham training.
  
  
  METHODS
  Respiratory muscle strength and endurance, lung function, exercise performance, and health-related quality of life (HRQOL).
  
  
  RESULTS
  After RMT, maximal inspiratory mouth pressure was increased (27.6%+/-36.5%, P=.013). In patients who could perform cycle ergometer testing (n=17), peak oxygen consumption (2.24+/-3.39mLxkg(-1).min(-1) vs -1.71+/-2.54mLxkg(-1).min(-1), P=.014) and maximal work rate (9.4+/-14.8W vs -5.1+/-10.8W, P=.043) increased relative to a control group. Similar differences occurred regarding changes of HRQOL (physical performance, 3.3+/-11.4 score vs -6.6+/-9.0 score; P=.012) and time of ventilator use (-0.6+/-1.2h/d vs 0.4+/-0.5h/d, P=.010). Lung volumes, 12-second maximum voluntary ventilation, 6-minute walking distance, and blood gases were unchanged.
  
  
  CONCLUSIONS
  In patients with restrictive thoracic disorders and NPPV, RMT improved inspiratory muscle strength. Exercise performance and HRQOL were improved when the 2 groups were compared. RMT was practicable and safe despite severe respiratory impairment. Further evaluation, including different training intensities and modalities, seems warranted.
authors.affiliation: Center for Pneumology, Donaustauf Hospital, Donaustauf, Germany.
authors.forename: Stephan
authors.initials: S
authors.lastname: Budweiser
authors.forename: Markus
authors.initials: M
authors.lastname: Moertl
authors.forename: Rudolf A
authors.initials: RA
authors.lastname: Jörres
authors.forename: Wolfram
authors.initials: W
authors.lastname: Windisch
authors.forename: Frank
authors.initials: F
authors.lastname: Heinemann
authors.forename: Michael
authors.initials: M
authors.lastname: Pfeifer
mesh_terms: D001945:Breathing Exercises; D017079:Exercise Tolerance / Q000502:physiology; D005260:Female; D005355:Fibrosis; D006801:Humans; D007320:Inspiratory Capacity / Q000502:physiology; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption / Q000502:physiology; D010994:Pleura / Q000473:pathology; D011175:Positive-Pressure Respiration; D011446:Prospective Studies; D011788:Quality of Life; D012131:Respiratory Insufficiency / Q000503:physiopathology / Q000534:rehabilitation*; D012132:Respiratory Muscles / Q000503:physiopathology*; D012600:Scoliosis / Q000503:physiopathology; D016896:Treatment Outcome; D014397:Tuberculosis, Pulmonary / Q000503:physiopathology