title: INSPIRATIonAL--INSPIRAtory muscle training in amyotrophic lateral sclerosis.
abstract: Respiratory impairment, due to respiratory muscle weakness, is a major cause of morbidity and mortality in patients with amyotrophic lateral sclerosis/motor neuron disease (ALS/MND). Threshold loading may strengthen the inspiratory muscles and thereby improve patient prognosis. A phase II, double-blind, randomized-controlled trial was undertaken to determine whether a 12-week inspiratory muscle training programme attenuated the decline in respiratory function and inspiratory muscle strength in patients with ALS/MND. Nine patients were randomized to inspiratory muscle training and 10 to sham training. Primary endpoints were respiratory function (forced vital capacity, vital capacity), lung volumes and inspiratory muscle strength. Patients were assessed before, during and immediately after a 12-week training period, and at eight weeks follow-up. While improvements in inspiratory muscle strength were observed in both treatment arms, there was a non-significant increase in maximum inspiratory pressure of 6.1% in the experimental group compared to controls (standard error of mean, 6.93%; 95% confidence interval -8.58 -20.79; p=0.39). The gains in inspiratory muscle strength were partially reversed during a period of training cessation. In conclusion, inspiratory muscle training may potentially strengthen the inspiratory muscles and slow the decline in respiratory function in patients with ALS/MND.
authors.affiliation: Prince of Wales Medical Research Institute & Prince of Wales Clinical School, University of New South Wales, Sydney, NSW, Australia.
authors.forename: Benjamin C
authors.initials: BC
authors.lastname: Cheah
authors.forename: Robert A
authors.initials: RA
authors.lastname: Boland
authors.forename: Nina E
authors.initials: NE
authors.lastname: Brodaty
authors.forename: Margie C
authors.initials: MC
authors.lastname: Zoing
authors.forename: Sandra E
authors.initials: SE
authors.lastname: Jeffery
authors.forename: David K
authors.initials: DK
authors.lastname: McKenzie
authors.forename: Matthew C
authors.initials: MC
authors.lastname: Kiernan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000690:Amyotrophic Lateral Sclerosis / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength / Q000502:physiology*; D012119:Respiration; D012133:Respiratory Paralysis / Q000503:physiopathology; D012138:Respiratory Therapy / Q000295:instrumentation / Q000379:methods*; D016896:Treatment Outcome; D014797:Vital Capacity / Q000502:physiology; D055815:Young Adult