title: Effects of inspiratory muscle training and yoga breathing exercises on respiratory muscle function in institutionalized frail older adults: a randomized controlled trial.
abstract: BACKGROUND
  In older adults, respiratory function may be seriously compromised when a marked decrease of respiratory muscle (RM) strength coexists with comorbidity and activity limitation. Respiratory muscle training has been widely studied and recommended as a treatment option for people who are unable to participate in whole-body exercise training (WBET); however, the effects of inspiratory muscle training and yoga breathing exercises on RM function remain unknown, specifically in impaired older adults.
  
  
  OBJECTIVE
  To evaluate the effects of inspiratory threshold training (ITT) and yoga respiratory training (YRT) on RM function in institutionalized frail older adults.
  
  
  METHODS
  Eighty-one residents (90% women; mean age, 85 years), who were unable to perform WBET (inability to independently walk more than 10 m), were randomly assigned to a control group or one of the 2 experimental groups (ITT or YRT). Experimental groups performed a supervised interval-based training protocol, either through threshold inspiratory muscle training device or yoga breathing exercises, which lasted 6 weeks (5 days per week). Outcome measures were collected at 4 time points (pretraining, intermediate, posttraining, and follow-up) and included the maximum respiratory pressures (maximum inspiratory pressure [MIP] and maximum expiratory pressure [MEP]) and the maximum voluntary ventilation (MVV).
  
  
  RESULTS
  Seventy-one residents completed the study: control (n = 24); ITT (n = 23); YRT (n = 24). The treatment on had a significant effect on MIP YRT (F(6,204) = 6.755, P < .001, η2 = 0.166), MEP (F(6,204) = 4.257, P < .001, η2 = 0.111), and MVV (F(6,204) = 5.322, P < .001, η2 = 0.135). Analyses showed that the YRT group had a greater increase of RM strength (MIP and MEP) and endurance (MVV) than control and/or ITT groups.
  
  
  CONCLUSIONS
  Yoga respiratory training appears to be an effective and well-tolerated exercise regimen in frail older adults and may therefore be a useful alternative to ITT or no training, to improve RM function in older population, when WBET is not possible.
authors.affiliation: 1Department of Physiotherapy, University of Valencia, Valencia, Spain. 2Cardiopulmonary Rehabilitation Service, University Hospital "La Fe," Valencia, Spain. 3Physical Therapy Department, East Tennessee State University, Johnson City, Tenessee, USA. 4Musculoskeletal Rehabilitation Service, Clinic University Hospital of Valencia, Spain. 5Department of Behavioral Sciences Methodology, University of Valencia, Valencia, Spain.
authors.forename: Maria dels Àngels
authors.initials: Md
authors.lastname: Cebrià i Iranzo
authors.forename: David Alan
authors.initials: DA
authors.lastname: Arnall
authors.forename: Celedonia
authors.initials: C
authors.lastname: Igual Camacho
authors.forename: José Manuel
authors.initials: JM
authors.lastname: Tomás
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001945:Breathing Exercises / Q000379:methods*; D015577:Geriatric Assessment; D006707:Homes for the Aged; D006801:Humans; D053580:Muscle Strength / Q000502:physiology; D009735:Nursing Homes; D012129:Respiratory Function Tests; D012132:Respiratory Muscles / Q000502:physiology*; D015013:Yoga