title: Effects of respiratory muscle training on pulmonary functions in patients with slowly progressive neuromuscular disease: a randomized controlled trial.
abstract: OBJECTIVE
  To investigate the effects of inspiratory and expiratory muscle training on pulmonary functions in patients with slowly progressive neuromuscular disease.
  
  
  METHODS
  Prospective randomized controlled double-blinded study.
  
  
  METHODS
  Chest diseases clinic of university hospital.
  
  
  METHODS
  Twenty-six patients with slowly progressive neuromuscular disease followed for respiratory problems were included in the study. Patients were randomly divided into two groups; experimental (n = 14; age 31.6 ±12.3 years) and sham (n = 12; age 26.5 ±8.6 years) groups.
  
  
  METHODS
  Spirometry, peak cough flow, maximal inspiratory pressure, maximal expiratory pressure, and sniff nasal inspiratory pressure were measured before the eighth week of study, and subsequently at end of it. Respiratory muscle training was performed by inspiratory (Threshold Inspiratory Muscle Trainer) and expiratory (Threshold Positive Expiratory Pressure) threshold loading methods. Training intensities were increased according to maximal inspiratory and expiratory pressures in the experimental group, while the lowest loads were used for training in the sham group. Patients performed 15 minutes inspiratory muscle training and 15 minutes expiratory muscle training, twice a day, five days/week, for a total of eight weeks at home. Training intensity was adjusted in the training group once a week.
  
  
  RESULTS
  Maximal inspiratory and expiratory pressures (cmH2O, % predicted) (respectively p = 0.002, p = 0.003, p = 0.04, p = 0.03) and sniff nasal inspiratory pressure (p = 0.04) were improved in the experimental group when compared with the sham group. However, there was no improvement in spirometric measurements when groups were compared (p > 0.05).
  
  
  CONCLUSIONS
  As a conclusion of our study, we found that respiratory muscle strength improved by inspiratory and expiratory muscle training in patients with slowly progressive neuromuscular disease.
authors.affiliation: Department of Physical Therapy and Rehabilitation, Istanbul University, Istanbul, Turkey.
authors.forename: Goksen Kuran
authors.initials: GK
authors.lastname: Aslan
authors.affiliation: Department of Physiotherapy and Rehabilitation, BezmialemVakif University, Istanbul, Turkey fztnilgun@yahoo.com.
authors.forename: H Nilgun
authors.initials: HN
authors.lastname: Gurses
authors.affiliation: Department of Public Health, Istanbul University, Istanbul, Turkey.
authors.forename: Halim
authors.initials: H
authors.lastname: Issever
authors.affiliation: Department of Chest Disease, Istanbul University, Istanbul, Turkey.
authors.forename: Esen
authors.initials: E
authors.lastname: Kiyan
mesh_terms: D000328:Adult; D001945:Breathing Exercises / Q000379:methods*; D018450:Disease Progression; D005260:Female; D018575:Home Care Services, Hospital-Based; D006801:Humans; D008168:Lung / Q000503:physiopathology*; D008297:Male; D000072277:Maximal Respiratory Pressures; D009468:Neuromuscular Diseases / Q000503:physiopathology / Q000534:rehabilitation*; D011446:Prospective Studies; D013147:Spirometry
keywords: Neuromuscular diseases; hospital-supported home rehabilitation; maximal expiratory pressure; maximal inspiratory pressure; respiratory muscle training