title: Inspiratory muscle training in allogeneic hematopoietic stem cell transplantation recipients: a randomized controlled trial.
abstract: OBJECTIVE
  Respiratory muscles are known to be weakened and are a cause of reduced exercise capacity in both recipients and candidates of allogeneic hematopoietic stem cell transplantation (allo-HSCT). Effects of inspiratory muscle training (IMT) in this patient population have not been comprehensively investigated so far. The current study was planned to investigate the effects of IMT during allo-HSCT on early transplantation-related outcomes.
  
  
  METHODS
  This is a prospective, randomized controlled, double-blinded study. Thirty-eight allo-HSCT recipients, 20 of whom were allocated to the treatment group (40 % of maximal inspiratory pressure (MIP)) and 18 to the control group (5 % of MIP), received IMT for 6 weeks. Pulmonary functions, dyspnea, respiratory (MIP, maximal expiratory pressure (MEP)) and peripheral muscle strength, maximal exercise capacity using modified incremental shuttle walking test (MISWT) and submaximal exercise capacity using 6-min walking test (6-MWT), fatigue, depression, and quality of life were evaluated before and after IMT.
  
  
  RESULTS
  The distance covered during MISWT (61.94 m) and 6-MWT (29.30 m), respiratory muscle strength (MIP 34.99 cmH2O, MEP 12.69 cmH2O), depression (-0.95), and modified Borg dyspnea scores (-0.11) showed a significant improvement in the treatment group compared to controls (p ≤ 0.05).
  
  
  CONCLUSIONS
  Inspiratory muscle training is a safe and effective intervention which improves respiratory muscle strength and exercise capacity and decreases depression and dyspnea in allo-HSCT recipients. These positive changes might be further enhanced by prolonging the duration of training or inclusion of more recipients with inspiratory muscle weakness.
  
  
  BACKGROUND
  NCT02270346.
authors.affiliation: Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Emniyet Mah. Muammer Yaşar Bostancı Cad. No: 16, Beşevler, 06500, Ankara, Turkey. gulsahbargi@gazi.edu.tr.
authors.forename: Gülşah
authors.identifier: http://orcid.org/0000-0002-5243-3997
authors.initials: G
authors.lastname: Barğı
authors.affiliation: Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Emniyet Mah. Muammer Yaşar Bostancı Cad. No: 16, Beşevler, 06500, Ankara, Turkey.
authors.forename: Meral Boşnak
authors.initials: MB
authors.lastname: Güçlü
authors.affiliation: Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Emniyet Mah. Muammer Yaşar Bostancı Cad. No: 16, Beşevler, 06500, Ankara, Turkey.
authors.forename: Zeynep
authors.initials: Z
authors.lastname: Arıbaş
authors.affiliation: Department of Hematology, Faculty of Medicine, Gazi University, 06500, Ankara, Turkey.
authors.forename: Şahika Zeynep
authors.initials: ŞZ
authors.lastname: Akı
authors.affiliation: Department of Hematology, Faculty of Medicine, Gazi University, 06500, Ankara, Turkey.
authors.forename: Gülsan Türköz
authors.initials: GT
authors.lastname: Sucak
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001945:Breathing Exercises / Q000379:methods*; D004311:Double-Blind Method; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D007320:Inspiratory Capacity / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities; D011446:Prospective Studies; D011788:Quality of Life; D012132:Respiratory Muscles / Q000502:physiology*; D014184:Transplantation, Homologous; D055815:Young Adult
keywords: Allogeneic hematopoietic stem cell transplantation; Dyspnea; Exercise capacity; Inspiratory muscle training; Pulmonary function; Quality of life