Literature DB >> 11932850

Resistive inspiratory muscle training in sleep-disordered breathing of traumatic tetraplegia.

Tyng-Guey Wang1, Yen-Ho Wang, Fu-Tan Tang, Kwan-Hwa Lin, I-Nan Lien.   

Abstract

OBJECTIVE: To assess the effect of resistive inspiratory muscle training (RIMT) on the static pulmonary function and sleep-induced breathing disorder of individuals with chronic cervical cord injury.
DESIGN: Before-after training.
SETTING: Home-setting training program. PATIENTS: Fourteen complete traumatic tetraplegic patients (12 men, 2 women; mean age, 41.1 +/- 14y; range, 19-56y) injured for more than 6 months. INTERVENTION: Subjects participated in a 6-week RIMT program for 15 minutes twice daily at a training intensity of 60% of maximum inspiratory pressure (MIP). The participants were reevaluated at the end of 6-week training. MAIN OUTCOME MEASURES: Lung volume, peak expiratory flow (PEF), MIP, and maximum expiratory pressure (MEP) were measured by using a spirometry and inspiratory force meter, respectively. Capnography was used to monitor nocturnal pulse oxyhemoglobin saturation (SpO(2)) and end-tidal carbon dioxide tension level (ETCO(2)) of the patients.
RESULTS: The maximum voluntary ventilation (MVV) and MIP of individuals with chronic cervical cord injury substantially improved after RIMT. MIP increased from -68.7 +/- 27.4cmH(2)O to -77.3 +/- 24.0cmH(2)O and MVV rose from 62.7 +/- 33.2L to 73.4 +/- 31.3L (P <.05). Despite increasing from 3.5 +/- 1.8L/s to 4.0 +/- 1.7L/s, PEF was statistically insignificant. For the individuals with improved MIP, the duration of ETCO(2) greater than 48mmHg reduced from 2.2% +/- 3.3% to 1.0% +/- 2.0% of total sleep time (P =.05) and that of SpO(2) less than 90% significantly declined from 1.8% +/- 2.8% to 1.3% +/- 2.4% of total sleep time (P <.05).
CONCLUSION: These findings suggest that RIMT can enhance the respiratory muscle strength and endurance of chronic tetraplegia and further ameliorate the sleep-induced breathing disorder. Therefore, RIMT is suggested as a home program for patients with sleep-disordered breathing. Copyright 2002 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation

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Year:  2002        PMID: 11932850     DOI: 10.1053/apmr.2002.30937

Source DB:  PubMed          Journal:  Arch Phys Med Rehabil        ISSN: 0003-9993            Impact factor:   3.966


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