Volume 83, Issue 4 , Pages 491-496, April 2002
Resistive inspiratory muscle training in sleep-disordered breathing of traumatic tetraplegia☆1☆2☆3☆4☆5☆6☆7☆8
Abstract
Wang T-G, Wang Y-H, Tang F-T, Lin K-H, Lien I-N. Resistive inspiratory muscle training in sleep-disordered breathing of traumatic tetraplegia. Arch Phys Med Rehabil 2002;82:491-6. 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 (SpO2) and end-tidal carbon dioxide tension level (ETCO2) 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 ± 27.4cmH2O to −77.3 ± 24.0cmH2O 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 ETCO2 greater than 48mmHg reduced from 2.2% ± 3.3% to 1.0% ± 2.0% of total sleep time (P = .05) and that of SpO2 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. © 2002 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation
Keywords: Exercise, Inspiratory capacity, Muscles, Pulmonary function tests, Rehabilitation, Sleep apnea, syndromes, Spinal cord injuries
☆1 Supported by the National Science Council of the Republic of China (grant no. NSC 85-2331-B-002-149).
☆2 No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors(s) or upon any organization with which the author(s) is/are associated.
☆3 Reprint requests to Tyng-Guey Wang, MD, Dept of Physical Medicine & Rehabilitation, National Taiwan University Hospital, 7 Chung-Shan S RD, Taipei, Taiwan, ROC.
☆4 Suppliers
☆5 a. Escort II; Vitrography Ltd, Maids Moreton House, Buckingham, MK18 1SW, England.
☆6 b. Model 4103; Boehringer Laboratories Inc, PO Box 870, Norristown, PA 19404.
☆7 c. Novometrix; Medical System Inc, 1 Barnes Industrial Park Rd, Wallingford, CT 06492.
☆8 d. DHD 22-7500; Diemolding, Healthcare Div, One Madison St, Wampsville, NY 13163.
PII: S0003-9993(02)04653-1
doi:10.1053/apmr.2002.30937
© 2002 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.
Volume 83, Issue 4 , Pages 491-496, April 2002
