Expiratory Muscle Strength Training in Persons With Multiple Sclerosis Having Mild to Moderate Disability: Effect on Maximal Expiratory Pressure, Pulmonary Function, and Maximal Voluntary Cough
Presented as poster presentations to the University of Florida Women’s Health Research Day, March 2003, Gainesville, FL; the University of Florida College of Public Health and Health Professions Graduate and Faculty Research Forum, April 2003, Gainesville, FL; the European Committee for Treatment and Research in Multiple Sclerosis, September 2003, Milan, Italy; and the American Physical Therapy Association Combined Section Meeting, February 2004, Nashville, TN; and as an oral presentation to University of Florida Graduate Student Forum, March 2003, Gainesville, FL.
Abstract
Chiara T, Martin AD, Davenport PW, Bolser DC. Expiratory muscle strength training in persons with multiple sclerosis having mild to moderate disability: effect on maximal expiratory pressure, pulmonary function, and maximal voluntary cough.
Objective
To determine the effect of expiratory muscle strength training (EMST) on maximal expiratory strength, pulmonary function, and maximal voluntary cough in persons with multiple sclerosis (MS) having mild to moderate disability.
Design
Before-after trial.
Setting
Assessments were completed in the privacy of the subject’s home or exercise physiology laboratory.
Participants
Seventeen persons with MS were age- and sex-matched to 14 healthy controls.
Intervention
Eight weeks of EMST and 4 weeks of detraining.
Main Outcome Measures
Maximal respiratory pressures, pulmonary function, and maximal voluntary cough were assessed 3 times (pretraining, posttraining, detraining). Maximal expiratory pressure (MEP) was assessed weekly and training intensity adjusted based on the new measurement.
Results
Subjects with MS had lower MEP, decreased pulmonary function, and weaker maximal voluntary cough at each assessment. EMST increased MEP and peak expiratory flow. However, improvement in maximal voluntary cough only occurred in subjects with a moderate level of disability when the MS group was subdivided into mild and moderate disability levels based on the Expanded Disability Status Scale.
Conclusions
EMST is a viable tool to enhance the strength of the respiratory muscles. However, further work is needed to determine the best parameters to assess change in cough following EMST.
aBrain Rehabilitation Research Center, Malcom Randall VA Medical Center, Gainesville, FL
bPhysical Therapy Department, College of Public Health and Health Professions, University of Florida, Gainesville, FL
cPhysiological Sciences Department, College of Veterinary Medicine, University of Florida, Gainesville, FL
Correspondence to Toni Chiara, PhD, PT, BRRC Malcom Randall VA Medical Center (151A), 1601 SW Archer Rd, Gainesville, FL 32608. Reprints are not available from the author.
Supported by the Physical Therapy Department, University of Florida, for purchase of equipment and reimbursement for mileage to travel to recruit, assess, and train subjects.
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 or upon any organization with which the authors are associated.
ABSTRACT