Comparison between Two Inspiratory Muscle Training Protocols, Low Loads versus High Loads, in Institutionalized Elderly Women: A Double-Blind Randomized Controlled Trial

Abstract

<b><i>Background:</i></b> Aging results in a decline in the function of the respiratory muscles. Inspiratory muscle training is presented as a possible solution to attenuate the loss of respiratory function in the elderly. The objective of the study was to evaluate and compare the efficacy of 2 protocols with inspiratory muscle training (IMT), low loads and high loads, to improve respiratory strength, functional capacity and dyspnea in institutionalized elderly women, over 65 years. <b><i>Methods:</i></b> The study was a controlled, randomized, double-blind trial and with allocation concealment performed on 26 institutionalized elderly women distributed in 2 groups, the high-intensity group (HIG) and low-intensity group (LIG). Over an 8-week period an IMT protocol was followed 5 days/week, 15 min/day. The HIG trained with a load of 40% of the maximum inspiratory pressure (MIP) and the LIG with 20%. MIP, maximum expiratory pressure (MEP), functional capacity and dyspnea were evaluated. <b><i>Results:</i></b> After training, in the HIG MIP, MEP and functional capacity increased 52, 16 and 7%, respectively (<i>p</i> = 0.000, <i>p</i> = 0.001, <i>p</i> = 0.001) and in the LIG 30, 18 and 9%, respectively (<i>p</i> = 0.002, <i>p</i> = 0.014, <i>p</i> = 0.001). The improvement in MIP was significantly higher in the HIG than in the LIG (<i>p</i> = 0.042). <b><i>Conclusion:</i></b> IMT with low and high loads improves respiratory muscle strength and functional capacity in institutionalized elderly women. In addition, high loads were significantly more effective to improve MIP.

Effect of postoperative high load long duration inspiratory muscle training on pulmonary function and functional capacity after mitral valve replacement surgery: A randomized controlled trial with follow-up

“…The improvement in MIP in the experimental group lasted for 6 months after surgery as presented in the follow up which provide evidence about the effectiveness of IMT on improving inspiratory muscle strength. This study come online with the previous study by Martin-Sanchez et al [33], who reported that high load of IMT (40%MIP) achieved higher improvement in the MIP than lower load IMT (20%) in institutionalized elderly women after 8 weeks of training.…”

“…The improvement of MIP in the experimental group can be explained by improved inspiratory muscle strength and endurance induced by IMT due to improving the neuromuscular recruitment pattern resulting from repeated exposure to the same task (additional resistance to the inspiration process) [33]. Thus, IMT improves the inspiratory muscle strength leading to improving oxygenation and reduce the risk of developing PPC, the length of hospital stay and the cost of hospitalization consequently.…”

Association of Apolipoprotein e polymorphism with SARS-CoV-2 infection

“…In another study performed among Czeck subjects, Hubacek and colleagues found no significant difference in the frequency of Apo E alleles in 408 SARS CoV-2 PCR-positive subjects compared to the general population. However, when they compared symptomatic and asymptomatic COVID-19 subjects separately with the control population, they found a significant difference in the frequency of the Apo E4 allele between symptomatic patients and the control groups ( Hubacek et al, 2021 ). Given that our COVID-19 subjects were symptomatic patients the results obtained by Hubacek and colleagues might not be in real contradiction to our results, as they found a significant difference when compared the symptomatic group of their COVID-19 subjects to the general population.…”

“…ApoE protein is a multi-faceted protein that has been found associated with many diseases ( Smith, 2000 ). Several studies have been performed to reveal a possible association between Apo E polymorphism and COVID-19 acquisition and severity ( Kuo et al, 2020b ); including few experimental studies ( Hubacek et al, 2021 ) and the current study would be one of that few.…”

Exercise Physiology at “Conversational Level” Is Not Impaired in Healthy Young Subjects Wearing Masks or Respirators

“…An interval of about 1 min was allowed between the measurements to avoid short-term fatigue for respiratory muscles. The highest of 2 reproducible values was considered in the data analysis [26]. The advantage of this test is that it is a quick and noninvasive way to assess the strength of the inspiratory muscles through the PI max .…”