Inspiratory muscle training in patients with diabetic autonomic neuropathy: a randomized clinical trial

Kaminski, Diogo Machado; Schaan, Beatriz D.; Silva, Antônio Marcos Vargas da; Soares, Pedro Paulo da Silva; Lago, Pedro Dal

doi:10.1007/s10286-015-0291-0

Cited by 22 publications

(27 citation statements)

References 12 publications

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“…From them, one observed the reduction of sympathetic nervous activity (SNA), evinced by the reduction of noradrenaline blood levels after the training period 15 . Two other studies have showed an increased in vagal modulation 13 and reduction in the SNA 13,14 , which were pointed out, respectively, by the increase in spectral density in the high frequency band and by the reduction of low frequency band assessed by the HFV ( Table 2). In one study 12 , no changes in autonomic control assessed by HFV measurements with the performance of IMT were observed ( Table 2).…”

Section: Imt Effects On Autonomic Controlmentioning

confidence: 83%

“…In three studies, the IMT improved autonomic control [13][14][15] . From them, one observed the reduction of sympathetic nervous activity (SNA), evinced by the reduction of noradrenaline blood levels after the training period 15 .…”

Section: Imt Effects On Autonomic Controlmentioning

confidence: 97%

“…Autonomic modulation was assessed in three studies by the indirect HRV technique [12][13][14] and in another study by dosing plasmatic levels of plasma catecholamines 15 .…”

Section: Studies' Characteristicsmentioning

confidence: 99%

“…The IMT consists on performing inspirations against a resistance through many mechanisms, it is an easily applied and low-cost intervention, which is also considered clinically significant in the rehabilitation scenario 11 . Studies with different populations point out the improvement of inspiratory muscle force after performing the IMT [9][10][11][12][13][14][15] . In addition, functional capacity and blood pressure also seem to be favored by this training modality 9,13 .…”

Section: Introductionmentioning

confidence: 99%

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Efeitos do treinamento muscular inspiratório no controle autonômico: revisão sistemática

et al. 2018

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| The autonomic nervous system dysfunction has an important role on the physiopathology of some diseases. A possible option to improve the autonomic control is the inspiratory muscle training (IMT). The aim of this study was to systematically review the available literature about the effects of this training modality on autonomic control. A search was performed for controlled and randomized clinical trials on database MEDLINE, PEDro, SciELO and LILACS by two independent reviewers, who also evaluated the methodologic quality (PEDro scale). 181 articles were found and, after elegibility criteria analysis, four studies were included. The included studies showed good methodological quality and assessed the effect of IMT on the autonomic control of participants with risk factors for cardiovascular disease. The autonomic control was evaluated by heart rate variability (HRV) analysis and by noradrenaline plasma levels. The IMT improved autonomic control in 3 studies,reducing the sympathetic nervous system (noradrenaline plasma levels; LF nu -HRV) and increasing the vagal nervous system (HF un -HRV). It is concluded that IMT may be a therapeutic alternative to improve the autonomic control.

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Section: Imt Effects On Autonomic Controlmentioning

confidence: 83%

Section: Imt Effects On Autonomic Controlmentioning

confidence: 97%

“…Autonomic modulation was assessed in three studies by the indirect HRV technique [12][13][14] and in another study by dosing plasmatic levels of plasma catecholamines 15 .…”

Section: Studies' Characteristicsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Efeitos do treinamento muscular inspiratório no controle autonômico: revisão sistemática

et al. 2018

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“…This catabolic effect on muscles is induced by more complications including neuropathy, insulin resistance, and chronic low-grade inflammation and may impact the diaphragm muscle negatively. Indeed, neuropathy may play a role in the reduced PI MAX , as a study [22] in patients with T2DM and autonomic neuropathy found reduced PI MAX in their participants. In the present study, most of the patients also suffered from OSA, and when previous and recent data are taken into account, it is difficult to see whether T2DM plays a significant role in the development of impaired IMS.…”

Section: Discussionmentioning

confidence: 99%

Reduced Inspiratory Muscle Strength in Patients with Type 2 Diabetes Mellitus and Obstructive Sleep Apnoea

Rehling

Banghøj

Kristiansen

et al. 2017

Journal of Diabetes Research

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Background Obstructive sleep apnoea (OSA) is related to type 2 diabetes (T2DM), and it may be associated with reduced inspiratory muscle strength (IMS). The aim of this study was to investigate the IMS in patients with T2DM, with or without OSA. Methods Patients with T2DM with OSA (n = 33) and without OSA (n = 28) were included. The maximum IMS was tested using the POWERbreathe KH2 device. Reference IMS values were data calculated using an algorithm based on general populations and adjusted for age and gender. Results There was no difference in IMS between the OSA group (median (range) 77 (35–124) cmH2O) and the non-OSA group (84 (33–122) cmH2O) (p = 0.97). The IMS values were reduced in the OSA group compared with the reference values (92.9 (62.3–100.0) cmH2O) (p = 0.030), whereas the non-OSA group did not have reduced IMS. When the IMS values of all T2DM patients were compared with reference values, the IMS values were 79 (33–124) cmH2O and 93.8 (62.3–102.4) cmH2O, respectively (p = 0.017). Conclusion No difference in IMS between patients with T2DM with or without OSA was found. However, patients with T2DM and OSA had reduced IMS compared with age- and gender-matched references whereas the non-OSA group did not have reduced IMS.

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Effects of Inspiratory Muscle Training on Heart Rate Variability in Children with Cystic Fibrosis: A Pilot Study

McCreery

Mackintosh

McNarry

2020

J. of SCI. IN SPORT AND EXERCISE

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Purpose Cystic Fibrosis (CF) is a multisystem disease associated with symptoms such as dyspnoea, tachycardia and tachypnea that may be related to changes in autonomic function and sensitive to improvement following inspiratory muscle training (IMT). The aim of the present study was to investigate the effect of IMT on heart rate variability (HRV) and respiratory function in children. Methods Five CF and five matched controls (40% boys) performed a 4-weeks IMT programme, involving 30 breaths, twice a day. Weeks 1–2 of training were set at 40% of a participant’s maximal strength index (S.Index), with week’s 3–4 set at 50%. Participants wore an ActiHeart for three consecutive days at baseline and post-intervention and indices of HRV were derived. Standard measures of lung function were obtained along with health-related quality of life (HRQoL) using the CF-specific questionnaire (CFQ-R). Results IMT elicited clinically meaningful increases in respiratory muscle strength and respiratory symptom domain scores, but no improvements in respiratory volume, irrespective of group. Similarly, no significant improvements were found in HRQoL despite 62.5% of the population increased their HRQoL score. Post-intervention, CF participants showed a clinically meaningful decrease in the very low frequency (VLF) domain. Conclusion These results may indicate clinically meaningful changes in HRV and inspiratory muscle strength following a 4-week IMT intervention, although a more powerful study is required to draw further conclusions. Indeed, the trends for improved HRQoL support the need for such studies to ascertain the potential therapeutic role of IMT in those with CF.

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Inspiratory muscle training in patients with diabetic autonomic neuropathy: a randomized clinical trial

Abstract: The IMT group had a greater increase in maximum inspiratory pressure as compared to P-IMT (p < 0.05). The IMT improved inspiratory muscle strength in patients with DAN.

Cited by 22 publications

References 12 publications

Efeitos do treinamento muscular inspiratório no controle autonômico: revisão sistemática

Efeitos do treinamento muscular inspiratório no controle autonômico: revisão sistemática

Reduced Inspiratory Muscle Strength in Patients with Type 2 Diabetes Mellitus and Obstructive Sleep Apnoea

Effects of Inspiratory Muscle Training on Heart Rate Variability in Children with Cystic Fibrosis: A Pilot Study

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