Respiratory muscle training for cystic fibrosis

Stanford, Gemma; Ryan, H A; Solís-Moya, Arturo

doi:10.1002/14651858.cd006112.pub5

Cited by 12 publications

(26 citation statements)

References 47 publications

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“…Thus, RMT could be an effective intervention to enhance the overall exercise response in young and older women. Other groups with imbalances in the load/capacity ratio of respiratory muscles, and which might therefore benefit from RMT, include: exercise-induced laryngeal obstruction (Sandnes et al 2022), obstructive sleep apnea (Torres-Castro et al 2022), cystic fibrosis (Stanford et al 2020), interstitial lung disease (Zaki et al 2022), stroke (Fabero-Garrido et al 2022, hypertension (Craighead et al 2022), chronic heart failure (Azambuja et al 2020), pulmonary hypertension (Tran et al 2021), neurological disorders (He et al 2021), spinal cord injury (Woods et al 2022), pre-operative surgery (Dsouza et al 2021), weaning from mechanical ventilation (Worraphan et al 2020), ventilator-induced diaphragm dysfunction in the recovery phase (Ahmed et al 2019), and COVID-19 (e.g., risk reduction, ICU, recovery, and long-COVID) (McNarry et al 2022). Evidence of the efficacy of RMT in these groups requires further prospective study.…”

Section: Additional Applications and Population Subgroupsmentioning

confidence: 99%

Distinguishing science from pseudoscience in commercial respiratory interventions: an evidence-based guide for health and exercise professionals

et al. 2023

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Respiratory function has become a global health priority. Not only is chronic respiratory disease a leading cause of worldwide morbidity and mortality, but the COVID-19 pandemic has heightened attention on respiratory health and the means of enhancing it. Subsequently, and inevitably, the respiratory system has become a target of the multi-trillion-dollar health and wellness industry. Numerous commercial, respiratory-related interventions are now coupled to therapeutic and/or ergogenic claims that vary in their plausibility: from the reasonable to the absurd. Moreover, legitimate and illegitimate claims are often conflated in a wellness space that lacks regulation. The abundance of interventions, the range of potential therapeutic targets in the respiratory system, and the wealth of research that varies in quality, all confound the ability for health and exercise professionals to make informed risk-to-benefit assessments with their patients and clients. This review focuses on numerous commercial interventions that purport to improve respiratory health, including nasal dilators, nasal breathing, and systematized breathing interventions (such as pursed-lips breathing), respiratory muscle training, canned oxygen, nutritional supplements, and inhaled l-menthol. For each intervention we describe the premise, examine the plausibility, and systematically contrast commercial claims against the published literature. The overarching aim is to assist health and exercise professionals to distinguish science from pseudoscience and make pragmatic and safe risk-to-benefit decisions.

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Section: Additional Applications and Population Subgroupsmentioning

confidence: 99%

Distinguishing science from pseudoscience in commercial respiratory interventions: an evidence-based guide for health and exercise professionals

et al. 2023

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“…These data provide the clearest evidence of a dose–response relationship for improvements in inspiratory muscle strength after IMT. This finding can inform the delivery of IMT as a rehabilitative tool for postacute COVID-19 syndrome, but it is likely that similar heterogeneity would also be observed with the delivery of home-based IMT in other chronic respiratory conditions where IMT has been shown to be beneficial for inspiratory muscle strength, such as chronic obstructive pulmonary disease (29), asthma (30), or cystic fibrosis (31). There are a wide range of individual, psychosocial, and disease-specific factors that influence adherence to home-based exercise (e.g., [32,33]), and it will be important for future research to determine the potential barriers and facilitators that influence adherence to unsupervised home-based exercise in people with postacute COVID-19 syndrome.…”

Section: Discussionmentioning

confidence: 87%

Heterogeneous Treatment Effects after Inspiratory Muscle Training during Recovery from Postacute COVID-19 Syndrome

Metcalfe

Swinton

Mackintosh

et al. 2023

Medicine &Amp; Science in Sports &Amp; Exercise

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Purpose The objective of this study is to investigate whether heterogeneous treatment effects occur for changes in inspiratory muscle strength, perceived dyspnea, and health-related quality of life after 8 wk of unsupervised home-based inspiratory muscle training (IMT) in adults with postacute coronavirus disease 2019 (COVID-19) syndrome. Methods In total, 147 adults with self-reported prior COVID-19 either completed an 8-wk home-based IMT intervention (n = 111, 92 females, 48 ± 11 yr, 9.3 ± 3.6 months postacute COVID-19 infection) or acted as “usual care” wait list controls (n = 36, 34 females, 49 ± 12 yr, 9.4 ± 3.2 months postacute COVID-19 infection). Results Applying a Bayesian framework, we found clear evidence of heterogeneity of treatment response for inspiratory muscle strength: the estimated difference between standard deviations (SD) of the IMT and control groups was 22.8 cm H2O (75% credible interval (CrI), 4.7–37.7) for changes in maximal inspiratory pressure (MIP) and 86.8 pressure time units (75% CrI, 55.7–116.7) for sustained MIP (SMIP). Conversely, there were minimal differences in the SD between the IMT and the control group for changes in perceived dyspnea and health-related quality of life, providing no evidence of heterogeneous treatment effects. Higher cumulative power during the IMT intervention was related to changes in MIP (β = 10.9 cm H2O (95% CrI, 5.3–16.8) per 1 SD) and SMIP (β = 63.7 (32.2–95.3) pressure time units per 1 SD), clearly indicating an IMT dose response for changes in inspiratory muscle strength. Older age (>50 yr), a longer time postacute COVID-19 (>3 months), and greater severity of dyspnea at baseline were also associated with smaller improvements in inspiratory muscle strength. Conclusions Heterogeneous individual responses occurred after an 8-wk home-based IMT program in people with postacute COVID-19 syndrome. Consistent with standard exercise theory, larger improvements in inspiratory muscle strength are strongly related to a greater cumulative dose of IMT.

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“…Physical training can even improve lung capacity and quality of life (34). Muscle training by generating a 60-80% maximal effort in patients leads to improved lung function (35). A less common technique, such as singing, can help improve peak expiratory pressure and quality of life (36).…”

Section: Resultsmentioning

confidence: 99%

The Evolving Management of Cystic Fibrosis

García¹,

García²,

Gómez³

et al. 2022

EPRA

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Introduction: Cystic fibrosis is a genetic pathological condition, affecting chromosome 7, which encodes the CFTR protein. This pathology is characterised by abundant mucus production, which in turn leads to blockage of the airways and blockage of the digestive tract. Objective: The aim of this literature review is to gather the largest available amount of information related to cystic fibrosis and analyse it in detail, indicating the results and expectations that have been had with the use of some drugs over time in patients with cystic fibrosis. It is also intended to mention updates of procedures and their effectiveness.Methodology: a systematic and complete search was carried out using the Cochrane Library database, with the term Cystic Fibrosis. The documents found were in Spanish and English. Some articles were excluded due to lack of updated information. Results: Inhalation Dornase alfa alfa is a useful drug for airway improvement and mucus viscosity reduction, as are bronchodilators. Pancreatic enzymes and ursodeoxycholic acid are beneficial in the gastrointestinal area, reducing intestinal symptomatology. In patients with diabetes, Insulin is preferred. Only glutathione has a beneficial effect in patients with cystic fibrosis. Rehabilitation and management of postural abnormalities is vital to improve patients' lives. In patients with nutritional deficiencies, nasogastric tube placement or gastrostomy is preferred to improve their nutrition. Conclusions: Cystic fibrosis is a disease that has an inevitable progression. The treatments studied here show that they only help quality of life and pulmonary and gastrointestinal functions temporarily. Further studies are needed to determine therapies that can significantly improve patients, both physically and psychologically; and who knows, some therapy or therapies that may lead to a cure for this disease.

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Respiratory muscle training for cystic fibrosis

Cited by 12 publications

References 47 publications

Distinguishing science from pseudoscience in commercial respiratory interventions: an evidence-based guide for health and exercise professionals

Distinguishing science from pseudoscience in commercial respiratory interventions: an evidence-based guide for health and exercise professionals

Heterogeneous Treatment Effects after Inspiratory Muscle Training during Recovery from Postacute COVID-19 Syndrome

The Evolving Management of Cystic Fibrosis

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