The Effects of Respiratory Muscle Training on Phonatory Measures in Individuals with Parkinson's Disease

Reyes, Álvaro; Castillo, Adrián; Castillo, Javiera; Cornejo, Isabel; Cruickshank, Travis

doi:10.1016/j.jvoice.2019.05.001

Cited by 31 publications

(36 citation statements)

References 32 publications

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“…The initial search identified 117 studies, and after all the selection stages, five papers incorporating three randomized controlled studies met the inclusion criteria and were included in this review. [14][15][16][17][18] Thus, this systematic review comprises two pairs of papers reporting data from the same studies, with different analyses (Sapienza et al 14 and Troche et al, 15 and both by Reyes et al 17,18 ), although we will refer to all of them as independent studies. In total, 111 participants were covered by the analysis.…”

Section: Resultsmentioning

confidence: 99%

Should respiratory muscle training be part of the treatment of Parkinson’s disease? A systematic review of randomized controlled trials

et al. 2019

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Objective: To determine the effectiveness of respiratory muscle training in persons with Parkinson’s disease. Data sources: PubMed/MEDLINE, EMBASE, Web of Science, Scopus and PEDro electronic databases were searched until 15 November 2019. Reference lists of included studies were hand-searched. Methods: Randomized controlled trials assessing the effects of respiratory muscle training programmes (both inspiratory and expiratory) in patients with Parkinson’s disease were included. Two reviewers independently identified eligible studies and extracted data. Method quality was appraised with the PEDro scale. Results: Five papers including three randomized controlled trials with a total of 111 patients were identified. Method appraisal showed a mean score of 5 in the PEDro scale. One study analysed inspiratory muscle training, one expiratory muscle training and two established a comparison between both of them. Statistically positive results were found in maximal inspiratory pressure ( P < 0.05 and d = 0.76), maximal expiratory pressure ( P < 0.01 and d = 1.40), perception of dyspnoea ( P < 0.01), swallowing function ( d = 0.55) and phonatory measures, without significant differences in spirometric indices. Conclusions: Respiratory muscle training may be an effective alternative for improving respiratory muscle strength, swallowing function and phonatory parameters in subjects with Parkinson’s disease. Nevertheless, the lack of primary studies about this type of training prevents obtaining robust evidence.

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Section: Resultsmentioning

confidence: 99%

Should respiratory muscle training be part of the treatment of Parkinson’s disease? A systematic review of randomized controlled trials

et al. 2019

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“…[22,29] For EMST, training frequency of 5 sets, 5 repetitions, 6 days a weeks within an intensity of 75% of MEP showed the greatest effects on MEP, PAS, and voice production. [22,25,30] Finally, in four studies, EMST was provided as a combined intervention with either IMST, air stacking and postural training.…”

Section: Discussionmentioning

confidence: 99%

“…Attempts were made to keep the participants blinded (by using sham devices) for at least the intervention. Blinding of outcome assessment was guaranteed in all studies, except for the two papers of Reyes et al [25,30]. Although in both papers of Reyes et al, the attempts to ascertain blinding of the personnel that provided instructions for training was unclear, we decided to rate all six RCTs for low risk of bias on the criterion 'blinding of participants and personnel'.…”

Section: Other Interventionsmentioning

confidence: 99%

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The Effects of Respiratory Training in Parkinson’s Disease: A Systematic Review

Dongen

Kalf

Wees³

et al. 2020

JPD

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Background: Signs of respiratory dysfunction can be present already early in the course of Parkinson’s disease (PD). Respiratory training could alleviate this, but its effectiveness is not well understood. Objective: The purpose of this systematic review is to review the efficacy of different respiratory training interventions in PD. Methods: A search strategy was performed in four databases: PubMed, Physiotherapy Evidence Database (PEDro), Cochrane Library, and Cumulative Index to Nursing and Allied Health Literature (CINAHL). Methodological quality of original full-text articles was assessed using the Cochrane Risk of Bias tool for randomized controlled trials (RCTs) and the Risk Of Bias In Non-randomized Studies of Interventions (ROBINS-I) tool for the controlled trials (CTs). Levels of evidence were rated by the Grading of Recommendation Assessment, Development and Evaluation (GRADE) approach. Results: Six papers reporting on four randomized controlled trials and another four controlled trials were included. Positive effects were reported for inspiratory muscle strength training (IMST), expiratory muscle strength training (EMST), air stacking, breath-stacking, incentive spirometry and postural training on respiratory muscle strength, swallowing safety, phonatory aspects and chest wall volumes. Best methodological quality was found for breath-stacking and incentive spirometry. Best levels of evidence were found for EMST, IMST and EMST plus air stacking. Conclusion: Respiratory training shows positive effects and should be considered when people with PD experience respiratory dysfunction. Future studies should focus on standardizing both training devices, instruments to measure outcomes and intervention protocols to further increase the level of evidence.

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“…Results showed that those PD patients receiving RMT had significant improvement not only in pulmonary function, but also in functional scores and cardiovascular autonomic function. The effects of RMT in patients with PD have been validated in several previous reports [18][19][20][31][32][33]. However, these studies only evaluated certain domains of function, such as respiratory or cough function, speech function (or phonation), swallowing function, or quality of life.…”

Section: Discussionmentioning

confidence: 98%

Simultaneously Improved Pulmonary and Cardiovascular Autonomic Function and Short-Term Functional Outcomes in Patients with Parkinson’s Disease after Respiratory Muscle Training

Huang

Lai

et al. 2020

JCM

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Both pulmonary function and autonomic function are impaired in patients with Parkinson’s diseases (PD). This study tested the hypothesis that respiratory muscle training (RMT) can not only improve pulmonary function, but also simultaneously improve cardiovascular autonomic function and short-term functional outcomes in patients with PD. Pulmonary function was measured by the forced vital capacity (FVC), forced expiratory volume in one second (FEV1), maximum inspiratory pressures (MIP), and maximum expiratory pressures (MEP). Cardiovascular autonomic function was measured by the heart rate response to deep breathing (HRDB), Valsalva ratio, baroreflex sensitivity, and spectral analysis. The functional and severity scores were measured by the Hoehn and Yahr stage and Unified Parkinson’s Disease Rating Scale (UPDRS). These measures were evaluated in patients with PD before and after 3 months of RMT, compared with a control group of PD patients without RMT. The results showed significant improvement of clinical scores (total UPDRS and UPDRS I, II and III) after RMT (p < 0.0001). Concerning pulmonary function, the parameters of MIP and MEP improved significantly. The parameters of cardiovascular function also improved after RMT, although only HRDB reached statistical significance. Based on the results of our study, RMT can not only improve both pulmonary and cardiovascular autonomic function, but can also improve short-term functional outcomes in patients with PD.

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The Effects of Respiratory Muscle Training on Phonatory Measures in Individuals with Parkinson's Disease

Cited by 31 publications

References 32 publications

Should respiratory muscle training be part of the treatment of Parkinson’s disease? A systematic review of randomized controlled trials

Should respiratory muscle training be part of the treatment of Parkinson’s disease? A systematic review of randomized controlled trials

The Effects of Respiratory Training in Parkinson’s Disease: A Systematic Review

Simultaneously Improved Pulmonary and Cardiovascular Autonomic Function and Short-Term Functional Outcomes in Patients with Parkinson’s Disease after Respiratory Muscle Training

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