PURPOSE: Respiratory muscles are known to be weakened and are a cause of reduced exercise capacity in both recipients and candidates of allogeneic hematopoietic stem cell transplantation (allo-HSCT). Effects of inspiratory muscle training (IMT) in this patient population have not been comprehensively investigated so far. The current study was planned to investigate the effects of IMT during allo-HSCT on early transplantation-related outcomes.
METHODS: This is a prospective, randomized controlled, double-blinded study. Thirty-eight allo-HSCT recipients, 20 of whom were allocated to the treatment group (40 % of maximal inspiratory pressure (MIP)) and 18 to the control group (5 % of MIP), received IMT for 6 weeks. Pulmonary functions, dyspnea, respiratory (MIP, maximal expiratory pressure (MEP)) and peripheral muscle strength, maximal exercise capacity using modified incremental shuttle walking test (MISWT) and submaximal exercise capacity using 6-min walking test (6-MWT), fatigue, depression, and quality of life were evaluated before and after IMT.
RESULTS: The distance covered during MISWT (61.94 m) and 6-MWT (29.30 m), respiratory muscle strength (MIP 34.99 cmH2O, MEP 12.69 cmH2O), depression (-0.95), and modified Borg dyspnea scores (-0.11) showed a significant improvement in the treatment group compared to controls (p ≤ 0.05). ,br>CONCLUSIONS: Inspiratory muscle training is a safe and effective intervention which improves respiratory muscle strength and exercise capacity and decreases depression and dyspnea in allo-HSCT recipients. These positive changes might be further enhanced by prolonging the duration of training or inclusion of more recipients with inspiratory muscle weakness.
KEYWORDS: Allogeneic hematopoietic stem cell transplantation; Dyspnea; Exercise capacity; Inspiratory muscle training; Pulmonary function; Quality of life
PMID: 26135532 DOI: 10.1007/s00520-015-2825-3

This research aims to evaluate the effects of inspiratory muscle training (IMT) on apnea hypopnea index, sleepiness, sleep quality, cognitive function, motor task, executive function, quality of life, chemoreflex sensitivity and vagal modulation of heart rate in patients with heart failure and obstructive sleep apnea syndrome.

"PURPOSE The purpose of this study was to investigate the relationship between radiological indices, pulmonary function, and inspiratory capacity in patients with idiopathic scoliosis after taking into account their age, height, weight, muscle mass, and BMI.
METHODS We enrolled a total of 31 female patients with mild to moderate, right-sided idiopathic scoliosis. We took standardized standing anteroposterior and lateral radiographs using full spine radiography. The following radiological indices were measured: the thoracic Cobb's angle, the level of shoulder asymmetry, the pelvic tilt, the thoracic kyphotic angle, and the number of vertebra. Pulmonary function was measured as the maximum inspiration volume, and our measures of inspiratory capacity were inspiratory pressure and inspiratory velocity. Pearson's and partial correlation analyses were used to analyze data.
RESULTS We found that pulmonary function was not significantly correlated with age, height, weight, muscle mass, or BMI in patients with mild to moderate idiopathic scoliosis or with a thoracic Cobb’s angle of less than 40°. But we found that inspiratory capacity was significantly correlated with these factors save for height (p<.05). After adjusting for these factors, we found that radiological indices were not significantly correlated with either pulmonary function or inspiratory capacity in these patients.
CONCLUSIONS After adjusting for factors associated with inspiratory capacity, we found that radiological indices in patients with mild to moderate idiopathic scoliosis were not associated with respiratory parameters such as pulmonary function and inspiratory capacity. Therefore, our data suggest giving a consultation of a possible impairment in pulmonary-related function to such patients on the basis of radiological findings such as the Cobb’s angle may be ungrounded and should be refrained.
Keywords: idiopathic scoliosis, Cobb's angle, pulmonary function, inspiratory ability, peak inspiratory flow"
https://doi.org/10.15758/jkak.2016.18.2.53

BACKGROUND: Pulmonary arterial hypertension is often associated with skeletal-muscle weakness. The purpose of this randomized controlled trial was to determine the effects of an 8-week intervention combining muscle resistance, aerobic and inspiratory pressure-load exercises on upper/lower-body muscle power and other functional variables in patients with this disease.
METHODS: Participants were allocated to a control (standard care) or intervention (exercise) group (n=20 each, 45±12 and 46±11years, 60% women and 10% patients with chronic thromboembolic pulmonary hypertension per group). The intervention included five, three and six supervised (inhospital) sessions/week of aerobic, resistance and inspiratory muscle training, respectively. The primary endpoint was peak muscle power during bench/leg press; secondary outcomes included N-terminal pro-brain natriuretic peptide levels, 6-min walking distance, five-repetition sit-to-stand test, maximal inspiratory pressure, cardiopulmonary exercise testing variables (e.g., peak oxygen uptake), health-related quality of life, physical activity levels, and safety.
RESULTS: Adherence to training sessions averaged 94±0.5% (aerobic), 98±0.3% (resistance) and 91±1% (inspiratory training). Analysis of variance showed a significant interaction (group×time) effect for leg/bench press (P<0.001/P=0.002), with both tests showing an improvement in the exercise group (P<0.001) but not in controls (P>0.1). We found a significant interaction effect (P<0.001) for five-repetition sit-to-stand test, maximal inspiratory pressure and peak oxygen uptake (P<0.001), indicating a training-induced improvement. No major adverse event was noted due to exercise.
CONCLUSIONS: An 8-week exercise intervention including aerobic, resistance and specific inspiratory muscle training is safe for patients with pulmonary arterial hypertension and yields significant improvements in muscle power and other functional variables.
KEYWORDS: Cardio-pulmonary exercise testing; NT-proBNP; Pulmonary disease; Resistance exercise; VO(2peak)
PMID: 28189191 DOI: 10.1016/j.ijcard.2016.12.026

OBJECTIVES: This study sought to evaluate the effects of inspiratory muscle training in inspiratory muscle strength, as well as in functional capacity, ventilatory responses to exercise, recovery oxygen uptake kinetics, and quality of life in patients with chronic heart failure (CHF) and inspiratory muscle weakness.
BACKGROUND: Patients with CHF may have reduced strength and endurance in inspiratory muscles, which may contribute to exercise intolerance and is associated with a poor prognosis.
METHODS: Thirty-two patients with CHF and weakness of inspiratory muscles (maximal inspiratory pressure [Pi(max)] <70% of predicted) were randomly assigned to a 12-week program of inspiratory muscle training (IMT, 16 patients) or to a placebo-inspiratory muscle training (P-IMT, 16 patients). The following measures were obtained before and after the program: Pi(max) at rest and 10 min after maximal exercise; peak oxygen uptake, circulatory power, ventilatory oscillations, and oxygen kinetics during early recovery (VO2/t-slope); 6-min walk test; and quality of life scores.
RESULTS: The IMT resulted in a 115% increment Pi(max), 17% increase in peak oxygen uptake, and 19% increase in the 6-min walk distance. Likewise, circulatory power increased and ventilatory oscillations were reduced. The VO2/t-slope was improved during the recovery period, and quality of life scores improved.
CONCLUSIONS: In patients with CHF and inspiratory muscle weakness, IMT results in marked improvement in inspiratory muscle strength, as well as improvement in functional capacity, ventilatory response to exercise, recovery oxygen uptake kinetics, and quality of life
PMID: 16487841 DOI: 10.1016/j.jacc.2005.09.052