Implications of expiratory muscle strength training for rehabilitation of the elderly: Tutorial

With age, physical functions decline, which influences respiratory performance. One of the physical changes associated with aging is sarcopenia, a reduction in muscle strength and power. Sarcopenia has been extensively studied in the elderly with regard to limb function but less with regard to respiratory function. Elderly individuals experience reduced muscle mass and strength in respiratory musculature, which may hinder the ability to generate adequate expiratory driving force for both ventilatory and nonventilatory activities. Increasing expiratory muscle strength may enhance an elderly individual's ability to generate and maintain the expiratory driving force critical to cough, speak, and swallow. Previous studies demonstrate that expiratory muscle strength training (EMST) improves ventilatory and nonventilatory functions. This paper discusses the potential impact that EMST can have on the rehabilitation of respiratory muscle decline, particularly in the elderly. This tutorial reviews an EMST paradigm, its physiological underpinnings, and its potential outcomes.