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Inspiratory muscle training attenuates irradiation-induced diaphragm dysfunction
Li-Ying Wang1,2, Pei-Yu Yang1, Yu-Jen Chen3,4,5
1Physical Therapy Center, National Taiwan University Hospital Taipei, Taiwan, Republic of China.
American Journal of Translational Research
|October 22, 2019
Summary
Inspiratory muscle training (IMT) protected diaphragms from radiotherapy damage in esophageal cancer patients and an animal model. IMT improved diaphragm function and exercise capacity during treatment.
Area of Science:
- Oncology
- Pulmonology
- Radiotherapy
Background:
- Radiotherapy (RT) can impair diaphragm function.
- Esophageal cancer patients undergoing concurrent chemoradiotherapy (CCRT) are at risk for diaphragm dysfunction.
- Inspiratory muscle training (IMT) may offer a protective strategy.
Purpose of the Study:
- To investigate the protective effect of IMT on RT-induced diaphragm damage.
- To explore the underlying mechanisms in a preclinical setting and an animal model.
Main Methods:
- A small human pilot study (n=6) with concurrent-IMT during CCRT.
- An animal model (SD rats) using IMT followed by RT to the diaphragm.
- Assessment of diaphragmatic function, exercise capacity, contractile function, antioxidant capacity, and oxidative injury.
Main Results:
- In patients, IMT improved diaphragm activation, fatigability, and functional exercise capacity during CCRT.
- In rats, IMT enhanced diaphragm peak twitch and tetanus tension, reduced fatigue, and decreased oxidative injury.
- IMT increased antioxidant enzyme mRNA expression (Cu/Zn-SOD, Mn-SOD) in rat diaphragms.
Conclusions:
- Preclinical data suggest IMT conditions the diaphragm to better resist RT-induced damage.
- Larger patient studies are needed to confirm clinical applicability of IMT for protecting diaphragms during cancer treatment.
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