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Published on: August 24, 2019
Home-based inspiratory muscle training in pediatric patients after kidney transplantation: a randomized clinical
Raquel P Carbonera1, Ana Paula O Barbosa2, Tatiana C Normann2
1Graduate Program in Pediatrics, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil.
Insights
Home-based inspiratory muscle training (IMT) significantly improved respiratory muscle strength in pediatric kidney transplant recipients. This intervention also led to beneficial changes in hemoglobin and hematocrit levels.
Area of Science:
- Nephrology
- Pulmonology
- Pediatric Medicine
Background:
- Chronic kidney disease (CKD) is a global health concern, leading to renal failure and reduced quality of life.
- Kidney transplantation is a primary treatment, but patients often experience diminished respiratory muscle strength post-surgery.
- Inspiratory muscle training (IMT) is known to enhance respiratory muscle function, strength, and endurance.
Purpose of the Study:
- To assess the impact of IMT on respiratory muscle strength, functional capacity, and pulmonary function in pediatric kidney transplant recipients.
- To evaluate secondary effects of IMT on the biochemical profile of these patients.
Main Methods:
- A randomized, double-blind, placebo-controlled trial involving 31 pediatric kidney transplant recipients.
- Participants were assigned to an intervention group (IG) or a control group (CG) for 6 weeks of home-based IMT.
- The IG used a load at 40% of maximal inspiratory pressure, while the CG used a placebo load (9 cm H2O).
Main Results:
- The IG showed a significant increase in maximal inspiratory pressure (35%) and maximal expiratory pressure (26%) compared to the CG (5% and 4%, respectively).
- No significant changes were observed in functional capacity or pulmonary function in either group.
- The IG experienced an increase in hemoglobin and hematocrit levels.
Conclusions:
- Home-based IMT effectively enhances respiratory muscle strength in pediatric kidney transplant recipients.
- The intervention demonstrated positive effects on biochemical markers, specifically hemoglobin and hematocrit.
- IMT did not significantly alter functional capacity or pulmonary function in this patient cohort.
Background:
Chronic kidney disease (CKD) represents the irreversible stages of renal failure and is a growing worldwide public health issue associated with increases in morbidity, mortality, and decreased quality of life. Kidney transplantation is considered one of the best treatment options in this population. However, even after surgery, respiratory muscle strength is below normal values, and inspiratory muscle training (IMT) improves respiratory muscle function, strength, and endurance. This study aimed to evaluate the effects of IMT regarding respiratory muscle strength, functional capacity, and pulmonary function in pediatric kidney transplant recipients with CKD, and secondarily, to assess the biochemical profile of patients after intervention.
Methods:
This is a randomized, double-blind, placebo-controlled trial. Patients were randomized into two groups, intervention (IG) and control (CG) and performed IMT home-based training for 6 weeks. In the IG, the load was adjusted to 40% of the maximal inspiratory pressure and in the CG was adjusted to a minimum placebo load (9 cm H2O).
Results:
Thirty-one patients were randomly allocated to the intervention (n = 16) or control (n = 15) groups. There were no differences at baseline between groups. Increase of 35% in the maximal inspiratory pressure predicted and 26% in the maximal expiratory pressure predicted in the IG were found, compared with 5 and 4% in the CG. There was an increase in hemoglobin and hematocrit values in the IG.
Conclusions:
Home-based IMT provides a significant increase in respiratory muscle strength, without changes in functional capacity and pulmonary function. Benefits regarding biochemical markers (hemoglobin and hematocrit) were also observed.
