Inspiratory-Expiratory Muscle Training Improved Respiratory Muscle Strength in Dialysis Patients: A Pilot Randomised
Nicola Lamberti1, Giovanni Piva2, Yuri Battaglia3
1Department of Neuroscience and Rehabilitation, University of Ferrara, Via Luigi Borsari 46, 44121 Ferrara, Italy.
Advances in Respiratory Medicine
|February 24, 2023
Summary
Home-based respiratory muscle training (RMT) improved respiratory muscle strength in end-stage kidney disease (ESKD) patients. This low-intensity program, using a simple device, showed significant gains in maximal inspiratory and expiratory pressures.
Area of Science:
- Nephrology
- Pulmonology
- Rehabilitation Medicine
Background:
- End-stage kidney disease (ESKD) is associated with progressive physical deconditioning, particularly affecting respiratory muscles.
- Maintaining respiratory muscle function is crucial for the overall health and quality of life in ESKD patients.
Purpose of the Study:
- To assess the feasibility and effectiveness of a low-intensity, home-based respiratory muscle training (RMT) program for ESKD patients.
- To determine if RMT can improve respiratory muscle strength and lung function in this population.
Main Methods:
- A pilot randomized controlled trial with 22 ESKD patients randomized to RMT or usual care (CON).
- The RMT group performed 5-minute breathing exercises twice daily for 4 weeks using an inspiratory-expiratory system with progressively increasing resistance.
- Primary outcomes included maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP); secondary outcomes were lung capacity measures (FEV1, FVC, MVV).
Main Results:
- Nineteen patients completed the trial. The RMT group showed significant improvements in both MIP and MEP compared to the CON group.
- A significant difference in MEP of 23 cmH2O was observed in favor of the RMT group (p = 0.008).
- No significant changes in FVC, FEV1, or MVV were noted in either group, though the CON group showed a decreasing trend in FVC over time.
Conclusions:
- Low-fatiguing, home-based RMT using a simple device is feasible and effective in significantly increasing respiratory muscle strength in ESKD patients.
- RMT may help counteract the respiratory deconditioning commonly seen in end-stage kidney disease.
- Further research is warranted to explore the long-term effects and broader clinical impact of RMT in ESKD management.
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