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A Murine Model of Muscle Training by Neuromuscular Electrical Stimulation
Published on: May 9, 2012
Inspiratory muscle training in children with neuromuscular disorders
Anri Human1,2,3, Lieselotte Corten2,4, Eleonora Lozano-Ray5
1Department of Physiotherapy, School of Health Care Sciences, Sefako Makgatho Health Sciences University, Pretoria, South Africa.
Insights
Inspiratory muscle training (IMT) is safe and effective for children with neuromuscular disorders (NMD), improving respiratory muscle strength and cough. This intervention offers a cost-effective addition to respiratory care for NMD patients.
Area of Science:
- Pediatric Pulmonology
- Neuromuscular Disorders
- Rehabilitation Medicine
Background:
- Children with neuromuscular disorders (NMD) often experience progressive respiratory muscle weakness and ineffective cough, leading to significant morbidity and mortality.
- Inspiratory muscle training (IMT) is a therapeutic approach designed to enhance respiratory muscle strength and mitigate respiratory complications in these vulnerable patients.
Purpose of the Study:
- To evaluate the safety and efficacy of a 3-month inspiratory muscle training (IMT) program in pediatric patients diagnosed with neuromuscular disorders (NMD).
Main Methods:
- A randomized cross-over study design was employed, comparing a 3-month IMT intervention period with a control period of no IMT.
- Participants (aged 5-18 years) performed 30 breaths twice daily at 30% of their maximum inspiratory mouth pressure (Pimax) using an electronic threshold device.
Main Results:
- Twenty-three children with NMD participated; no adverse events related to IMT were reported.
- IMT led to significant improvements in maximum inspiratory mouth pressure (Pimax) and peak cough flow compared to the non-training period.
- No significant differences were observed in patient hospitalization or respiratory tract infection rates between the intervention and control periods. Spirometry results did not show significant changes.
Conclusions:
- A 3-month IMT program is safe and well-tolerated in children with NMD.
- IMT demonstrates efficacy in improving respiratory muscle strength and cough effectiveness in this population.
- Inspiratory muscle training presents a potentially cost-effective adjunct therapy for respiratory management in children with NMD.
Background:
Progressive respiratory muscle weakness and ineffective cough contribute to morbidity and mortality in children with neuromuscular disorders (NMD). Inspiratory muscle training (IMT) aims to preserve or improve respiratory muscle strength and reduce respiratory morbidity. This study aimed to determine the safety and efficacy of IMT in children with NMD.
Methods/Design:
A randomised cross-over study compared a 3-month intervention (IMT) with control periods (no IMT). Children diagnosed with NMD (5 years - 18 years) performed 30 breaths (at 30% of maximum inspiratory mouth pressure [Pimax]) with an electronic threshold device, twice daily. During the control period, participants did not perform any IMT.
Discussion:
Twenty three children (median [interquartile range {IQR}] age of 12.33 [10.03-14.17] years), mostly male (n = 20) and non-ambulant (n = 14) participated. No adverse events related to IMT were reported. No difference in median patient hospitalisation and respiratory tract infection (RTI) rates between non-training and intervention periods (p = 0.60; p = 0.21) was found. During IMT, Pimax and peak cough flow improved with a mean ± standard deviation (s.d.) of 14.57 ± 15.67 cmH2O and 32.27 ± 36.60 L/min, compared to 3.04 ± 11.93 cmH2O (p = 0.01) and -16.59 ± 48.29 L/min (p = 0.0005) during the non-training period. Similar to other studies, spirometry did not show a significant change.
Conclusion:
A 3-month IMT programme in children with NMD appears safe and well-tolerated, with significant improvement in respiratory muscle strength and cough efficacy.
Clinical Implications:
Inspiratory muscle training could be considered a cost-effective adjunct to respiratory management in children with NMD.
Trial Registration:
Pan African Clinical Trial Registry, PACTR201506001171421, https://pactr.samrc.ac.za.
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