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Effects of combined inspiratory and expiratory muscle training in pediatric kidney transplant recipients: a
Hikmet Ucgun1, Meltem Kaya2, Aysenur Temizel Tombul2
1Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul Atlas University, Anadolu St. No:40, Istanbul, Turkey. hikmetucgun92@gmail.com.
Insights
Combined inspiratory and expiratory muscle training (IMT+EMT) plus chest physiotherapy significantly enhanced pulmonary function and strength in pediatric kidney transplant recipients. This approach offers a valuable addition to post-transplant rehabilitation for improved functional capacity.
Area of Science:
- Pediatric Nephrology
- Pulmonary Rehabilitation
- Transplant Medicine
Background:
- Children with chronic kidney disease often experience persistent respiratory muscle weakness and reduced functional capacity post-kidney transplant.
- While inspiratory muscle training (IMT) is known to improve respiratory muscle strength, evidence for combined IMT and expiratory muscle training (EMT) is limited.
- This study aimed to evaluate the efficacy of a combined IMT+EMT program alongside chest physiotherapy in pediatric kidney transplant recipients.
Purpose of the Study:
- To investigate the effects of an 8-week combined IMT+EMT program with chest physiotherapy on pulmonary function, respiratory and peripheral muscle strength, and functional capacity.
- To compare the outcomes of the combined IMT+EMT program against chest physiotherapy alone in pediatric kidney transplant recipients.
Main Methods:
- A single-blinded randomized controlled trial involving 30 pediatric kidney transplant recipients aged 8-18 years.
- Participants were randomized into an experimental group (EG; n=15) receiving combined IMT+EMT plus chest physiotherapy, or a control group (CG; n=15) receiving chest physiotherapy with sham training.
- Assessments of pulmonary function, respiratory and peripheral muscle strength, and functional capacity were conducted at baseline and after 8 weeks.
Main Results:
- The experimental group showed significantly greater improvements in pulmonary function parameters (FVC, FEV1, PEF) compared to the control group (p<0.01).
- Maximal inspiratory and expiratory pressures (MIP, MEP) increased significantly more in the EG (p<0.05).
- Functional capacity, measured by the 6-minute walk test, improved significantly more in the EG (+49.46 m vs. +13.33 m; p=0.006).
Conclusions:
- Combined IMT+EMT integrated with chest physiotherapy significantly enhances pulmonary function, respiratory muscle strength, and functional capacity in pediatric kidney transplant recipients.
- This combined training approach represents a valuable adjunct to standard post-transplant rehabilitation protocols.
- The findings support the integration of comprehensive respiratory muscle training in the management of pediatric kidney transplant recipients to improve outcomes.
Background:
Children with chronic kidney disease may continue to experience respiratory muscle weakness and reduced functional capacity after kidney transplantation. While inspiratory muscle training (IMT) improves respiratory muscle strength, evidence on the combined use of IMT and expiratory muscle training (EMT) is limited. This study investigated whether an 8-week combined IMT + EMT program integrated with chest physiotherapy improves pulmonary function, respiratory and peripheral muscle strength, and functional capacity in pediatric kidney transplant recipients compared with chest physiotherapy alone.
Methods:
In this single-blinded randomized controlled trial, 30 pediatric kidney transplant recipients (8-18 years) were randomized to an experimental group (EG; n = 15) receiving combined IMT + EMT plus chest physiotherapy or a control group (CG; n = 15) receiving chest physiotherapy with sham training. Pulmonary function, respiratory and peripheral muscle strength, and functional capacity were assessed at baseline and after 8 weeks.
Results:
Significant time × group interactions were observed for pulmonary function parameters, with greater improvements in the experimental group (FVC: + 11.53 vs. + 1.06; FEV₁: + 8.40 vs. - 1.06; PEF: + 10.20 vs. - 3.13; all p < 0.01). Maximal inspiratory and expiratory pressures increased more in the experimental group (MIP: + 8.66 vs. + 4.13 cmH₂O; MEP: + 12.73 vs. + 2.06 cmH₂O; p < 0.05). Functional capacity (6-min walk test) improved in both groups but was significantly greater in the experimental group (+ 49.46 m vs. + 13.33 m; p = 0.006). No significant between-group differences were observed in exercise-related dyspnea or fatigue.
Conclusions:
Combined IMT + EMT integrated with chest physiotherapy significantly improved pulmonary function, respiratory muscle strength, and functional capacity in pediatric kidney transplant recipients, suggesting it is a valuable adjunct in post-transplant rehabilitation.
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