Glossopharyngeal pistoning for lung insufflation in children with spinal muscular atrophy type II.

AIM: To evaluate whether children with spinal muscular atrophy (SMA) type II were able to learn glossopharyngeal pistoning for lung insufflation (GI), and to evaluate the effects of GI on pulmonary function and chest expansion. METHODS: Eleven children with SMA type II were recruited. They performed 10 cycles of GI, four times per week, for 8 weeks. Lung function and chest expansion were measured before and after the 8-week period. RESULTS: Five of the 11 children learned the technique. The median GI volume was 0.28 (range 0.15-0.98) L. Four of the children who completed the study showed a mean increase in inspiratory vital capacity (IVC) of 0.13 L (95% confidence interval (CI) 0.03-0.23) and peak expiratory flow (PEF) of 116 L/min (95% CI 60-173). They also had an increased chest expansion with GI at the level of the xiphoid process of 1.50 cm (95% CI 0.16-2.84) and at the level of the fourth costa of 1.79 cm (95% CI 0.85-2.73). The children reported temporary symptoms of dizziness and tension in the chest. CONCLUSION: Five of the 11 children were able to learn the technique of GI and for the four who fulfilled the training, it had positive effects on IVC, PEF and chest expansion. GI did not cause major discomfort.

Effects of glossopharyngeal pistoning for lung insufflation in elite swimmers.

PURPOSE: To investigate whether sessions of glossopharyngeal pistoning (GP) to lung volumes exceeding maximum inspiratory capacity in a group of extremely well-trained elite swimmers would affect maximum lung volumes and buoyancies. METHODS: Ten female and 16 male swimmers performed GP four times a week for 5 wk in addition to their regular swimming training program. Pulmonary function, chest expansion, hydrostatic weights (maximally inhaled and exhaled), and body composition (relative amounts of fat, bone, muscle, and fat-free tissue) were measured. RESULTS: Training compliance was 79% for the males and 82% for the females. Chest expansion increased significantly during the training period, by 1.0 cm and by 0.8 cm at the level of the xiphiod and the fourth costae for the males, and by 0.6 cm and 0.8 cm for the females. The buoyancy lifting force increased significantly by 0.17 and 0.37 kg for the males and the females, respectively. The females also increased their vital capacity significantly by 2%. No significant changes in body composition took place in either group. CONCLUSION: The lung volumes and buoyancies of swimmers can be increased by sessions of GP.

Experiences of decreased lung function in people with cervical spinal cord injury.

PURPOSE: The present aim was to explore and describe experience of decreased lung function among people with cervical spinal-cord injury (CSCI). METHOD: Thirty-three people with CSCI with a lesion between levels C4 and C8 entered the study. Qualitative content analysis was used. A semi-structured interview guide was constructed with the main focus on experience of symptoms related to decreased lung function. RESULTS: The experience related to decreased lung function was limitations in breathing function, the ability to cough and voice function. Individual self-management strategies were described in relation to these limitations. The overarching theme throughout the interviews was that although the limitations were in most cases significant compared to the situation before injury, they were not necessarily experienced or referred to as a problem. CONCLUSIONS: Breathing function, the ability to cough and voice function were perceived as limited in most of the present participants with CSCI compared to before the injury. Most had adapted to the situation and had developed their own strategies for handling the limitations. However, these limitations did not only become normal for the individuals because of compensatory strategies, these limitations were usually experienced as a problem not to speak of.

Effects of glossopharyngeal pistoning for lung insufflation on vital capacity in healthy women.

OBJECTIVES: To determine whether healthy women could be trained to perform glossopharyngeal pistoning (GP) to insufflate the lungs to volumes exceeding maximum inspiratory capacity (IC), whether such insufflation caused discomfort, and the immediate and long-term effects on vital capacity (VC). DESIGN: A randomized controlled trial. Twenty-six healthy women were randomly assigned to a training group (TG, n = 17) or to a control group (CG, n = 9). The TG performed 15-30 deep inspiratory efforts supplemented by GP to lung volumes exceeding IC, three times per week for 6 wks. Pulmonary function and chest expansion were measured before and after the 6-wk period. The TG was retested again 12 wks after the end of the training period. RESULTS: One of 17 women had difficulty performing GP and was excluded. Temporary symptoms (while performing GP) were reported in 44% of subjects in the TG. After 6 wks of training, subjects in the TG had significantly increased their VC (P < 0.001). VC did not change in the CG. The increase in vital capacity of the TG was still evident after 12 wks without performing GP. Chest expansion increased significantly with GP. CONCLUSION: The women in the TG were able to perform the technique, and it did not cause major discomfort. VC increased significantly in the TG, and the increase was still present after 12 wks without GP.

Effect of inspiratory muscle training in patients with multiple sclerosis.

OBJECTIVE: To evaluate whether inspiratory muscle training (IMT) improves inspiratory muscle strength, respiratory capacity, fatigue, and subjective perception of physical endurance in patients with advanced multiple sclerosis (MS). DESIGN: Randomized controlled trial. SETTING: Outpatient clinic in Sweden. PARTICIPANTS: Fifteen severely disabled patients with MS, randomized to a training or control group. INTERVENTION: Seven patients trained with a Threshold inspiratory muscle trainer, twice every other day, with 3 sets of 10 loaded inspirations (40%-60% of patients' maximal inspiratory pressure [Pimax]) over a 10-week period. MAIN OUTCOME MEASURES: Spirometry, Pimax, maximal expiratory pressure (Pemax), clinical assessments, and questionnaires on the patients' fatigue severity and physical endurance were evaluated. RESULTS: After training, the Pimax (P<.008) and Pemax (P<.02) increased in the training group. The improvement in Pimax after 10 weeks of training was higher than the improvement in the control group (P<.01) and was maintained 1 month after the training period ended. The training affected neither respiratory function nor the patients' symptoms. CONCLUSIONS: IMT had a beneficial effect on inspiratory muscle strength in patients with MS and is recommended as a complement to ordinary physical training.