Effect of respiratory muscle training on load sensations in people with chronic tetraplegia: a secondary analysis of a randomised controlled trial.

ABSTRACT

STUDY DESIGN: Secondary analysis of a randomised controlled trial. OBJECTIVES: Our primary study showed that increasing inspiratory muscle strength with training in people with chronic (>1 year) tetraplegia corresponded with reduced sensations of breathlessness when inspiration was loaded. This study investigated whether respiratory muscle training also affected the respiratory sensations for load detection and magnitude perception. SETTING: Independent research institute in Sydney, Australia. METHODS: Thirty-two adults with chronic tetraplegia participated in a 6-week, supervised training protocol. The active group trained the inspiratory muscles through progressive threshold loading. The sham group performed the same protocol with a fixed threshold load (3.6 cmH2O). Primary measures were load detection threshold and perceived magnitudes of six suprathreshold loads reported using the modified Borg scale. RESULTS: Maximal inspiratory pressure (PImax) increased by 32% (95% CI, 18-45) in the active group with no change in the sham group (p =  0.51). The training intervention did not affect detection thresholds in the active (p =  0.24) or sham (p =  0.77) group, with similar overall decreases in Borg rating of 0.83 (95% CI, 0.49-1.17) in active and 0.72 (95% CI, 0.32-1.12) in sham group. Increased inspiratory muscle strength reduced slope magnitude between Borg rating and peak inspiratory pressure (p =  0.003), but not when pressure was divided by PImax to reflect contraction intensity (p =  0.92). CONCLUSIONS: Training reduces the sensitivity of load sensations for a given change in pressure but not for a given change in contraction intensity.