High-intensity inspiratory muscle training in bronchiectasis: A randomized controlled trial.

BACKGROUND AND OBJECTIVE: Inspiratory muscle training (IMT) enhances velocity of inspiratory muscle contraction and modifies inspiratory and expiratory time. This study aimed to examine the impact of high-intensity IMT (H-IMT) on exercise capacity in bronchiectasis. METHODS: Forty-five patients were included. Lung function, respiratory muscle strength and endurance, exercise capacity, dyspnoea, fatigue and quality of life (QOL) were evaluated. Patients were randomized into two groups: H-IMT and control groups. Twenty-three patients underwent H-IMT for 8 weeks, using threshold loading with a target workload of maximal inspiratory pressure (MIP) of at least 70%, with 3-min cycles (as 2-min training: 1-min rest intervals) for 21 min. There was a total period of 14 min of loaded breathing and 7 min of recovery. The control group (n = 22) underwent low-intensity IMT at 10% of the initial MIP and was maintained at the same intensity until the end of the training. RESULTS: After training, both MIP and maximal expiratory pressure (MEP) and the incremental shuttle walk distance were increased in the H-IMT group compared with the control group (P < 0.05). There was a significant difference in constant threshold load, time and pressure-time units in the H-IMT group (P < 0.05) but not in the control group (P > 0.05). A significant decrease was found in fatigue in both groups (P < 0.05). The Leicester Cough Questionnaire social score for the H-IMT group decreased significantly after the treatment (P < 0.05). CONCLUSION: The H-IMT increased exercise capacity in patients with non-cystic fibrosis bronchiectasis. It has also positive effects on respiratory muscle strength and endurance, and social aspects of QOL.

Arm strength training improves activities of daily living and occupational performance in patients with COPD.

OBJECTIVES: Arm strength training may improve functional performance for patients with chronic obstructive pulmonary disease (COPD). This trial investigated the effects of arm strength training on arm exercise capacity, activities of daily living (ADL) and occupational performance in patients with COPD. METHODS: These was a randomized controlled trial in an outpatient clinic. Forty-two stable patients with COPD were randomly assigned into treatment and control groups. The treatment group underwent an 8-week (23 sessions) arm strength training programme. Both groups completed daily breathing exercises at home. Tests included hand grip strength, arm ergometer test, the Glittre-ADL and ADL Simulation tests and measures included the Milliken ADL Scale (MAS) and the Canadian Occupational Performance Measure (COPM). RESULTS: Statistically significant increases were detected in hand grip strength and %hand grip strength values, peak arm ergometer workload and the number of ADL simulation test cycles for the treatment group (P < 0.05). Significant decreases were also found in dyspnea and arm fatigue perception during arm ergometer test, and heart rate and dyspnea perception during Glittre-ADL test in the treatment group (P < 0.05). The treatment group also showed significant increases in MAS-house cleaning and laundry and MAS-other activities integrated scores and COPM-performance and satisfaction scores (P < 0.05). CONCLUSIONS: Arm strength training increases peripheral muscle strength, arm exercise capacity, ADL performance and patients' ADL performance satisfaction. Training decreases dyspnea and arm fatigue perception during supported arm exercises, and dyspnea perception during ADL. Arm strength training is a reliable and feasible treatment for COPD patients.

[Respiratory symptoms and functions in tea workers]. / Cay isçilerinde solunum semptomlari ve fonksiyonlari

Respiratory symptoms and function tests were studied in tea workers and in a control group. The prevalance of acute and chronic respiratory symptoms were not different in two groups except for an acute burning sensation of eye-nose-throat and a chronic cough. Also the comparison of the respiratory function tests between tea workers (both smokers and nonsmokers) and the controls were not different at preshift and postshift 30th minute and 8th hour. When preshift and postshift results were compared in tea workers (both in smokers and nonsmokers); statistically significant reductions of FEV1, FEV1/FVC, FEF25-75 and FEF25 were seen at the postshift values. However statistically significant reductions were not observed in controls. Thus we conclude acute tea dust exposure may cause bronchial obstruction particularly in small airways.