Inspiratory muscle training in children with neuromuscular disorders

IF 1 Q4 REHABILITATION
A. Human, L. Corten, E. Lozano-Ray, Brenda M Morrow
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Abstract

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.
神经肌肉障碍儿童的吸气肌肉训练
背景:渐进性呼吸肌无力和无效咳嗽是神经肌肉疾病(NMD)患儿发病和死亡的主要原因。吸气肌训练(IMT)旨在保持或改善呼吸肌力量,降低呼吸系统发病率。本研究旨在确定吸气肌训练对 NMD 儿童的安全性和有效性:一项随机交叉研究比较了为期 3 个月的干预期(IMT)和对照期(无 IMT)。被诊断为 NMD 的儿童(5 岁至 18 岁)使用电子阈值装置进行 30 次呼吸(最大吸气口压 [Pimax] 的 30%),每天两次。在对照期间,参与者不进行任何 IMT:共有 23 名儿童(中位数[四分位数间距{IQR}]年龄为 12.33 [10.03-14.17] 岁)参加了此次活动,其中大部分为男性(n = 20)和非残障儿童(n = 14)。没有与 IMT 相关的不良事件报告。在非培训期和干预期,患者住院率和呼吸道感染 (RTI) 率的中位数没有差异(P = 0.60;P = 0.21)。在 IMT 期间,Pimax 和咳嗽峰值流量有所改善,平均值为 14.57 ± 15.67 cmH2O,标准差为 32.27 ± 36.60 L/min,而在非培训期间,Pimax 和咳嗽峰值流量分别为 3.04 ± 11.93 cmH2O(p = 0.01)和 -16.59 ± 48.29 L/min(p = 0.0005)。与其他研究类似,肺活量也未出现明显变化:结论:对 NMD 患儿进行为期 3 个月的吸气肌训练似乎安全且耐受性良好,呼吸肌力量和咳嗽效果显著改善:临床意义:吸气肌训练可作为 NMD 儿童呼吸管理的一种经济有效的辅助手段:泛非临床试验注册中心,PACTR201506001171421,https://pactr.samrc.ac.za。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
1.70
自引率
9.10%
发文量
35
审稿时长
30 weeks
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