The Science Journal of the American Association for Respiratory Care

1996 OPEN FORUM Abstracts

EFFECT OF RESPIRATORY MUSCLES TRAINING ON LUNG FUNCTIONS AND CENTRAL NEURAL REGULATION IN CHRONIC PULMONARY DISEASES PATIENTS

E.K. Shikhmirzaeva, A.P. Zilber Petrozavodsk University, Petrozavodsk, Russia

We evaluated the effect of special respiratory muscles training on 23 patients with chronic obstructive pulmonary diseases on lung functions and central neural regulation of breathing in comparison with 37 nontrained patients and 48 normals. Changes and correlation of pulmonary mechanics tests (parameters of MEFV curve and respiratory resistances), inspiratory (PI_{max}) and expiratory (PE_{max}) muscular efforts and neural respiratory drive (P_{100}) were compared. A special method of occlusion pressure measurement was worked out for simultaneous noninvasive determination of all these indices. The results of the study showed that the initial level PI_{max} and PE_{max} in patients without training were lower. PI_{max} in patients and in normals were (M ± m) 56,67 ± 8,15 and 106,38 ± 8,48 cm H_{2}O respectively. In the same groups PE_{max} was 100,27 ± 14,26 and 180,74 ± 12.56 cm H_{2}O. Neurorespiratory drive (P_{100}) increased in keeping with the decrease of respiratory muscles efforts, and in the same group it was 3,36 ± 0,34 and 1,35 ± 0,22 cm H_{2}O respectively. A special 3 months training of patients by using calibrated artificial resistances improved all parameters of ventilation - respiratory muscles efforts, neurorespiratory drive and pulmonary mechanics. After the training PI_{max} became 89 ± 8,4, PE_{max} - 114,4 ± 17,3, P_{100} - 3,1 ± 0,27 cm H_{2}O. Parameters of respiratory mechanics improved by 15-20%. The best correlation was observed between P_{100} (neurorespiratory drive) and PI_{max} (r=-0.68), VC (-0.65), FVC (-0.63), Rrs (+0.63), FEE_{25/75} (-0.55), and Raw (+0.53). It is evident that all studied mechanisms of respiratory failure are always interdependent. By influencing one of them (in our study - muscular efforts), we can improve others. The special training of respiratory muscles is quite an effective noninvasive method of respiratory care to improve not only respiratory muscles activity, but the neuro-respiratory drive and mechanics of breathing. The individual selection of a training regime allowed not only to improve the effectiveness of the method, but to make the training more pleasant for patients.

Reference: OF-96-055

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