The Science Journal of the American Association for Respiratory Care

1997 OPEN FORUM Abstracts

DIFFERENT EFFECTS OF RESPIRATORY MUSCLE STRETCH GYMNASTICS AND INSPIRATORY MUSCLE TRAINING IN PATIENTS WITH COPD

Tetsuo Miyagawa RRT RPT RCET, Hideko Kobayashi MD, and Fumio Kokubu MD, PhD for the Respiratory Muscle Conditioning Group

Introduction: Respiratory muscle stretch gymnastics (RMSG) has been proposed as a possible new rehabilitation protocol for patients with chronic obstructive pulmonary diseases (COPD). The purpose of the present study was to compare the effect of RMSG with that of inspiratory muscle training (IMT) using the device Threshold^{TM}.

Methods: Sixteen naive patients with COPD were entered in the study. They performed IMT (2 sessions of 10 minutes of training at 30% of PImax, daily) for 4 weeks and RMSG (3 sessions of 5 RMSG patterns 4 times each, daily) for 4 weeks, in a randomized order, with a 4-week washout period in-between. Evaluating personnel were masked regarding each patients^{1} schedule. Four patients dropped out due to pre-determined criteria.

Results: Results shown are mean values (n=12).

IMT RMSG

before after before after

PImax (cmH_{2}O) 66.1 ** 79.1 66.0 69.3

expansion (cm), 4.45 * 5.91 4.33 * 5.91

lower chest wall

total lung capacity (ml) 5275 5348 5424 5301

functional residual 3345 3351 3407 * 3250

capacity (ml)

residual volume (ml) 2212 2210 2308 2239

6-min walking 385 * 412 383 * 430

distance (6MD) (m)

150mm VAS at the 5.3 4.8 5.0 4.3

end of 6MD (mm)

VAS/6MD (10^{-3}) 14.3 12.3 14.1 * 10.4

Chronic Respiratory 100 106 106 * 116

Questionnaire

(*, P < 0.05; **, P < 0.01 comparing values before and after each rehabilitation protocol)

There were no significant changes in VC, FEV_{1}, PFR nor in the arterial blood gas analysis with either rehabilitation protocol.

Conclusion: The results suggest that decrease in FRC is a unique feature of RMSG. This may suggest that RMSG decreases chest wall stiffness. RMSG may have clinically significant benefits for patients with COPD.

Secretarial office of the Respiratory Muscle Conditioning Group; Second Department of Physiology, Showa University School of Medicine, Tokyo 142 Japan

OF-97-151

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