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Clinical Investigations: CYSTIC FIBROSIS |

Inspiratory Muscle Training Improves Lung Function and Exercise Capacity in Adults With Cystic Fibrosis*

Stephanie Enright, PhD, MPhil, MSc; Ken Chatham, MCSP; Alina A. Ionescu, MD; Viswanath B. Unnithan, PhD, MSc; Dennis J. Shale, MD
Author and Funding Information

*From the School of Health Care Professions (Dr. Enright), University of Salford, Manchester, UK; Llandough Hospital NHS Trust (Mr. Chatham, and Drs. Ionescu and Shale), Cardiff, Wales, UK; and Exercise Science Department (Dr. Unnithan), Syracuse University, Syracuse, NY.

Correspondence to: Stephanie Enright, PhD, MPhil, MSc, School of Health Care Professions, University of Salford, Manchester, M6 6PU, UK; e-mail: s.enright@salford.ac.uk



Chest. 2004;126(2):405-411. doi:10.1378/chest.126.2.405
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Study objectives: To investigate the effects of high-intensity inspiratory muscle training (IMT) on inspiratory muscle function (IMF), diaphragm thickness, lung function, physical work capacity (PWC), and psychosocial status in patients with cystic fibrosis (CF).

Design: Twenty-nine adult patients with CF were randomly assigned to three groups. Two groups were required to complete an 8-week program of IMT in which the training intensity was set at either 80% of maximal effort (group 1; 9 patients) or 20% of maximal effort (group 2; 10 patients). A third group of patients did not participate in any form of training and acted as a control group (group 3; 10 patients).

Interventions: In all patients, baseline and postintervention measures of IMF were determined by maximal inspiratory pressure (Pimax), and sustained Pimax (SPimax); pulmonary function, body composition, and physical activity status were also determined. In addition, diaphragm thickness was measured at functional residual capacity (FRC) and total lung capacity (TLC) [TDIcont], and the diaphragm thickening ratio (TR) was calculated (TR = thickness during Pimax at FRC/mean thickness at FRC). Subjects also completed an incremental cycle ergometer test to exhaustion and two symptom-related questionnaires, prior to and following training.

Results: Following training, significant increases in Pimax and SPimax (p < 0.05), TDIcont (p < 0.05), TR (p < 0.05), vital capacity (p < 0.05), TLC (p < 0.05), and PWC (p < 0.05) were identified, and decreases in anxiety scores (p < 0.05) and depression scores (p < 0.01) were noted in group 1 patients compared to group 3 patients. Group 2 patients significantly improved Pimax and SPimax (both p < 0.05) only with respect to group 3 patients. No significant differences were observed in group 3 patients.

Conclusion: An 8-week program of high-intensity IMT resulted in significant benefits for CF patients, which included increased IMF and thickness of the diaphragm (during contraction), improved lung volumes, increased PWC, and improved psychosocial status.


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