Muscle Weakness Clinical Trial
Official title:
The Effectiveness of Pranayama Breathing Exercises vs. Threshold Inspiratory Muscle Trainer to Improve Respiratory Muscle Function in an Institutionalized Frail Elderly Population
The global loss of muscle mass and strength associated with aging is a cause of functional
impairment and disability, particularly in the frail elderly. Respiratory function can be
severely compromised if there is a decrease of respiratory (RM) strength complicated by the
presence of comorbidities and physical immobility.
Previous studies have shown that the specific RM training is an effective method to increase
RM strength, both in healthy people and patients. In this case, specific RM training may be
regarded as a beneficial alternative to improve RM function, and thus prevent physical and
clinical deterioration in this population.
The hypothesis is that specific RM training would improve RM strength and endurance in the
experimental groups vs. control who do not participate in RM training.
Institutionalized elderly people with an inability to walk were randomly allocated to a
control group, a Threshold group or a Pranayama group. Both experimental groups performed a
supervised RM training, five days a week for six consecutive weeks. The maximum inspiratory
and expiratory pressures (MIP and MEP) and the maximum voluntary ventilation (MVV) were
assessed at four time points in each of three groups.
Studies have shown that general aerobic exercise training is accompanied by significant
respiratory physiological benefits, including gains in RM strength and endurance (Larson, et
al., 1999; Sheel, 2002; Watsford, et al., 2005; Lacasse et al., 2006). This benefit appears
to be greater when general exercise conditioning is combined with specific RM training
(Weiner, et al., 1992; Wanke, et al., 1994; Larson, et al., 1999; Hill y Eastwood, 2005;
O'Brien, et al., 2008). However, many frail elderly are not able to perform general aerobic
exercise, related or not to ADL, as it is mentioned above (e.g., institutionalized elderly
with comorbidities, functional impairment and RM weakness). In this case, specific RM
training may be used as a beneficial alternative to maintain or improve RM function
(Watsford and Murphy, 2008), and thus prevent deterioration in this functionally impaired
elderly.
The most commonly used techniques of specific RM training are: a) isocapnic hyperpnoea
(Leith and Bradley, 1976; Belman and Mittman, 1980), b) respiratory resistive loading
(Pardy, et al., 1981; Sonne and Davis, 1982; Belman, et al., 1986), and c) respiratory
threshold loading (Clanton, et al., 1985; Chen, et al., 1985; Martyn, et al., 1987; Larson,
et al., 1988). Apart from these three well-known techniques, other less studied types of
exercise such as the controlled breathing exercises of Yoga, Pranayama, may also be added to
this list (Kulpati, et al., 1982; Manocha, et al., 2002; Donesky-Cueco, et al., 2009).
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Factorial Assignment, Masking: Open Label, Primary Purpose: Treatment
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