Exercise Clinical Trial
Official title:
The Effects of a New Integrated Exercise Program Called 'Functional' Inspiratory Muscle Training in Geriatric Individuals With and Without Chronic Obstructive Pulmonary Disease
This study was designed as a prospective and experimental study. Geriatric individuals (age ≥ 65 years) with COPD and non-COPD were included in the study. Training program was identical for both groups and consisted of 4 weeks of foundation IMT followed by 4 weeks of functional IMT. Respiratory muscle strength, symptoms, exercise capacity, balance, postural control, physical activity and quality of life were evaluated.
The incidence of chronic obstructive pulmonary disease (COPD), which is one of the most
important causes of worldwide mortality and morbidity, increases with age and the disease
worsens with the effects of aging. The effects of COPD are not only limited to the lungs, it
also affects other organs and systems, causing loss of strength in the respiratory muscles.
Respiratory muscles are the skeletal muscles that must maintain their continuous activities
for the continuity of life. Just like other skeletal muscles, the respiratory muscles can
also be trained based on the principles of exercise. Inspiratory muscle training (IMT) is an
exercise method used in both patients with COPD and the elderly population. Studies have
shown that IMT has positive effects in COPD and elderly individuals. However, in all these
studies IMT applications (also known as "foundation or conventional IMT") focus only on the
respiratory task of the respiratory muscles. Nevertheless, in addition to their basic task of
respiration, respiratory muscles are also involved in core stabilization and postural
control.The aim of this study was to create an integrated IMT program for geriatric
individuals with and without COPD and investigate its effects.
The participants were divided into two groups as individuals with and without COPD. A total
of 8 weeks of IMT was applied for both groups using a threshold pressure loading device The
participants were asked to perform IMT twice a day in the morning and evening. Both groups
were trained 3 days a week under the supervision of a physiotherapist and other days of the
week without a supervisor. The treatment program consisted of 4 weeks of foundation IMT
followed by 4 weeks of functional IMT.The intensity of the exercise was adjusted to 40-50% of
the MIP. After 10 consecutive breathing cycles, the participants were asked to perform 3-4
breathe controls. As the tolerance increased, consecutive respiratory cycles were increased.
The intensity of MIP was adjusted by weekly MIP measurements. Currently, foundation IMT is
commonly used to train respiratory muscles. In the present study, foundation IMT was applied
during the first 4 weeks of training. The participants were asked to sit in a comfortable
upright position. Then the nose clip was placed, and the patients were instructed to tighten
their lips around the mouthpiece and breathe against the resistance. During this 4-week-long
training, all IMT applications were performed solely in a sitting position, without any
loading in other positions. Following the foundation IMT, all participants underwent four
weeks of functional IMT. Initially, all participants were taught diaphragmatic breathing and
activating abdominal wall musculature. Each training session started with warm-up exercises
and ended with cool-down exercises. During the loading phase, core stability, dynamic trunk
activation and postural control exercises were applied together with IMT.
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