Effects of home-based inspiratory muscle training on sickle cell disease (SCD) patients

Introduction: Inspiratory muscle training (IMT) has been shown to be an efficient method of improving exercise tolerance and inspiratory and expiratory muscle strength in several diseases. The effects of IMT on patients with sickle cell anemia (SCD) are relatively unknown. Our study aimed to evaluat...

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Autores principales:	Fábio Galvão, Camila Tatiana Zanoni, Marcos Mello Moreira, Ilma Aparecida Paschoal, Sara Teresinha Olalla Saad
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Inspiratory muscle training Sickle cell disease Volumetric capnography Exercise tolerance PImax, PEmax Diseases of the blood and blood-forming organs RC633-647.5
Acceso en línea:	https://doaj.org/article/51cc09d0434749bcaf15b999a51feb60
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spelling	oai:doaj.org-article:51cc09d0434749bcaf15b999a51feb602021-11-04T04:37:01ZEffects of home-based inspiratory muscle training on sickle cell disease (SCD) patients2531-137910.1016/j.htct.2020.08.005https://doaj.org/article/51cc09d0434749bcaf15b999a51feb602021-10-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S253113792030122Xhttps://doaj.org/toc/2531-1379Introduction: Inspiratory muscle training (IMT) has been shown to be an efficient method of improving exercise tolerance and inspiratory and expiratory muscle strength in several diseases. The effects of IMT on patients with sickle cell anemia (SCD) are relatively unknown. Our study aimed to evaluate the effects of IMT on adult SCD patients, regarding respiratory muscle strength (RMS) variables, lung function, exercise tolerance, blood lactation concentration, limitation imposed by dyspnea during daily activities and impact of fatigue on the quality of life. Methods: This was a randomized single-blind study, with an IMT design comprising true load (TG) and sham load (SG) groups. Initial assessment included spirometry, volumetric capnography (VCap) and measurement of RMS by maximal inspiratory and expiratory pressure (PImax and PEmax). The Medical Research Council dyspnea scale and modified fatigue impact scale were also applied and blood lactate concentration was measured before and after the 6-minute walk test. After this initial assessment, the patient used the IMT device at home daily, returning every 6 weeks for RMS reassessment. Both groups used the same device and were unaware of which group they were in. After a period totaling 18 weeks, patients underwent the final evaluation, as initially performed. Results: Twenty-five patients in total participated until the end of the study (median age 42 years). There were no significant differences between TG and SG based on age, sex, body mass index or severity of genotype. At the end of the training, both groups showed a significant increase in PEmax and PImax, improvement in Vcap and in exercise tolerance and dyspnea reduction while performing daily life activities. The same was observed in patients grouped according to disease severity (HbSS and HbSβ0 vs HbSC and HbSβ+), without differences between groups. Conclusion: Home-based inspiratory muscle training benefits outpatients with SCD, including the sham load group. Trial registration: http://www.ensaiosclinicos.gov.br; registration number: RBR-6g8n92.Fábio GalvãoCamila Tatiana ZanoniMarcos Mello MoreiraIlma Aparecida PaschoalSara Teresinha Olalla SaadElsevierarticleInspiratory muscle trainingSickle cell diseaseVolumetric capnographyExercise tolerancePImax, PEmaxDiseases of the blood and blood-forming organsRC633-647.5ENHematology, Transfusion and Cell Therapy, Vol 43, Iss 4, Pp 443-452 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Inspiratory muscle training Sickle cell disease Volumetric capnography Exercise tolerance PImax, PEmax Diseases of the blood and blood-forming organs RC633-647.5
spellingShingle	Inspiratory muscle training Sickle cell disease Volumetric capnography Exercise tolerance PImax, PEmax Diseases of the blood and blood-forming organs RC633-647.5 Fábio Galvão Camila Tatiana Zanoni Marcos Mello Moreira Ilma Aparecida Paschoal Sara Teresinha Olalla Saad Effects of home-based inspiratory muscle training on sickle cell disease (SCD) patients
description	Introduction: Inspiratory muscle training (IMT) has been shown to be an efficient method of improving exercise tolerance and inspiratory and expiratory muscle strength in several diseases. The effects of IMT on patients with sickle cell anemia (SCD) are relatively unknown. Our study aimed to evaluate the effects of IMT on adult SCD patients, regarding respiratory muscle strength (RMS) variables, lung function, exercise tolerance, blood lactation concentration, limitation imposed by dyspnea during daily activities and impact of fatigue on the quality of life. Methods: This was a randomized single-blind study, with an IMT design comprising true load (TG) and sham load (SG) groups. Initial assessment included spirometry, volumetric capnography (VCap) and measurement of RMS by maximal inspiratory and expiratory pressure (PImax and PEmax). The Medical Research Council dyspnea scale and modified fatigue impact scale were also applied and blood lactate concentration was measured before and after the 6-minute walk test. After this initial assessment, the patient used the IMT device at home daily, returning every 6 weeks for RMS reassessment. Both groups used the same device and were unaware of which group they were in. After a period totaling 18 weeks, patients underwent the final evaluation, as initially performed. Results: Twenty-five patients in total participated until the end of the study (median age 42 years). There were no significant differences between TG and SG based on age, sex, body mass index or severity of genotype. At the end of the training, both groups showed a significant increase in PEmax and PImax, improvement in Vcap and in exercise tolerance and dyspnea reduction while performing daily life activities. The same was observed in patients grouped according to disease severity (HbSS and HbSβ0 vs HbSC and HbSβ+), without differences between groups. Conclusion: Home-based inspiratory muscle training benefits outpatients with SCD, including the sham load group. Trial registration: http://www.ensaiosclinicos.gov.br; registration number: RBR-6g8n92.
format	article
author	Fábio Galvão Camila Tatiana Zanoni Marcos Mello Moreira Ilma Aparecida Paschoal Sara Teresinha Olalla Saad
author_facet	Fábio Galvão Camila Tatiana Zanoni Marcos Mello Moreira Ilma Aparecida Paschoal Sara Teresinha Olalla Saad
author_sort	Fábio Galvão
title	Effects of home-based inspiratory muscle training on sickle cell disease (SCD) patients
title_short	Effects of home-based inspiratory muscle training on sickle cell disease (SCD) patients
title_full	Effects of home-based inspiratory muscle training on sickle cell disease (SCD) patients
title_fullStr	Effects of home-based inspiratory muscle training on sickle cell disease (SCD) patients
title_full_unstemmed	Effects of home-based inspiratory muscle training on sickle cell disease (SCD) patients
title_sort	effects of home-based inspiratory muscle training on sickle cell disease (scd) patients
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/51cc09d0434749bcaf15b999a51feb60
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Effects of home-based inspiratory muscle training on sickle cell disease (SCD) patients

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