Comparison study of chest physiotherapy home training programmes on respiratory functions in patients with muscular dystrophy

Abstract

Objective: To compare the effects of home training programmes, threshold inspiratory muscle training and breathing exercise on spirometry and maximal pressures in patients with muscular dystrophy.

Design: Prospective blinded 12-week study.

Settings: Cardiopulmonary department of university hospital.

Subjects: Twenty-three patients with muscular dystrophy (17 patients with limb girdle muscular dystrophy and 6 patients with Becker muscular dystrophy) assigned to the threshold inspiratory muscle training and breathing exercise groups with alternate allocation.

Methods: Spirometry, maximal inspiratory pressure (PI_max) and maximal expiratory pressure (PE_max) were measured before and after training. In the threshold inspiratory muscle training group threshold pressure load was determined as equal to 30% of weekly PI_max measurement. In the breathing exercise group, patients performed deep and forceful diaphragmatic and segmental exercises. All patients performed exercises at home and once a week at hospital under supervision.

Results: The improvement of PI_max in the threshold inspiratory muscle training group was more significant than the improvement observed in the breathing exercise group (P= 0.05). PE_max increased significantly only in the breathing exercise group (P= 0.01). Spirometry results did not change significantly in both groups after the training.

Conclusions: We conclude that respiratory muscle strength is enhanced by training in the patients with muscular dystrophy who are ambulatory, but inspiratory and/or expiratory training effect is specific to the trained muscles. The techniques that improve the strength of respiratory muscles should be included in the physiotherapy management of patients with muscular dystrophy.

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