27Mar 2017

DOES INSPIRATORY MUSCLE TRAINER HAVE AN EFFECT ON DIAPHRAGMATIC EXCURSION IN HEMODIALYTIC PATIENTS?

  • Assistant Professor, of Physical Therapy for Cardiovascular/Respiratory Disorder and Geriatrics, Faculty of Physical Therapy, Cairo University.
  • Lecturer of Physical Therapy for Cardiovascular/Respiratory Disorder and Geriatrics, Faculty of Physical Therapy, Cairo University.
  • Chairman of Nephrology Department El-Sahel Teaching Hospital.
Crossref Cited-by Linking logo
  • Abstract
  • Keywords
  • References
  • Cite This Article as
  • Corresponding Author

Background: Hemodialysis patients suffer from severe muscular weakness and one of the most important muscle is the diaphragm –main muscle of respiration – that was experienced by dyspnea and decreased functional capacity due to a unique form of protein and energy malnutrition .Purpose: to determine the response of diaphragmatic excursion to inspiratory muscle trainer prior hemodialysis session. Methods: Thirty patients of both sexes (10 men and 20 women) were included in this study with mean age(± SD) was 35.47 (± 6.51). They were chosen from El Sahel Teaching Hospital, Nephrology department, dialysis unit, and undergoing dialysis from at least 2-3 years.Ultrasonography (U.S) was used to assess diaphragmatic excursion (D.E) during deep breathing maneuver before and at the end of the training program. All patients received the inspiratory muscle training for 12 weeks, 3 times/week. Results: The results of this study showed statistical significant difference between pre and post-training in diaphragmatic excursion (p ?0.001) with a percentage of improvement 65.74%. The percentage of improvement in men was 65.29% corresponds that in women was 66.08% compared to the pre-data status. Conclusion: Inspiratory muscle training by inspiratory muscle trainer device for 12 weeks in hemodialysis patients had significantly improved the diaphragmatic excursion (DE) that ensures the improvement in their mechanics of breathing and sense of dyspnea

  1. Tavana S, Hashemian S and Jahromi F (2015): Effect of Dialysis on Maximum Inspiratory and Expiratory Pressures in End Stage Renal Disease Patients. National Research Institute of Tuberculosis and Lung Disease. 14(2): 128-133
  2. Onuigbo MAC, Onuigbo NT, Musso CG.(2014):Syndrome of rapid onset end stage renal disease in incident Mayo Clinic chronic hemodialysis patient. Indian J Nephrol ;24:75-81.
  3. Stephen G. John1, Mhairi K. Sigrist 1, Maarten W. Taal1, Christopher W. McIntyre(2013): Natural History of Skeletal Muscle Mass Changes in Chronic Kidney Disease Stage 4 and 5 Patients: An Observational Study
  4. John SG, Sigrist MK, Taal MW, McIntyre CW (2013) :Natural History of Skeletal Muscle Mass Changes in Chronic Kidney Disease Stage 4 and 5 Patients: An Observational Study. PLoS ONE 8(5): e65372. doi:10.1371/journal.pone.0065372
  5. Ikizler T. Alp and Jonathan Himmelfarb (2006):Muscle Wasting in Kidney Disease: Let’s Get Physical . J Am Soc Nephrol 17: 2097–2098, doi: 10.1681/ASN.2006060629
  6. Ikizler TA,Pupim LB,Brouillette JR,Levenhagen DK,Farmer k,Hakim RM,Flakoll PJ (2002):Hemodialysis stimulates muscle and whole body protein loss and alters substrate oxidation.Am J physiol Endocrinol Metab 282:E107-E116.
  7. Cury J, Brunetto A and Aydos R (2010): Negative effects of chronic kidney failure on lung function and functional capacity. Rev Bras Fisioter. 14(2):91-98.
  8. Abdalla M, AbdElgawad M and Alnahal (2013): Evaluation of pulmonary function in renal transplant recipients and chronic renal failure patients undergoing maintenance hemodialysis. Egyptian Journal of Chest Diseases and Tuberculosis. 62, 145–150
  9. Silva IS, Fregonezi GAF, Dias FAL, Ribeiro CTD, Guerra RO, Ferreira GMH(2013): Inspiratory muscle training for asthma.
  10. Illi SK, Held U, Frank I, Spengler CM.(2012): Effect of respiratory muscle training on exercise performance in healthy individuals: a systematic review and meta-analysis.Sports Medicine ;42(8):707–24.
  11. Alison K. McConnell Æ Graham R. Sharpe (2005): The effect of inspiratory muscle training upon maximum lactate steady-state and blood lactate concentration. Eur J Appl Physiol 94: 277–284
  12. Saad N., (2013): Effect of inspiratory muscle training on diaphragmatic excursion post liver transplantation, Master Thesis, Faculty of physical therapy, Cairo University.
  13. Saafan K.(2013):Effect of inspiratory muscle training on diaphragmatic strength after upper abdominal surgeries ,Master thesis ,Faculty of Physical Therapy, Cairo University
  14. Hamad H., El Nahas NG, Abdel Aziz A.(2012): Response of diaphragmatic excursion to inspiratory muscle trainer post thoracotomy, Master Thesis, Faculty of physical therapy, Cairo University.
  15. Casali C.C, Pereira A.P, Martinez J.A, de Souza H.C and Gastaldi A.C, (2011): Obesity Surgery Effects of Inspiratory Muscle Training on Muscular and Pulmonary Function after Bariatric Surgery in Obese Patients. Obesity Surgery: 64(7): 683–689.
  16. Fatma M., (2012): Does inspiratory muscle training following thoracic surgery has an effect on the outcomes? Journal of American science; 8(3)
  17. Edwards A.M. and Cooke C.B, (2008): Oxygen uptake kinetics and maximal aerobic power are unaffected by inspiratory muscle training in healthy subjects where time to exhaustion is extended. European Journal of Applied Physiology, 93(2), 139-44.
  18. Hart N, Jenkins S, Hillman D and Eastwood P, (2006): Dyspnea in COPD: Can inspiratory muscle training help? Aust J physiother 50: 169- 180.
  19. Ribeiro J., Chiappa G., Neder J. and Frankenstein, (2009): Respiratory muscles function and exercise intolerance in heart failure. Curr Heart Fail Rep; 6(2):95-101.
  20. Ysayama L, Lopes LR, Silva AMO, and And reollo NA (2008): The influence of the respiratory muscular training in the recovery of esophagectomy. ABCD Arq Bras Cir Dig; 21(2):61–64.
  21. McGill S. and Brown L. (2011): Effect of inspiratory muscle training in post operative patients. Phys ther; 108(3): 505-510.

[Nesreen G. El-Nahas, Heba A Abdeen and Abdel-Naser Abdel Moneem (2017); DOES INSPIRATORY MUSCLE TRAINER HAVE AN EFFECT ON DIAPHRAGMATIC EXCURSION IN HEMODIALYTIC PATIENTS? Int. J. of Adv. Res. 5 (Mar). 1224-1229] (ISSN 2320-5407). www.journalijar.com

Heba Ahmed Abdeen
(2) Lecturer of Physical Therapy for Cardiovascular/Respiratory Disorder and Geriatrics, Faculty of Physical Therapy, Cairo University

DOI:

Article DOI: 10.21474/IJAR01/3627      
DOI URL: http://dx.doi.org/10.21474/IJAR01/3627

Download Full Paper

Download PDF No. of Downloads: 14 | No. of Views: 86