Respiratory Muscle Training

I had never heard of POWERbreathe before until a personal trainer attending this practice brought it to my attention.  POWERbreathe is a respiratory training device which basically uses resistance training to the inspiratory muscles and has been described as “dumbbells for the diaphragm.   As with any muscles when regularly overloaded, the respiratory muscles adapt by becoming stronger and less prone to fatigue.    Breathing effort has been shown to improve in healthy individuals who use the device. 

 Studies have also shown Inspiratory Muscle Training has a role to play in management of COPD, asthma and even chronic heart failure with few side effects, no interactions with existing treatments and no adverse effects (though IMT is not recommended for those with history of pneumothorax, those with frequent exacerbation of asthma or those who have had a recently perforated ear drum).

POWERbreathe training yields improvement in dyspneoa within the first few days of use, and measurable improvements in exercise tolerance in just three weeks. (McConnel et al., 1998)

Many of our COPD patients are referred for pulmonary rehabilitation.  Previous blogs by Heather (Pulmonary rehab for COPD patients- June 2010) Jessica (Singing, Quality of Life and Pulmonary function- Sept 2009) and Andrew (COPD rehabilitation –Sept 2009)   discuss the merits of this. Studies have shown that pulmonary rehabilitation can have a significant effect in improving exercise performance (walking and cycling), breathing (less shortness of breath), psychological state (less depression and anxiety), fatigue and a patients feeling of control over their disease.

What we are talking about here are non invasive treatments to improve dyspnoea and exercise tolerance.  

But what actually sparked my interest this week were some articles I read highlighting the relationship between upper airway muscle tone, snoring and OSA. Both were similar in that they were assessing if specific training of the upper airways might reduce collapsibility of the upper airways during sleep.

 A pilot study to see if singing exercises could reduce snoring showed that snoring was on average  reduced, especially  in those  who performed the singing exercises accurately and consistently and were not overweight.

Likewise a trial to assess didgeridoo playing as an alternative treatment for obstructive sleep apnoea showed that regular playing of the didgeridoo reduces daytime sleepiness and snoring in people with moderate obstructive sleep apnoea, improved quality of sleep of partners and substantial reduction in AHI indexes after 4 months of playing.

Both of these were only small trials, with findings to be confirmed with larger studies, but certainly food for thought..

I am just trying to imagine patient reaction if we offered them an extensive course of didgeridoo playing or singing instead of CPAP therapy.  Maybe some, if musically inclined, would think this was great.  Others may think that CPAP might just be the easier alternative after all.

Irene