ARTICLE INFO

Article Type

Original Research

Authors

Ghodrati   N. (1 )
Hosseini Kakhk   S.A.R. (* )
Hamedinia   M.R (3)






(* ) Exercise Physiology Department, Physical Education & Sports Sciences Faculty, Hakim Sabzevari University, Sabzevar, Iran
(1 ) Exercise Physiology Department, Physical Education & Sports Sciences Faculty, Hakim Sabzevari University, Sabzevar, Iran
(3) Exercise Physiology Department, Physical Education & Sports Sciences Faculty, Hakim Sabzevari University, Sabzevar, Iran

Correspondence

Address: Physical Education & Sports Sciences Faculty, Hakim Sabzevari University, Tohidshahr, Sabzevar, Iran. Postal Code: 9617976487
Phone: +985144012620
Fax: +985144012611
hosseini18@yahoo.com

Article History

Received:  November  22, 2014
Accepted:  March 9, 2015
ePublished:  April 16, 2015

BRIEF TEXT


… [1-5] People with asthma have the lower average of respiratory function compared to others without asthma [4, 6]. … [7, 8] One of the known methods for the treatment of asthma is rehabilitation [9]. This method is often used in the training of respiratory muscles [10]. … [11] This training method increases the production capacity of the hail and expiratory muscle and improves respiratory function [12, 13]. … [14] Exercise is one of the most important components of rehabilitation [15, 16].

6-week especial exercises of respiratory muscles do not lead to any change in pulmonary function in patients with asthma, but it improves their respiratory muscle strength, increases exercise tolerance and improves breathlessness in these patients [14]. Regular physical activity may be useful in managing asthma [17]. 8-week exercise with an ergometer bicycle of upper and lower extremity physical endurance improves lung function in patients with asthma [16]. … [18-22] The effects of strength training (with a focus on respiratory muscles) have not yet been studied in patients with asthma, and only few studies have been done about the combined training [23].

The aim of this study was to investigate the effect of two exercise training programs (respiratory muscle strength exercise and special training of respiratory muscles) on respiratory and physical function in patients with asthma.

This is a quasi-experimental study with pretest-posttest design as well as control and experimental groups.

Women with asthma, who hospitalized in Sabzevar Vasei Hospital (Iran) during 2005-2013, were studied in 2013.

23 women were selected using Random Sampling Method.

The women were randomly divided into three groups including respiratory muscle strength exercise (n=8), special training of respiratory muscles (n=8) and control (n=7). Inclusion criteria were a history of asthma more than two years and aged between 30-55years. Exclusion criteria were musculoskeletal problems, defects, pregnancy, cardiovascular disease or acute diseases that interfere with the exercises. At first, respiratory parameters of participants in three groups were evaluated by spirometer device (Chestgraph HI-701; France). People diagnosed to have asthma symptoms by a doctor with 20% less FEV1 than the predicted value or FEV1 equal to the value and with more than 2 years asthma were taken into account as patients with asthma [24]. … [25] The muscle strength was measured using 1RM method in the bench press, and respiratory muscle strength was measured using a spirometer (Voldyne5000; USA). The training program was conducted for 8 weeks (two sessions per week). The main program included the training of 6 movements of bench press, fly, crunch, pull side by side, lift and repeat row in three sets with 8-12 repetition (equivalent to 70-60% 1RM) and a 1-2minute rest between repetitions [26]. After 8 weeks of training in groups of respiratory muscle strength exercise, and special training of respiratory muscles, in all three groups of subjects, again, spirometer test were performed as well as muscle strength and respiratory muscle strength evaluation in conditions similar to the pre-test conditions. Data was analyzed using SPSS 18 software. One- way Analysis of Variance (to investigate the effect of exercise on the correlated variables and comparing pretest and posttest) and Scheffe Post-hoc test (to assess differences between the groups) were used. Using descriptive statistics, the average age, height, weight and disease history were calculated (Table 1). ... [27-29]

Mean age of 23 asthmatic women was 41.70 ± 7.10years and mean body mass index was 26.70 ± 5.40 kg/m2.. Based on the results of Analysis of Variance, respiratory parameters of FVC and FEV1 increased significantly only in group trained with respiratory muscle strength exercise. In addition, there were statistically significant differences in this group between pretest and posttest results of FVC, FEV1 and PEF respiratory parameters. There was no significant difference between the group trained with respiratory muscle strength exercise and the group trained with special training of respiratory muscles in the respiratory parameters of PEF and FEV1 / FVC (Table 2). Muscle strength and respiratory muscle strength significantly increased in respiratory muscle strength exercise, only. Respiratory muscle strength did not show significant increase in the group with special training of respiratory muscles, but a significant difference was observed between pretest and posttest results in this group. With respect to index of respiratory muscle strength, no significant difference was observed between the group trained by respiratory muscle strength exercise and the group with the special training of respiratory muscles.  

The results of this study showed that respiratory muscle strength exercises significantly improves the parameters of FEV1 and FVC in patients with asthma, and they significantly improve respiratory muscle strength and physical performance. No study was found in the domain of muscle strength exercises with emphasis on strengthening the respiratory muscles in patients with asthma, but studies about the effects of exercises on pulmonary function in asthmatic patients have had mixed results. 10-week exercise program of rehabilitation exercises in the water improves cardiovascular fitness in patients with asthma as well as a significant increase in forced expiratory volume in one second (FEV1) and peak expiratory flow (PEF) in these patients [30]. These results are consistent with the results of the study. 8-week training of respiratory muscle strength exercises, twice a week, also, significantly increased the respiratory parameters of FEV1/FVC and PEF, but in respiratory parameters PEF and FEV1 / FVC no significant improvement was observed in these patients. Progressive combined three-month intermittent running protocol with the frequency of three times a week, every week for 15 to 40 min 40-80% HRMAX submaximal intensity could enhance the significant decrease in respiratory parameters FEV1, PEF, FEV1 / FVC and FVC in obese people with asthma [31]. These results are consistent with the results of this research. The effect of 10 weeks of aerobic training on pulmonary function and physical fitness of patients with asthma and people with no asthma symptoms causes significant improvement in aerobic fitness patients with asthma and people without asthma, and improves pulmonary function (respiratory index MVV) in people with asthma [20]. 12 weeks (three sessions per week of aerobic exercise and one set per week strength exercises) and 12 weeks of exercise in patients with asthma with their own self-management does not make any changes in pulmonary function parameters of these individuals [23]. The results of that study are inconsistent with the results of the current study. The main researches on the use of respiratory muscle training device in patients with asthma show an improvement in the respiratory muscles of these patients. However, most of these studies have not reported any improvement in respiratory function. Implementation of 6-week intensive training of respiratory muscles in patients with asthma will causes: (1) respiratory muscle strength increase and reduction of training fatigue in the muscles and (2) oxygen consumption and dyspnea during exercise decrease [13]. 3-month intensive training of respiratory muscles does not make any change in FEV1 in patients with asthma, but it increases the strength of their respiratory muscles [12]. Specific respiratory muscle training group showed significant improvements in respiratory muscle strength in their post-test data. However, this index showed no significant improvement in the group trained with respiratory muscle strength exercises compared to the group trained with special training of respiratory muscles. In addition, in this exercises, the subjects did not show any significant changes in pulmonary function.

The physicians should teach respiratory muscle strength exercises to the clients with asthma, and recommend it to these patients. The effects of these exercises in reducing the utilization of inhaled sprays in these patients should be studied.

One of the limitations of this study was the lack of control of drugs used by subjects.

The results of this study show the beneficial effects of respiratory muscle strength exercises on the respiratory parameters, muscle strength and respiratory muscle strength in patients with asthma. It shows that special training of respiratory muscles can play an effective role to improve the parameters of respiratory muscles in patients with asthma as well.

The cooperation of Sabzevar University of Medical Sciences is appreciated.

There is no conflict of interest.

All stages are approved by the Research Ethics Committee of Sabzevar University of Medical Sciences.

This study was funded by Research and Technology Deputy, Hakim Sabzevari University.

TABLES and CHARTS

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