The purpose of this review article is to identify exercise prescription components (EPCs) used and results obtained during previous respiratory muscle training studies. The need for further scientific inquiry pertaining to this topic is discussed. Respiratory skeletal muscles have proven responsive to basic training principles for improving strength and/or endurance in persons having normal health, cystic fibrosis, chronic obstructive pulmonary disease, and quadriplegia, and in persons being weaned from ventilators. The ingredients for successful training are unclear because of interstudy variations in the EPCs of frequency, intensity, and duration of a training session; level of subject supervision; training mode; length of training period; and in the initial level of fitness, the age, the gender, and the disease states of the persons to be trained. A self-selected breathing rate was a common factor in all studies cited. By the selective manipulation of each EPC in a series of future, controlled investigations, the guidelines for safe, reproducible, affordable, tolerable, and effective respiratory muscle training prescriptions could be generated. (Respir Care 1985;30:34-42.)
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References
1.
LuceJM, CulverBH. Respiratory muscle function in health and disease. Chest1982;81:82–89.
RochesterDF, BraunNMT. The respiratory muscles. Basics of RD1978;6:1–6.
4.
TenneySM, ReeseRE. The ability to sustain great breathing efforts. Respir Physiol1968;5:187–201.
5.
OtisAB. The work of breathing. Physiol Rev1954;34:449–458.
6.
BraunNMT, RochesterDF. Respiratory muscle function in chronic obstructive pulmonary disease (abstract). Am Rev Respir Dis1977;115:91.
7.
RochesterDF, EnsonY.Current concepts in the pathogenesis of the obesity-hypoventilation syndrome: Mechanical and circulatory factors. Am J Med1974;57:402–420.
8.
MacklemPT. Respiratory muscles: The vital pump. Chest1980;78:753–758.
9.
LeithDE, BradleyM.Ventilatory muscle strength and endurance training. J Appl Physiol1976;41:508–516.
10.
DerenneJPH, MacklemPT, RoussosCH. The respiratory muscles: Mechanics, Control, and Pathophysiology. Part III. Am Rev Respir Dis1978;118:373–390.
11.
GollnickPD, SembrowichWL. Adaptations in human skeletal muscles as a result of training. In: AmsterdamEA, WilmoreJH, DeMariaAn, eds Exercise in cardiovascular health and disease. New York: York Medical Books, 1977:70–94.
12.
KeensTG, ChenV, PatelP, O'BrienP, LevisonH, IanuzzoCD. Cellular adaptation of the diaphragm in response to chronic respiratory overload in rats. J Appl Physiol1978;44:905–908.
13.
LiebermanDA, FaulknerJA, CraigAB, MaxwellLC. Performance and histochemical composition of guinea pig and human diaphragm. J Appl Physiol1973;34:233–237.
14.
HolloszyJO. Biochemical adaptation in muscle. J Biol Chem1967;242:2278–2286.
15.
KeensTG, KrastinsIRB, WannamakerEM, LevisonH, CrozierDN, BryanAC. Ventilatory muscle endurance training in normal subjects and patients with cystic fibrosis. Am Rev Respir Dis1977;116:853–860.
16.
RoussosCS, MacklemPT. Diaphragmatic fatigue in man. J Appl Physiol1977;43:189–197.
17.
RoussosCS, FixleyM, GrossD, MacklemPT. Fatigue of inspiratory muscles and their synergic behavior. J Appl Physiol1979;46:897–904.
18.
BelmanMJ. Ventilatory muscle training in the pulmonary patient. Respir Ther1983;23:23–35.
19.
AshutoshK, GilbertR, AuchinclossH, PeppiD.Asynchronous breathing movements in patients with chronic obstructive pulmonary disease. Chest1975;5:553–557.
20.
SharpJT, GoldbergNB, DruzWS, FishmanHC, DanonJ.Thoracoabdominal motion in chronic obstructive pulmonary disease. Am Rev Respir Dis1977;115:47–56.
21.
RochesterDF, BraunNMT, AroraNS. Respiratory muscle strength in chronic obstructive pulmonary disease. Am Rev Respir Dis1979;119:151–154.
22.
GrossD, LaddHW, RileyEJ, MacklemPT, GrassinoA.The effect of training on strength and endurance of the diaphragm in quadriplegia. Am J Med1980;68:27–35.
23.
PeressL, McCleanP, WoolfC, ZamelN.Respiratory muscle training in severe chronic obstructive pulmonary disease. Am Rev Respir Dis1979;119:157.
24.
BelmanMJ, MittmanC.Ventilatory muscle training improves exercise capacity in chronic obstructive pulmonary disease patients. Am Rev Respir Dis1980;121:273–280.
25.
AndersenJB, DragstedL, KannT, . Resistive breathing training in severe chronic obstructive pulmonary disease: A pilot study. Scand J Respir Dis1979;60:151–156.
26.
PardyRL, RivingtonRN, DespasPJ, MacklemPT. The effects of inspiratory muscle training on exercise performance in chronic airflow limitation. Am Rev Respir Dis1981;123:426–433.
27.
SonneLJ, DavisJA. Increased exercise performance in patients with severe COPD following inspiratory resistive training. Chest1982;81:436–439.
28.
BelmanMJ. Respiratory failure treated by ventilatory muscle training (VMT). A report of two cases. Eur J Respir Dis1981;62:391–395.
29.
PollockML. How much exercise is enough?Phys Sports Med1978;6:6–9.
30.
DoddDS, BrancatisanoT, EngelLA. Chest wall mechanics during exercise in patients with severe chronic air-flow obstruction. Am Rev Respir Dis1984;129:33–38.
31.
FantaCH, LeithDE, CrownR.Maximal shortening of inspiratory muscles: Effect of training. J Appl Physiol1983;54:1618–1623.
32.
SharpJT, DruzWS, MoisanT, FosterJ, MachnachW.Postural relief of dyspnea in severe chronic obstructive pulmonary disease. Am Rev Respir Dis1980;122:201–211.
33.
Medicare Program. Prospective payments for Medicare inpatient hospital service: Interim final rule. Federal Register1983;48:171.
