The effects of 8 weeks of inspiratory muscle training on the balance of healthy older adults: a randomized, double-blind, placebo-controlled study

Francesco V Ferraro, James P Gavin, Tom Wainwright, Alison McConnell, Francesco V Ferraro, James P Gavin, Tom Wainwright, Alison McConnell

Abstract

To examine the effects of 8-week unsupervised, home-based inspiratory muscle training (IMT) on the balance and physical performance of healthy older adults. Fifty-nine participants (74 ± 6 years) were assigned randomly in a double-blinded fashion to either IMT or sham-IMT, using a pressure threshold loading device. The IMT group performed 30-breath twice daily at ~50% of maximal inspiratory pressure (MIP). The sham-IMT group performed 60-breaths once daily at ~15% MIP; training was home-based and unsupervised, with adherence self-reported through training diaries. Respiratory outcomes were assessed pre- and postintervention, including forced vital capacity, forced expiratory volume, peak inspiratory flow rate (PIFR), MIP, and inspiratory peak power. Balance and physical performance outcomes were measured using the shortened version of the Balance Evaluation System test (mini-BEST), Biodex® postural stability test, timed up and go, five sit-to-stand, isometric "sit-up" and Biering-Sørensen tests. Between-group effects were examined using two-way repeated measures ANOVA, with Bonferroni correction. After 8-week, the IMT group demonstrated greater improvements (P ≤ 0.05) in: PIFR (IMT = 0.9 ± 0.3 L sec-1 ; sham-IMT = 0.3 L sec-1 ); mini-BEST (IMT = 3.7 ± 1.3; sham-IMT = 0.5 ± 0.9) and Biering-Sørensen (IMT = 62.9 ± 6.4 sec; sham-IMT = 24.3 ± 1.4 sec) tests. The authors concluded that twice daily unsupervised, home-based IMT is feasible and enhances inspiratory muscle function and balance for community-dwelling older adults.

Keywords: Breathing exercise; falls prevention; frail elderly; mini-BEST; postural balance.

Conflict of interest statement

This work was sponsored by Bournemouth University. FF, JG and TW declare no conflicts of interests. AM acknowledges a previous (now expired) beneficial interest in POWERbreathe® inspiratory muscle trainers in the form of a share of royalty income to the University of Birmingham and a potential share of royalty income to Brunel University. In the past, AM has also provided consultancy services to POWERbreathe® International Ltd., but no longer does so. AM is named on two patents relating to POWERbreathe® products, including the device used in the present study, as well as being the author of two books on inspiratory muscle training.

© 2019 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of The Physiological Society and the American Physiological Society.

Figures

Figure 1
Figure 1
PRISMA flow diagram displaying participant pathways through the study. IMT = inspiratory muscle training.
Figure 2
Figure 2
(A) Peak inspiratory power (Watts) versus inspiratory load pressure PI (cmH2O). (B) Inspiratory flow rate VI (L sec−1) versus Inspiratory mouth pressure PI (cmH2O). (C) Peak inspiratory power (Watts) versus inspiratory flow rate VI (L sec−1). Before (■) and after () 8 weeks of inspiratory muscle training (IMT) and sham‐IMT. Data are represented in both axes as mean ± percentage error.

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