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A Safe Inspiratory Threshold Load in Chronic Obstructive Pulmonary Disease Patients


Affiliations
1 Lovely Faculty of Applied Medical Sciences, Lovely Professional University, Phagwara, Punjab, India
2 Department of Physiotherapy, Khalsa College, Amritsar, Punjab, India
3 Discipline of Physiotherapy, Lovely Faculty of Applied Medical Sciences, Lovely Professional University, Phagwara, Punjab, India
     

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Objective: To determine a safe threshold resistive load that induce minimal respiratory muscle damage in clinical measures like maximal inspiratory pressure, delayed onset muscle soreness and plasma creatine kinase following a bout of inspiratory loading exercise in COPD patients.

Material and Method: 30 patients with GOLD stages II and III were selected with random sampling and were divided into Group A, B & C and received inspiratory threshold loading (ITL) at intensities of 70, 50 and 30% maximal inspiratory pressure (MIP) respectively for 30 minutes. Pre and post ITL readings of delayed onset muscle soreness at 0, 4, 24 and 48 hours and maximal inspiratory pressure and plasma creatine kinase at 0, 24 and 48 hours were conducted.

Results: There was a significant difference in VAS and Body chart diagram of delayed onset muscle soreness, MIP and plasma creatine in Group A than C (p < 0.05), with no marked difference between Group A and B (p > 0.05).

Conclusion: Inspiratory threshold loading performed at low intensity loads (


Keywords

COPD (Chronic Obstructive Pulmonary Disease), ITL (Inpiratory Threshold Loading), Plasma Creatine Kinase
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  • Orozco-Levi M. Structure and function of the respiratory muscles in patients with COPD: impairment or adaptation? Eur. Respir. J. 2003;22(Suppl. 46):41–51.
  • Macgowan Nori A, Evans Kenneth G, Road Jeremy D, Reid W. Darlene. Diaphragm Injury in Individuals with Airflow Obstruction. Am. J. Respir. Crit. Care Med. 2001;163:1654–1659.
  • Ramý´rez-Sarmiento Alba, Orozco-Levi M, Guell R, Barreiro E, Hernandez N, Mota S et al. Inspiratory Muscle Training in patients with Chronic Obstructive Pulmonary Disease: Structural Adaptation and Physiologic Outcomes. Am. J. Respir. Crit. Care Med. 2002;166:1491–1497.
  • Mathur Sunita, Sheel AW, Road JD, Reid WD. Delayed Onset Muscle Soreness after Inspiratory Threshold Loading in Healthy Adults. Cardiopulm Phys Ther J 2010;21(1):5-12.
  • Riera Hildegard Sanchez, Rubio TM, Ruiz FO, Ramos PC, Otero DDC, Hernandez TE et al. Inspiratory Muscle Training in Patients with COPD Effect on Dyspnea, Exercise Performance, and Quality of Life. Chest 2001;120:748–756.
  • Nield MA. Inspiratory Muscle Training Protocol Using a Pressure Threshold Device: Effect on Dyspnea in Chronic Obstructive Pulmonary Disease. Arch. Phys. Med. Rehab. 1999;l80:100- 102.
  • Lisboa C, Munoz V, Beroiza T, Leiva A, Cruz E. Inspiratory muscle training in chronic airflow limitation: comparison of two different training loads with a threshold device. Eur. Respir. J. 1994;7:1266–1274.
  • Howell JN, Chleboun Gary, Conatser Robert. Muscle Stiffness, Strength Loss, Swelling and Soreness Following Exercise-Induced Injury in Humans. J of Phys. 1993;464:183-196.
  • Sorichter S, Puschendorf B, Mair J. Skeletal muscle injury induced by eccentric muscle action: muscle proteins as markers of muscle fiber injury. Exerc. Immunol. Rev. 1999;5:5-21.
  • Harik-Khan RI, Wise RA, Fozard JL. Determinants of Maximal Inspiratory Pressure: The Baltimore Longitudinal Study of Aging. Am. J. Respir. Crit. Care Med. 1998;158:1459–1464.
  • Bundey Sarah. Serum creatine kinase levels in pubertal, mature, pregnant, and postmenopausal women. J Med Genet 1979;16:117-121.
  • Miller MR. Standardisation of spirometry. ATS. Eur. Respir. J. 2005;26:319–338.
  • Gosselink R, Wagenaar RC, Decramer Marc. Reliability of a commercially available threshold loading device in healthy subjects and in patients with chronic obstructive pulmonary disease. Thorax 1996;51:601-605.
  • Dannecker EA, O’Connor P, Atchison JW, Robinson ME. The Use of Delayed Onset Muscle Pain as a Clinically Relevant Pain Stimulus: Reliability. Med & Sci Sprts & Ex 2002;34(5):127.
  • Gilbert R, Auchincloss JH, Bleb Sharon. Measurement of maximum inspiratory pressure during routine spirometry. Lung 1979;155(1):23- 32.
  • Orozco-Levi M, Lloreta J, Minguella J, Serrano S, Broquetas JM, Gea J. Injury of the Human Diaphragm Associated with Exertion and Chronic Obstructive Pulmonary Disease. Am. J. Respir. Crit. Care Med. 2001;164:1734–1739.
  • McCully KK, Faulkner JA. Characteristics of lengthening contractions associated with injury to skeletal muscle fibers. J. Appl. Physiol. 1986;61:293-299.
  • Warren GL, Hayes DA, Lowe DA, Armstrong RB. Mechanical factors in the initiation of eccentric contraction- induced injury in rat soleus muscle. J. Physiol. 1993;464:457-475.
  • Proske U, Morgan DL. Muscle damage from eccentric exercise: mechanism, mechanical signs, adaptation and clinical applications. J. Physiol. 2001;537:333-345.
  • Mador MJ, Rodis A, Magalang UJ, Ameen K. Comparison of cervical magnetic and transcutaneous phrenic nerve stimulation before and after threshold loading. Am. J. Respir. Crit. Care Med. 1996;154:448-453.
  • St. Croix CM, Morgan BJ, Wetter TJ, Dempsey JA. Fatiguing inspiratory muscle work causes reflex sympathetic activation in humans. J. Physiol. 2000;529(Pt. 2):493-504.
  • Eastwood PR, Hillman DR, Finucane KE. Ventilatory responses to inspiratory threshold loading and role of muscle fatigue in task failure. J. Appl. Physiol. 1994;76:185-195.
  • Byrnes WC, Clarkson PM, White JS, Hsieh SS, Frykman PN, Maughan RJ. Delayed onset muscle soreness following repeated bouts of downhill running. J. Appl. Physiol. 1985;59:710-715.
  • Schwane, JA, Johnson SR, Vandenakker CB, Armstrong RB. Delayed onset muscular soreness and plasma CPK and LDH activities after downhill running. Med. Sci. Sports. Exerc. 1983;15(1):1551-1556.

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  • A Safe Inspiratory Threshold Load in Chronic Obstructive Pulmonary Disease Patients

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Authors

Shylla Ibakordor
Lovely Faculty of Applied Medical Sciences, Lovely Professional University, Phagwara, Punjab, India
Davinder K. Dhillon
Department of Physiotherapy, Khalsa College, Amritsar, Punjab, India
S. Saravanan
Discipline of Physiotherapy, Lovely Faculty of Applied Medical Sciences, Lovely Professional University, Phagwara, Punjab, India

Abstract


Objective: To determine a safe threshold resistive load that induce minimal respiratory muscle damage in clinical measures like maximal inspiratory pressure, delayed onset muscle soreness and plasma creatine kinase following a bout of inspiratory loading exercise in COPD patients.

Material and Method: 30 patients with GOLD stages II and III were selected with random sampling and were divided into Group A, B & C and received inspiratory threshold loading (ITL) at intensities of 70, 50 and 30% maximal inspiratory pressure (MIP) respectively for 30 minutes. Pre and post ITL readings of delayed onset muscle soreness at 0, 4, 24 and 48 hours and maximal inspiratory pressure and plasma creatine kinase at 0, 24 and 48 hours were conducted.

Results: There was a significant difference in VAS and Body chart diagram of delayed onset muscle soreness, MIP and plasma creatine in Group A than C (p < 0.05), with no marked difference between Group A and B (p > 0.05).

Conclusion: Inspiratory threshold loading performed at low intensity loads (


Keywords


COPD (Chronic Obstructive Pulmonary Disease), ITL (Inpiratory Threshold Loading), Plasma Creatine Kinase

References