Authors: Reyes A, Castillo A, Castillo J, Cornejo I
Title: The effects of respiratory muscle training on peak cough flow in patients with Parkinson’s disease: a randomized controlled study
Source: Clinical Rehabilitation 2018 32(10): 1317-1327
Year: 2018
Research Design: Randomised Controlled Trial
Rating Score: 05/10
This rating is confirmed
Eligibility specified - N
Random allocation - Y
Concealed allocation - Y
Baseline comparability - Y
Blind subjects - N
Blind therapists - N
Blind assessors - N
Adequate follow-up - N
Intention-to-treat analysis - N
Between-group comparisons - Y
Point estimates and variability - Y

Objective: To compare the effects of an inspiratory versus and expiratory muscle-training program on voluntary and reflex peak cough flow in patients with Parkinson disease. Design: A randomized controlled study. Setting: Home-based training program. Participants: In all, 40 participants with diagnosis of Parkinson’s disease were initially recruited in the study and randomly allocated to three study groups. Of them, 31 participants completed the study protocol (control group, n = 10; inspiratory training group, n = 11; and expiratory training group, n = 10) Intervention: The inspiratory and expiratory group performed a home-based inspiratory and expiratory muscle-training program, respectively (five sets of five repetitions). Both groups trained six times a week for two months using a progressively increased resistance. The control group performed expiratory muscle training using the same protocol and a fixed resistance. Main measures: Spirometric indices, maximum inspiratory pressure, maximum expiratory pressure, and peak cough flow during voluntary and reflex cough were assessed before and at two months after training. Results: The magnitude of increase in maximum expiratory pressure (d = 1.40) and voluntary peak cough flow (d = 0.89) was greater for the expiratory muscle-training group in comparison to the control group. Reflex peak cough flow had a moderate effect (d = 0.27) in the expiratory group in comparison to the control group. Slow vital capacity (d = 0.13) and forced vital capacity (d = 0.02) had trivial effects in the expiratory versus the control group. Conclusions: Two months of expiratory muscle-training program was more beneficial than inspiratory muscle-training program for improving maximum expiratory pressure and voluntary peak cough flow in patients with Parkinson’s disease.

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