Effects of inspiratory muscle training on postural stability, pulmonary function and functional capacity in children with cystic fibrosis: A randomised controlled trial

Abstract

Background: Previous research has found conflictive results regarding the benefits of inspiratory muscle training (IMT) for cystic fibrosis (CF) patients. Also, involvement of postural stability is a rising concern in chronic lung diseases but its role in CF patients is poorly understood. Our aim was to investigate the effects of IMT in CF patients as well as analysing the factors which may be related to postural stability.

Methods: Thirty-six children aged between 8 and 18 years with CF were randomly allocated to either "comprehensive chest PT" group (PT) or "IMT alongside comprehensive chest PT" group (PT+IMT). Both groups trained for 8 weeks. Dynamic and static postural stability tests on Biodex Balance system^®, spirometry, respiratory muscle strength and 6-min walk distance (6MWD) was assessed at baseline and after 8 weeks of training. Determinants of postural stability was also analysed on baseline values.

Results: Maximum expiratory pressure (MEP) was found to be an independent predictor for overall limits of stability (LOS) score explaining %26 of variance (R = 0.514, p = 0.003). Overall LOS score, FVC, FEV₁, peak expiratory flow, MEP and 6MWD significantly improved in both groups, with no significant differences between groups. Maximum inspiratory pressure (MIP) also improved in both groups but the magnitude of improvement in MIP was greater in PT+IMT group (38 cmH₂O vs 13 cmH₂O; p < 0.001).

Conclusions: Combining IMT with chest PT failed to provide further improvements, except for MIP, suggesting that a comprehensive chest PT program may be individually effective in improving overall LOS score, spirometry, respiratory muscle strength and 6MWD.

Trial registration: www.ClinicalTrials.gov; registration number: NCT03375684.

Keywords: Cystic fibrosis; Inspiratory muscle training; Pediatric chest diseases; Postural stability; Pulmonary rehabilitation.