PDF herunterladen
Semin Speech Lang 2011; 32(1): 021-030
DOI: 10.1055/s-0031-1271972
© Thieme Medical Publishers

Respiratory Strength Training: Concept and Intervention Outcomes

Christine Sapienza1 , Michelle Troche1 , Teresa Pitts2 , Paul Davenport2
  • 1Department of Speech Language and Hearing Sciences, Brain Rehabilitation Research Center, Malcom Randall VA, University of Florida, Gainesville, Florida
  • 2Department of Physiological Sciences, University of Florida, Gainesville, Florida
Weitere Informationen

Publikationsverlauf

Publikationsdatum:
13. April 2011 (online)

Auch verfügbar auf
    Lizenzen und Reprints

ABSTRACT

Respiratory muscle strength training (RMST) focuses on increasing the force-generating capacity of the inspiratory and expiratory muscles. The choice of respiratory muscles that are targeted using RMST depends on the outcome desired. For example, if an individual has reduced inspiratory muscle strength due to a neurogenic injury and is unable to ventilate the lungs, then inspiratory muscle strength training may be the chosen rehabilitation target. On the other hand, if a professional voice user is complaining of difficulty generating adequate vocal loudness during song production and is suffering from laryngeal dysfunction, then an expiratory muscle strength training paradigm may be the chosen rehabilitation target. Our most recent work with RMST has focused on increasing expiratory muscle force generation for those with Parkinson's disease who have difficulty with breathing, swallowing, and cough production. This difficulty typically worsens as the disease progresses. Highlights of these outcomes are summarized in this article.

KEYWORDS

Respiratory - strength - training

REFERENCES

  • 1 McConnell A K, Romer L M. Respiratory muscle training in healthy humans: resolving the controversy.  Int J Sports Med. 2004;  25 (4) 284-293
    Thieme ConnectPubMedSuche in Google Scholar
  • 2 Baker S, Davenport P, Sapienza C. Examination of strength training and detraining effects in expiratory muscles.  J Speech Lang Hear Res. 2005;  48 (6) 1325-1333
    CrossrefPubMedSuche in Google Scholar
  • 3 Burkhead L M, Sapienza C M, Rosenbek J C. Strength-training exercise in dysphagia rehabilitation: principles, procedures, and directions for future research.  Dysphagia. 2007;  22 (3) 251-265
    CrossrefPubMedSuche in Google Scholar
  • 4 Carpinelli R N, Otto R M. Strength training. Single versus multiple sets.  Sports Med. 1998;  26 (2) 73-84
    CrossrefPubMedSuche in Google Scholar
  • 5 Chiara T, Martin A D, Davenport P W, Bolser D C. Expiratory muscle strength training in persons with multiple sclerosis having mild to moderate disability: effect on maximal expiratory pressure, pulmonary function, and maximal voluntary cough.  Arch Phys Med Rehabil. 2006;  87 (4) 468-473
    CrossrefPubMedSuche in Google Scholar
  • 6 Chiara T, Martin D, Sapienza C. Expiratory muscle strength training: speech production outcomes in patients with multiple sclerosis.  Neurorehabil Neural Repair. 2007;  21 (3) 239-249
    CrossrefPubMedSuche in Google Scholar
  • 7 Kim J, Sapienza C M. Implications of expiratory muscle strength training for rehabilitation of the elderly: tutorial.  J Rehabil Res Dev. 2005;  42 (2) 211-224
    CrossrefPubMedSuche in Google Scholar
  • 8 Kraemer W J. A series of studies—the physiological basis for strength training in American football: fact over philosophy.  J Strength Cond Res. 1997;  11 (3) 131-142
    CrossrefPubMedSuche in Google Scholar
  • 9 Pitts T, Bolser D, Rosenbek J, Troche M, Okun M S, Sapienza C. Impact of expiratory muscle strength training on voluntary cough and swallow function in Parkinson disease.  Chest. 2009;  135 (5) 1301-1308
    CrossrefPubMedSuche in Google Scholar
  • 10 Saleem A, Sapienza C, Rosenbek J, Musson N, Okun M. The effects of expiratory muscle strength training program on pharyngeal swallowing in patients with idiopathic Parkinson's disease. Presented at: the 9th International Congress of Parkinson's Disease and Movement Disorders; March 5–8, 2005; New Orleans, LA
  • 11 Saleem A F, Sapienza C, Rosenbek J, Musson N, Okun M. The effects of expiratory muscle strength training program on pharyngeal swallowing in patients with idiopathic Parkinson's disease. Presented at: the 57th Annual Meeting of the American Academy of Neurology; 2005; Miami, FL
  • 12 Saleem A F, Sapienza C M, Okun M S. Respiratory muscle strength training: treatment and response duration in a patient with early idiopathic Parkinson's disease.  NeuroRehabilitation. 2005;  20 (4) 323-333
    PubMedSuche in Google Scholar
  • 13 Sapienza C. Strength training implications for swallowing. Paper presented at: Pre-ASHA seminar; November 18–20, 2004; Philadelphia, PA
  • 14 Sapienza C M, Davenport P W, Martin A D. Expiratory muscle training increases pressure support in high school band students.  J Voice. 2002;  16 (4) 495-501
    CrossrefPubMedSuche in Google Scholar
  • 15 Sapienza C M, Wheeler K. Respiratory muscle strength training: functional outcomes versus plasticity.  Semin Speech Lang. 2006;  27 (4) 236-244
    Thieme ConnectPubMedSuche in Google Scholar
  • 16 Schlumberger A, Stec J, Schmidtbleicher D. Single- vs. multiple-set strength training in women.  J Strength Cond Res. 2001;  15 (3) 284-289
    PubMedSuche in Google Scholar
  • 17 Troche M S, Okun M S, Rosenbek J C et al.. Aspiration and swallowing in Parkinson's disease and rehabilitation with EMST: the ASPIRE study.  Neurology. 2010;  75 (21) 1912-1919
    CrossrefPubMedSuche in Google Scholar
  • 18 Kim Y, McCullough G H. Maximum hyoid displacement in normal swallowing.  Dysphagia. 2008;  23 (3) 274-279
    CrossrefPubMedSuche in Google Scholar
  • 19 Otto R M, Carpinelli R N. A critical analysis of the single versus multiple set debate.  JEP Online.. 2006;  9 (1) 32-57
    PubMedSuche in Google Scholar
  • 20 Rhea M R, Alvar B A, Burkett L N. Single versus multiple sets for strength: a meta-analysis to address the controversy.  Res Q Exerc Sport. 2002;  73 (4) 485-488
    CrossrefPubMedSuche in Google Scholar
  • 21 Wheeler K M, Chiara T, Sapienza C M. Surface electromyographic activity of the submental muscles during swallow and expiratory pressure threshold training tasks.  Dysphagia. 2007;  22 (2) 108-116
    CrossrefPubMedSuche in Google Scholar
  • 22 Wheeler K, Troche M S, Rosenbek J C, Sapienza C. Physiologic aspects of swallow function in patients with idiopathic Parkinson's disease with and without penetration and/or aspiration. Paper presented at: Dysphagia Research Symposium; March 5–8, 2008; Charleston, SC
  • 23 Hewitt A, Hind J, Kays S et al. Standardized instrument for lingual pressure measurement.  Dysphagia. 2008;  23 (1) 16-25
    CrossrefPubMedSuche in Google Scholar
  • 24 Clark H M, O'Brien K, Calleja A, Corrie S N. Effects of directional exercise on lingual strength.  J Speech Lang Hear Res. 2009;  52 (4) 1034-1047
    CrossrefPubMedSuche in Google Scholar
  • 25 Lazarus C. Tongue strength and exercise in healthy individuals and in head and neck cancer patients.  Semin Speech Lang. 2006;  27 (4) 260-267
    Thieme ConnectPubMedSuche in Google Scholar
  • 26 Henwood T R, Taaffe D R. Detraining and retraining in older adults following long-term muscle power or muscle strength specific training.  J Gerontol A Biol Sci Med Sci. 2008;  63 (7) 751-758
    CrossrefPubMedSuche in Google Scholar
  • 27 Cheah B C, Boland R A, Brodaty N E et al. INSPIRATIonAL—INSPIRAtory muscle training in amyotrophic lateral sclerosis.  Amyotroph Lateral Scler. 2009;  10 (5-6) 384-392
    CrossrefPubMedSuche in Google Scholar
  • 28 Sabaté M, González I, Ruperez F, Rodríguez M. Obstructive and restrictive pulmonary dysfunctions in Parkinson's disease.  J Neurol Sci. 1996;  138 (1-2) 114-119
    CrossrefPubMedSuche in Google Scholar
  • 29 Sathyaprabha T N, Kapavarapu P K, Pall P K, Thennarasu K, Raju T R. Pulmonary functions in Parkinson's disease.  Indian J Chest Dis Allied Sci. 2005;  47 (4) 251-257
    PubMedSuche in Google Scholar
  • 30 Shill H, Stacy M. Respiratory function in Parkinson's disease.  Clin Neurosci. 1998;  5 (2) 131-135
    PubMedSuche in Google Scholar
  • 31 de Bruin P F, de Bruin V M, Lees A J, Pride N B. Effects of treatment on airway dynamics and respiratory muscle strength in Parkinson's disease.  Am Rev Respir Dis. 1993;  148 (6 Pt 1) 1576-1580
    CrossrefPubMedSuche in Google Scholar
  • 32 Zec R F, Landreth E S, Fritz S et al. A comparison of phonemic, semantic, and alternating word fluency in Parkinson's disease.  Arch Clin Neuropsychol. 1999;  14 (3) 255-264
    PubMedSuche in Google Scholar
  • 33 Tzelepis G E, McCool F D, Friedman J H, Hoppin Jr FG. Respiratory muscle dysfunction in Parkinson's disease.  Am Rev Respir Dis. 1988;  138 (2) 266-271
    PubMedSuche in Google Scholar
  • 34 Hovestadt A, Bogaard J M, Meerwaldt J D, van der Meché F G, Stigt J. Pulmonary function in Parkinson's disease.  J Neurol Neurosurg Psychiatry. 1989;  52 (3) 329-333
    CrossrefPubMedSuche in Google Scholar
  • 35 Bogaard J M, Hovestadt A, Meerwaldt J, vd Meché F G, Stigt J. Maximal expiratory and inspiratory flow-volume curves in Parkinson's disease.  Am Rev Respir Dis. 1989;  139 (3) 610-614
    PubMedSuche in Google Scholar
  • 36 Hoehn M M, Yahr M D. Parkinsonism: onset, progression and mortality.  Neurology. 1967;  17 (5) 427-442
    CrossrefPubMedSuche in Google Scholar
  • 37 Folstein M F, Folstein S E, McHugh P R. “Mini-mental state.” A practical method for grading the cognitive state of patients for the clinician.  J Psychiatr Res. 1975;  12 (3) 189-198
    CrossrefPubMedSuche in Google Scholar
  • 38 Rosenbek J C, Robbins J A, Roecker E B, Coyle J L, Wood J L. A penetration-aspiration scale.  Dysphagia. 1996;  11 (2) 93-98
    Suche in Google Scholar
  • 39 Troche M S, Sapienza C M, Rosenbek J C. Effects of bolus consistency on timing and safety of swallow in patients with Parkinson's disease.  Dysphagia. 2008;  23 (1) 26-32
    CrossrefPubMedSuche in Google Scholar
  • 40 Ebihara S, Saito H, Kanda A et al. Impaired efficacy of cough in patients with Parkinson disease.  Chest. 2003;  124 (3) 1009-1015
    CrossrefPubMedSuche in Google Scholar
  • 41 Fernandez H H, Lapane K L. Predictors of mortality among nursing home residents with a diagnosis of Parkinson's disease.  Med Sci Monit. 2002;  8 (4) CR241-CR246
    PubMedSuche in Google Scholar
  • 42 Bolser D C, Poliacek I, Jakus J, Fuller D D, Davenport P W. Neurogenesis of cough, other airway defensive behaviors and breathing: a holarchical system?.  Respir Physiol Neurobiol. 2006;  152 (3) 255-265
    CrossrefPubMedSuche in Google Scholar
  • 43 Chung K F, Bolser D, Davenport P, Fontana G, Morice A, Widdicombe J. Semantics and types of cough.  Pulm Pharmacol Ther. 2009;  22 (2) 139-142
    CrossrefPubMedSuche in Google Scholar
  • 44 Fontana G, Widdicombe J. Physiological down-regulation of cough.  Pulm Pharmacol Ther. 2004;  17 (6) 465-468
    CrossrefPubMedSuche in Google Scholar
  • 45 Fontana G A, Lavorini F. Cough motor mechanisms.  Respir Physiol Neurobiol. 2006;  152 (3) 266-281
    CrossrefPubMedSuche in Google Scholar
  • 46 McCool F D, Leith D E. Pathophysiology of cough.  Clin Chest Med. 1987;  8 (2) 189-195
    PubMedSuche in Google Scholar
  • 47 Fontana G A, Pantaleo T, Lavorini F, Benvenuti F, Gangemi S. Defective motor control of coughing in Parkinson's disease.  Am J Respir Crit Care Med. 1998;  158 (2) 458-464
    CrossrefPubMedSuche in Google Scholar
  • 48 Smith Hammond C A, Goldstein L B, Horner R D et al. Predicting aspiration in patients with ischemic stroke: comparison of clinical signs and aerodynamic measures of voluntary cough.  Chest. 2009;  135 (3) 769-777
    CrossrefPubMedSuche in Google Scholar
  • 49 Smith Hammond C A, Goldstein L B, Zajac D J, Gray L, Davenport P W, Bolser D C. Assessment of aspiration risk in stroke patients with quantification of voluntary cough.  Neurology. 2001;  56 (4) 502-506
    PubMedSuche in Google Scholar

Christine SapienzaPh.D. CCC-SLP 

P.O. Box 117420, Department of Speech Language and Hearing Sciences

University of Florida, Gainesville, FL 32611

eMail: sapienza@ufl.edu