Effects of Inspiratory Muscle Training and Yoga Breathing Exercises on Respiratory Muscle Function in Institutionalized Frail Older Adults: A Randomized Controlled Trial

1Department of Physiotherapy, University of Valencia, Valencia, Spain 2Cardiopulmonary Rehabilitation Service, University Hospital "La Fe," Valencia, Spain 3Physical Therapy Department, East Tennessee State University, Johnson City, Tenessee, USA 4Musculoskeletal Rehabilitation Service, Clinic University Hospital Valencia, Spain 5Department of Behavioral Sciences Methodology, University of Valencia, Valencia, Spain.
Journal of geriatric physical therapy (2001) 07/2013; 37(2). DOI: 10.1519/JPT.0b013e31829938bb
Source: PubMed

ABSTRACT

In the older adults, the respiratory function may be seriously compromised when a marked decrease of respiratory muscle (RM) strength coexists with comorbidity and activity limitation. Respiratory muscle training has been widely studied and recommended as a treatment option for people who are unable to participate in whole-body exercise training (WBET); however, the effects of inspiratory muscle training and yoga breathing exercises on RM function remain unknown, specifically in impaired older adults.
To evaluate the effects of inspiratory threshold training (ITT) and yoga respiratory training (YRT) on RM function in institutionalized frail older adults.
Eighty-one residents (90% women; mean age, 85 years), who were unable to perform WBET (inability to independently walk more than 10 m), were randomly assigned to a control group or one of the 2 experimental groups (ITT or YRT). Experimental groups performed a supervised interval-based training protocol, either through threshold inspiratory muscle training device or yoga breathing exercises, which lasted 6 weeks (5 days per week). Outcome measures were collected at 4 time points (pretraining, intermediate, posttraining, and follow-up) and included the maximum respiratory pressures (maximum inspiratory pressure [MIP] and maximum expiratory pressure [MEP]) and the maximum voluntary ventilation (MVV).
Seventy-one residents completed the study: control (n = 24); ITT (n = 23); YRT (n = 24). The treatment on had a significant effect on MIP YRT (F6,204 = 6.755, P < .001, η = 0.166), MEP (F6,204 = 4.257, P < .001, η = 0.111), and MVV (F6,204 = 5.322, P < .001, η = 0.135). Analyses showed that the YRT group had a greater increase of RM strength (MIP and MEP) and endurance (MVV) than control and/or ITT groups.
Yoga respiratory training appears as an effective and well-tolerated exercise regimen in frail older adults and may therefore be a useful alternative to ITT or no training, to improve RM function in older population, when WBET is not possible.

Download full-text

Full-text

Available from: David Arnall, Oct 12, 2015
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The purpose of this study was to verify, in elderly women, the effects of Yoga on bone biochemical markers (BBM) of formation (osteocalcin) and absorption (carboxy-terminal collagen crosslinks, CTX), and estradiol hormone. Forty eight post-menopausal women (63,9 ± 5,6 years old) were divided into two groups: Yoga Group (YG, n = 24) and Control Group (CG, n = 24). The YG performed yoga three times per week (one hour each session) for six months, while the CG was instructed to do not alter their habitual daily routine. Bone mineral density (BMD), BBM and estradiol hormone were analyzed before and after Yoga program by standard procedures. A mixed factorial ANOVA was performed to verify intra and inter group differences. A significant decrease in spinal lumbar and total hip BMD for the CG was observed while only spinal lumbar BMD decreased in the YG. Osteocalcin values increased in YG and decreased in CG, while CTX values decreased in both groups. No significant differences were observed for the estradiol hormone. It was concluded that the yoga intervention failed to induce significant improvements in post-menopausal women BMD, however, it was capable of enhancing biochemical marker of bone formation as measured by serum osteocalcin, thus suggesting an increased bone turnover.
    Full-text · Article · Aug 2010 · Journal of Exercise Physiology Online
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Background A growing number of randomized controlled trials (RCTs) have investigated the therapeutic value of yoga interventions. This bibliometric analysis aimed to provide a comprehensive review of the characteristics of the totality of available randomized yoga trials. Methods All RCTs of yoga were eligible. Medline/PubMed, Scopus, the Cochrane Library, IndMED, and the tables of content of yoga specialty journals not listed in medical databases were screened through February 2014. Bibliometric data, data on participants, and intervention were extracted and analyzed descriptively. Results Published between 1975 and 2014, a total of 366 papers were included, reporting 312 RCTs from 23 different countries with 22,548 participants. The median study sample size was 59 (range 8–410, interquartile range = 31, 93). Two hundred sixty-four RCTs (84.6%) were conducted with adults, 105 (33.7%) with older adults and 31 (9.9%) with children. Eighty-four RCTs (26.9%) were conducted with healthy participants. Other trials enrolled patients with one of 63 varied medical conditions; the most common being breast cancer (17 RCTs, 5.4%), depression (14 RCTs, 4.5%), asthma (14 RCTs, 4.5%) and type 2 diabetes mellitus (13 RCTs, 4.2%). Whilst 119 RCTs (38.1%) did not define the style of yoga used, 35 RCTs (11.2%) used Hatha yoga and 30 RCTs (9.6%) yoga breathing. The remaining 128 RCTs (41.0%) used 46 varied yoga styles, with a median intervention length of 9 weeks (range 1 day to 1 year; interquartile range = 5, 12). Two hundred and forty-four RCTs (78.2%) used yoga postures, 232 RCTs (74.4%) used breath control, 153 RCTs (49.0%) used meditation and 32 RCTs (10.3%) used philosophy lectures. One hundred and seventy-four RCTs (55.6%) compared yoga with no specific treatment; 21 varied control interventions were used in the remaining RCTs. Conclusions This bibliometric analysis presents the most complete up-to-date overview on published randomized yoga trials. While the available research evidence is sparse for most conditions, there was a marked increase in published RCTs in recent years.
    Full-text · Article · Sep 2014 · BMC Complementary and Alternative Medicine
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Aging produces several respiratory limitations and reduces tolerance to physical efforts, sometimes leading to pulmonary diseases in the elderly. The literature draws attention to the possible benefits of Yoga practice among the elderly, presenting evidence for significant improvements in quality of life. It was hypothesized that yoga practice can improve respiratory function in the elderly. The effects of a yoga program on pulmonary volumes and respiratory muscle strength were verified in 36 elderly women divided into a yoga group [YG] (63.1 ± 13.3 years of age) and a control group (61.0 ± 6.9 years of age). Maximal inspiratory and expiratory pressure (MIP and MEP) were assessed by a manovacuometer and tidal volume (VT), vital capacity (VC) and minute ventilation (VE) were measured by a ventilometer. The program comprised 65 min sessions, 3 times/week during 12 weeks. The heart rate and respiratory rate decreased significantly in the YG (76-39 ± 8-03 vs. 74-61±10.26 bpm and 18.61 ± 3.15 vs. 16.72 ± 3.12 resp/min, respectively). In the YG, VT and VE increased significantly (0.55 ± 0.22 vs. 0.64 ± 0.2 ml and 9.19 ± 2.39 vs. 10.05 ± 2.11 ml, respectively), as well as VC (1.48 ± 0.45 vs. 2.03 ± 0.72 ml). Improvements were also found in MIP and MEP in the YG (62.17 ± 14.77 vs. 73.06 ± 20.16 cmH2O and 80.56 ± 23.94 vs. 86.39 ± 20.16 cmH2O, respectively). It was concluded that a 12-week yoga program significantly improves pulmonary function of aged women
    Full-text · Article · Nov 2014 · Journal of Human Kinetics
Show more