Comparison study of chest physiotherapy home training programmes on respiratory functions in patients with muscular dystrophy

Objective: To compare the effects of home training programmes, threshold inspiratory muscle training and breathing exercise on spirometry and maximal pressures in patients with muscular dystrophy. Design: Prospective blinded 12-week study. Settings: Cardiopulmonary department of university hospital. Subjects: Twenty-three patients with muscular dystrophy (17 patients with limb girdle muscular dystrophy and 6 patients with Becker muscular dystrophy) assigned to the threshold inspiratory muscle training and breathing exercise groups with alternate allocation. Methods: Spirometry, maximal inspiratory pressure (PImax) and maximal expiratory pressure (PE max) were measured before and after training. In the threshold inspiratory muscle training group threshold pressure load was determined as equal to 30% of weekly PImax measurement. In the breathing exercise group, patients performed deep and forceful diaphragmatic and segmental exercises. All patients performed exercises at home and once a week at hospital under supervision. Results: The improvement of PImax in the threshold inspiratory muscle training group was more significant than the improvement observed in the breathing exercise group (P= 0.05). PEmax increased significantly only in the breathing exercise group (P= 0.01). Spirometry results did not change significantly in both groups after the training. Conclusions: We conclude that respiratory muscle strength is enhanced by training in the patients with muscular dystrophy who are ambulatory, but inspiratory and/or expiratory training effect is specific to the trained muscles. The techniques that improve the strength of respiratory muscles should be included in the physiotherapy management of patients with muscular dystrophy.