open access

Vol 89, No 2 (2021)
Case report
Submitted: 2020-06-26
Accepted: 2020-09-02
Published online: 2021-02-17
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The feasibility and tolerability of using inspiratory muscle training with adults discharged from the hospital with community-acquired pneumonia

Harry J Pick1, Mark A Faghy2, Gareth Creswell3, Deborah Ashton1, Charlotte E Bolton1, Tricia McKeever1, Wei Shen Lim1, Thomas Bewick3
DOI: 10.5603/ARM.a2021.0002
·
Pubmed: 33881155
·
Adv Respir Med 2021;89(2):216-220.
Affiliations
  1. Nottingham University Hospital NHS Trust, Nottingham City Hospital, United Kingdom
  2. University of Derby, Derby, United Kingdom
  3. University Hospitals of Derby and Burton NHS Foundation Trust, Derby, United Kingdom

open access

Vol 89, No 2 (2021)
CASE REPORTS
Submitted: 2020-06-26
Accepted: 2020-09-02
Published online: 2021-02-17

Abstract

Introduction: Patients experience substantial morbidity following discharge from hospital and during recovery from communi-ty-acquired pneumonia (CAP). Inspiratory muscle training (IMT) has demonstrated improved functional capacity and reduced patient-reported symptoms. To date the safety and tolerability of these methods have not been determined in CAP patients recovering following hospitalization. Accordingly, this study aimed to assess the safety and tolerability of IMT in adults discharged from hospital with CAP.
Material and methods: Participants received an IMT device (POWERbreathe KHP2) and completed 9-weeks IMT training with weekly follow-up. Frequency (twice daily) and load (50% PImax) were fixed throughout, but training volume increased incrementally (2-week habituation phase, 7-week training phase). Primary outcomes of interest included IMT safety and tolerability. Results: Twenty-two participants were recruited; 16 were male, mean age 55.2 years (range 27.9–77.3). From 1183 possible training days, side effects were reported on 15 occasions by 10 individual participants. All reported side-effects were assessed as grade 1 and did not prevent further training. Participant-reported IMT acceptability was 99.4%.
Conclusion: Inspiratory muscle training is safe and tolerable in patients following hospitalisation for CAP. Patient satisfaction with IMT is high and it is viewed by patients as being helpful in their recovery. Distinguishing CAP-related symptoms and device-related side effects is challenging. Symptom prevalence declined during follow-up with concurrent improvements in spirometry observed. Further research is required to determine the efficacy of IMT interventions following CAP and other acute respiratory infections.

Abstract

Introduction: Patients experience substantial morbidity following discharge from hospital and during recovery from communi-ty-acquired pneumonia (CAP). Inspiratory muscle training (IMT) has demonstrated improved functional capacity and reduced patient-reported symptoms. To date the safety and tolerability of these methods have not been determined in CAP patients recovering following hospitalization. Accordingly, this study aimed to assess the safety and tolerability of IMT in adults discharged from hospital with CAP.
Material and methods: Participants received an IMT device (POWERbreathe KHP2) and completed 9-weeks IMT training with weekly follow-up. Frequency (twice daily) and load (50% PImax) were fixed throughout, but training volume increased incrementally (2-week habituation phase, 7-week training phase). Primary outcomes of interest included IMT safety and tolerability. Results: Twenty-two participants were recruited; 16 were male, mean age 55.2 years (range 27.9–77.3). From 1183 possible training days, side effects were reported on 15 occasions by 10 individual participants. All reported side-effects were assessed as grade 1 and did not prevent further training. Participant-reported IMT acceptability was 99.4%.
Conclusion: Inspiratory muscle training is safe and tolerable in patients following hospitalisation for CAP. Patient satisfaction with IMT is high and it is viewed by patients as being helpful in their recovery. Distinguishing CAP-related symptoms and device-related side effects is challenging. Symptom prevalence declined during follow-up with concurrent improvements in spirometry observed. Further research is required to determine the efficacy of IMT interventions following CAP and other acute respiratory infections.

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Keywords

recovery; pnuemonia; respiratory muscles; training

About this article
Title

The feasibility and tolerability of using inspiratory muscle training with adults discharged from the hospital with community-acquired pneumonia

Journal

Advances in Respiratory Medicine

Issue

Vol 89, No 2 (2021)

Article type

Case report

Pages

216-220

Published online

2021-02-17

DOI

10.5603/ARM.a2021.0002

Pubmed

33881155

Bibliographic record

Adv Respir Med 2021;89(2):216-220.

Keywords

recovery
pnuemonia
respiratory muscles
training

Authors

Harry J Pick
Mark A Faghy
Gareth Creswell
Deborah Ashton
Charlotte E Bolton
Tricia McKeever
Wei Shen Lim
Thomas Bewick

References (13)
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  12. Severin R, Arena R, Lavie CJ, et al. Respiratory muscle performance screening for infectious disease management following COVID-19: a highly pressurized situation. Am J Med. 2020; 133(9): 1025–1032.
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