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Inspiratory muscle training improves aerobic capacity and pulmonary function in patients with ankylosing spondylitis: a randomized controlled study [with consumer summary]
Dragoi R-G, Amaricai E, Dragoi M, Popoviciu H, Avram C
Clinical Rehabilitation 2016 Apr;30(4):340-346
clinical trial
7/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: To evaluate the impact of inspiratory muscle training on aerobic capacity and pulmonary function in patients with ankylosing spondylitis. DESIGN: Randomized controlled study. SETTING: Rheumatic Rehabilitation Centre. SUBJECTS: A total of 54 ankylosing spondylitis patients, all males, were randomized to a conventional exercise training associated with an inspiratory muscle training group, or to a conventional exercise training group. INTERVENTIONS: Group 1 (27 patients) performed eight weeks of conventional exercise training (supervised weekly group sessions followed by a home-based exercise programme) associated with inspiratory muscle training sessions. Group 2 (27 patients) received eight weeks of conventional exercise training only. MAIN MEASURES: Resting pulmonary function (forced vital capacity -- FVC, forced expiratory volume in one second -- FEV1); effort ventilatory efficiency (lowest ventilatory equivalent ratio for oxygen and carbon dioxide -- VE/VO2 and VE/VCO2) and aerobic capacity (peak oxygen uptake -- VO2peak) were assessed at baseline and after eight weeks of exercise-based intervention. RESULTS: After eight weeks follow-up, patients in group 1 had a significant increased chest expansion and VO2peak compared with group 2 (3.6 +/- 0.8 cm versus 3.2 +/- 0.5 cm, p = 0.032; 2.0 +/- 0.5 l/min versus 1.8 +/- 0.3 l/min, p = 0.033). There were no significant differences of spirometric measurements, except FVC which significantly improved in patients who performed inspiratory muscle training (82.7 +/- 5.1% versus 79.5 +/- 3.5%, p = 0.014). VE/VCO2 also improved significantly in group 1 (26.6 +/- 3.6 versus 29.2 +/- 4.7, p = 0.040). CONCLUSIONS: Ankylosing spondylitis patients who performed eight weeks of inspiratory muscle training associated to conventional exercise training had an increased chest expansion, a better aerobic capacity, resting pulmonary function and ventilatory efficiency than those who performed conventional exercise training only.

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