Inspirational (Inspiratory Training In Amyotrophic Lateral Sclerosis)
Background:
Motor neuron disease (MND) is a fatal neurodegenerative disease of the human motor system. Most patients succumb to respiratory failure. Inspiratory muscle training (IMT) may strengthen the inspiratory muscles and increase respiratory reserve, thereby improving the prognosis of MND. Better respiratory function should also impact positively on quality of life.
Objective:
To demonstrate that a 12-week IMT program could attenuate the decline in respiratory function in MND patients.
Methods:
A phase II, double-blind, randomised-controlled trial of a 12-week IMT program was conducted in 2007-2008. Nineteen MND patients entered the study. Nine patients were randomised to IMT, and 10 to sham IMT. Primary endpoints included respiratory function and respiratory muscle strength. Repeated measures analysis of covariance was used to analyse the data.
Results:
Over the IMT period, measures of inspiratory muscle strength increased in both treatment arms. However, the experimental group outperformed the control group with maximum inspiratory pressure in the former exceeding that attained in the latter by 6.1%. Spirometric measures were also greater in the experimental group than in the control group (for example, forced vital capacity was 4.6% higher in the experimental group), suggesting that IMT partially ameliorated the restrictive ventilatory defect that develops in MND patients. The effects of training were partially lost after eight weeks of detraining.
Conclusion:
IMT strengthened the inspiratory muscles in MND patients, and slowed the decline in respiratory function in MND patients. As a result, a formal phase III clinical trial is currently underway to expand and verify these pilot findings.