Abstract
The purpose of this study is to investigate the effects of an inspiratory muscle training using incentive spirometer (IS) on respiratory function in patients with amyotrophic lateral sclerosis (ALS). This study was carried out as a multi-institutions non-randomized controlled trial. The subjects were 14 ALS patients who have been notified their diagnosis, and assigned treatment or control group by the institutions. The treatment group was 9 patients with the inspiratory muscle training in addition to ordinary physical therapy, while control group was 5 patients without any additional training. The inspiratory muscle training was performed at a moderate load, once a day for 8 weeks. The outcome measure were the Japanese version ALS functional rating scale-revised edition (ALSFRS-R), respiratory function test (VC, FVC, PEF, PCF), respiratory muscle strength (PImax, PEmax), and arterial blood gas test. The evaluation was done at before training, 4th week (except ALSFRS-R) and 8th week. After 8 weeks training period, the score of ALSFRS-R declined in treatment group due to progress of disease while the score did not change in control group.
Regarding the respiratory function test, the result was that only PCF showed a significant decreasing in control group, whereas keeping with no change in treatment group. In the change rate of respiratory function, the change rate of PCF also showed a significant difference.
As the respiratory muscle strength and the change rate of respiratory muscle strength, although the differences were not significant, %PImax tended to increase in treatment group and to decrease in control group. %PEmax tended to decrease in both groups.
Although the results of arterial blood gas test also did not show any significant difference between two groups, there was a tendency to keep in treatment group.
These results suggest that the inspiratory muscle training has a possibility to inhibit declining of respiratory functions in ALS patients. It is considered that the degree of load of respiratory training in this study is not overwork and could be provide for ALS patients safely.
