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Effects of Cough Training and Inspiratory Muscle Training on Cough Strength in Older Adults: A Randomized Controlled Trial

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Abstract

Purpose

While the need for preventive strategies to reduce the incidence of aspiration pneumonia has been indicated, it is also important to investigate effective training methods to improve cough function, which is associated with the development of aspiration pneumonia. This study aimed to investigate whether a 4-week home-based unsupervised cough training (CT) or inspiratory muscle training (IMT) program was effective in improving cough strength in older adults.

Methods

Fifty-three ambulatory older adults without airflow limitations were randomly assigned to one of three groups: a CT group (n = 18), an IMT group (n = 18), or a control group (n = 17). The CT and IMT groups performed home-based unsupervised training with a device for 4 weeks. Cough strength (cough peak flow), forced vital capacity, and respiratory muscle strength were assessed at the 4-week and 16-week follow-up. Intention-to-treat analyses were performed to investigate differences between the three groups using linear mixed models.

Results

At the 4-week follow-up, the CT group showed significant increases in cough peak flow and forced vital capacity compared with the control group, while the IMT group showed significant increases in inspiratory muscle strength compared with the cough training and control groups. At the 16-week follow-up, the CT group showed a significant increase in cough peak flow compared with the IMT group.

Conclusion

These preliminary results suggest that a 4-week home-based CT program may have short-term effectiveness in improving cough peak flow in ambulatory older adults.

Trial registration: This trial was registered on UMIN-CTR on 01/05/2018 (UMIN000031656).

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Data Availability

All data generated or analyzed during this study are included in this published article and its supplementary information file.

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Acknowledgements

The authors thank all the participants who took part in this study and the staffs who helped with the data collection.

Funding

This work was supported by the Japan Society for the Promotion of Science (JSPS KAKENHI Grant number JP17K01792).

Author information

Authors and Affiliations

  1. Department of Physical Therapy, School of Health Sciences at Fukuoka, International University of Health and Welfare, 137-1 Enokizu, Okawa-shi, Fukuoka, 831-8501, Japan

    Hideo Kaneko & Akari Suzuki

  2. Department of Physical Therapy, School of Health Sciences, Kyoto Tachibana University, Kyoto, Japan

    Jun Horie

Authors
  1. Hideo Kaneko
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  2. Akari Suzuki
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  3. Jun Horie
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Contributions

Conceptualization: HK and JH; Methodology: HK and AS; Formal analysis and investigation: HK and AS; Writing—original draft preparation: HK; Writing—review and editing: HK, AS, and JH; Funding acquisition: HK; Resources: HK and AS; Supervision: HK and JH.

Corresponding author

Correspondence to Hideo Kaneko.

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Conflict of interest

The authors have no relevant financial or non-financial interests to disclose.

Ethical Approval

Approval was granted by the Institutional Review Board of International University of Health and Welfare in April 2017 (17-Ifh-002).

Consent to Participate

Informed consent was obtained from all individual participants included in the study.

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Kaneko, H., Suzuki, A. & Horie, J. Effects of Cough Training and Inspiratory Muscle Training on Cough Strength in Older Adults: A Randomized Controlled Trial. Lung 200, 49–57 (2022). https://doi.org/10.1007/s00408-022-00509-2

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  • DOI: https://doi.org/10.1007/s00408-022-00509-2

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