Inspiratory muscle training improves cerebrovascular and postural control responses during orthostatic stress in older women

Abstract

Purpose

We aimed to investigate the effect of inspiratory muscle training (IMT) on, hemodynamic, cerebrovascular and postural balance responses during orthostatic stress, in older women.

Methods

Fourteen elderly women were assigned to perform IMT at 50% of maximal inspiratory pressure (MIP) (IMT group, n = 8) or placebo training at 5% MIP (Sham group, n = 6), in a counter-balanced order, using an inspiratory threshold device for 4 weeks. During the protocol, MIP was tested weekly once. In a second visit, blood pressure, heart rate, stroke volume, cardiac output, middle cerebral artery blood flow velocity (MCAv), and ventilation parameters were recorded continuously at rest and during orthostatic stress testing, which was conducted on a force plate to measure center-of-pressure (COP) oscillations (postural balance) and the electromyographic activity of the right medial gastrocnemius and tibialis anterior.

Results

IMT increased MIP from second to 4th week. The drops in MCAv, stroke volume, and cardiac output, as well as COP displacements during initial orthostasis decreased post-IMT.

Conclusion

IMT improves the interplay of the respiratory pump, hemodynamic, cerebrovascular and postural balance responses during orthostatic stress in older women.

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Abbreviations

ANCOVA:

Analysis of covariance

ANOVA:

Analysis of variance

BP:

Blood pressure

BR:

Breathing rate

CO:

Cardiac output

COP:

Center of pressure

EMG:

Electromyography

ES:

Effect size

E t :

Expiratory time

FEV1:

Forced expiratory volume in one second

FVC:

Forced vital capacity

HR:

Heart rate

IMT:

Inspiratory muscle training

I t :

Inspiratory time

MBP:

Mean blood pressure

MCAv:

Middle cerebral artery blood velocity

MIP:

Maximal inspiratory pressure

MVC:

Maximum voluntary contraction

ORT:

Orthostatic stress

PetCO2 :

Expired carbon dioxide pressure

SBP:

Systolic blood pressure

SV:

Stroke volume

T tot :

Total respiratory cycle time

VE:

Minute ventilation

V t :

Tidal volume

Δ:

Delta

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Acknowledgements

We greatly appreciate the time and effort expended by all volunteer subjects in this study. We would also like to thank professor Igor Fernandes for his support discussing the results, and my lab’s colleagues Andre Musmmano and Luana Farinazzo for their support during the experiments.

Funding

This work was supported by Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) and Fundação Carlos Chagas de Amparo à Pesquisa do Estado do Rio de Janeiro (FAPERJ/ E-26/110.079/2013).

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GDR, JLG, ISG, ACLN and PPSS conceived and designed research. GDR and ISG conducted experiments. GDR, JLG, ACLN and PPSS analyzed the data. GDR, JLG, ISG, ACLN and PPSS wrote the manuscript. All authors read and approved the manuscript.

Corresponding author

Correspondence to Pedro Paulo da Silva Soares.

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None of the authors have any financial or personal relationships with people or organizations.

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Communicated by Massimo Pagani.

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Rodrigues, G.D., Gurgel, J.L., Galdino, I.d. et al. Inspiratory muscle training improves cerebrovascular and postural control responses during orthostatic stress in older women. Eur J Appl Physiol 120, 2171–2181 (2020). https://doi.org/10.1007/s00421-020-04441-2

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Keywords

  • Respiratory muscles
  • Center-of-pressure
  • Aging
  • Cardiac output
  • Middle cerebral artery blood flow velocity