Effects and Costs of Respiratory Muscle Training in Institutionalized Elderly People

Determination of the Effects and Costs of Respiratory Muscle Training in Institutionalized Elderly People With Functional Impairment: A Randomized Controlled Trial

The global loss of muscle mass and strength associated with aging is a cause of functional impairment and disability, particularly in the older elderly (>80 years). Respiratory function can be severely compromised if there is a decrease of respiratory (RM) strength complicated by the presence of comorbidities and physical immobility. In this context, the need for supportive services involves the need for long-term care and consequently the institutionalization.

Previous studies have shown that the increase of RM strength has positive healthy effects, such as the increase in functional capacity, the decrease in RM fatigue, the decrease of dyspnoea and the improvement of quality of life, both in healthy people and patients. Therefore, specific RM training may be regarded as a beneficial alternative to improve RM function, and thus prevent physical and clinical deterioration in this frail population.

Study hypothesis: The inspiratory muscle training (IMT) would improve respiratory muscle strength and endurance, exercise capacity and quality of life in an elderly population, who are unable to engage in general exercise conditioning.

Inclusion Criteria:

• People aged > 65 years
• Barthel Index < 75 score
• Mini-mental state examination ≥ 20 score
• Inspiratory muscle weakness (MIP ≤ 30% predicted value)

Exclusion Criteria:

• Ability to independently walk more than 14 m
• Significant chronic cardiorespiratory diagnoses
• Acute cardiorespiratory episode during the 2 previous months
• Neurological, muscular, or neuromuscular problems interfering with the capacity to engage in the tests and training protocol
• Active smokers or former smokers (< 5 years)
• A terminal disease