Abstract: Respiratory Muscle Training (RMT), while not a new concept for pulmonology does offer new treatment techniques for the field of Speech-Language Pathology. According to the evidence, RMT can improve vocal strength, endurance, cough and swallowing. The challenge for clinicians, is what techniques will be most beneficial to each specific client.
Description: This presentation will provide an overview on Breathing, Ventilation, Respiratory drive, and Gas Exchange that are the respiratory system so each clinician understands how the systems work. Additionally, the muscles for inspiration, expiration, and swallowing will be reviewed to provide information on why the muscles are impacted by respiratory muscle training. General Respiratory Muscle Training and the different types, Inspiratory Muscle Training (IMT) vs. Expiratory Muscle Training (EMT) will be discussed with what muscles they impact and how best to determine deficits in the systems. The Devices for IMT, EMT, and Dual use will be demonstrated and defined which includes the function of the device Calibration or Resistance. Training – How is a starting point determined for each patient? How does the patient use the device? Which training schedule is appropriate for which patient? And what happens once maximum results have therapy have been met. (Patient and symptom/disease specific) Dysphonia (Voice), Dysphagia (Swallowing), Dystussia (Cough), Dyspnea (Breathlessness) which according to Sapienza in 2008 are targets for Respiratory Muscle Training. • Further, Cough production will be explained with the relevant data on strength and function as well as how and why this is important. “The relationship of abnormal voluntary cough to aspiration risk in patients with acute stroke is likely due to deficits of the systems that underlie both swallowing and cough. The results suggest that the efficacy of cough may be as important if not more important than deficits in swallowing in determining aspiration risk.” (Hammond et al 2008.) In the final section, Evidence from more recent studies will be compared and contrasted to assist clinicians in determining appropriate treatment techniques and plans of care for each specific patient.
Presentation Format & Methods: PowerPoint and interactive demonstrations
Supporting Research: Reference 1: Arnold, R., & Bausek, N. (2020). Effect of respiratory muscle training on dysphagia in stroke patients-A retrospective pilot study. Laryngoscope Investigative Otolaryngology, 5, 1050-1055.
Supporting Research: Reference 2: Donahue, C., & Coyle, J. (2020). The safety, tolerability, and impact of respiratory-swallow coordination training and expiratory muscle strength training on pulmonary, cough, and swallow function surrogates in amyotrophic lateral sclerosis. Perspecatives of the ASHA Special Interest Grouops, 5, 1603-1615.
Supporting Research: Reference 3: Mancopes, R., Smaoui, S., & Steele, C. (2020). Effects of expiratory muscle strength training on videofluoroscopic measures of swallowing: A systematic review. American Journal of Speech-Language Pathology. 29, 335-356.
Supporting Research: Reference 4: Sapienza, C. M.(2008). Respiratory muscle strength training applications. Current Opinion in Otolaryngology & Head and Neck Surgery, 16(3), 216–220.
Supporting Research: Reference 5: Yuenyongchaiwat, K., Namdang, P., Vasinsarunkul, P., Phongsukree, P., Chaturattanachaiyaporn, K., Pairojkittrakul, S., & Traitanon, O. (2021). Effectiveness of inspiratory muscle training on respiratory fitness and breathlessness in chronic renal failure: A randomized control trial. Physiotherapy Research International, 26(1), 1–7. https://doi.org/10.1002/pri.1879
Learning Objectives:
analyze and discuss the respiratory/ventilation cycle.
explain the different types of respiratory muscle training and the benefits.
discuss the recent literature and create plan for future research opportunities