There are a number of methods of inspiratory muscle training, some of which are heavily used in clinical practice but for which relevant evidence-based is more scarce, such as the abdominal compression sandbag training method (abdominal weight-loading training/abdominal compression/resistance abdominal breathing/resistance diaphragm training).
It so happens that there are many people like me, have doubts about this method, so tried the relevant search, but found nothing, but the basic old books, found some description. The first time I saw this, I was able to find a way to get to the top of the page and see what I could do!
01 "Rehabilitation Medicine" - China Rehabilitation Medicine Research Association [by]
"Rehabilitation Medicine" is the China Rehabilitation Medicine Research Association, edited by the People's Health Publishing House in 1984, published in the book of the twelve chapters of the rehabilitation of chronic pulmonary diseases in the medical treatment mentioned:
Petty et al. used the method of abdominal compression (the application of a 15 ~ 20-pound bag of sand to the abdomen). Petty et al. used abdominal compression (applying a 15~20 lb. sandbag to the abdomen) to temporarily lower the partial pressure of arterial blood carbon dioxide in patients with hypercapnia, with the same results as those achieved with the application of intermittent positive-pressure respiratory therapy. This is due to the increase in tidal volume caused by abdominal compression and the decrease in functional residual air volume, with the result that alveolar oxygen and carbon dioxide are exchanged more efficiently [1]."
02 The Complete Book of Rehabilitation Techniques - Ichiro Hattori [Author]/Tianjian Zhou [Translator]
The Complete Book of Rehabilitation Techniques is a large-scale rehabilitation toolbook edited by Ichiro Hattori and others from Japan, translated by experts from the China Rehabilitation Research Center and the once-former Baikou'en University of Medical Sciences, and published by the Beijing Publishing House in 1989. In the book's nineteenth chapter of respiratory diseases (pulmonary physiotherapy) mentioned:
"Resistance when lying down: umbilicus put 1 kilograms of sand bags, every 2 days to increase the weight, to 3 kilograms. At this point you will feel relaxed and easy to breathe. A thick book can also be used instead for 30 minutes [2]."
03 Exercise Therapy and Occupational Therapy - Yu Tuisheng et al [by]
Exercise Therapy and Occupational Therapy was edited by Yu Tuisheng and Yun Xiaoping, and published by Hwa Hsia Publishing House in 1984, and it was the first professional book in China at that time that systematically introduced the treatment techniques of exercise therapy and occupational therapy.
In Chapter 17 of the book, it is mentioned in the evaluation of respiratory function: "Evaluation of diaphragm muscle strength by using the method of abdominal augmentation: make the patient take the supine position, put a heavy weight on the abdomen, and roughly evaluate the diaphragm muscle strength by testing the weight lifted during abdominal breathing."
"In Chapter 45, Rehabilitation of Respiratory Diseases, it is mentioned that: diaphragm resistance training Apply resistance during inhalation to make inhalation more difficult, so that the inspiratory muscle (diaphragm) to do resistance exercise. If you put your hand on the abdomen and apply downward pressure, in the abdominal respiration inspiratory phase to do the whole range of maximum resistance movement, repeat 10 times; can also be placed on the patient's abdomen with a sandbag for resistance exercise."
04 "Pulmonary Rehabilitation" - Meng Shen [by]
"Pulmonary Rehabilitation" is a book edited by Meng Shen, People's Health Publishing House published respiratory rehabilitation books in 2007. In the fifth chapter of the book, physical therapy techniques in respiratory rehabilitation mentioned:
"Abdominal weight loading method: in abdominal respiration (inhalation) against the abdominal bulge with a heavy resistance, so that the diaphragm movement
method. The patient can be placed in a supine position on his knees, and a sandbag can be placed on his upper abdomen.
The weight of the sandbag is determined by the weight that can be used to complete 10 abdominal breaths as the load, which is the maximum contraction of the diaphragm in 10 repetitions, called 10RM (10 repetition
maximum). Training for muscular strength is set at 50%, 75%, and 100% of the 10RM
,10 repetitions of each for a total of three sets of 30 repetitions, and training for endurance is set at 35% to 75% of the load for 10 to 15 minutes."
With the passage of time, the progress of science and technology, and the development of evidence-based medicine, abdominal pressure sandbag resistance training respiratory muscle function is used less and less in the clinic, and the current resistance methods used for IMT are more selective of inspiratory airflow resistive load type (
inspiratory ?flow resistive load, IFRL), dynamic inspiratory ?flow resistive loading (dynamic
IFRL), inspiratory ?pressure threshold loading
IPTL), and voluntary non-hypercapnic exertional breathing (voluntary isocapric ? hyperpnoca
?training, VIH) four [5].
1
Inspiratory flow resistive loading resistance training:
Inspiratory flow resistive loading (
inspiratory ?flow resistive
load, IFRL) resistance training is a training of trainees to complete the inspiratory activity through the small diameter of the airflow channel, with the help of the size of the tube diameter to adjust the The smaller the diameter of the tube, the greater the resistance. In addition to the size of the tube diameter, the trainee's inspiratory flow rate is also an important factor affecting inspiratory resistance. That is, there is the disadvantage of resistance load is not constant.
2
Dynamic inspiratory airflow resistance load resistance training:
Dynamic inspiratory airflow resistance load (dynamic IFRL) resistance training device. The inspiratory load of this device can be adjusted between or within respiratory cycles to create different load levels to match a predetermined percentage of maximum inspiratory pressure, i.e. the inspiratory load provided by this instrument will gradually decrease as the lung expands.
3
Inspiratory Pressure Threshold Loading Resistance Training:
During inspiratory pressure threshold loading (
inspiratory ?pressure threshold loading
IPTL) resistance training, the trainee is required to first generate a sufficient negative inspiratory pressure ( pressure threshold) to complete the inspiratory activity, during which the device achieves resistance breathing training by providing a non-flow-dependent, variable, quantitative resistance to the inspiratory activity.
4
Voluntary isocapric ?hyperpnoca ?training (VIH):
is a commonly used mode of endurance training that requires the trainee to engage in sustained high levels of ventilation for up to 30 minutes. Hyperventilation is avoided, and the trainee is generally required to repeat breaths in the same small confined space and given oxygen. Training Prescription
It is generally set at 60% to 90% of the individual's maximum minute ventilation, 3 to 5 times per week. Studies have shown that VIH-type endurance training increases endurance performance in healthy individuals and in individuals with neuromuscular disease and chronic obstructive pulmonary disease.
Summary
Abdominal weight loading training/abdominal compression/resistance abdominal breathing/resistance diaphragm training as an empirical clinical method of training the diaphragm was used more in the past when the instrumentation was not sufficiently complete, and with time, technological advances, and the development of evidence-based medicine, evidence-based evidence-based inspiratory flow resistance loading type (
inspiratory ?flow resistive loading, IFRL), dynamic inspiratory airflow resistance loading (dynamic
IFRL), inspiratory pressure threshold loading (inspiratory ?pressure threshold loading
IPTL), and autonomic Non-hypercapnic exertional breathing (voluntary isocapric ?hyperpnoca
?training, VIH) and other respiratory muscle training methods are gaining popularity in clinical practice!
References
[1] Chinese Society of Rehabilitation Medicine. Rehabilitation Medicine [M]. Beijing: People's Health Publishing House,1984.271-273.
[2] [Japan] Hattori Ichiro. Complete book of rehabilitation techniques [M]. Zhou Tianjian. Beijing: Beijing Publishing House,1989.938-942.
[3]Yu Tuisheng. Exercise therapy and occupational therapy [M]. Beijing: Huaxia Publishing House,2002.666-668.
[4]Meng Shen. Pulmonary rehabilitation [M]. Beijing: People's Health Publishing House,2007.123-126.
[5]Zhang Mingsheng. Respiratory rehabilitation [M]. Beijing: People's Health Publishing House,2018.115-130.
[6]G?hl
O, Walker DJ, Walterspacher S, et al. Atemmuskeltraining:
State-of-the-Art [Respiratory Muscle Training: State of the Art].
Pneumologie. 2016;70(1):37-48. doi:10.1055/s-0041-109312
[7]O'Connor
C, Lawson R, Waterhouse J, Mills GH. Is inspiratory muscle training
(IMT) an acceptable treatment option for people with chronic obstructive
pulmonary disease (COPD) who have declined pulmonary rehabilitation
(PR) and can IMT enhance PR uptake? A single-group prepost feasibility
study in a home-based setting. BMJ Open. . 2019;9(8):e028507. published
2019 Aug 8. doi:10.1136/bmjopen-2018-028507