Sternocleidomastoid muscle activation following inspiratory muscle training in patients with chronic obstructive pulmonary disease: a randomized clinical trial

Authors

DOI:

https://doi.org/10.1590/1809-2950/19009727022020

Keywords:

Electromyography, Respiratory Muscles, Pulmonary Disease, Chronic Obstructive; Respiratory Terapy

Abstract

This study aims to assess the effect of short-time low frequency inspiratory muscle trainer (Threshold IMT) on inspiratory muscle strength and electromyographic activity of the sternocleidomastoid (SCM) muscle in people with chronic obstructive pulmonary disease (COPD). People with COPD participating in a lung rehabilitation program were allocated to a control or inspiratory muscle training (IMT) group. The control group participated in the usual rehabilitation, whereas the other group received IMT (performed with a load of 50% maximal inspiratory pressure (MIP) adjusted weekly). Both interventions lasted for 2 months. Outcomes included electromyographic analysis of the SCM and MIP. In total, ten participants were allocated to each group. The IMT group presented an increase in absolute (p<0.001) and predicted (p<0.001) values of MIP and also in pre- and post-intervention variation between groups (p=0.003 and p=0.008, respectively). Such differences were not found in the control group. The SCM muscle activity decreased in the IMT post intragroup evaluation (p=0.008). IMT provided a reduction of the electromyographic activity of SCM in COPD patients, also increasing inspiratory muscle strength in the study participants.

Downloads

Download data is not yet available.

References

Global Initiative For Chronic Obstructive Lung Disease. Global

Strategy for Diagnosis, Management, and Prevention of Chronic

Obstructive Lung Disease. Fontana; 2018.

Cardoso DM, Fregonezi GAF, Jost RT, Gass R, Alberton CL,

Albuquerque IM, et al. Acute effects of expiratory positive

airway pressure (EPAP) on different levels in ventilation and

electrical activity of sternocleidomastoid and parasternal

muscles in Chronic Obstructive Pulmonary Disease (COPD)

patients: a randomized controlled trial. Braz J Phys Ther.

;20(6):525-34. doi: 10.1590/bjpt-rbf.2014.0190

Hudson AL, Gandevia SC, Butler JE. The effect of lung volume

on the co-ordinated recruitment of scalene and sternomastoid

muscles in humans. J Physiol. 2007;584(Pt 1):261-70.

doi: 10.1113/jphysiol.2007.137240

Sá RB, Pessoa MF, Cavalcanti AGL, Campos SL, Amorim C,

Andrade AD. Immediate effects of respiratory muscle

stretching on chest wall kinematics and electromyography

in COPD patients. Respir Physiol Neurobiol. 2017;242:1-7.

doi: 10.1016/j.resp.2017.03.002

Sinderby C, Beck J, Spahija J, Weinberg J, Grassino A. Voluntary

activation of the human diaphragm in health and disease. J Appl

Physiol. 1998;85(6):2146-58. doi: 10.1152/jappl.1998.85.6.2146

American Thoracic Society, European Respiratory Society. ATS/

ERS Statement on respiratory muscle testing. Am J Respir Crit

Care Med. 2002;166(4):518-624. doi: 10.1164/rccm.166.4.518

Duiverman ML, Huberts AS, van Eykern LA, Bladder G,

Wijkstra PJ. Respiratory muscle activity and patient–ventilator asynchrony during different settings of noninvasive ventilation

in stable hypercapnic COPD: does high inspiratory pressure

lead to respiratory muscle unloading? Int J Chron Obstruct

Pulmon Dis. 2017;12:243-57. doi: 10.2147/copd.S119959

Tout R, Tayara L, Halimi M. The effects of respiratory muscle

training on improvement of the internal and external thoracopulmonary respiratory mechanism in COPD patients. Ann Phys

Rehabil Med. 2013;56(3):193-211. doi: 10.1016/j.rehab.2013.01.008

Paiva DN, Assmann LB, Bordin DF, Gass R, Jost RT, Bernardo

Filho M, et al. Inspiratory muscle training with threshold

or incentive spirometry: which is the most effective? Rev

Port Pneumol. 2014;S0873-2159(14)00096-8. doi: 10.1016/

j.rppnen.2014.05.005

Chuang HY, Chang HY, Fang YY, Guo SE. The effects of threshol

dinspiratorymuscletraining in patients with chronic obstructive

pulmonary (COPD) disease: a randomized experimental study.

J Clin Nurs. 2017;26(23-24):4830-8. doi: 10.1111/jocn.13841

Langer D, Charususin N, Jácome C, Hoffman M, McConnell

A, Decramer M, Gosselink R. Efficacy of a novel method

for inspiratory muscle training in people with chronic obstructive

pulmonary disease. Phys Ther. 2015;95(9):1264-73. doi: 10.2522/

ptj.20140245

Majewska-Pulsakowska M, Wytrychowski K, Rożek-Piechura

K. The role of inspiratory muscle training in the process

of rehabilitation of patients with chronic obstructive

pulmonary disease. Adv Exp Med Biol. 2016;885:47-51.

doi: 10.1007/5584_2015_194

Nikoletou D, Man WD, Mustfa N, Moore J, Rafferty G,

Grant RL, et al. Evaluation of the effectiveness of a homebased inspiratory muscle training programme in patients

with chronic obstructive pulmonary disease using

multiple inspiratory muscle tests. Disabil Rehabil.

;38(3):250-9. doi: 10.3109/09638288.2015.1036171

López-García A, Souto-Camba S, Blanco-Aparicio M,

et al. Effects of a muscular training program on chronic

obstructive pulmonary disease patients with moderate or

severe exacerbation antecedents. Eur J Phys Rehabil Med.

;52(2):169-75.

Elmorsi, AS, Eldosoky ME, Mohsen MAA, Shalaby NM,

Abdalla DA. Effect of inspiratoty muscle training on exercise

performance and quality of life in patients with chronic

obstructive pulmonay disease. Egypt J Chest Dis Tuberc.

;65(1):41-6. doi: 10.1016/j.ejcdt.2015.10.006

Garcia S, Rocha M, Pinto P, Lopes AMF, Bárbara C. Inspiratory

muscle training in COPD patients. Rev Port Pneumol.

;14(2):177-94. doi: 10.1016/S0873-2159(15)30229-4

Meyer FJ, Borst MM, Buschmann HC, Ewert R, Friedmann-Bette

B, Ochmann U, et al. Exercise testing in respiratory medicine.

Pneumologie. 2013;67(1):16-34. doi: 10.1055/s-0032-1325901

Pereira C, Sato T, Rodrigues SC. New reference values for

forced spirometry in white adults in Brazil. J Bras Pneumol.

;33(4):397-406. doi: 10.1590/S1806-37132007000400008

Neder JA, Andreoni S, Lerario MC, Nery LE. Reference values

for lung function tests. II. Maximal respiratory pressures and

voluntary ventilation. Braz J Med Biol Res. 1999;32(6):719-27.

doi: 10.1590/S0100-879X1999000600007

Hermens HJ, Freriks B, Disselhorst-Klug C, Rau G. Development

of recommendations for SEMG sensors and sensor placement

procedures. J Electromyogr Kinesiol. 2000;10(5):361-74.

doi: 10.1016/S1050-6411(00)00027-4

Faul F, Erdfelder E, Lang A-G, Buchner A. G*Power 3:

A flexible statistical power analysis program for the social,

behavioral, and biomedical sciences. Behav Res Methods.

;39:175-91. doi: 10.3758/BF03193146

Faul F, Erdfelder E, Buchner A, Lang A-G. Statistical power

analyses using G*Power 3.1: tests for correlation and regression

analyses. Behav Res Methods. 2009;41(4):1149-60. doi: 10.3758/

BRM.41.4.1149

Vickers AJ, Altman DG. Analysing controlled trials with baseline

and follow upmeasurements, BMJ. 2001;323:1123-4. doi: 10.1136/

bmj.323.7321.1123

Croitoru A, Bogdan MA. Respiratory muscle training in pulmonary

rehabilitation. Pneumologie. 2013;62(3):166-71.

Charususin N, Gosselink R, Decramer M, McConnell A, Saey D,

Maltais F, et al. Inspiratory muscle training protocol for patients

with chronic obstructive pulmonary disease (IMTCO study):

a multicentre randomised controlled trial. BMJ Open. 2013;3(8).

doi: 10.1136/bmjopen-2013-003101

Gosselink R, De Vos J, van den Heuvel SP, Segers J, Decramer M,

Kwakkel G. Impact of inspiratory muscle training in patients with

COPD: what is the evidence? Eur Respir J. 2011;37(2):416-25.

doi: 10.1183/09031936.00031810

Campbell EJ. The role of the scalene and sternomastoid muscles

in breathing in normal subjects; an electromyographic study. J

Anat. 1955;89(Pt 3):378-86.

Raper AJ, Thompson WT Jr, Shapiro W, Patterson JL Jr.

Scalene and sternomastoid muscle function. J Appl Physiol.

;21(2):497-502. doi: 10.1152/jappl.1966.21.2.497

Gama AEF, Carvalho LA, Feitosa LA, Nascimento JF Jr,

Silva MGNM, Amorim CF, et al. Acute effects of incremental

inspiratory loads on compartmental chest wall volume

and predominant activity frequency of inspiratory muscle.

J Electromyogr Kinesiol. 2013;23(6):1269-77. doi: 10.1016/

j.jelekin.2013.07.014

Luce JM, Culver BH. Respiratory muscle function in health and

disease. Chest. 1982;81(1):82-90. doi: 10.1378/chest.81.1.82

Ramirez-Sarmiento A, Orozco-Levi M, Güell R, Barreiro E,

Hernandez N, Mota S, et al. Inspiratory muscle training in

patients with chronic obstructive pulmonary disease: structural

adaptation and physiologic outcomes. Am J Respir Crit Care

Med. 2002;166(11):1491-7. doi: 10.1164/rccm.200202-075OC

Gandevia SC, McKenzie DK. Human diaphragmatic EMG:

changes with lung volume and posture during supramaximal

phrenic nerve stimulation. J Appl Physiol. 1986;60:1420-8.

doi: 10.1152/jappl.1986.60.4.1420

Sinderby C, Friberg S, Comtois N, Grassino A. Chest wall muscle

cross-talk in canine costal diaphragm electromyogram. J Appl

Physiol. 1996;81:2312-27. doi: 10.1152/jappl.1996.81.5.2312

Downloads

Published

2020-03-03

Issue

Section

Original Research

How to Cite

Sternocleidomastoid muscle activation following inspiratory muscle training in patients with chronic obstructive pulmonary disease: a randomized clinical trial. (2020). Fisioterapia E Pesquisa, 27(2), 133-139. https://doi.org/10.1590/1809-2950/19009727022020