The article titled “The effects of 8 weeks of inspiratory muscle training on the balance of healthy older adults: a randomized, double-blind, placebo-controlled study” has been published by Physiological Reports.
It is the first research to describe the effects of inspiratory muscle training (i.e. breathing exercises that improve the strength of inspiratory muscles) on static and dynamic balance (measured with the clinical tool mini-BEST) and functional mobility (such as Timed Up and Go and 5 sit to stand tasks) with community dwellers older adults (aged 65+).
The research is part of Francesco Ferraro PhD journey. Journey guided with the supervision of Professor Alison McConnell, Dr James Gavin and Tom Wainwright
The article is now fully available as open access here
To examine the effects of 8‐week unsupervised, home‐based inspiratory muscle training (IMT) on the balance and physical performance of healthy older adults. Fifty‐nine participants (74 ± 6 years) were assigned randomly in a double‐blinded fashion to either IMT or sham‐IMT, using a pressure threshold loading device. The IMT group performed 30‐breath twice daily at ~50% of maximal inspiratory pressure (MIP). The sham‐IMT group performed 60‐breaths once daily at ~15% MIP; training was home‐based and unsupervised, with adherence self‐reported through training diaries. Respiratory outcomes were assessed pre‐ and postintervention, including forced vital capacity, forced expiratory volume, peak inspiratory flow rate (PIFR), MIP, and inspiratory peak power. Balance and physical performance outcomes were measured using the shortened version of the Balance Evaluation System test (mini‐BEST), Biodex® postural stability test, timed up and go, five sit‐to‐stand, isometric “sit‐up” and Biering–Sørensen tests. Between‐group effects were examined using two‐way repeated measures ANOVA, with Bonferroni correction. After 8‐week, the IMT group demonstrated greater improvements (P ≤ 0.05) in: PIFR (IMT = 0.9 ± 0.3 L sec−1; sham‐IMT = 0.3 L sec−1); mini‐BEST (IMT = 3.7 ± 1.3; sham‐IMT = 0.5 ± 0.9) and Biering–Sørensen (IMT = 62.9 ± 6.4 sec; sham‐IMT = 24.3 ± 1.4 sec) tests. The authors concluded that twice daily unsupervised, home‐based IMT is feasible and enhances inspiratory muscle function and balance for community‐dwelling older adults.
Over the past four weeks during our research project at Bournemouth University, we have carried out and participated in numerous tests and activities in the Orthopaedic Research Institute under the supervision of PGR Francesco Ferraro; some of which being more exciting, and others being more interesting.
One the simplest tests that we have carried out for the purpose of the research is the Mini-BESTest, this is a Balance Evaluation Systems Test and requires numerous subsidiary tests to be carried out for different aspects associated with balance, these include: anticipatory tests (when preparing for something to happen), reactive postural control (how you react to a change in motion), sensory orientation, and dynamic gait speeds (walking speeds and how they change in different circumstances). This was necessary in order to see how the effects of inspiratory muscle training effects balance over the course of 8 weeks.
In terms of analysis and methods, one of the most interesting tests for us involved the breathing system and using a spirometer. This device was used to measure the Forced Vital Capacity (total air volume of the lungs), Forced Expiratory Volume (how much air a person can exhale in a forced breath), MIP (maximum pressure generated by inhalation against occluded airway), and the MEP (this is the same but is the pressure generated by exhaling). For us, this was particularly interesting because it allowed us to see how a spirometer works in a hands on experience and how the data is presented and analysed.
Another series of tests involved the PrimusRS, a very impressive machine. It served to be a challenge and required lots of problem solving to carry out the tests successfully. During our use of the PrimusRS we experienced the different processes that were needed to be carried out involving; calibration, setting up, creating templates, correcting motion to improve the results, and the analysis of the final results. This was an extraordinary piece of equipment as it allowed us to carry out endurance and isometric tests (strength tests) for both flexion, extension and rotation regarding the trunk muscles, and gave us different data including power of the muscles/ movement.
Finally, the most exciting and enjoyable session to carry out involved using Virtual Reality Simulators for knee arthroscopy (operations) that surgeons all over the world travel to see. The reason for this being the most enjoyable test/session was due to complexity behind machines that looked so simple, and it allowed us to carry out practise operations teaching you the motions and procedures that would be used in real life. Other fascinating features of the virtual simulator was the way in which it introduced us to the different textures of the bone structures and tissues by giving feedback involving vibrations and stiffness of the simulator drill/ saw as well as the screen display.
As well as all of these above tests, we also are aware of the protocols and ethics of the tests that we have carried out in the duration of the project, this allowed us to experience and build up our own picture of the research that needs to be carried out before conducting the actual investigation.