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Respiratory Exercise Training

Given that he has a C5 level injury, Mr. CM is concerned about his breathing and the fact he often becomes easily short of breath on exertion.  He wants to know if it is worthwhile working on exercise training to improve his shortness of breath on exertion and improve his overall endurance.
What is the evidence for exercise training in enhancing respiratory function?
1.For exercise training to improve respiratory function the training intensity must be relatively high (70-80% of maximum heart rate) performed three times per week for six weeks. Ideal training regimes have not been identified.

For more information please see: Exercise Training in Enhancing Respiratory Function

What are the two forms of respiratory trainers and how does each of these work?
1. The two main types of devices are resistive and threshold trainers (see figure 3).  Both of these devices have a one-way valve that closes during inspiration so that the subject must breathe through a small diameter hole for the resistive trainer or against a spring loaded valve for the threshold trainer. The one-way valve opens during expiration such that no load is imposed during the expiratory phase of respiration. An additional devices is an incentive spirometer, commonly used by respiratory therapists which has the advantage of being able to be used unassisted by individuals with poor hand strength.

For more information please see: Inspiratory Muscle Training

Figure 3. Threshold trainer(top) has an adjustable spring-loaded valve that imposes the inspiratory load. The inspiratory load can be increased by winding the spring more tightly. Advantage of this trainer is that the same load is imposed on the inspiratory muscles regardless of breathing pattern. Resistive trainer (bottom) has holes of different diameters. The inspiratory load can be increased by setting the dial to holes of lesser diameter. Disadvantage of this trainer is that the subject can reduce the inspiratory load by breathing more slowly. If this device is used for training, a target must be used. Various targets have been designed that set a breathing rate (flow and/or inspiratory pressure) for the subject Threshold and P-Flex trainers available from Respironics HealthScan Inc., 41 Canfield Rd., Cedar Grove, NJ7, 0009-1201. 1-800-962-1266.