Respiratory Exercise Training: Inspiratory and Expiratory Training

Respiratory Exercise Training:

The process of improving the strength or endurance of muscles of ventilation is called respiratory resistance training.

Goals

1. Improve or redistribute ventilation.
2. Increase the effectiveness of the cough mechanism and promote airway clearance.
3. Prevent post-operative pulmonary complications.
4. Improve the strength, endurance, and coordination of the muscle of ventilation.
5. Maintain or improve the chest and thoracic spine mobility.
6. Promote relaxation.
7. Improve the functional capacity for daily living. 
8. Correct abnormal breathing pattern. 
9. Decrease the work of breathing.

Precaution

1. Avoid prolonged period of resistance training of inspiratory muscles, because the diaphragm cannot totally rest to recover from a session of resistance exercises. 
2. The use of accessory muscles of respiration is a sign that the diagram is beginning to fatigue. 

There are 3 approaches to respiratory resistance training:

1. Inspiratory resistance training

This type of training uses breathing devices (registers) to improve the strength and endurance of muscles of inspiration and decrease the occurrence of inspiratory muscle fatigue.

                               

2. Diaphragmatic training using weights

The use of small weights, such as sandbags, to strengthen or improve the endurance of the diaphragm.

Procedure:

1. Have the patient assume a  slightly head-up position.
2. Place a small weight over the epigastric region of the patient's abdomen.
3. Tell the patient to breathe deeply while trying to keep the upper chest quiet. The resistance should not interfere with the full excursion of the diaphragm and the normal size of the epigastric area.
4. Gradually increase the time that the patient breathes against the resistance of the weight.
5. The weight can be increased when the patient can tolerate the diaphragmatic breathing pattern without the use of accessory muscles of inspiration for 15 minutes.

3. Incentive Respiratory Spirometry

1. Incentive spirometry is a form of ventilatory training that gives sustained maximum inspiration.
2. The patient in his close parameter that provides visual or audio feedback as the patient breaths deeply as possible.
3. Incentive spirometry increases the volume of air inspired and prevents alveolar collapse and atelectasis.