EXPIRATORY TRAINING IN MULTIPLE-SCLEROSIS

Objective: To compare the effects of expiratory muscle training and sh am training on respiratory muscle strength in patients with multiple s clerosis (MS). Design: A randomized control trial; subjects were rando mly assigned to either expiratory muscle training or sham training. Se tting: Training and measurement of respiratory muscle pressures were c onducted in patients' homes. Weekly home visits were conducted to assu re compliance with the training protocols and to obtain measurements, Patients: Twenty subjects with clinically definite MS and decreased ex piratory muscle strength entered the study; 10 subjects completed 3 mo nths of expiratory training using a threshold training device and 5 su bjects completed 3 months of sham training using the same device but w ithout an expiratory training threshold load, Measurement: Respiratory muscle strength was assessed at baseline and after 1, 2, and 3 months of training; maximal inspiratory and expiratory pressures were used a s measures of respiratory muscle strength. Results: There was a signif icant increase in expiratory muscle strength after 3 months of trainin g when the expiratory training group was compared to the sham group (p = .003); no significant change in inspiratory muscle strength was obs erved. Conclusions: The results of this pilot study suggest that the s trength of the expiratory muscles of persons with MS can be increased through respiratory muscle training targeted to the expiratory muscles . Further research is indicated to determine if increasing the strengt h of the expiratory muscles in MS has an effect on clinical outcomes i n this patient population. (C) 1996 by the American Congress of Rehabi litation Medicine and the American Academy of Physical Medicine and Re habilitation