Inspiratory Muscle Trainer Versus Diaphragmatic Breathing Exercise on 6-Minute Walk Test in Adolescent Girls with End-Stage Renal Disease

Abstract

Objective: Inspiratory muscle weakness (IMW) is very common among adolescents with end-stage renal disease (ESRD). Untreated IMW in ESRD adolescents induces acute and chronic pulmonary complications, low physical performance, and impairment in quality of life (QoL). This was a 12-week breathing-retraining trial that compared the effects of threshold inspiratory muscle trainer (TIMT) versus the diaphragmatic breathing exercise procedure (DBEP), on ESRD adolescent girls’ maximal inspiratory pressure (MIP) and QoL, which was assessed by the Child Health Questionnaire (50-item parent form) (CHQ/PF50), pulmonary functions, and six-minute walk test (6MWT). Material and Methods: This breathing-retraining trial enrolled forty adolescent girls with ESRD. The girls were randomly divided into two groups: one group contained twenty girls that were trained by TIMT, while the other group contained 20 girls whom were trained by DBEP. The 20-minute rehabilitation of IMW by TIMT or DBEP was applied 3 times weekly. Adolescent girls’ forced vital capacity (FVC), CHQ/PF50-related score of physical summary, MIP, 6MWT, CHQ/PF50-related score of psychosocial summary, forced expiratory volume in the first second of girls’ expiration (FEV1), and 6MWT-associated physiological data (blood pressure, heart rate, and rate of perceived exertion) were assessed. Results: All outcomes of adolescent girls with ESRD in the first group that were trained by TIMT showed significant improvements, whereas the other group’s girls did not show the same reported significant improvements. Conclusion: Compared to DBEP, the 12-week training by TIMT significantly improved ESRD adolescent girls’ FVC, CHQ/PF50-related score of physical summary, MIP, 6MWT, CHQ/PF50-related score of psychosocial summary, FEV1, and 6MWT-associated physiological data.