Article

Amyotrophic Lateral Sclerosis is a neurodegenerative disease with
rapid involvement of the inspiratory muscles, leading to respiratory
insufficiency. Death often occurs by aspiration and pneumonia. Endurance- and
strength therapy within ALS are discussed controversially. OBJECTIVE: To review
the current literature to assess the efficacy of inspiratory muscle training for ALS. METHOD: Systematic review, using databases as PubMed, PEDro, Cochrane and Google Scholar. INTERVENTION: Inspiratory muscle training vs. sham training or
inspiratory muscle training alone. OUTCOME MEASURES: Inspiratory muscle strength,
dyspnoea, quality of life and survival time. RESULTS: Four studies could be
included in this review, two RCT's, one pre-experimental study and one with a
historical control group. In total 73 patients underwent inspiratory muscle
training. CONCLUSION: Studies varied in onset of the training, the training
protocol and the outcomes measured. At time, there is limited evidence that
inspiratory muscle training leads to strengthening of inspiratory muscles in ALS.
Improvements made were minor, in only a few parameters and also in control
groups. Survival time was significantly longer in the experimental group in one
study. Interesting suppositions (diaphragm training vs. other IM training,
improvement of chest wall and lung compliance) need to be examined in robustly
designed future trials, defining exact therapeutic windows and interventions.

Langue : ANGLAIS