Article

Ankylosing Spondylitis (AS) presents with both musculoskeletal and
cardiorespiratory pathophysiological manifestations. Inspiratory muscle training
(IMT) may be a useful intervention to address deficits in respiratory and
functional status. CASE DESCRIPTION: A 25-year-old male with AS initially sought
treatment for low back and right hip pain, but 7 weeks of IMT was also provided
due to abnormal respiratory performance. OUTCOMES: At baseline, the patient
presented with a resting respiratory rate (RR) of 14.5 breaths/minute, tidal
volume (TV) of 0.76 L, minute ventilation (VE) of 10.87 L/min, and end tidal CO2
(PetCO2) of 30.56 mmHg. Baseline exercise test results revealed a VO2max of 44
ml/kg/min and VE to CO2 output (VE/VCO2) slope of 30. Baseline MIP, SMIP, and MEP
were 54 cm H2O, 507 PTU, and 87 cm H2O, respectively, and increased to 176 cm
H2O, 807 PTU, and 151 cm H2O, respectively, after IMT. The VO2max increased to 51
ml/kg/min with decreases in the VE/VCO2 slope (29), resting RR (12
breaths/minute), resting TV (0.52 L), and resting VE (6.83 L/min) after IMT.
Improvements during postural challenges were also observed. DISCUSSION: This case
demonstrates the clinical utility of respiratory gas analysis and respiratory
performance measures to identify functional deficits and manage a patient with
AS. The improvements in respiratory performance at rest, during postural
challenges, and during maximal exercise after a relatively short period of IMT
highlights the role IMT may have to improve functional status in patients with
AS. Further investigation of IMT in patients with AS is warranted.

Langue : ANGLAIS