Effect Combination of Inspiratory Muscle Training and Aerobic Exercise on Cardiopulmonary Endurance and Pulmonary Function in Systemic Lupus Erythematosus
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Published:
Dec 30, 2021
Keywords:
aerobic, inspiratory muscle training, lupus low disease activity state, maximal inspiratorypressure, metabolic equivalents, six-minute walk test.
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Abstract
ABSTRACTIntroduction: Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease which decreasedcardiopulmonary endurance and pulmonary function are the clinical manifestations. Inspiratory MuscleTraining (IMT) has never been studied before, but aerobic exercise is commonly studied in SLE patients.This study was conducted to know the combination ef fect of IMT and aerobic exercise in SLE patients.Materials and methods: This study use quasi experimental design with pre and post-test approach.Fourteen SLE patients that included in the Lupus Low Disease Activity State (LLDAS) were givenIMT and aerobic exercise for 8 weeks. Cardiopulmonary endurance is measured by 6-minute walk test(6MWT) and Metabolic Equivalents (METs), pulmonary function by Maximal Inspiratory Pressure(MIP), Forced Expiratory Volume in 1 second (FEV1), and Forced Vital Capacity (FVC).Results: There is significant increase in pre and post intervention data, 397.45 ± 49.34 vs 427.50 ± 48.67for 6MWT; 5.25 ± 1.14 vs 5.84 ± 1.08 for METs; 56.20 ± 14.24 vs 86.36 ± 20.73 for MIP; 68.00 ± 10.71vs 72.90 ± 11.30 for FEV1; and 1.81 ± 1 1.14 vs 77.36 ± 11.80 for FVC.Conclusion: The combination of IMT and aerobic exercise can increase cardiopulmonary endurance andpulmonary function in SLE patients.Keywords: aerobic, inspiratory muscle training, lupus low disease activity state, maximal inspiratorypressure, metabolic equivalents, six-minute walk test.
Article Details
How to Cite
Irsan Agung Ramdhani, Irma Ruslina Defi, Dian Marta Sari, & Rachmat Gunadi Wachjudi. (2021). Effect Combination of Inspiratory Muscle Training and Aerobic Exercise on Cardiopulmonary Endurance and Pulmonary Function in Systemic Lupus Erythematosus. Indonesian Journal of Physical Medicine and Rehabilitation, 10(02), 75 - 84. https://doi.org/10.36803/ijpmr.v10i02.306
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Original Article
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breathing during exercise in patients with systemic lupus erythematosus: a pilot-study. Lupus 2011; 20: 1535–40.
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Davis: Philadelphia, 2012.
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patients and their relationship with duration of the disease. Medical Today 2014.
29. Pessoa IS, Parreira VF, Fregonezi G, Chung F. Reference values for maximal inspiratory
pressure: A systematic review. Can Respir J 2014; 21: 8.
30. Guleria R, Pangtey G. Lung in SLE. Indian J Rheumatol 2007; 2(4):131-2.
31. Jakati S, Rajasekhar L, Uppin M, Challa S. SLE myopathy: a clinicopathological study.
Int J Rheum Dis 2015; 18: 886–91.
32. Wang R, Jiao H, Zhao J, Wang X, Lin H. Glucocorticoids enhance muscle proteolysis through a myostatin-dependent pathway at the early stage. PLoS One 2016; 11.
33. Amirouche A, Durieux A-C, Banzet S, Koulmann N, Bonnefoy R, Mouret C, et al. Down-regulation of akt/mammalian target of rapamycin signaling pathway in response to myostatin overexpression in skeletal muscle. Endocrinology 2009; 150: 286–94
of systemic lupus erythematosus. Nat Rev Rheumatol 2021; 17: 515–32.
2. Kaul A, Gordon C, Crow MK, Touma Z, Urowitz MB et al. Systemic lupus erythematosus. Nat
Rev Dis Primers 2016; 2: 16039.
3. Houghton KM, Tucker LB, Potts JE, Mckenzie DC. Fitness, fatigue, disease activity, and quality of life in pediatric lupus. Arthritis Rheumatol 2008; 59: 537–45.
4. Balsamo S, Cunha Nascimento D da, Tibana RA, de Santana FS, da Mota LMH, Santos-
Neto LLD. The quality of life of patients with lupus erythematosus influences cardiovascular capacity in6-minute walk test. Rev Bras (Reumatol English Edition) 2013; 53: 75–87.
5. Tench C, Bentley D, Vleck V, McCurdie I, White P, D’Cruz D. Aerobic fitness, fatigue,
and physical disability in systemic lupus erythematosus. J Rheumatol 2002; 29: 474–81.
6. Amra B, Mirzaei MR, Bonakdar ZS, Golshan M. Respiratory muscle function and spirometry
in patients with systemic lupus erythematosus. Tanaffos 2006; 5(4):53-8.
7. Perandini LA, Sales-de-Oliveira D, Mello SBV, Camara NO, Benatti FB, Lima FR, et al. Exercise training can attenuate the inflammatory milieu in women with systemic lupus erythematosus. J Appl Physiol 2014; 117: 639–47.
8. Carvalho MRP de, Sato EI, Tebexreni AS, Heidecher RTC, Schenkman S, Neto TLB.
Effects of supervised cardiovascular training program on exercise tolerance, aerobic capacity, and quality of life in patients with systemic lupus erythematosus. Arthritis Rheumatol 2005; 53: 838–44.
9. Wu M-L, Yu K-H, Tsai J-C. The effectiveness of exercise in adults with systemic lupus erythematosus: a systematic review and meta-analysis to guide evidence-based practice: meta-analysis of exercise in SLE. Worldviews Evid Based Nurs 2017; 14: 306–15.
10. lli SK, Held U, Frank I, Spengler CM. Effect of respiratory muscle training on exercise
performance in healthy individuals: a systematic review and meta-analysis. Sports Med 2012; 42(8): 707-24.
11. Jakhotia K, Jain N, Retharekar S, Shimpi A, Rairikar S, Shyam AK, et al. Effect of
inspiratory muscle training (IMT) on aerobic performance in young healthy sedentary individuals. J Med Thesis 2014; 2(3): 21-5
12. Drăgoi R-G, Amaricai E, Drăgoi M, Popoviciu H, Avram C. Inspiratory muscle training
improves aerobic capacity and pulmonary function in patients with ankylosing spondylitis: a randomized controlled study. Clin Rehabil 2016; 30: 340–6.
13. Pfalzer L, Fry D. Effects of a 10-week inspiratory muscle training program on lower-extremity mobility in people with multiple sclerosis: a randomized controlled trial. Int J MS Care 2011; 13: 32–42.
14. Karadall MN, Bo nak-Guclu M, Camc o lu B, Kokturk N, Turkta H. Effects of inspiratory
muscle training in subjects with sarcoidosis: a randomized controlled clinical trial. Respir Care 2016; 61: 483–94.
15. de Medeiros AIC, Fuzari HKB, Rattesa C, Brandão DC, de Melo Marinho PÉ. Inspiratory
muscle training improves respiratory muscle strength, functional capacity and quality of life in patients with chronic kidney disease: a systematic review. J Physiother 2017; 63: 76–83.
16. Soriano-Maldonado A, Vargas-Hitos J, Sabio J. Cardiovascular training vs. resistance
training for improving quality of life and physical function in patients with systemic lupus erythematosus: a randomized controlled trial: comments on the article by abrãhao et al. Scand J Rheumatol 2016; 45: 253–4.
17. Franklyn K, Lau CS, Navarra SV, Louthrenoo W, Lateef A, Hamijoyo L, et al. Definition
and initial validation of a Lupus Low Disease Activity State (LLDAS). Ann Rheum Dis 2015; 8.
18. Nusdwinuringtyas N, Widjajalaksmi W, Bachtiar A. Healthy adults maximum oxygen
uptake prediction from a six-minute walking test. Med J Indonesia 2011; 195.
19. Nusdwinuringtyas N. Six minute walking distance cut-off point in Indonesian
(Mongoloid) population. J Indon Med Assoc 2018; 6.
20. Khanna S, Pal H, Panday R M, Handa R. The relationship between disease activity and quality of life in systemic lupus erythematosus. Rheumatol (Oxford) 2004; 43(12): 1536-40
21. Enright P L, McBurnie M A, Bittner V, Tracy RP, McNamara R, Arnold A, et al. The six min walk test: a quick measure of functional status in elderly adults. Chest 2003; 123: 387-98
22. Riebe D, Ehrman JK, Liguori G, Magal M. ACSM’s guidelines for exercise testing and prescription. Tenth edition. Wolters Kluwer: Philadelphia, 2018.
23. Silva AG PD. Impaired aerobic capacity in systemic lupus erythematosus patients: what are the physiological mechanisms.Rheumatology (Sunnyvale) 2015; s6.
24. Waki D, Onishi A, Morinobu A. Large vessel vasculopathy in a patient with systemic lupus
erythematosus: a case report. J Med Case Reports 2019; 13: 189.
25. do Prado D, Gualano B, Miossi R, Lima F, Roschel H, Borba E, et al. Erratic control of
breathing during exercise in patients with systemic lupus erythematosus: a pilot-study. Lupus 2011; 20: 1535–40.
26. Harms CA. Insights into the role of the respiratory muscle metaboreflex. J Physiol
2007; 584: 711.
27. Kisner C, Colby LA. Therapeutic exercise: foundations and techniques. 6th ed. F.A.
Davis: Philadelphia, 2012.
28. Hussain D, Begum S, Ali T, Ahmed M, Farzana R. Fvc, Fev1 and Fev1/Fvc % in female SLE
patients and their relationship with duration of the disease. Medical Today 2014.
29. Pessoa IS, Parreira VF, Fregonezi G, Chung F. Reference values for maximal inspiratory
pressure: A systematic review. Can Respir J 2014; 21: 8.
30. Guleria R, Pangtey G. Lung in SLE. Indian J Rheumatol 2007; 2(4):131-2.
31. Jakati S, Rajasekhar L, Uppin M, Challa S. SLE myopathy: a clinicopathological study.
Int J Rheum Dis 2015; 18: 886–91.
32. Wang R, Jiao H, Zhao J, Wang X, Lin H. Glucocorticoids enhance muscle proteolysis through a myostatin-dependent pathway at the early stage. PLoS One 2016; 11.
33. Amirouche A, Durieux A-C, Banzet S, Koulmann N, Bonnefoy R, Mouret C, et al. Down-regulation of akt/mammalian target of rapamycin signaling pathway in response to myostatin overexpression in skeletal muscle. Endocrinology 2009; 150: 286–94