Document Detail


Respiratory physiotherapy can increase lower esophageal sphincter pressure in GERD patients.
MedLine Citation:
PMID:  23026445     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Inspiratory muscle training (IMT) has been shown to increase diaphragm thickness. We evaluated the effect of IMT on mid-respiratory pressure (MRP) in patients with gastroesophageal reflux disease (GERD) and hypotensive lower esophageal sphincter (LES), and compared the results with a sham group.
METHODS: Twenty consecutive patients (progressive loading group) and 9 controls (sham group) were included. All patients had end expiratory pressure (EEP) between 5 and 10 mmHg, underwent esophageal manometry and pulmonary function tests before and after 8 weeks of training, and used a threshold IMT twice daily. The threshold IMT was set at 30% of the maximal inspiratory pressure for the progressive loading group; while, the threshold for sham-treated patients was set at 7 cmH(2)O for the whole period.
RESULTS: There was an increase in MRP in 15 (75%) patients in the progressive loading group, with an average gain of 46.6% (p < 0.01), and in six (66%) patients in the sham group with a mean increase of 26.2% (p < 0.01). However, there was no significant difference between the groups (p = 0.507). The EEP also increased compared with measurements before training (p < 0.01), but it did not differ between groups (p = 0.727).
CONCLUSION: IMT increased LES pressure in patients with GERD, in both the treatment and sham groups, after an eight-week program. Although there was no statistically significant difference between groups, suggesting the pressure increase in LES occurs regardless of the resistance load of the threshold IMT. These findings need to be confirmed in further studies with a larger sample.
REGISTRATION NUMBER: 0922/09.
Authors:
Renata Carvalho de Miranda Chaves; Milena Suesada; Fabiane Polisel; Cláudia Cristina de Sá; Tomas Navarro-Rodriguez
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Publication Detail:
Type:  Journal Article     Date:  2012-09-29
Journal Detail:
Title:  Respiratory medicine     Volume:  106     ISSN:  1532-3064     ISO Abbreviation:  Respir Med     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-10-22     Completed Date:  2013-02-22     Revised Date:  2013-11-06    
Medline Journal Info:
Nlm Unique ID:  8908438     Medline TA:  Respir Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  1794-9     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Elsevier Ltd. All rights reserved.
Affiliation:
Department of Gastroenterology, Hospital das Clínicas, Universidade de São Paulo, Av. Dr. Eneas de Carvalho Aguiar 155, Cerqueira César, 05403-000 São Paulo, SP, Brazil. remicasa@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Breathing Exercises*
Case-Control Studies
Esophageal Sphincter, Lower / physiology*
Female
Gastroesophageal Reflux / physiopathology,  therapy*
Humans
Male
Manometry
Middle Aged
Pressure
Respiratory Function Tests
Respiratory Therapy / methods*
Comments/Corrections
Comment In:
Respir Med. 2013 Mar;107(3):476-7   [PMID:  23266039 ]
Respir Med. 2013 Mar;107(3):478   [PMID:  23273407 ]

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