Feasibility of oropharyngeal and respiratory muscle training in individuals with OSA and spinal cord injury or disease: A pilot study

Physiological Reports, 2024 · DOI: 10.14814/phy2.15930 · Published: January 8, 2024

Simple Explanation

This study investigates whether people with spinal cord injuries or diseases (SCI/D) and obstructive sleep apnea (OSA) can perform combined oropharyngeal and respiratory muscle training (RMT). RMT involves breathing exercises using devices to improve muscle strength and endurance. The study found that individuals with SCI/D can indeed perform these exercises, suggesting it's a feasible approach. The exercise group showed significant improvement in inspiratory muscle strength compared to the control group. However, the study did not find significant improvements in sleep apnea severity or symptoms of sleepiness and fatigue after the exercise program. Further research is needed to determine the actual clinical benefits of these exercises.

Study Duration

3 months

Participants

24 Veterans with chronic SCI/D and OSA

Evidence Level

Level II: Randomized controlled single-blinded study

Key Findings

1
Combined oropharyngeal and RMT are feasible for individuals with SCI/D, as evidenced by high recruitment, adherence, and retention rates.
2
The 3-month exercise arm was associated with a significant improvement in maximal inspiratory muscle forces (MIP).
3
There were no significant changes in sleep apnea severity, symptoms of daytime sleepiness and fatigue, or other physiological parameters after the exercise program.

Research Summary

This pilot study examined the feasibility and impact of combined oropharyngeal and respiratory muscle training (RMT) on respiratory function in individuals with spinal cord injury or disease (SCI/D) and obstructive sleep apnea (OSA). The study found that the combined training program was feasible and acceptable, with a reasonable level of adherence among participants. Participants in the exercise group showed significant improvement in maximal inspiratory muscle forces (MIP). However, the study did not find significant improvements in sleep quality or apnea severity. Future studies are needed to determine the clinical efficacy of these respiratory muscle exercises in this population.

Practical Implications

Feasibility of Home-Based Training

The study demonstrates that a home-based combined oropharyngeal and respiratory muscle training program is feasible and acceptable for individuals with OSA and SCI/D.

Potential for Improved Respiratory Muscle Strength

The significant increase in MIP suggests that this training program could be a valuable tool for improving respiratory muscle strength in this population.

Need for Further Research

Further investigations are needed to determine the efficacy of this program in improving respiratory and sleep quality, especially in those who struggle with other treatment options.

Study Limitations

1
Patients had moderate-to-severe OSA with both SCI and disease, hence, there was heterogeneity of spinal cord involvement that could affect the response to RMT.
2
The exercise was performed at home without direct observation, and the level of resistance was not recorded from each participant at each measurement time point.
3
The sample of participants was small and heterogeneous, including SCI/D at different levels and severity.

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