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Considerations When Testing and Training the Respiratory Muscles

WD Reid, PhD, BMR(PT), is Assistant Professor, Division of Physical Therapy, School of Rehabilitation Sciences, University of British Columbia, T325-2211 Wesbrook Mall, Vancouver, British Columbia, Canada, V6T 2B5 (wreid@unixg.ubc.ca).
G Dechman, PhD, BSc(PT), is Assistant Professor, School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada H3G 1Y5. She was a postdoctoral fellow in the School of Rehabilitation Sciences, University of British Columbia, at the time this article was written.

The purpose of this review is to describe the muscles of respiration, mechanisms that lead to their dysfunction, and unique features of the respiratory muscles that should be considered when designing testing and training protocols for patients with respiratory compromise. The diaphragm's unique shape is an important determinant of its function. Respiratory pathophysiology combined with systemic abnormalities may result in inspiratory muscle weakness, fatigue, and injury. The specificity of training principle, as it applies to respiratory muscle training in patients with respiratory compromise, will be described. Precautions related to this type of training will also be outlined. In conclusion, a better understanding of the mechanisms contributing to inspiratory muscle dysfunction will assist physical therapists in designing the most appropriate training programs. This article, along with the other articles in this focus on respiratory muscle training, will provide therapists with scientifically based guidelines for rehabilitation of patients with impaired respiratory muscle function.

Key Words: Chronic obstructive lung disease • Diaphragm • Dyspnea • Exercise tolerance • Rehabilitation

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