Physiological effects of expiratory muscle strength training with the sedentary healthy elderly: Pulmonary, cough, swallow, and speech functions

With age, physical functions decline which can influence respiratory performance. One of the physical changes is sarcopenia. With sarcopenia, elderly individuals experience reduced muscle mass and strength in the respiratory musculature. Age-related loss of muscle strength in expiratory muscles with reductions in elastic recoil of the lungs and chest wall compliance may compromise the necessary lung pressure for both ventilatory and non-ventilatory activities. This study examined the effects of a 4-week expiratory muscle strength training (EMST) program in healthy but sedentary elderly adults as measured by maximum expiratory pressure (MEP) as well as magnitudes of pulmonary, cough, swallow, and speech functions.;Eighteen healthy sedentary elderly people participated in this study. Sedentary was defined as a person with 24-hours maximum exertion time below 50 in a physical activity scale described within a physical activity questionnaire. Pulmonary measures included maximum expiratory pressure (MEP), maximum inspiratory pressure (MIP), forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), the ratio of FEV1 to FVC (FEV1/FVC), and expiratory reserve volume (ERV). Cough measures during capsaicin induced cough included inspiratory phase duration, compression phase duration (CPD), peak expiratory flow rate (PEFR), and post-peak plateau duration, and post-peak plateau integral amplitude (PPPIA). Swallow measures included peak amplitude (PA), duration, and integral amplitude (IA) of submental muscle group activity in surface electromyography (SM-sEMG) during maximal voluntary dry (saliva) swallow, wet swallow (5 cc and 10 cc water), and thin paste swallow (5 cc and 10 cc pudding). Speech measures included aerodynamic measures and acoustic measures including excess lung pressure (PEL) as well as maximum phonation durations (MPDs) at comfortable and loud intensity levels.;Results indicated significant improvements in MEP and MIP, decrease in CPD, increases in PEFR and PPPIA during reflexive coughs produced by capsaicin challenge, PA and IA of SM-sEMG during maximal voluntary dry and 10 cc pudding swallows as well as increase in PEL and MPD at comfortable intensity level.;The utility of EMST as a method of strength training for rehabilitation of respiratory muscle weakness/sarcopenia in sedentary elderly seems to be a viable consideration as a treatment tool, given the positive outcomes of this treatment on multiple physiological functions.