Effect of respiratory muscle training on load sensations in people with chronic tetraplegia: a secondary analysis of a randomised controlled trial

Study design Secondary analysis of a randomised controlled trial. Objectives Our primary study showed that increasing inspiratory muscle strength with training in people with chronic (>1 year) tetraplegia corresponded with reduced sensations of breathlessness when inspiration was loaded. This study investigated whether respiratory muscle training also affected the respiratory sensations for load detection and magnitude perception. Setting Independent research institute in Sydney, Australia. Methods Thirty-two adults with chronic tetraplegia participated in a 6-week, supervised training protocol. The active group trained the inspiratory muscles through progressive threshold loading. The sham group performed the same protocol with a fixed threshold load (3.6 cmH 2 O). Primary measures were load detection threshold and perceived magnitudes of six suprathreshold loads reported using the modified Borg scale. Results Maximal inspiratory pressure (P i max ) increased by 32% (95% CI, 18–45) in the active group with no change in the sham group ( p = 0.51). The training intervention did not affect detection thresholds in the active ( p = 0.24) or sham ( p = 0.77) group, with similar overall decreases in Borg rating of 0.83 (95% CI, 0.49–1.17) in active and 0.72 (95% CI, 0.32–1.12) in sham group. Increased inspiratory muscle strength reduced slope magnitude between Borg rating and peak inspiratory pressure ( p = 0.003), but not when pressure was divided by P i max to reflect contraction intensity ( p = 0.92). Conclusions Training reduces the sensitivity of load sensations for a given change in pressure but not for a given change in contraction intensity.