Naoki Maki, Harumi Sakamoto, Yu Takata, Naohiro Kobayashi, Shinji Kikuchi, Yukinobu Goto, Hideo Ichimura, Yukio Sato, Hisako Yanagi
Department of Thorasic Surgery, Faculty of Medicine, University of Tsukuba, 305-8577 Tsukuba, Japan
DOI: 10.2340/16501977-2490

Objective: To investigate the effects of respiratory rehabilitation on respiratory function, swallowing in community-dwelling frail older patients with musculoskeletal disorders.
Design: Randomized open-label controlled trial.
Setting: Day-care facility in a rehabilitation hospital in Japan.
Subjects: A total of 63 participants with musculoskeletal disorders (intervention group: n = 31; control group: n = 32) completed the randomized controlled trial.
Interventions: All participants received 12 20-min sessions twice a week for 6 weeks of either typical rehabilitation (control) or typical rehabilitation with respiratory rehabilitation (intervention).
Main measures: Outcome measures were assessed prior to rehabilitation and after 12 sessions. The measures included: respiratory function, swallowing function, exercise tolerance, 6-min walk distance, thorax flexibility, muscle strength (grip and abdominal), activities of daily living, and quality of life.
Results: Participants in the intervention group showed significantly greater improvement in respiratory function (95% confidence interval (CI), 3. 8–6. 6; p = 0. 01), swallowing function (95% CI –1. 8–0. 6; p = 0. 01), and quality of life (SF8 Physical Summary Score) (95% CI 2. 4–7. 1; p = 0. 01) compared with those in the control group.
Conclusion: Addition of respiratory rehabilitation to a typical rehabilitation programme could improve not only respiratory and swallowing function, but also quality of life, in frail older patients.

Older persons can be susceptible to respiratory-related conditions, particularly pneumonia. This study examined the effects of breathing training on respiratory function, swallowing function, and quality of life in community-dwelling frail older persons with musculo-skeletal disorders. The participants were divided into 2 groups. One group performed a regular rehabilitation programme, and the other group performed breathing training exercises, including a coughing exercise, respiratory muscle stretching exercise, and respiratory muscle training using a hand-held resistance device. The exercises improved respiratory function, swallowing, and quality of life. Such breathing training might be effective in helping to prevent pneumonia in frail older patients with musculoskeletal disorders.