The eff ect of a respiratory physiotherapy program on extraoesophageal refl ux dis ease symptoms

Czech version

Authors: Horová P. ¹; Dvořáček M. ¹; Zatloukal J. ²; Rybnikár T. ³; Raisová K. ¹
Published in: Rehabil. fyz. Lék., 31, 2024, No. 3, pp. 108-115.
Category: Original Papers
doi: https://doi.org/10.48095/ccrhfl 2024108

Overview

Introduction: Respiratory physiotherapy methods can reduce the incidence and intensity of oesophageal symptoms in patients with gastroesophageal reflux disease. Whether this therapy has the same effect on the extraoesophageal symptoms of gastroesophageal reflux disease has not been investigated yet. Therefore, the aim of this study was to investigate the effect of a respiratory physiotherapy program aimed at activating and strengthening the diaphragm by inspiratory muscle training performed in postural positions on the intensity of extraoesophageal reflux disease (EERD) symptoms and to assess whether the effect of this program differs in patients with normal and decreased inspiratory muscle strength. Methods: Patients with EERD were included in the study. Patients with decompensated cardiovascular disease, pulmonary disease, soft tissue disease, post-fundoplication patients, smokers and pregnant women were excluded from the study. Patients were assessed for inspiratory muscle strength (PI_max) and the severity of EERD symptoms before and after completing an 8-week respiratory physiotherapy program using the Hull Airway Reflux Questionnaire (HARQ) and the Reflux Symptom Index. Based on the initial PI_max value, patients were divided into two groups: Group 1 – patients with PI_max ≥ 90% of the normative value (NV) (15 patients, mean age 45.6 ± 10.4 years); Group 2 – patients with PI_max < 90% NV (21 patients, mean age 46.9 ± 10.9 years). The respiratory physiotherapy program included diaphragmatic breathing training and inspiratory muscle training, which was performed in three postural positions with the Threshold inspiratory muscle trainer resistance device. Results: A total of 36 patients (8 males) with EERD, mean age 46.4 ± 10.4 years and body mass index 25.6 ± 4.5 kg/m² were included in the study. Significantly higher symptom severity according to the HARQ before treatment was found in group 2. Both groups showed a statistically significant increase in inspiratory muscle strength and a decrease in symptom intensity according to both questionnaires after treatment. Patients who were found to have reduced inspiratory muscle strength below 90% NV at baseline achieved greater improvement in inspiratory muscle strength and a greater reduction in symptom intensity after treatment. Conclusion: The respiratory physiotherapy program led to an increase in inspiratory muscle strength and a reduction in symptom intensity regardless of initial inspiratory muscle strength.

Keywords:

respiratory muscle strength – respiratory physiotherapy – extraoesophageal reflux – extraoesophageal reflux disease symptoms

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Doručeno/Submitted: 22. 1. 2024

Přijato/Accepted: 19. 4. 2024

Korespondenční autor:

Mgr. Pavla Horová

Katedra fyzioterapie

Fakulta tělesné kultury

Univerzita Palackého v Olomouci

třída Míru 671/117

771 11 Olomouc

e-mail: pavla.horova01@upol.cz