Maximal inspiratory pressure and exercise-induced inspiratory muscle fatigue in chronic nonspecific low back pain

Sim Klaps; Jonas Verbrugghe; Nina Goossens; Timo Meus; Albère Köke; Jeanine Verbunt; Daniel Langer; Annick Timmermans; Lotte Janssens

doi:10.1016/j.rmed.2024.107887

Maximal inspiratory pressure and exercise-induced inspiratory muscle fatigue in chronic nonspecific low back pain

Respir Med. 2024 Dec 5:236:107887. doi: 10.1016/j.rmed.2024.107887. Online ahead of print.

Authors

Sim Klaps¹, Jonas Verbrugghe², Nina Goossens², Timo Meus², Albère Köke³, Jeanine Verbunt³, Daniel Langer⁴, Annick Timmermans², Lotte Janssens²

Affiliations

¹ REVAL Rehabilitation Research Center, Hasselt University, Diepenbeek, Belgium. Electronic address: sim.klaps@uhasselt.be.
² REVAL Rehabilitation Research Center, Hasselt University, Diepenbeek, Belgium.
³ Adelante Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, the Netherlands; Department of Rehabilitation Medicine, Research School CAPHRI, Maastricht University, Maastricht, the Netherlands.
⁴ Faculty of Kinesiology and Rehabilitation Sciences, Department of Rehabilitation Sciences, Research Group for Cardiovascular and Respiratory Rehabilitation, KU Leuven, Leuven, Belgium; Respiratory Rehabilitation and Respiratory Division, University Hospital Leuven, Leuven, Belgium.

PMID: 39645006
DOI: 10.1016/j.rmed.2024.107887

Abstract

Background: Patients with chronic nonspecific low back pain (CNSLBP) show reduced inspiratory muscle function. However, studies comparing maximal inspiratory pressure (MIP) and exercise-induced inspiratory muscle fatigue (IMF) between CNSLBP and healthy controls (HC) are lacking.

Objective: To compare MIP and exercise-induced IMF between CNSLBP and HC.

Design: Cross-sectional study.

Methods: MIP was recorded in 25 persons with CNSLBP and 15 HC before and immediately, 15 and 30 minutes after a maximal cardiopulmonary exercise test. Inspiratory muscle weakness was defined as a predicted MIP value lower than 80%, and exercise-induced IMF as a ≥10% reduction in MIP following the exercise test.

Results: Baseline MIP was similar between CNSLBP (109±32 cmH2O) and HC (116±32 cmH2O) (p= 0.525). Inspiratory muscle weakness was present in 36% of the CNSLBP group and in 20% of the HC group, with no significant difference between groups (p= 0.777). None of the groups showed significant exercise-induced IMF immediately (CNSLBP: -2.1%, HC: 3.7%), 15 minutes (CNSLBP: -5.4%, HC: -5.2%), and 30 minutes (CNSLBP: -4.7%, HC: -6.6%) after the maximal exercise test (p> 0.05), with no between group differences with regard to magnitude and proportion (CNSLBP: 24%, HC: 33%) (p> 0.05).

Conclusions: This study shows that there is no difference in MIP and the proportion of inspiratory muscle weakness between persons with CNSLBP and HC. Additionally, within both groups, there was no exercise-induced IMF immediately, 15 and 30 minutes after a maximal exercise test. Furthermore, there was no difference in the magnitude and proportion of exercise-induced IMF between both groups.

Keywords: Cross-Sectional Study; Exercise Performance; Inspiratory Muscle Fatigue; Low Back Pain; Musculoskeletal Pain; Respiratory Muscles.