Training, detraining, and retraining: Two 12-week respiratory muscle training regimens in a child with infantile-onset Pompe disease

J Pediatr Rehabil Med. 2020;13(1):71-80. doi: 10.3233/PRM-190601.

Abstract

Background: Respiratory muscle weakness is a primary cause of morbidity and mortality in patients with Pompe disease. We previously described the effects of our 12-week respiratory muscle training (RMT) regimen in 8 adults with late-onset Pompe disease [1] and 2 children with infantile-onset Pompe disease [2].

Case report: Here we describe repeat enrollment by one of the pediatric participants who completed a second 12-week RMT regimen after 7 months of detraining. We investigated the effects of two 12-week RMT regimens (RMT #1, RMT #2) using a single-participant A-B-A experimental design. Primary outcome measures were maximum inspiratory pressure (MIP) and maximum expiratory pressure (MEP). Effect sizes for changes in MIP and MEP were determined using Cohen's d statistic. Exploratory outcomes targeted motor function.

Relevance: From pretest to posttest, RMT #2 was associated with a 25% increase in MIP and a 22% increase in MEP, corresponding with very large effect sizes (d= 2.92 and d= 2.65, respectively). Following two 12-week RMT regimens over 16 months, MIP increased by 69% and MEP increased by 97%, corresponding with very large effect sizes (d= 3.57 and d= 5.10, respectively). MIP and MEP were largely stable over 7 months of detraining between regimens. Magnitude of change was greater for RMT #1 relative to RMT #2.

Keywords: Pompe disease; glycogen storage disease type II; neuromuscular disease; rehabilitation; respiratory muscle training; skeletal muscle.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Breathing Exercises / methods*
  • Female
  • Glycogen Storage Disease Type II / complications
  • Glycogen Storage Disease Type II / physiopathology*
  • Glycogen Storage Disease Type II / rehabilitation*
  • Humans
  • Infant
  • Muscle Strength / physiology
  • Respiratory Insufficiency / complications
  • Respiratory Insufficiency / physiopathology*
  • Respiratory Insufficiency / rehabilitation*
  • Respiratory Muscles / physiopathology
  • Retreatment
  • Treatment Outcome