Effects of inspiratory muscle training on functional capacity, endothelial function, cardiac autonomic control and peripheral muscle oxygenation in eutrophic and obese children and adolescents with asthma: randomized controlled clinical trial

• Grant number: 23/13077-3
• Support Opportunities: Regular Research Grants
• Start date: May 01, 2025
• End date: April 30, 2028
• Field of knowledge: Health Sciences - Physiotherapy and Occupational Therapy
• Principal Investigator: Adriana Sanches Garcia de Araújo
• Grantee: Adriana Sanches Garcia de Araújo
• Host Institution: Centro de Ciências Biológicas e da Saúde (CCBS). Universidade Federal de São Carlos (UFSCAR). São Carlos , SP, Brazil
• Associated researchers: Audrey Borghi Silva ; Cássia da Luz Goulart

Abstract

Introduction Asthma is characterized by chronic inflammation with both pulmonary and systemic manifestations, causing a significant impact on the quality of life of children and their families. Children with asthma often have respiratory symptoms such as dyspnea, limitations in physical activity and exacerbations of the disease. When associated with childhood obesity, these symptoms are intensified and evidenced in the individual. Objectives To assess the effects of inspiratory muscle training (IMT) on functional capacity, endothelial function, cardiac autonomic control and peripheral muscle oxygenation in children and adolescents with asthma. Methods 45 children and adolescents with asthma, aged between 6 and 17 years, of both sexes, will take part in the study. They will be evaluated initially and randomly divided into three groups in a 1:1:1 ratio, with the third group being made up of asthmatic and obese children and adolescents (with a BMI>35). The TMI group will only receive inspiratory muscle training with an initial load of 30% of MIP and will progress over the weeks with a 5% increase in the new MIP assessed, TMI Sham will have the TMI load fixed at 5% and TMI Plus will perform the same protocol as the TMI group. The children will be assessed for respiratory muscle strength, heart rate variability, functional capacity, endothelial function, peripheral muscle oxygenation and will also answer questionnaires on quality of life, sleep and disease control before and after training. The training will be supervised and will last eight weeks, three times a week, totaling 24 sessions. The children and adolescents will have their MIP assessed weekly and the same value will be maintained during the first two weeks of the intervention. For statistical analysis, the Shapiro-Wilk test will be applied to verify the normality of the data. The ANOVA Two Way test with Bonferroni post hoc will be used to compare the groups. Pearson's or Spearman's correlation will be applied depending on the nature of the data to correlate participation outcomes, functional capacity, sleep and cardiorespiratory variables. Expected Results After the intervention, it is expected that the children and adolescents in the TMI group will show an improvement in functional capacity, endothelial function, cardiac autonomic control, peripheral muscle oxygenation, disease control, quality of life and sleep that is superior to the TMI Sham group. The TMI Plus group is expected to show improvements equal to or as significant as the TMI group. (AU)