Effect of 4 weeks inspiratory muscle training on inspiratory muscle strength and quality of life in dialysis patients. A pilot study


  • Aarya Mehta Under Graduate Student, D.V.V.P.F.’S College of Physiotherapy, Ahmednagar.
  • Dr. Arijit Kumar Das Associate Profesor
  • Dr. Abhijit D. Diwate Professor & HOD
  • Dr. Archana Nagargoje Assistant Professor




Kidney disease, Keywords – Abdominal surgery, inspiratory muscle training, preoperative, post-operative, pulmonary complications., respiratory muscles, maximum respiratory pressure, muscle weakness, CLOSED AND OPEN KINETIC CHAIN EXERCISES


Background: Dialysis is the most preferred way to treat chronic kidney disease (CKD). The
commonest complication associated with dialysis is uremic myopathy. Inspiratory muscle
training (IMT) improves the strength of respiratory muscles.
Methods: 11 patients with Stage 4 and 5 of chronic kidney disease with more than 3 months
of dialysis underwent Inspiratory muscle training using self-made inspiratory trainer by taking
pre and post intervention values of Maximum inspiratory pressure (MIP) and QOL.
Result: Paired t test was used and the MIP and QOL values are statistically significant with a
p-value of < 0.0001 and 0.0124 respectively.
Conclusion: Inspiratory muscle strength and QOL is reduced in dialysis patients and a 4-week
inspiratory muscle training using a self-made inspiratory muscle trainer is effective to reverse
the adverse effects of dialysis.
Keywords: Kidney disease, complications, respiratory muscles, maximum respiratory
pressure, muscle weakness, exercise.

Author Biographies

Aarya Mehta, Under Graduate Student, D.V.V.P.F.’S College of Physiotherapy, Ahmednagar.

Under Graduate Student, Department of Cardiovascular and Respiratory Sciences Physiotherapy, D.V.V.P.F.’S College of Physiotherapy, Ahmednagar.

Dr. Arijit Kumar Das, Associate Profesor

Associate Profesor, Department of Cardiovascular and Respiratory Sciences Physiotherapy, D.V.V.P.F’s College of Physiotherapy, Ahmednagar

Dr. Abhijit D. Diwate, Professor & HOD

Professor & HOD, Department of Cardiovascular and Respiratory Sciences Physiotherapy, D.V.V.P.F’s College of Physiotherapy, Ahmednagar

Dr. Archana Nagargoje, Assistant Professor

Assistant Professor, Department of Cardiovascular and Respiratory Sciences Physiotherapy, D.V.V.P.F.’S College of Physiotherapy, Ahmednagar.


Inker LA, Astor BC, Fox CH, Isakova T, Lash JP, Peralta CA, Tamura MK, Feldman HI. KDOQI US commentary on the 2012 KDIGO clinical practice guideline for the evaluation and management of CKD. American Journal of Kidney Diseases. 2014 May 1;63(5):713-35.

Tattersall J, Dekker F, Heimbürger O, Jager KJ, Lameire N, Lindley E, Van Biesen W, Vanholder R, Zoccali C, ERBP Advisory board. When to start dialysis: updated guidance following publication of the Initiating Dialysis Early and Late (IDEAL) study.?

Hakim RM, Lazarus JM. Initiation of dialysis. Journal of the American Society of Nephrology. 1995 Nov 1;6(5):1319-28.

Lee KY. A unified pathogenesis for kidney diseases, including genetic diseases and cancers, by the protein-homeostasis-system hypothesis. Kidney research and clinical practice. 2017 Jun;36(2):132.

Graham T. VII. The Bakerian lecture.—On osmotic force. Philosophical Transactions of the Royal Society of London. 1854 Jan 1;144:177-228.

Yilmaz S, Yildirim Y, Yilmaz Z, Kara AV, Taylan M, Demir M, Coskunsel M, Kadiroglu AK, Yilmaz ME. Pulmonary function in patients with end-stage renal disease: effects of hemodialysis and fluid overload. Medical science monitor: international medical journal of experimental and clinical research. 2016;22:2779.

Navari K, Farshidi H, POURREZA GF, Nafar M, Zand S, SOHRABPOUR H, EGHBAL ET. Spirometry parameters in patients undergoing hemodialysis with bicarbonate and acetate dialysates.

Conger JD, Hammond WS, Alfrey AC, Contiguglia SR, Stanford RE, Huffer WE. Pulmonary calcification in chronic dialysis patients: clinical and pathologic studies. Annals of internal medicine. 1975 Sep 1;83(3):330-6.

Abdalla ME, AbdElgawad M, Alnahal A. Evaluation of pulmonary function in renal transplant recipients and chronic renal failure patients undergoing maintenance hemodialysis. Egyptian Journal of Chest Diseases and Tuberculosis. 2013 Jan 1;62(1):145-50.

Chen CT, Lin SH, Chen JS, Hsu YJ. Muscle wasting in hemodialysis patients: new therapeutic strategies for resolving an old problem. The Scientific World Journal. 2013;2013.

Pierson DJ. Respiratory considerations in the patient with renal failure. Respiratory care. 2006 Apr 1;51(4):413-22.

Kouidi E, Albani M, Natsis K, Megalopoulos A, Gigis P, Guiba-Tziampiri O, Tourkantonis A, Deligiannis A. The effects of exercise training on muscle atrophy in haemodialysis patients. Nephrology, dialysis, transplantation: official publication of the European Dialysis and Transplant Association-European Renal Association. 1998 Mar 1;13(3):685-99.

Bavbek N, Akay H, Uz B, Uz E, Turgut F, Kanbay M, Senes M, Akcay A, Duranay M. The effects of L-carnitine therapy on respiratory function tests in chronic hemodialysis patients. Renal failure. 2010 Mar 1;32(2):157-61.

Karacan Ö, Tutal E, Colak T, Sezer S, Eyübo?lu FÖ, Haberal M. Pulmonary function in renal transplant recipients and end-stage renal disease patients undergoing maintenance dialysis. InTransplantation proceedings 2006 Mar 1 (Vol. 38, No. 2, pp. 396-400). Elsevier.

Cury JL, Brunetto AF, Aydos RD. Negative effects of chronic kidney failure on lung function and functional capacity. Brazilian Journal of Physical Therapy. 2010 Apr;14(2):91-8.

European RS, American Thoracic Society. ATS/ERS Statement on respiratory muscle testing. American journal of respiratory and critical care medicine. 2002 Aug 15;166(4):518.

Isikhan V, Güner P, Kömürcü S, Özet A, Arpaci F, Öztürk B. The relationship between disease features and quality of life in patients with cancer—I. Cancer nursing. 2001 Dec 1;24(6):490-5.

Taylor WJ, Myers J, Simpson RT, McPherson KM, Weatherall M. Quality of life of people with rheumatoid arthritis as measured by the World Health Organization Quality of Life Instrument, Short Form (WHOQOL?BREF): Score distributions and psychometric properties. Arthritis Care & Research. 2004 Jun 15;51(3):350-7.

Soleymanian T, Kokabeh Z, Ramaghi R, Mahjoub A, Argani H. Clinical outcomes and quality of life in hemodialysis diabetic patients versus non-diabetics. Journal of nephropathology. 2017 Mar;6(2):81.

Hasanpour-Dehkordi A, Khaledi-Far A, Khaledi-Far B, Salehi-Tali S. The effect of family training and support on the quality of life and cost of hospital readmissions in congestive heart failure patients in Iran. Applied Nursing Research. 2016 Aug 1;31:165-9.

Coelho DM, Castro AM, Tavares HA, Abreu P, Glória R, Duarte M. Effects of a physical exercising program on conditioning of hemodialysis patients. Brazilian Journal of Nephrology. 2006;28:121-7.

El-Deen HA, Alanazi FS, Ahmed KT. Effects of inspiratory muscle training on pulmonary functions and muscle strength in sedentary hemodialysis patients. Journal of physical therapy science. 2018;30(3):424-7.

Medeiros AI, Brandão DC, Souza RJ, Fuzari HK, Barros CE, Barbosa JB, Leite JC, Cavalcanti FC, Dornelas de Andrade A, de Melo Marinho PÉ. Effects of daily inspiratory muscle training on respiratory muscle strength and chest wall regional volumes in haemodialysis patients: a randomised clinical trial. Disability and rehabilitation. 2019 Dec 18;41(26):3173-80.

Geddes EL, O'Brien K, Reid WD, Brooks D, Crowe J. Inspiratory muscle training in adults with chronic obstructive pulmonary disease: an update of a systematic review. Respiratory medicine. 2008 Dec 1;102(12):1715-29.

Ghiasi B, Sarokhani D, Dehkordi AH, Sayehmiri K, Heidari MH. Quality of Life of patients with chronic kidney disease in Iran: Systematic Review and Meta-analysis. Indian journal of palliative care. 2018 Jan;24(1):104.

Leelarungrayub J, Pinkaew D, Puntumetakul R, Klaphajone J. Effects of a simple prototype respiratory muscle trainer on respiratory muscle strength, quality of life and dyspnea, and oxidative stress in COPD patients: a preliminary study. International journal of chronic obstructive pulmonary disease. 2017;12:1415.




How to Cite

Mehta, A., Das, D. A. K. ., Diwate, D. A. D. ., & Nagargoje, D. A. . (2022). Effect of 4 weeks inspiratory muscle training on inspiratory muscle strength and quality of life in dialysis patients. A pilot study. VIMS JOURNAL OF PHYSICAL THERAPY, 4(1), 19–25. https://doi.org/10.46858/VIMSJPT.4104



Pilot Study