Adding torso exercises to breathing exercises shows gains in SMA
A program that aims to simultaneously strengthen muscles needed for breathing and postural muscles in the trunk may benefit people with spinal muscular atrophy (SMA) more than a program that focuses only on breathing muscles, a new study shows.
“Combining [breathing exercises] with trunk control exercises yielded synergistic improvements in respiratory strength, pulmonary capacity, trunk stability, upper limb function, and overall motor performance,” the researchers wrote. “These findings support comprehensive rehabilitation protocols tailored to individual needs and highlight the potential for incorporating such strategies into routine clinical practice for ambulatory or sitter-type SMA populations.”
The study, “Inspiratory muscle training and trunk control exercises on respiratory strength and motor function in spinal muscular atrophy: randomized controlled trial,” was published in Scientific Reports.
SMA is a genetic disorder that causes muscle weakness and wasting. This can affect muscles in the torso, including those responsible for maintaining posture, and the inspiratory muscles, that is, those that move air into and out of the lungs.
People with SMA often benefit from respiratory exercises and inspiratory muscle training, which are techniques aimed at supporting breathing ability by strengthening the inspiratory muscles. In this study, scientists in Turkey conducted a clinical trial (NCT06178653) to test whether patients undergoing this type of therapy might benefit from additional exercises that would strengthen the torso more generally.
Gains with strengthening exercises
In the study, 38 children with SMA (mean age, 10.2), were divided into two groups. One group underwent an eight-week program of respiratory exercise, or pulmonary rehabilitation (five days a week, two times a day). The other did the same respiratory exercise program, but also performed exercises to work out torso muscles (three days a week, with pulmonary rehabilitation in each session), along with activities such as stretching or turning, while sitting on firm or soft surfaces.
Most of the patients were able to sit independently, but could not walk. All but one had received treatment with Spinraza (nusinersen), and nine were treated with Zolgensma (onasemnogene abeparvovec-xioi).
Before and after the eight-week intervention, the patients underwent a battery of assessments to measure breathing ability and overall physical function. In both groups, measures of lung function showed significant improvements following the eight-week intervention.
Both groups also showed statistically significant improvements on the Hammersmith Functional Motor Scale Expanded, an assessment of overall motor function. But scores on the Revised Upper Limb Module (RULM) — a test that specifically measures functionality of the arms and hands — only showed significant improvements in the group that received additional torso exercises.
Patients in the torso exercise group also showed significant improvements in sitting balance and selective movement control — which is moving one joint or muscle group in isolation, without unwanted movement at other joints — that weren’t seen in the group that only received breathing exercises.
Direct comparisons between the two groups generally didn’t reveal statistically significant differences across breathing and motor function outcomes, but the researchers said the findings overall suggest that adding torso exercises may lead to greater benefits for SMA patients than breathing exercises alone.
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