Abstract：
Introduction: Children with obesity suffer excess dyspnea that contributes to sedentariness. Developing innovative strategies to increase exercise tolerance and participation in children with obesity is a high priority. Because inspiratory training (IT) has reduced dyspnea, we sought to assess IT in children with obesity. Methods: We conducted a 6-week randomized IT trial involving 8- to 17-year-olds with obesity. Participants were randomized 1:1 to either high [75% of maximal inspiratory pressure (MIP)] or low resistance control (15% of MIP) three times weekly. Assessments included adherence, patient satisfaction, and changes in inspiratory strength and endurance, dyspnea scores and total activity level. Results: Among 27 randomized, 24 (89%) completed the intervention. Total session adherence was 72% which did not differ between treatment groups. IT was safe, and more than 90% felt IT benefitted breathing and general health. IT led to a mean improvement (95% CI) in inspiratory strength measured by MIP of 10.0 cm H2O (-3.5, 23.6; paired t-test, p = 0.139) and inspiratory endurance of 8.9 (1.0, 16.8; paired t-test, p = 0.028); however, there was no significant difference between high- and low-treatment groups. IT led to significant reductions in dyspnea with daily activity (p < 0.001) and in prospectively reported dyspnea during exercise (p = 0.024). Among the high- versus low-treatment group, we noted a trend for reduced dyspnea with daily activity (p = 0.071) and increased daily steps (865 vs. -51, p = 0.079). Discussion: IT is safe and feasible for children with obesity and holds promise for reducing dyspnea and improving healthy activity in children with obesity. Breathe-Fit trial NCT05412134.
摘要：
简介：肥胖儿童患有过度的呼吸困难，这有助于镇静。制定创新策略以提高肥胖儿童的运动耐量和参与度是当务之急。因为吸气训练（IT）可以减少呼吸困难，我们试图评估肥胖儿童的IT.方法：我们进行了为期6周的随机IT试验，涉及8至17岁的肥胖儿童。参与者每周3次，以1：1随机分为高[最大吸气压力（MIP）的75％]或低阻力控制（MIP的15％）。评估包括依从性，患者满意度,吸气强度和耐力的变化，呼吸困难评分和总活动水平。结果：在27个随机分组中，24(89%)完成了干预。总的疗程依从性为72%,这在治疗组之间没有差异。它是安全的，超过90%的人认为IT有益于呼吸和整体健康。IT导致MIP测得的吸气强度平均改善（95％CI）为10.0cmH2O（-3.5，23.6；配对t检验，p=0.139），吸气耐力为8.9（1.0，16.8；配对t检验，p=0.028)；然而，高治疗组和低治疗组之间无显著差异.IT导致日常活动的呼吸困难（p<0.001）和运动过程中的呼吸困难（p=0.024）显着减少。在高和低治疗组中，我们注意到每日活动减少呼吸困难的趋势（p=0.071）和增加每日步数（865vs.-51，p=0.079）。讨论：IT对于肥胖儿童是安全可行的，并有望减少呼吸困难和改善肥胖儿童的健康活动。呼吸拟合试验NCT05412134。
