Comparison of the Effects of Peripheral Muscle Training and Inspiratory Muscle Training in Geriatric Individuals

In geriatric individuals, there is a decrease in muscle strength, muscle mass and physical performance with ageing. These physiological changes occurring in geriatric individuals make maintaining the physical activity necessary for a healthy life difficult. Weakness of respiratory muscles in geriatric individuals can increase the prevalence of diseases and disability. It has been shown in the literature that peripheral muscle training and inspiratory muscle training increase exercise capacity similarly. The effectiveness of moderate-intensity peripheral muscle training and inspiratory muscle training in sarcopenic geriatric individuals was compared and found to have similar effects on muscle strength.

Our study aims to compare the effects of inspiratory and peripheral muscle training in addition to aerobic exercise on muscle strength, physical performance, respiratory muscle strength, functional capacity, sarcopenia, and quality of life.

Aging causes decline in physiological systems, including the cardiorespiratory system, musculo-skeletal system, vestibulo-ocular system, slowed postural control and cognitive function (especially dual task and executive functions). These changes occurring in geriatric individuals are an increased risk factor for various diseases and affect the individual's daily living activities, working life, addiction status and communication with the environment.

The most recommended physical activity subgroups in the guidelines for geriatric individuals are aerobic exercises, strengthening exercises, flexibility exercises and balance exercises. Physiological changes that occur in the organism during the aging process can cause muscle weakness, functional losses/limitations, balance problems, cognitive problems, chronic diseases and mortality. However, physiological and mechanical respiratory changes in geriatric individuals; It is known that there is a decrease in lung elasticity, respiratory muscle strength and chest wall compliance. These physiological changes make it difficult to maintain the physical activity necessary for a healthy life. It has also been shown that weakness of respiratory muscles in geriatric individuals can increase the rate of morbidity and mortality.

It is reported in the literature that respiratory muscle training (RMT) strengthens the diaphragm in geriatric individuals and may have a protective effect against respiratory tract infections by improving aerobic capacity, physical performance and coughing skill. In addition, studies have shown that Inspiratory Muscle Training (IMT) increases the strength of the inspiratory respiratory muscles, allows a more mechanically effective breathing pattern, and provides improvements in exercise capacity, diaphragm thickness and mobility, cardiac autonomic control and functional autonomy. Studies have shown that IMT is effective and applicable in improving balance ability. It has been reported to improve dynamic and reactive balance, as well as gait speed and inspiratory muscle function in healthy geriatric individuals. Considering the stated benefits of IMT, some authors suggest that it is an alternative or complementary training method that can be used for geriatric individuals, especially when other types of exercise are not possible, and that it should be added to rehabilitation programs.

In general, it has been reported in the literature that resistant exercise training is preferred as an intervention in geriatric individuals and that this training improves muscle strength, physical performance and functional performance. In a study where a high-intensity resistance training program was applied in sarcopenic geriatric women, it was reported that it increased respiratory muscle strength and Maximum Expiratory Pressure (MEP) and affected health-related quality of life.

There are opinions reported in the literature that improvement in peripheral and inspiratory muscle strength will reduce the risk of mortality. The effects of moderate-intensity peripheral muscle training and inspiratory muscle training were compared in sarcopenic geriatric individuals and were found to have similar effects on muscle strength. It has been reported that there is no significant change in muscle mass and physical performance. However, no study has been found in which the aerobic and strengthening exercises recommended for geriatric individuals are combined. In order to shed light on this deficiency in the literature, the investigators aim in our study to compare the effects of peripheral muscle training and inspiratory muscle training combined with aerobic training on muscle strength, physical performance, functional capacity and quality of life.

Eligibility Criteria:
Inclusion Criteria:

* 65 years to 80 years (Older ),
* Standardised Mini Mental Test score ≥ 20,
* To walk 10 meters with or without an assistive device,
* If the participants answered No all of the questions of The Physical Activity Readiness Questionnaire
* Volunteering to participate in the study

Exclusion Criteria:

* With serious neurological and orthopedic problems that may prevent them from exercising,
* With serious vision and hearing problems,
* With a psychiatric disease,
* With serious cardiac and pulmonary system diseases that may prevent them from exercising,
* With vestibular system problems or medication use that may affect the vestibular system,
* Smokers.