WHAT IS EXPIRATORY MUSCLE TRAINING (EMT)?
Like inspiratory muscle training (IMT), EMT is another form of respiratory muscle training, which focuses on strengthening the muscles of expiration. Our expiratory muscles include the intercostal and abdominal muscles which are required for forced expiratory efforts such as during exercise, talking, singing, swallowing and coughing.
EMT can therefore be relevant for a range of individuals, from those looking to enhance vocal, musical or athletic performance, through to others who have health conditions where voice, cough or swallow capabilities are weak and impaired.
In the clinic, we measure maximal expiratory pressure (MEP) to determine if EMT is indicated and guide the load we prescribe for someone’s EMT programme using an expiratory muscle trainer.
WHAT’S THE EVIDENCE TO SUPPORT EMT?
- EMT improved quality of life, cough and expiratory muscle strength in individuals with Multiple Sclerosis (Silverman et al., 2014).
- EMT can help improve swallow safety and cough function in patients with Parkinson’s Disease and dysphagia (Sapienza et al., 2012; Troche et al., 2010).
- When used in combination with voice therapy, EMT can improve speech volume in the Parkinson’s population (Tong & Ng, 2018).
- EMT in combination with IMT improves respiratory muscle strength in singers (Ray et al., 2018).
- EMT improved MEP and subjective reporting of symptoms in individuals with voice disorders (Tsai et al., 2016).
For both our IMT and EMT programmes, we use POWERbreathe respiratory muscle trainers.
Breathing Works is also the New Zealand distributor of POWERbreathe products. Check out our online shop for the full range of POWERBREATHE products
Full reference list:
Ray, C., Trudeau, M. D., & McCoy, S. (2018). Effects of Respiratory Muscle Strength Training in Classically Trained Singers. Journal of Voice, 32(5), 644.e625-644.e634. https://doi.org/https://doi.org/10.1016/j.jvoice.2017.08.005
Sapienza, C. M., Troche, M., Silverman, E. P., Rosenbek, J., & Musson, N. (2012). Strength training outcomes for airway protection in PD [Journal article; Conference proceeding] . Movement disorders, 27, S139. https://doi.org/10.1002/mds.25051
Silverman, E., Miller, S., Davenport, P. W., Musson, N., & Yeager, J. (2014). Changes in quality of life and cough after expiratory muscle strength training (EMST) in individuals with multiple sclerosis (MS) [Journal article; Conference proceeding] . Dysphagia, 29(6), 755. https://doi.org/10.1007/s00455-014-9571-4
Tong, T. S., & Ng, M. W. (2018). Effects of expiratory muscle strength training and voice therapy on Parkinsonian speech [Journal article; Conference proceeding] . Movement disorders, 33, S179‐S180. https://www.cochranelibrary.com/central/doi/10.1002/central/CN-01654668/full
Troche, M. S., Okun, M. S., Rosenbek, J. C., Musson, N., Fernandez, H. H., Rodriguez, R., Romrell, J., Pitts, T., Wheeler-Hegland, K. M., & Sapienza, C. M. (2010). Aspiration and swallowing in Parkinson disease and rehabilitation with EMST: a randomized trial [Journal article] . Neurology, 75(21), 1912‐1919. https://doi.org/10.1212/WNL.0b013e3181fef115
Tsai, Y.-C., Huang, S., Che, W.-C., Huang, Y.-C., Liou, T.-H., & Kuo, Y.-C. (2016). The Effects of Expiratory Muscle Strength Training on Voice and Associated Factors in Medical Professionals With Voice Disorders. Journal of Voice, 30(6), 759.e721-759.e727. https://doi.org/https://doi.org/10.1016/j.jvoice.2015.09.012