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Inspiratory muscle training in adults with chronic obstructive pulmonary disease: an update of a systematic review.

Abstract

The purpose was to update an original systematic review to determine the effect of inspiratory muscle training (IMT) on inspiratory muscle strength and endurance, exercise capacity, dyspnea and quality of life for adults with chronic obstructive pulmonary disease (COPD). The original MEDLINE and CINAHL search to August 2003 was updated to January 2007 and EMBASE was searched from inception to January 2007. Randomized controlled trials, published in English, with adults with stable COPD, comparing IMT to sham IMT or no intervention, low versus high intensity IMT, and different modes of IMT were included. Nineteen of 274 articles in the original search met the inclusion criteria. The updated search revealed 17 additional articles; 6 met the inclusion criteria, all of which compared targeted, threshold or normocapneic hyperventilation IMT to sham IMT. An update of the sub-group analysis comparing IMT versus sham IMT was performed with 10 studies from original review and 6 from the update. Sixteen meta-analyses are reported. Results demonstrated significant improvements in inspiratory muscle strength (PI(max), PI(max) % predicted, peak inspiratory flow rate), inspiratory muscle endurance (RMET, inspiratory threshold loading, MVV), exercise capacity (Ve(max), Borg Score for Respiratory Effort, 6MWT), Transitional Dyspnea Index (focal score, functional impairment, magnitude of task, magnitude of effort), and the Chronic Respiratory Disease Questionnaire (quality of life). Results suggest that targeted, threshold or normocapneic hyperventilation IMT significantly increases inspiratory muscle strength and endurance, improves outcomes of exercise capacity and one measure of quality of life, and decreases dyspnea for adults with stable COPD.

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  • Authors+Show Affiliations

    ,

    School of Rehabilitation Science, Institute of Applied Health Science, Room 403, McMaster University, 1400 Main Street West, Hamilton, ON, Canada L8S 1C7. geddesl@mcmaster.ca

    , , ,

    Source

    Respiratory medicine 102:12 2008 Dec pg 1715-29

    MeSH

    Breathing Exercises
    Dyspnea
    Exercise Tolerance
    Humans
    Inspiratory Capacity
    Muscle Strength
    Pulmonary Disease, Chronic Obstructive
    Respiratory Muscles

    Pub Type(s)

    Journal Article
    Meta-Analysis
    Research Support, Non-U.S. Gov't
    Review
    Systematic Review

    Language

    eng

    PubMed ID

    18708282

    Citation

    Geddes, E Lynne, et al. "Inspiratory Muscle Training in Adults With Chronic Obstructive Pulmonary Disease: an Update of a Systematic Review." Respiratory Medicine, vol. 102, no. 12, 2008, pp. 1715-29.
    Geddes EL, O'Brien K, Reid WD, et al. Inspiratory muscle training in adults with chronic obstructive pulmonary disease: an update of a systematic review. Respir Med. 2008;102(12):1715-29.
    Geddes, E. L., O'Brien, K., Reid, W. D., Brooks, D., & Crowe, J. (2008). Inspiratory muscle training in adults with chronic obstructive pulmonary disease: an update of a systematic review. Respiratory Medicine, 102(12), pp. 1715-29. doi:10.1016/j.rmed.2008.07.005.
    Geddes EL, et al. Inspiratory Muscle Training in Adults With Chronic Obstructive Pulmonary Disease: an Update of a Systematic Review. Respir Med. 2008;102(12):1715-29. PubMed PMID: 18708282.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Inspiratory muscle training in adults with chronic obstructive pulmonary disease: an update of a systematic review. AU - Geddes,E Lynne, AU - O'Brien,Kelly, AU - Reid,W Darlene, AU - Brooks,Dina, AU - Crowe,Jean, Y1 - 2008/08/15/ PY - 2008/03/17/received PY - 2008/07/05/revised PY - 2008/07/08/accepted PY - 2008/8/19/pubmed PY - 2009/1/3/medline PY - 2008/8/19/entrez SP - 1715 EP - 29 JF - Respiratory medicine JO - Respir Med VL - 102 IS - 12 N2 - The purpose was to update an original systematic review to determine the effect of inspiratory muscle training (IMT) on inspiratory muscle strength and endurance, exercise capacity, dyspnea and quality of life for adults with chronic obstructive pulmonary disease (COPD). The original MEDLINE and CINAHL search to August 2003 was updated to January 2007 and EMBASE was searched from inception to January 2007. Randomized controlled trials, published in English, with adults with stable COPD, comparing IMT to sham IMT or no intervention, low versus high intensity IMT, and different modes of IMT were included. Nineteen of 274 articles in the original search met the inclusion criteria. The updated search revealed 17 additional articles; 6 met the inclusion criteria, all of which compared targeted, threshold or normocapneic hyperventilation IMT to sham IMT. An update of the sub-group analysis comparing IMT versus sham IMT was performed with 10 studies from original review and 6 from the update. Sixteen meta-analyses are reported. Results demonstrated significant improvements in inspiratory muscle strength (PI(max), PI(max) % predicted, peak inspiratory flow rate), inspiratory muscle endurance (RMET, inspiratory threshold loading, MVV), exercise capacity (Ve(max), Borg Score for Respiratory Effort, 6MWT), Transitional Dyspnea Index (focal score, functional impairment, magnitude of task, magnitude of effort), and the Chronic Respiratory Disease Questionnaire (quality of life). Results suggest that targeted, threshold or normocapneic hyperventilation IMT significantly increases inspiratory muscle strength and endurance, improves outcomes of exercise capacity and one measure of quality of life, and decreases dyspnea for adults with stable COPD. SN - 1532-3064 UR - https://www.unboundmedicine.com/medline/citation/18708282/Inspiratory_muscle_training_in_adults_with_chronic_obstructive_pulmonary_disease:_an_update_of_a_systematic_review_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0954-6111(08)00247-3 DB - PRIME DP - Unbound Medicine ER -