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Rationale of the combined use of inspiratory and expiratory devices in improving maximal inspiratory pressure and maximal expiratory pressure of patients with chronic obstructive pulmonary disease.
Arch Phys Med Rehabil. 2009 Jun; 90(6):913-8.AP

Abstract

OBJECTIVE

To examine the rationale of the combined use of a new expiratory device in association with a previously assessed inspiratory device in improving 3 indicators of the respiratory muscle strength, for example, maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), and dyspnea grade.

DESIGN

Randomized trial.

SETTING

Home-based pulmonary rehabilitation.

PARTICIPANTS

Adults (N=32; mean age, 68y).

MAIN OUTCOME MEASURE

We instructed 32 patients with mild to very severe COPD to use the devices, and randomized them in a 1:1 ratio: they were assigned to the sham training control group (16 patients who trained at a load not able to improve MIP and MEP) or to the training group (16 patients). The patients trained at home twice daily for 15 minutes, 7 days a week, for 12 months. MIP and MEP as well as dyspnea perception were evaluated at 1, 6, and 12 months from the beginning of the training. The impact of additional work of breathing was measured at baseline and after the use of the expiratory device.

RESULTS

The patients who performed the respiratory training showed significant and progressive improvements of MIP (81+/-4 at 12 months vs 57+/-7 as basal values expressed in cm H2O; P<.05) and MEP (97+/-2 at 12 months vs 62+/-4 as basal values; P<.05) at the end of the training. In addition, they showed a significant reduction of dyspnea perception (1.18+/-0.29 vs 2.93+/-0.32 as basal values; P<.05) at the end of the training.

CONCLUSIONS

This study suggests that home exercise with the combined use of our expiratory and inspiratory devices leads to a significant improvement of respiratory muscle function in patients with mild to very severe COPD.

Authors+Show Affiliations

Pulmonary Department, San Carlo Borromeo Hospital, Milan, Italy.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

19480865

Citation

Battaglia, Elvia, et al. "Rationale of the Combined Use of Inspiratory and Expiratory Devices in Improving Maximal Inspiratory Pressure and Maximal Expiratory Pressure of Patients With Chronic Obstructive Pulmonary Disease." Archives of Physical Medicine and Rehabilitation, vol. 90, no. 6, 2009, pp. 913-8.
Battaglia E, Fulgenzi A, Ferrero ME. Rationale of the combined use of inspiratory and expiratory devices in improving maximal inspiratory pressure and maximal expiratory pressure of patients with chronic obstructive pulmonary disease. Arch Phys Med Rehabil. 2009;90(6):913-8.
Battaglia, E., Fulgenzi, A., & Ferrero, M. E. (2009). Rationale of the combined use of inspiratory and expiratory devices in improving maximal inspiratory pressure and maximal expiratory pressure of patients with chronic obstructive pulmonary disease. Archives of Physical Medicine and Rehabilitation, 90(6), 913-8. https://doi.org/10.1016/j.apmr.2008.12.019
Battaglia E, Fulgenzi A, Ferrero ME. Rationale of the Combined Use of Inspiratory and Expiratory Devices in Improving Maximal Inspiratory Pressure and Maximal Expiratory Pressure of Patients With Chronic Obstructive Pulmonary Disease. Arch Phys Med Rehabil. 2009;90(6):913-8. PubMed PMID: 19480865.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Rationale of the combined use of inspiratory and expiratory devices in improving maximal inspiratory pressure and maximal expiratory pressure of patients with chronic obstructive pulmonary disease. AU - Battaglia,Elvia, AU - Fulgenzi,Alessandro, AU - Ferrero,Maria Elena, PY - 2008/06/12/received PY - 2008/12/09/revised PY - 2008/12/23/accepted PY - 2009/6/2/entrez PY - 2009/6/2/pubmed PY - 2009/6/18/medline SP - 913 EP - 8 JF - Archives of physical medicine and rehabilitation JO - Arch Phys Med Rehabil VL - 90 IS - 6 N2 - OBJECTIVE: To examine the rationale of the combined use of a new expiratory device in association with a previously assessed inspiratory device in improving 3 indicators of the respiratory muscle strength, for example, maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), and dyspnea grade. DESIGN: Randomized trial. SETTING: Home-based pulmonary rehabilitation. PARTICIPANTS: Adults (N=32; mean age, 68y). MAIN OUTCOME MEASURE: We instructed 32 patients with mild to very severe COPD to use the devices, and randomized them in a 1:1 ratio: they were assigned to the sham training control group (16 patients who trained at a load not able to improve MIP and MEP) or to the training group (16 patients). The patients trained at home twice daily for 15 minutes, 7 days a week, for 12 months. MIP and MEP as well as dyspnea perception were evaluated at 1, 6, and 12 months from the beginning of the training. The impact of additional work of breathing was measured at baseline and after the use of the expiratory device. RESULTS: The patients who performed the respiratory training showed significant and progressive improvements of MIP (81+/-4 at 12 months vs 57+/-7 as basal values expressed in cm H2O; P<.05) and MEP (97+/-2 at 12 months vs 62+/-4 as basal values; P<.05) at the end of the training. In addition, they showed a significant reduction of dyspnea perception (1.18+/-0.29 vs 2.93+/-0.32 as basal values; P<.05) at the end of the training. CONCLUSIONS: This study suggests that home exercise with the combined use of our expiratory and inspiratory devices leads to a significant improvement of respiratory muscle function in patients with mild to very severe COPD. SN - 1532-821X UR - https://www.unboundmedicine.com/medline/citation/19480865/Rationale_of_the_combined_use_of_inspiratory_and_expiratory_devices_in_improving_maximal_inspiratory_pressure_and_maximal_expiratory_pressure_of_patients_with_chronic_obstructive_pulmonary_disease_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0003-9993(09)00184-1 DB - PRIME DP - Unbound Medicine ER -