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Efficacy of a Novel Method for Inspiratory Muscle Training in People With Chronic Obstructive Pulmonary Disease.

Abstract

BACKGROUND

Most inspiratory muscle training (IMT) interventions in patients with chronic obstructive pulmonary disease (COPD) have been implemented as fully supervised daily training for 30 minutes with controlled training loads using mechanical threshold loading (MTL) devices. Recently, an electronic tapered flow resistive loading (TFRL) device was introduced that has a different loading profile and stores training data during IMT sessions.

OBJECTIVE

The aim of this study was to compare the efficacy of a brief, largely unsupervised IMT protocol conducted using either traditional MTL or TFRL on inspiratory muscle function in patients with COPD.

DESIGN

Twenty patients with inspiratory muscle weakness who were clinically stable and participating in a pulmonary rehabilitation program were randomly allocated to perform 8 weeks of either MTL IMT or TFRL IMT.

METHODS

Participants performed 2 daily home-based IMT sessions of 30 breaths (3-5 minutes per session) at the highest tolerable intensity, supported by twice-weekly supervised sessions. Adherence, progression of training intensity, increases in maximal inspiratory mouth pressure (Pimax), and endurance capacity of inspiratory muscles (Tlim) were evaluated.

RESULTS

More than 90% of IMT sessions were completed in both groups. The TFRL group tolerated higher loads during the final 3 weeks of the IMT program, with similar effort scores on the 10-Item Borg Category Ratio (CR-10) Scale, and achieved larger improvements in Pimax and Tlim than the MTL group.

LIMITATIONS

A limitation of the study was the absence of a study arm involving a sham IMT intervention.

CONCLUSIONS

The short and largely home-based IMT protocol significantly improved inspiratory muscle function in both groups and is an alternative to traditional IMT protocols in this population. Participants in the TFRL group tolerated higher training loads and achieved larger improvements in inspiratory muscle function than those in the MTL group.

Links

  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    D. Langer, PT, PhD, KU Leuven, 3001 Leuven, Belgium.

    ,

    N. Charususin, PT, MSc, KU Leuven.

    ,

    C. Jácome, PT, MSc, School of Health Sciences, University of Aveiro (ESSUA), Aveiro, Portugal.

    ,

    M. Hoffman, PT, MSc, Department of Physical Therapy, Universidade Federal de Minas Gerais, Minas, Brazil.

    ,

    A. McConnell, PhD, Centre for Sports Medicine and Human Performance, Brunel University, London, United Kingdom.

    ,

    M. Decramer, MD, PhD, Respiratory Medicine, KU Leuven.

    R. Gosselink, PT, PhD, Rehabilitation Sciences, KU Leuven, Tervuursevest 101, 3001 Leuven, Belgium. rik.gosselink@faber.kuleuven.be.

    Source

    Physical therapy 95:9 2015 Sep pg 1264-73

    MeSH

    Aged
    Breathing Exercises
    Female
    Forced Expiratory Volume
    Functional Residual Capacity
    Humans
    Inhalation
    Male
    Middle Aged
    Muscle Fatigue
    Patient Compliance
    Physical Endurance
    Pulmonary Disease, Chronic Obstructive
    Respiratory Muscles
    Self Care
    Vital Capacity

    Pub Type(s)

    Comparative Study
    Journal Article
    Randomized Controlled Trial

    Language

    eng

    PubMed ID

    25858974

    Citation

    Langer, Daniel, et al. "Efficacy of a Novel Method for Inspiratory Muscle Training in People With Chronic Obstructive Pulmonary Disease." Physical Therapy, vol. 95, no. 9, 2015, pp. 1264-73.
    Langer D, Charususin N, Jácome C, et al. Efficacy of a Novel Method for Inspiratory Muscle Training in People With Chronic Obstructive Pulmonary Disease. Phys Ther. 2015;95(9):1264-73.
    Langer, D., Charususin, N., Jácome, C., Hoffman, M., McConnell, A., Decramer, M., & Gosselink, R. (2015). Efficacy of a Novel Method for Inspiratory Muscle Training in People With Chronic Obstructive Pulmonary Disease. Physical Therapy, 95(9), pp. 1264-73. doi:10.2522/ptj.20140245.
    Langer D, et al. Efficacy of a Novel Method for Inspiratory Muscle Training in People With Chronic Obstructive Pulmonary Disease. Phys Ther. 2015;95(9):1264-73. PubMed PMID: 25858974.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Efficacy of a Novel Method for Inspiratory Muscle Training in People With Chronic Obstructive Pulmonary Disease. AU - Langer,Daniel, AU - Charususin,Noppawan, AU - Jácome,Cristina, AU - Hoffman,Mariana, AU - McConnell,Alison, AU - Decramer,Marc, AU - Gosselink,Rik, Y1 - 2015/04/09/ PY - 2014/06/02/received PY - 2015/03/23/accepted PY - 2015/4/11/entrez PY - 2015/4/11/pubmed PY - 2015/11/14/medline SP - 1264 EP - 73 JF - Physical therapy JO - Phys Ther VL - 95 IS - 9 N2 - BACKGROUND: Most inspiratory muscle training (IMT) interventions in patients with chronic obstructive pulmonary disease (COPD) have been implemented as fully supervised daily training for 30 minutes with controlled training loads using mechanical threshold loading (MTL) devices. Recently, an electronic tapered flow resistive loading (TFRL) device was introduced that has a different loading profile and stores training data during IMT sessions. OBJECTIVE: The aim of this study was to compare the efficacy of a brief, largely unsupervised IMT protocol conducted using either traditional MTL or TFRL on inspiratory muscle function in patients with COPD. DESIGN: Twenty patients with inspiratory muscle weakness who were clinically stable and participating in a pulmonary rehabilitation program were randomly allocated to perform 8 weeks of either MTL IMT or TFRL IMT. METHODS: Participants performed 2 daily home-based IMT sessions of 30 breaths (3-5 minutes per session) at the highest tolerable intensity, supported by twice-weekly supervised sessions. Adherence, progression of training intensity, increases in maximal inspiratory mouth pressure (Pimax), and endurance capacity of inspiratory muscles (Tlim) were evaluated. RESULTS: More than 90% of IMT sessions were completed in both groups. The TFRL group tolerated higher loads during the final 3 weeks of the IMT program, with similar effort scores on the 10-Item Borg Category Ratio (CR-10) Scale, and achieved larger improvements in Pimax and Tlim than the MTL group. LIMITATIONS: A limitation of the study was the absence of a study arm involving a sham IMT intervention. CONCLUSIONS: The short and largely home-based IMT protocol significantly improved inspiratory muscle function in both groups and is an alternative to traditional IMT protocols in this population. Participants in the TFRL group tolerated higher training loads and achieved larger improvements in inspiratory muscle function than those in the MTL group. SN - 1538-6724 UR - https://www.unboundmedicine.com/medline/citation/25858974/Efficacy_of_a_Novel_Method_for_Inspiratory_Muscle_Training_in_People_With_Chronic_Obstructive_Pulmonary_Disease_ L2 - https://academic.oup.com/ptj/article-lookup/doi/10.2522/ptj.20140245 DB - PRIME DP - Unbound Medicine ER -