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Cycle ergometer and inspiratory muscle training offer modest benefit compared with cycle ergometer alone: a comprehensive assessment in stable COPD patients.
Int J Chron Obstruct Pulmon Dis 2017; 12:2655-2668IJ

Abstract

BACKGROUND

Cycle ergometer training (CET) has been shown to improve exercise performance of the quadriceps muscles in patients with COPD, and inspiratory muscle training (IMT) may improve the pressure-generating capacity of the inspiratory muscles. However, the effects of combined CET and IMT remain unclear and there is a lack of comprehensive assessment.

MATERIALS AND METHODS

Eighty-one patients with COPD were randomly allocated to three groups: 28 received 8 weeks of CET + IMT (combined training group), 27 received 8 weeks of CET alone (CET group), and 26 only received 8 weeks of free walking (control group). Comprehensive assessment including respiratory muscle strength, exercise capacity, pulmonary function, dyspnea, quality of life, emotional status, nutritional status, and body mass index, airflow obstruction, and exercise capacity index were measured before and after the pulmonary rehabilitation program.

RESULTS

Respiratory muscle strength, exercise capacity, inspiratory capacity, dyspnea, quality of life, depression and anxiety, and nutritional status were all improved in the combined training and CET groups when compared with that in the control group (P<0.05) after pulmonary rehabilitation program. Inspiratory muscle strength increased significantly in the combined training group when compared with that in the CET group (ΔPImax [maximal inspiratory pressure] 5.20±0.89 cmH2O vs 1.32±0.91 cmH2O; P<0.05). However, there were no significant differences in the other indices between the two groups (P>0.05). Patients with weakened respiratory muscles in the combined training group derived no greater benefit than those without respiratory muscle weakness (P>0.05). There were no significant differences in these indices between the patients with malnutrition and normal nutrition after pulmonary rehabilitation program (P>0.05).

CONCLUSION

Combined training is more effective than CET alone for increasing inspiratory muscle strength. IMT may not be useful when combined with CET in patients with weakened inspiratory muscles. Nutritional status had slight impact on the effects of pulmonary rehabilitation. A comprehensive assessment approach can be more objective to evaluate the effects of combined CET and IMT.

Authors+Show Affiliations

Department of Respiratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China.Department of Respiratory Medicine, The State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.Department of Respiratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China.Department of Respiratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China.Department of Respiratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China.Department of Respiratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China.Department of Respiratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China.Department of Respiratory Medicine, The State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.Department of Respiratory Medicine, The State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.Department of Respiratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China.

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

28919733

Citation

Wang, Kai, et al. "Cycle Ergometer and Inspiratory Muscle Training Offer Modest Benefit Compared With Cycle Ergometer Alone: a Comprehensive Assessment in Stable COPD Patients." International Journal of Chronic Obstructive Pulmonary Disease, vol. 12, 2017, pp. 2655-2668.
Wang K, Zeng GQ, Li R, et al. Cycle ergometer and inspiratory muscle training offer modest benefit compared with cycle ergometer alone: a comprehensive assessment in stable COPD patients. Int J Chron Obstruct Pulmon Dis. 2017;12:2655-2668.
Wang, K., Zeng, G. Q., Li, R., Luo, Y. W., Wang, M., Hu, Y. H., ... Chen, X. (2017). Cycle ergometer and inspiratory muscle training offer modest benefit compared with cycle ergometer alone: a comprehensive assessment in stable COPD patients. International Journal of Chronic Obstructive Pulmonary Disease, 12, pp. 2655-2668. doi:10.2147/COPD.S140093.
Wang K, et al. Cycle Ergometer and Inspiratory Muscle Training Offer Modest Benefit Compared With Cycle Ergometer Alone: a Comprehensive Assessment in Stable COPD Patients. Int J Chron Obstruct Pulmon Dis. 2017;12:2655-2668. PubMed PMID: 28919733.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cycle ergometer and inspiratory muscle training offer modest benefit compared with cycle ergometer alone: a comprehensive assessment in stable COPD patients. AU - Wang,Kai, AU - Zeng,Guang-Qiao, AU - Li,Rui, AU - Luo,Yu-Wen, AU - Wang,Mei, AU - Hu,Yu-He, AU - Xu,Wen-Hui, AU - Zhou,Lu-Qian, AU - Chen,Rong-Chang, AU - Chen,Xin, Y1 - 2017/09/06/ PY - 2017/9/19/entrez PY - 2017/9/19/pubmed PY - 2018/6/5/medline KW - chronic obstructive pulmonary disease KW - comprehensive assessment KW - cycle ergometer KW - exercise performance KW - inspiratory muscle training KW - pulmonary rehabilitation SP - 2655 EP - 2668 JF - International journal of chronic obstructive pulmonary disease JO - Int J Chron Obstruct Pulmon Dis VL - 12 N2 - BACKGROUND: Cycle ergometer training (CET) has been shown to improve exercise performance of the quadriceps muscles in patients with COPD, and inspiratory muscle training (IMT) may improve the pressure-generating capacity of the inspiratory muscles. However, the effects of combined CET and IMT remain unclear and there is a lack of comprehensive assessment. MATERIALS AND METHODS: Eighty-one patients with COPD were randomly allocated to three groups: 28 received 8 weeks of CET + IMT (combined training group), 27 received 8 weeks of CET alone (CET group), and 26 only received 8 weeks of free walking (control group). Comprehensive assessment including respiratory muscle strength, exercise capacity, pulmonary function, dyspnea, quality of life, emotional status, nutritional status, and body mass index, airflow obstruction, and exercise capacity index were measured before and after the pulmonary rehabilitation program. RESULTS: Respiratory muscle strength, exercise capacity, inspiratory capacity, dyspnea, quality of life, depression and anxiety, and nutritional status were all improved in the combined training and CET groups when compared with that in the control group (P<0.05) after pulmonary rehabilitation program. Inspiratory muscle strength increased significantly in the combined training group when compared with that in the CET group (ΔPImax [maximal inspiratory pressure] 5.20±0.89 cmH2O vs 1.32±0.91 cmH2O; P<0.05). However, there were no significant differences in the other indices between the two groups (P>0.05). Patients with weakened respiratory muscles in the combined training group derived no greater benefit than those without respiratory muscle weakness (P>0.05). There were no significant differences in these indices between the patients with malnutrition and normal nutrition after pulmonary rehabilitation program (P>0.05). CONCLUSION: Combined training is more effective than CET alone for increasing inspiratory muscle strength. IMT may not be useful when combined with CET in patients with weakened inspiratory muscles. Nutritional status had slight impact on the effects of pulmonary rehabilitation. A comprehensive assessment approach can be more objective to evaluate the effects of combined CET and IMT. SN - 1178-2005 UR - https://www.unboundmedicine.com/medline/citation/28919733/Cycle_ergometer_and_inspiratory_muscle_training_offer_modest_benefit_compared_with_cycle_ergometer_alone:_a_comprehensive_assessment_in_stable_COPD_patients_ L2 - https://dx.doi.org/10.2147/COPD.S140093 DB - PRIME DP - Unbound Medicine ER -