Comparative study of two different respiratory training protocols in elderly patients with chronic obstructive pulmonary disease

Abstract

AimThe aim of the present study was to compare threshold inspiratory muscle training (IMT) and expiratory muscle training (EMT) in elderly male patients with moderate degree of COPD.Materials and methodsForty male patients with moderate degree of COPD were recruited for this study. They were randomly divided into two groups: the IMT group who received inspiratory training with an intensity ranging from 15% to 60% of their maximal inspiratory pressure, and the EMT group who received expiratory training with an equal intensity which was adjusted according to the maximal expiratory pressure. Both groups received training three times per week for 2 months, in addition to their prescribed medications.ResultsBoth IMT and EMT groups showed a significant improvement in forced vital capacity, forced expiratory volume in the first second, forced expiratory volume in the first second% from the predicted values, and forced vital capacity% from the predicted value, with no difference between the groups. Both types of training resulted in a significant improvement in blood gases (SaO2%, PaO2, PaCO2, and HCO3), with the inspiratory muscle group showing the best results. Both groups showed a significant improvement in the 6-min walking distance: an increase of about 25% in the inspiratory muscle group and about 2.5% in the expiratory muscle group.ConclusionBoth IMT and EMT must be implemented in pulmonary rehabilitation programs in order to achieve improvements in pulmonary function test, respiratory muscle strength, blood oxygenation, and 6-min walking distance.

Effects of inspiratory muscle training in COPD patients: A systematic review and meta‐analysis

“…Two thousand and fifty‐seven articles were identified but only 43 studies (38 RCT, 2 CT, and 3 cohort studies) were included in the systematic review and 37 out of them in the meta‐analysis. Reasons for study exclusion are outlined in Figure …”

Efecto del entrenamiento de la musculatura inspiratoria con válvula umbral sobre la capacidad funcional en mujeres físicamente activas mayores de 60 años

“…Lo anterior es enfatizado por Rodríguez, et al, quien presenta resultados similares en 20 mujeres AM, evidenciando una mejor capacidad aeróbica y retrasando la aparición de la fatiga (17) . La conclusión de estos autores es que al postergar la depleción de glucógeno, se pospone la fatiga, definiéndose ésta como "la incapacidad de seguir manteniendo una fuerza muscular apropiada al esfuerzo, llevando a disminuir la performance del sujeto" (18) . Este concepto de fatiga en la musculatura respiratoria está ligado a procesos de activación de los mecanorreceptores y el metabolorreflejo.…”

“…Esto concuerda con una investigación en animales donde se demostró que se puede consumir más lactato en ejercicio intenso, llevando así a una mayor metabolización de este sustrato, y por lo tanto disminuyendo su concentración en sangre. Resultados similares fueron obtenidos por Mehani (18) , argumentando una disminución del metabolorreflejo, atenuando el fenómeno de vasoconstricción en los músculos de las extremidades inferiores.…”

Physical therapy in chronic obstructive pulmonary disease (analysis of the evidence-based medicine)

“…All studies found that pulmonary rehabilitation programs or individual physical therapy programs were effective in improving the quality of life [12][13][14][15][16][17], physical endurance [12][13][14][15][16][18][19][20][21][22][23], respiratory muscle strength [13,18,23], reducing symptoms of CoPd [14,16,19,23], improving the function of external breathing [16,[24][25][26], blood parameters [22,27], cognitive functions [21], functional state of muscles [28], survival rates [29,30], and reducing the number of hospital days [31]. The main part of investigations was devoted to the comparison of therapeutic rehabilitation programs that included several components and referred to stable patients with CoPd.…”