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

Beaumont, Marc; Forget, Patrice; Couturaud, Francis; Reychler, Grégory

doi:10.1111/crj.12905

Cited by 165 publications

(135 citation statements)

References 96 publications

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“…Adaptations in VO 2peak might have been promoted by an increased ability to supply oxygen to the working muscles, given the local reserve capacity to consume oxygen that has been reported in COPD subjects . By contrast, no effects were observed in lung function variables, which are more likely to improve with the inclusion of inspiratory muscle training . Of note, the non‐exercising group improved FEV1/FVC values, but it was actually due to a non‐significant albeit substantial decline in FVC values (−12%), while the trained group preserved FVC during the 12‐week period.…”

Section: Discussionmentioning

confidence: 91%

Effects of concurrent exercise training on muscle dysfunction and systemic oxidative stress in older people with COPD

Alcázar

Losa‐Reyna

Rodríguez-López

et al. 2019

Scandinavian Med Sci Sports

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Oxidative stress is associated with disease severity and limb muscle dysfunction in COPD. Our main goal was to assess the effects of exercise training on systemic oxidative stress and limb muscle dysfunction in older people with COPD. Twenty‐nine outpatients with COPD (66‐90 years) were randomly assigned to a 12‐week exercise training (ET; high‐intensity interval training (HIIT) plus power training) or a control (CT; usual care) group. We evaluated mid‐thigh muscle cross‐sectional area (CSA; computed tomography); vastus lateralis (VL) muscle thickness, pennation angle, and fascicle length (ultrasonography); peak VO2 uptake (VO2peak) and work rate (Wpeak) (incremental cardiopulmonary exercise test); rate of force development (RFD); maximal muscle power (Pmax; force‐velocity testing); systemic oxidative stress (plasma protein carbonylation); and physical performance and quality of life. ET subjects experienced changes in mid‐thigh muscle CSA (+4%), VL muscle thickness (+11%) and pennation angle (+19%), VO2peak (+14%), Wpeak (+37%), RFD (+32% to 65%), Pmax (+38% to 51%), sit‐to‐stand time (−24%), and self‐reported health status (+20%) (all P < 0.05). No changes were noted in the CT group (P > 0.05). Protein carbonylation decreased among ET subjects (−27%; P < 0.05), but not in the CT group (P > 0.05). Changes in protein carbonylation were associated with changes in muscle size and pennation angle (r = −0.44 to −0.57), exercise capacity (r = −0.46), muscle strength (r = −0.45), and sit‐to‐stand performance (r = 0.60) (all P < 0.05). The combination of HIIT and power training improved systemic oxidative stress and limb muscle dysfunction in older people with COPD. Changes in oxidative stress were associated with exercise‐induced structural and functional adaptations.

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Section: Discussionmentioning

confidence: 91%

Effects of concurrent exercise training on muscle dysfunction and systemic oxidative stress in older people with COPD

Alcázar

Losa‐Reyna

Rodríguez-López

et al. 2019

Scandinavian Med Sci Sports

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“…The minimal clinically important difference for TDI is 1 unit [98]. There was no benefit of adjunctive IMT in patients completing a pulmonary rehabilitation program [99].…”

Section: Inspiratory Muscle Training (Imt)mentioning

confidence: 92%

Dyspnea in COPD: New Mechanistic Insights and Management Implications

et al. 2019

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Dyspnea is the most common symptom experienced by patients with chronic obstructive pulmonary disease (COPD). To avoid exertional dyspnea, many patients adopt a sedentary lifestyle which predictably leads to extensive skeletal muscle deconditioning, social isolation, and its negative psychological sequalae. This ''dyspnea spiral'' is well documented and it is no surprise that alleviation of this distressing symptom has become a key objective highlighted across COPD guidelines. In reality, this important goal is often difficult to achieve, and successful symptom management awaits a Enhanced Digital Features To view enhanced digital features for this article go to https://doi.org/10.6084/ m9.figshare.9970322.

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“…These individuals generally suffer from significant weakness of their respiratory musculature with specific impairment described in the pressure‐generating and endurance capacity of the inspiratory muscles . Clinical implications of a weak inspiratory musculature in COPD include poorer exercise and functional capacity, greater dyspnea and decreased quality of life . Inspiratory muscle weakness has been traditionally evaluated in COPD based mainly upon maximal inspiratory pressure (MIP) values, but another measure has recently been introduced and validated in this population .…”

Section: Introductionmentioning

confidence: 99%

Higher serum levels of systemic inflammatory markers are linked to greater inspiratory muscle dysfunction in COPD

Formiga

Vital

Urdaneta

et al. 2019

Clinical Respiratory J

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Background Chronic obstructive pulmonary disease (COPD) is associated with an inflammatory response that becomes more pronounced in acute exacerbations. Considerable attention has recently focused on the value of several inflammatory mediators in predicting worsening of COPD‐related symptoms. Whereas respiratory muscle dysfunction is also widely present in this population, little is known about how systemic inflammation relates to inspiratory muscle dysfunction in COPD. Methods Fifty‐three males with mild‐to‐very severe airflow obstruction underwent blood sampling for 23 inflammatory markers, including acute‐phase proteins, cytokines and adipokines. Inspiratory muscle performance was assessed via the test of incremental respiratory endurance, providing measures of maximal (MIP) and sustained maximal (SMIP) inspiratory pressures. Results The mean ± SD MIP and SMIP were 75.32 ± 19.62 cmH2O and 406.15 ± 124.55 PTU. MIP negatively correlated with CRP, SAA and cystatin C (r‐values from −0.333 to −0.378, P < 0.02), while SMIP was inversely related to SAA and cystatin C (r = −0.534 and r = −0.396, P = 0.00). Significant differences in CRP, SAA, cystatin C and PARC were also found between subjects with and without inspiratory muscle weakness. No additional significant relationships were observed between either MIP or SMIP and other inflammatory markers in the study. Conclusions MIP and SMIP are markedly reduced with greater degrees of inflammation in COPD as expressed by higher levels of CRP, SAA and cystatin C. Future research is needed to further examine the above findings and determine the impact of systemic inflammation along with its underlying mechanisms on inspiratory muscle function in COPD.

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

Abstract: IMT using threshold devices improves inspiratory muscle strength, exercise capacity and quality of life, decreases dyspnea. However, there is no added effect of IMT on dyspnea during PR (compared with PR alone).

Cited by 165 publications

References 96 publications

Effects of concurrent exercise training on muscle dysfunction and systemic oxidative stress in older people with COPD

Effects of concurrent exercise training on muscle dysfunction and systemic oxidative stress in older people with COPD

Dyspnea in COPD: New Mechanistic Insights and Management Implications

Higher serum levels of systemic inflammatory markers are linked to greater inspiratory muscle dysfunction in COPD

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