Home respiratory muscle training in patients with chronic obstructive pulmonary disease

Abstract

This version is available at https://strathprints.strath.ac.uk/45007/ Strathprints is designed to allow users to access the research output of the University of Strathclyde. Unless otherwise explicitly stated on the manuscript, Copyright © and Moral Rights for the papers on this site are retained by the individual authors and/or other copyright owners. Please check the manuscript for details of any other licences that may have been applied. You may not engage in further distribution of the material for any profitmaking activities or any commercial gain. You may freely distribute both the url (https://strathprints.strath.ac.uk/) and the content of this paper for research or private study, educational, or not-for-profit purposes without prior permission or charge.Any correspondence concerning this service should be sent to the Strathprints administrator: strathprints@strath.ac.ukThe Strathprints institutional repository (https://strathprints.strath.ac.uk) is a digital archive of University of Strathclyde research outputs. It has been developed to disseminate open access research outputs, expose data about those outputs, and enable the management and persistent access to Strathclyde's intellectual output. Results: Maximal inspiratory pressure and maximal expiratory pressure values were significantly increased after 3 and 6 months of exercise. Dyspnoea grade was significantly reduced and the 6-min walking test showed an increase in effort tolerance, after 6 months of home training. Quality of life assessment showed an improvement, associated with a decrease of respiratory disease symptoms. Conclusions: Inspiratory muscle strength training with Respivol™ seems to be efficient in reducing symptoms and improving quality of life in adults with COPD.Key words: COPD, inspiratory muscle training, pulmonary rehabilitation. INTR ODUCTIONPulmonary rehabilitation for patients affected by chronic lung disease is accepted as a useful treatment option to reduce symptoms and improve functional ability as well as quality of life (QoL). In particular, patients affected by COPD frequently use health-care resources to improve lung performance. The first goal of rehabilitation is to restore patients to the highest possible level of independent function, in order to increase their level of pulmonary activity through exercise training and to reduce and gain control of symptoms. 1,2 Inspiratory muscle activity may be compromised in patients with COPD: such impairment may contribute to dyspnoea, 3 exercise limitation 4 and hypercapnia. 5 The rationale for ventilatory muscle training is that the enhancement of respiratory muscle function Correspondence: Maria Elena Ferrero, Istituto Patologia Generale Via Mangiagalli 31, 20133 Milano, Italy. Email: mariaelena.ferrero@unimi.it Conflict of interest: The authors have declared they do not have any financial or other affiliation with Respivol™, who developed and sells the product that they tested.potentially reduces the severity of breathlessness and improves exercise tolerance. 1 Respiratory...

Evaluation of the effectiveness of a home-based inspiratory muscle training programme in patients with chronic obstructive pulmonary disease using multiple inspiratory muscle tests

“…Adherence to the intervention was good in our study and our group reached a mean pressure of 62% PImax (11.7) at the end of the programme, well above the 30% PImax minimal intensity required to achieve a training effect [27] and similar to other home IMT studies [51,52]. Our study suggests that a community-based programme, shorter than previously reported in research [24,25], could be effective in improving PImax and perception of well-being in community patients.…”

“…Previous home-based IMT studies that have demonstrated increases in walking distance had longer durations of training [24,25,46], therefore it is possible that the duration of our IMT programme was a factor explaining this lack of improvement, although the duration of our programme was typical of UK practice. We did, however, find that the heart rate at the end of the ISWT in the PrBr-IMT group was slightly lower post-IMT than in the control group.…”

“…This effect was also evident in our study despite lack of consistent improvement in inspiratory muscle tests or in exercise capacity. Clinically, this is an important positive result, as the home based programme in this study did not include other forms of exercise training known to enhance the effects of IMT [5] and was of shorter duration than some home IMT programmes [24,25]. Therefore, our study suggests that community IMT programmes of seven week duration are likely to improve wellbeing and perception of breathlessness during activities of daily living in moderate to severe COPD patients even in the absence of improvements in respiratory muscle function and exercise capacity.…”

“…Many positive home-based studies have a long duration of training, ranging from 3 to 12 months [24,25] and close supervision, which would be unrealistic in community health services. It is unclear whether similar results can be achieved by a more feasible home-based programme.…”

Predicting maximum voluntary ventilation in normal healthy individuals using indirect inspiratory muscle strength measurements: a correlation study

“…As the pressure-generating capacity of the respiratory muscles falls and as the ratio of the pressures produced by the respiratory muscles to the maximum pressure that can be achieved increases dyspnea progressively worsens [11]. Since there is an established association between respiratory muscle dysfunction and dyspnea, an improvement in respiratory muscle function with inspiratory muscle training (IMT) could lead to a reduction in dyspnea [12,13]. A meta-analysis of IMT in 17 clinical trials found limited support for its use in terms of improving pulmonary function, respiratory muscle strength and endurance, exercise capacity, and functional status in patients with COPD [14][15][16].…”