Inspiratory Muscle Training in Patients With COPD

Riera, Humberto; Rubio, Teodoro Montemayor; Ruiz, Francisco Órtega; Ramos, Pilar Cejudo; Otero, D. del Castillo; Hernández, Teresa Elías; Gómez, J. Castillo

doi:10.1378/chest.120.3.748

Cited by 108 publications

(8 citation statements)

References 32 publications

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“…Decreased quality of life is a predictor for mortality and rehospitalization in COPD [ 32 ]. Studies have shown that both inspiratory and expiratory muscle training can improve quality of life in patients with COPD [ 8 , 33 ].…”

Section: Discussionmentioning

confidence: 99%

Combination of inspiratory and expiratory muscle training in same respiratory cycle versus different cycles in COPD patients: a randomized trial

Guan

et al. 2018

Respir Res

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BackgroundDifference between combined inspiratory and expiratory muscle training in same respiratory cycle or different cycles remained unclarified. We explored the difference between both patterns of combined trainings in patients with COPD.MethodsIn this randomized, open-label, controlled trial, stable COPD subjects trained for 48 minutes daily, for 8 weeks, using a monitoring device for quality control. Ninety-two subjects were randomly and equally assigned for sham training, inspiratory muscle training(IMT), combined inspiratory and expiratory muscle training in same cycle(CTSC) or combined inspiratory and expiratory muscle training in different cycles(CTDC). Respiratory muscle strength, as the primary endpoint, was measured before and after training. Registry: ClinicalTrials.gov (identifier: NCT02326181).ResultsRespiratory muscle training improved maximal inspiratory pressure(PImax), while no significant difference was found in PImax among IMT, CTSC and CTDC. Maximal expiratory pressure(PEmax) in CTSC and CTDC was greater than IMT(P = 0.026, and P=0.04, respectively) and sham training (P = 0.001). IMT, CTSC, and CTDC shortened inhalation and prolonged exhalation(P < 0.01). Subjects with respiratory muscle weakness in IMT and CTDC exhibited greater increase in PImax than those without. IMT, CTSC and CTDC showed no difference in symptoms and quality of life scales among themselves(P > 0.05).ConclusionBoth patterns of CTSC and CTDC improved inspiratory and expiratory muscle strength, while IMT alone only raised PImax. Respiratory muscle training might change the respiratory cycles, and be more beneficial for COPD patients with inspiratory muscle weakness.

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Section: Discussionmentioning

confidence: 99%

Combination of inspiratory and expiratory muscle training in same respiratory cycle versus different cycles in COPD patients: a randomized trial

Guan

et al. 2018

Respir Res

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“… 8 Clinical implications of a weak inspiratory musculature in COPD include poorer exercise and functional capacity, greater degrees of dyspnea and decreased health-related quality of life. 3 , 8 , 9 …”

Section: Introductionmentioning

confidence: 99%

Reliability and validity of the test of incremental respiratory endurance measures of inspiratory muscle performance in COPD

Formiga¹,

Roach²,

Vital³

et al. 2018

COPD

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PurposeThe Test of Incremental Respiratory Endurance (TIRE) provides a comprehensive assessment of inspiratory muscle performance by measuring maximal inspiratory pressure (MIP) over time. The integration of MIP over inspiratory duration (ID) provides the sustained maximal inspiratory pressure (SMIP). Evidence on the reliability and validity of these measurements in COPD is not currently available. Therefore, we assessed the reliability, responsiveness and construct validity of the TIRE measures of inspiratory muscle performance in subjects with COPD.Patients and methodsTest–retest reliability, known-groups and convergent validity assessments were implemented simultaneously in 81 male subjects with mild to very severe COPD. TIRE measures were obtained using the portable PrO2 device, following standard guidelines.ResultsAll TIRE measures were found to be highly reliable, with SMIP demonstrating the strongest test–retest reliability with a nearly perfect intraclass correlation coefficient (ICC) of 0.99, while MIP and ID clustered closely together behind SMIP with ICC values of about 0.97. Our findings also demonstrated known-groups validity of all TIRE measures, with SMIP and ID yielding larger effect sizes when compared to MIP in distinguishing between subjects of different COPD status. Finally, our analyses confirmed convergent validity for both SMIP and ID, but not MIP.ConclusionThe TIRE measures of MIP, SMIP and ID have excellent test–retest reliability and demonstrated known-groups validity in subjects with COPD. SMIP and ID also demonstrated evidence of moderate convergent validity and appear to be more stable measures in this patient population than the traditional MIP.

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“…Além disso, estudos de Gosselink et al (1996), sugerem que a diminuição da força muscular ventilatória esteja relacionada à hipercapnia, dispnéia, limitação da capacidade de física e, consequentemente, à qualidade de vida dos portadores de DPOC. Sabe-se que o treinamento dos músculos ventilatórios diminui a sensação de dispnéia e aumenta a endurance dos músculos respiratórios, de acordo com Casals (2005), Dekhuijzen et al (1991), Riera et al (2001), Sturdy et al (2003) e Wanke et al (1994). Portanto, o aumento da PI máx pós intervenção de EEDS apresenta resultados promissores na sensação de dispnéia, na capacidade funcional e na qualidade de vida.…”

Section: Resultsunclassified

Efeitos da estimulação diafragmática transcutânea sincronizada em pacientes com doença pulmonar obstrutiva crônica (DPOC): um estudo piloto

Nohama

Jorge

Valenga

2012

RBEB

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Resumo A pesquisa descrita neste artigo teve por objetivo avaliar quali-quantitativamente os efeitos da estimulação diafragmática transcutânea sincronizada em portadores de DPOC. Para isso, desenvolveu-se um sistema de estimulação elétrica controlado pelo sinal respiratório, a partir das variações de temperatura durante os eventos de inspiração e expiração, medidas por meio de dois termistores do tipo NTC inseridos dos lados interno e externo de uma máscara de respirador. Seis voluntários portadores de DPOC, de ambos os sexos, com idade entre 56 e 71 anos, foram submetidos a 10 sessões estimulatórias de 20 minutos. O padrão do sinal estimulatório continha pulsos com duração de 90 µs e repouso de 400 µs, gerados em intervalos regulares e modulados em bursts com período ativo de 1470 µs e inativo de 600 µs, apresentando perfil trapezoidal com tempos de subida, descida e platô de 500 ms cada. Todos os pacientes foram submetidos a uma avaliação inicial contendo: teste de força muscular respiratória avaliada por meio de PI máx e PE máx , teste de função pulmonar e aplicação do questionário de qualidade de vida SGRQ. Após 10 sessões, houve um aumento na força muscular inspiratória em todos os pacientes, onde a PI máx sofreu um incremento médio

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Inspiratory Muscle Training in Patients With COPD

Cited by 108 publications

References 32 publications

Combination of inspiratory and expiratory muscle training in same respiratory cycle versus different cycles in COPD patients: a randomized trial

Combination of inspiratory and expiratory muscle training in same respiratory cycle versus different cycles in COPD patients: a randomized trial

Reliability and validity of the test of incremental respiratory endurance measures of inspiratory muscle performance in COPD

Efeitos da estimulação diafragmática transcutânea sincronizada em pacientes com doença pulmonar obstrutiva crônica (DPOC): um estudo piloto

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