The Outcomes of Short Term Inspiratory Muscle Training (IMT) Combined with Chest Physiotherapy in Hospitalized COPD Patients

Abstract

Objective: The objective of this study was to identify the outcomes of short term inspiratory muscle training (IMT) combined with chest physiotherapy (CP) on lung function, inspiratory muscle strength, exercise tolerance and quality of life of COPD patients. Materials and Methods: This randomized-controlled trial was conducted at the Terendak Armed Forces Hospital, Melaka. Eighteen hospitalized COPD patients (FEV1 50% to = 80% predicted) were randomized into intervention (IG) and control group (CG). The IG received IMT and CP treatments whilst the CG received only CP for a period of 4 weeks. Assessments of lung function (FEV1/FVC), inspiratory muscle strength (PImax), exercise tolerance (6MWT) and quality of life (SGRQ score) were taken at baseline and after 4 weeks. Results: Analysis showed IG group increased in FEV1/FVC by 19.4%, PImax by 54.7%, 6MWT by 33.2% and quality of life by 52.6% (All, p<0.05). The control group increased in FEV1/FVC by 8.7% (p>0.05), PImax by 15% (p<0.05), 6MWT by 18.9% (p<0.05) and quality of life by 15.6% (p<0.05). Conclusion: The present study has established that by combining inspiratory muscle training (IMT) and chest physiotherapy, provides superior effects on lung function, inspiratory muscle strength, exercise tolerance and quality of life among COPD patients. DOI: http://dx.doi.org/10.3329/bjms.v12i4.13302 Bangladesh Journal of Medical Science Vol. 12 No. 04 October ’13 Page 398-404

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

“…This study was contradicted by the study conducted by Ahmed et al 25 who evaluated the effect of short-term IMT combined with chest physiotherapy on lung function in moderate hospitalized COPD patients. They concluded that an increase in FEV 1 /FVC could be seen after 4 weeks of training in contrast to the results of the present study in the IMT group.…”

The effect of home-based inspiratory muscle training on exercise capacity, exertional dyspnea and pulmonary function in COPD patients

“…This study and similar studies indicate that inspiratory training cannot cause changes in lung volumes,[ 17 20 ] while in the study of Ahmad et al ., an increase in lung volume was observed after 4 weeks of intervention. [ 3 ] The subjects examined in his study were patients admitted to hospital. As hospitalized patients are generally under corticosteroid therapy without an established treatment plan, changes in lung volumes seem to occur as a result of the treatment, because this disease is defined as an irreversible lung problem.…”

“…[ 1 ] According to a report by the World Health Organization (WHO), there are 80 million people with COPD worldwide[ 2 ] and more than 6.3% of the population over 30 years in the Asia-Pacific countries suffer from this condition, which ranges from moderate to severe. [ 3 ] In 2001, the number of COPD patients per 100,000 people, who were mostly men living in cities, was estimated to be 105 patients aged 15-49 years and 1057 patients aged 50 years and over in 18 provinces of Iran, respectively. [ 4 ] Many economic and social costs are imposed on the society by this disease, and we also saw a trend toward increased financial burden in the past decade.…”

“…showed that IMT, with all three types of threshold, resistive, and normocapnic devices, has beneficial effects on quality of life, exercise tolerance, and dyspnea in patients with COPD; but in the same study, it was noted that the clinical significance of the findings is unclear and further studies are needed with different protocols (in terms of intensity, frequency, and monitoring of training). [ 16 ] As rehabilitation programs are extensive due to the diversity in implementation, and most of the studies in this area have been performed in the long-term periods of 6-24 months[ 17 18 19 ] and the role of short-term periods of IMT (periods of 4 weeks to 3 months) has not been well established in previous studies,[ 3 20 ] the researchers intended to perform a study to determine the effect of short-term period of home-based IMT on dyspnea, exercise tolerance, and pulmonary function in patients with COPD.…”

Inspiratory Muscle Training in COPD

“…Of these, 25 studies (n ¼ 631 subjects) included subjects with respiratory muscle weakness. [17][18][19][22][23][24][25][26][27][28][31][32][33][34]37,38,40,41,43,[45][46][47][48][49]52 Various loads for IMT were 15% of P Imax , 42,46,48 30% of P Imax , 17,28,31,33,38,40,43,51 load progression of 5-35% of P Imax , 23,24 load progression up to 40-50% of P Imax , 21,39,53 load progression up to 60% of P Imax , 18,20,22,[24][25][26][27][28]30,…”