Effects of controlled inspiratory muscle training in patients with COPD: a meta-analysis

Abstract

Effects of controlled inspiratory muscle training in patients with COPD: a metaanalysis. F. Lötters, B. van Tol, G. Kwakkel, R. Gosselink. #ERS Journals Ltd 2002. ABSTRACT: The purpose of this meta-analysis is to review studies investigating the efficacy of inspiratory muscle training (IMT) in chronic obstructive pulmonary disease (COPD) patients and to find out whether patient characteristics influence the efficacy of IMT.A systematic literature search was performed using the Medline and Embase databases. On the basis of a methodological framework, a critical review was performed and summary effect-sizes were calculated by applying fixed and random effects models.Both IMT alone and IMT as adjunct to general exercise reconditioning significantly increased inspiratory muscle strength and endurance. A significant effect was found for dyspnoea at rest and during exercise. Improved functional exercise capacity tended to be an additional effect of IMT alone and as an adjunct to general exercise reconditioning, but this trend did not reach statistical significance. No significant correlations were found for training effects with patient characteristics. However, subgroup analysis in IMT plus exercise training revealed that patients with inspiratory muscle weakness improved significantly more compared to patients without inspiratory muscle weakness.From this review it is concluded that inspiratory muscle training is an important addition to a pulmonary rehabilitation programme directed at chronic obstructive pulmonary disease patients with inspiratory muscle weakness. The effect on exercise performance is still to be determined.

Respiratory muscle endurance training in obese patients

“…Therefore, although it would be critical to know which patients are susceptible to improve the most with RMET, the present study cannot distinguish between responders and non-responders, and can neither provide predictive factors regarding the effect of RMET as suggested in other patient populations (for example, respiratory muscle weakness in chronic obstructive pulmonary disease). 38 Limitations of the study Although the present study is the first to have investigated the effect of respiratory muscle training in obese patients, we nevertheless acknowledge some study limitations. Our sample size was limited and no sham respiratory muscle training was used.…”

A influência do treinamento muscular respiratório pré-operatório na recuperação de pacientes submetidos à esofagectomia

“…Diversos autores 4,8,14,15,16,19 têm relatado melhora nas forças musculares inspiratória e expiratória (PImáx e PEmáx, respectivamente) em pacientes submetidos a treinamento muscular respiratório (TMR).…”

“…Fatores extrínsecos como o tabagismo, o alcoolismo, o emagrecimento e a radioterapia pré-operatória podem agravar tais complicações 1 . Na prevenção das complicações pulmonares pós-operatórias das operações nesters segmentos, a fisioterapia possui meios de melhorar as condições cardiorespiratórias do paciente, garantindo-lhe melhor relação ventilação/ perfusão (V/Q), determinando seu prognóstico no pós-operatório com menor risco 10 .Diversos autores 4,8,14,15,16,19 têm relatado melhora nas forças musculares inspiratória e expiratória (PImáx e PEmáx, respectivamente) em pacientes submetidos a treinamento muscular respiratório (TMR).O presente estudo teve por objetivo avaliar a eficácia de um treinamento muscular respiratório pré-operatório, correlacionando a melhora da força muscular respiratória com seus efeitos no pós-operatório de esofagectomias. Foram utilizados 40 pacientes randomizados, divididos em 2 grupos: grupo controle, formado por 20 pacientes, sem qualquer intervenção fisioterápica pré-operatória, onde foram coletados valores pré e pós-operatórios e dados de complicações pulmonares, além do tempo de internação em unidade de terapia intensiva e hospitalar e grupo treinado, formado por 20 pacientes submetidos a treinamento muscular pré-operatório por até 4 semanas.…”

Avaliação clínica da capacidade do exercício em pacientes com doença pulmonar obstrutiva crônica

“…It is now known that identifying the strength of the respiratory muscles, and particularly the strength of the inspiratory muscles, is of fundamental importance in determining whether inspiratory muscle training (IMT) should be included in rehabilitation programs. Generally, when MIP is <60cm H 2 0, training based on the values obtained is advised 57 . Although there is a great contradiction in the role of IMT in respiratory muscle rehabilitation programs for COPD patients, there are studies that demonstrate the efficacy of training using linear valves to improve the inspiratory muscle strength and resistance 58 .…”