Efficacy of a Novel Method for Inspiratory Muscle Training in People With Chronic Obstructive Pulmonary Disease

Langer, Daniël; Charususin, Noppawan; Jácome, Cristina; Hoffman, Mariana; McConnell, Alison; Decramer, Marc; Gosselink, Rik

doi:10.2522/ptj.20140245

Cited by 101 publications

(135 citation statements)

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“…Wanke et al [10] previously studied the effects of mechanical threshold loading (MTL) IMT in addition to general exercise training and observed additional improvements in exercise capacity and larger VT expansion at peak exercise in the IMT group. We have reported recently that high intensity tapered flow resistive loading (TFRL) IMT resulted in significantly larger increases in respiratory muscle strength and endurance, as well as changes in breathing pattern during loaded breathing, compared with conventional MTL-IMT [11]. We were led to speculate that the specific characteristics of TFRL-IMT might result in beneficial changes in breathing pattern during whole body exercise [11].…”

mentioning

confidence: 99%

“…We have reported recently that high intensity tapered flow resistive loading (TFRL) IMT resulted in significantly larger increases in respiratory muscle strength and endurance, as well as changes in breathing pattern during loaded breathing, compared with conventional MTL-IMT [11]. We were led to speculate that the specific characteristics of TFRL-IMT might result in beneficial changes in breathing pattern during whole body exercise [11].…”

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confidence: 99%

“…Patients performed daily high intensity TFRL-IMT (POWERbreathe KH1; HaB International Ltd., Southam, UK) consisting of two cycles of 30 breaths at the highest tolerable intensity according to a recently published protocol [11].…”

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confidence: 99%

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Inspiratory muscle training improves breathing pattern during exercise in COPD patients

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Inspiratory muscle training improves breathing pattern during exercise in COPD patients

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“…Thus our study may have underestimated the potential impact of IMT. In future studies of IMT we recommend using a device with the capacity to provide higher training intensities, such as an electronic device (Langer et al, 2015). Furthermore, future studies may target those with identifiable strength deficits, as these may constitute a subgroup which is most likely to benefit from training, while those with high baseline values have probably diluted the potential benefits of training in our cohort.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, these studies have highlighted the limitations of simple spring-loaded inspiratory muscle trainers, which can thwart training efforts through a ceiling effect at an intensity of 41 cm H2O. Since this study was designed, there has been much progress in the development of electronic inspiratory muscle training devices (Langer et al, 2015) which have a much wider training bandwidth and may therefore be better suited to training intensive care patients. The feasibility and utility of these devices deserves exploration in both ventilator-dependent and spontaneously breathing intensive care patients.…”

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confidence: 99%

Inspiratory muscle training to enhance recovery from invasive mechanical ventilation

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Inspiratory muscle weakness is a consequence of prolonged mechanical ventilation and may contribute to the residual physical disability which has been observed in intensive care survivors. Inspiratory muscle weakness is associated with duration of mechanical ventilation, with those ventilated for 7 days or longer most at risk of developing both strength and endurance deficits.Specific resistance training of the inspiratory muscles (inspiratory muscle training) improves inspiratory muscle strength and endurance in normal people, athletes and patients with a wide variety of underlying pathologies. Mechanisms of improvement include proliferation of both Type 1 and Type 2 inspiratory muscle fibres, enhanced metabolism resulting in reduced lactate production, attenuation of a fatigue-induced metaboreflex, adaptations to neural pathways and modulation of the perception of dyspnoea.Furthermore, inspiratory muscle training enhances exercise tolerance and reduces dyspnoea in both patients and athletes, while improving quality of life for patients with chronic lung or heart disease.There is a lack of evidence for inspiratory muscle training in intensive care patients, despite the potential benefits of training in this group. This project explores the feasibility, safety and efficacy of inspiratory muscle training in intensive care patients who have been mechanically ventilated for 7 days or longer, as this subset of patients is most likely to demonstrate inspiratory muscle weakness and therefore benefit from specific training. This project includes patient-centred outcome measures, as most studies of inspiratory muscle training to date have focused solely on impairments, rather than the patient experiences of quality of life, physical function or dyspnoea.Study 1 establishes the safety and feasibility of high-intensity interval-based inspiratory muscle training in selected ventilator-dependent patients. Across 195 inspiratory muscle training sessions, there were no adverse events recorded during or immediately following the treatment. No significant changes were observed in heart rate, blood pressure, respiratory rate or oxygen saturation. Furthermore, mean training pressures increased by a mean difference of 18.6 cm H2O across the 10 patients studied. Thus Study 1 confirms that inspiratory muscle training is safe in selected ventilator-dependent patients.-ii- (mean difference 11%), but not endurance, while quality of life improved more in the experimental group than the control (mean difference 12%). Improvements in physical function and dyspnoea were equivalent. Thus 2 weeks of inspiratory muscle training improves inspiratory muscle strength and quality of life in the post-weaning period.-iiiFinally, Study 5 is a protocol for a randomised trial of inspiratory muscle training performed by patients while mechanically-ventilated. Study 5 measures the impact of inspiratory muscle training on duration of mechanical ventilation, as well as residual inspiratory muscle strength and endurance, quality of life, physical f...

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Inspiratory muscle training, with or without concomitant pulmonary rehabilitation, for chronic obstructive pulmonary disease (COPD)

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et al. 2020

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Efficacy of a Novel Method for Inspiratory Muscle Training in People With Chronic Obstructive Pulmonary Disease

Cited by 101 publications

References 31 publications

Inspiratory muscle training improves breathing pattern during exercise in COPD patients

Inspiratory muscle training improves breathing pattern during exercise in COPD patients

Inspiratory muscle training to enhance recovery from invasive mechanical ventilation

Inspiratory muscle training, with or without concomitant pulmonary rehabilitation, for chronic obstructive pulmonary disease (COPD)

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