Inspiratory muscle training in adults with chronic obstructive pulmonary disease: A systematic review

Abstract

The purpose of this study was to conduct a systematic review to determine the effect of inspiratory muscle training (IMT) on inspiratory muscle strength and endurance, exercise capacity, dyspnea and quality of life for adults with chronic obstructive pulmonary disease (COPD). A systematic review of the literature was conducted according the Cochrane Collaboration protocol using Medline and CINAHL. Nineteen of 274 extracted articles met the inclusion criteria and addressed comparisons of interest which included: IMT versus sham; IMT versus no intervention; low- versus high-intensity IMT; and two different modes of IMT. Thirteen meta-analyses were reported. Results indicate that targeted resistive or threshold IMT was associated with significant improvements in some outcomes of inspiratory muscle strength (PI(max) (cm H2O)) and endurance (Inspiratory Threshold Loading (kPa)), exercise capacity (Borg Scale for Respiratory Effort (modified Borg scale), Work Rate maximum (Watts)), and dyspnea (Transition Dyspnea Index), whereas IMT without a target or not using threshold training did not show improvement in these variables. There was no conclusive evidence regarding quality of life measures. IMT is effective for adults with COPD when using threshold or targeted devices that control or provide a target for training intensity.

The Effects of Respiratory Muscle Weakness and Pulmonary Involvement on Functional Status, Fatigue and Health Related Quality of Life in Patients With Systemic Sclerosis

“…Respiratory muscle function has been shown to contribute to dyspnea, exercise limitation, [23][24][25][26] Furthermore, trials in interstitial lung disease and pulmonary hypertension showed improved exercise capacity, symptoms and quality of life following pulmonary rehabilitation with or without respiratory muscle training. [27][28][29] Marcisz et al 30 showed that FVC, forced expiratory volume in one second, VC, MVV, maximum midexpiratory flow rate 25-75%, and peak expiratory flow rate values were significantly decreased in SSc patients compared to controls.…”

Respiratory muscle endurance training in obese patients

“…[15][16][17] This effect on respiratory muscle function was shown to be greater compared with whole-body exercise training (cycling or running). 18 In addition to improving respiratory muscle capacity, respiratory muscle training has also been shown to reduce the perception of adverse respiratory sensations and to increase the exercise performance in healthy subjects [19][20][21] as well as in patients with impaired lung function.…”

“…18 In addition to improving respiratory muscle capacity, respiratory muscle training has also been shown to reduce the perception of adverse respiratory sensations and to increase the exercise performance in healthy subjects [19][20][21] as well as in patients with impaired lung function. 15,17,22,23 Whether respiratory muscle training in obese patients may also improve respiratory muscle capacity, reduce dyspnea and increase exercise tolerance remains unknown.…”

Laser Acupuncture Therapy Added to Inspiratory Muscle and Aerobic Exercise Training Improves Small Airway Ventilation in Metal Arc Welders

“…The results of this study indicated that the mean FEF 0.2-1.2% , FEF 25-75% , FEF 75-85% , MEF 75% and MEF 50% values were significantly higher in both groups after treatments and there were statistically significant differences between mean values of the investigated parameters in group (A) and group (B) after treatment (Table 1, 2 and 3).The results of this study were in concordance with previous studies demonstrating that in welding workers, the improvement in small airway ventilation in welders after diaphragmatic breathing exercise, aerobic exercise training in addition to laser acupuncture therapy might be related to broncholytic effect, disappearance of inflammatory changes in bronchial mucosa, improved potency of airways and respiratory muscles strength. Diaphragmatic breathing exercise is associated with improvement in inspiratory muscles strength and endurance that may help to relieve the sensation of dyspnea (13). Also, diaphragmatic breathing enhances lower lung ventilation, reduces residual volume, improves airflow in small airways and as a result reduces pulmonary hyperinflation in patients with chronic obstructive lung disease (14).…”