Inspiratory Muscle Training in Patients with Chronic Obstructive Pulmonary Disease (COPD) as Part of a Respiratory Rehabilitation Program Implementation of Mechanical Devices: A Systematic Review

Abstract

Chronic Obstructive Pulmonary Disease (COPD) is a complex and heterogeneous disease, with pulmonary and extrapulmonary manifestations, which leads to the need to personalize the assessment and treatment of these patients. The latest updates of national and international guidelines for the management of COPD reveal the importance of respiratory rehabilitation (RR) and its role in improving symptoms, quality of life, and psychosocial sphere of patients. Within RR, the inspiratory muscle training (IMT) has received special interest, showing benefits in maximum inspiratory pressure, perception of well-being, and health status in patients with chronic heart disease, respiratory diseases, and dyspnea during exercise. The aim of this review is to assess the efficacy of IMT in COPD patients through the use of inspiratory muscle training devices, compared with respiratory rehabilitation programs without inspiratory muscle training. In the last years, many mechanical devices focused on inspiratory muscle training have been developed, some of them, such as the AirOFit PRO™, PowerBreath®, or FeelBreathe®, have shown clear benefits. The active search for candidate patients to undergo the RR program with inspiratory muscle training using this type of device in COPD patients represents an advance in the treatment of this disease, with direct benefits on the quality of life of the patients. In this article, we review the available evidence on IMT in these patients and describe the different devices used for it.

Closing the Gap between Inpatient and Outpatient Settings: Integrating Pulmonary Rehabilitation and Technological Advances in the Comprehensive Management of Frail Patients

“…Pulmonary rehabilitation (PR) is currently considered a milestone in the therapeutic management of patients with chronic pulmonary diseases [ 1 , 2 ]. To date, level one evidence supports its benefits in chronic obstructive pulmonary diseases (COPD), since it improves symptoms, exercise tolerance, physical and psychosocial issues, health-related quality of life, and reduces hospitalizations and socio-sanitary costs [ 1 , 2 , 3 , 4 , 5 , 6 ].…”

Reply to Yigit, S.; Akinci, B. Comment on “Vázquez-Gandullo et al. Inspiratory Muscle Training in Patients with Chronic Obstructive Pulmonary Disease (COPD) as Part of a Respiratory Rehabilitation Program Implementation of Mechanical Devices: A Systematic Review. Int. J. Environ. Res. Public Health 2022, 19, 5564”

“…We would like to thank you for your interest [ 1 ] in our systematic review article about inspiratory muscle training (IMT) in COPD patients [ 2 ] and for sharing your point of view on it.…”

“…In our review article, we carried out a systematic review of articles following the PRISMA recommendations [ 3 ], in which we used different databases independently. To determine the suitability of the studies, we established PICO questions that included: (a) participation of COPD patients, (b) avoidance of duplicity of studies, and (c) implementation of an inspiratory muscle training program, as reflected in the figure number 1 included in the article [ 2 ].…”

“…The assessment of the quality of the studies was defined according to the following criteria set out in our article [ 2 ], mainly the inclusion of original articles, systematic reviews, and meta-analyses, which were less than 10 years old.…”

“…However, the implementation of respiratory rehabilitation programs in COPD patients is not recommended by scientific societies such as the British Thoracic Society (BTS) or the Spanish Society of Pneumology and Thoracic Surgery (SEPAR), although the latter recommends the addition of inspiratory muscle training in patients with inspiratory muscle weakness, defined as a maximum inspiratory pressure of less than 60 cm H2O, as reflected in our article [ 2 ].…”