Inspiratory Muscle Training in Patients with Chronic Obstructive Pulmonary Disease: the State of the Evidence

Overview

Journal Cardiopulm Phys Ther J

Specialty Cardiology & Vascular Diseases

Date 2010 May 15

PMID 20467518

Citations 17

Authors

Michael J Shoemaker

Sarah Donker

Ashley Lapoe

Affiliations

Soon will be listed here.

Abstract

Purpose: The purpose of the present review was to assess the quality of evidence in the literature regarding the specific benefits of inspiratory muscle training (IMT) with an emphasis on training intensity and the relationships between changes in inspiratory muscle function and other clinical outcome measures.

Methods: Articles were found by searching CINAHL, PubMed, Medline via First Search, and ProQuest databases. Articles used in the review were randomized trials of IMT vs. sham IMT or no intervention, published in English in a peer-reviewed journal, included patients with chronic obstructive pulmonary disease (COPD), and specified the intensity of training. The quality of the studies was evaluated by 2 independent reviewers using the methodological rigor scale described by Medlicott and Harris as well as Sackett's levels of evidence. Fifteen articles met the inclusion criteria and were used in this review.

Results: Consistent improvements in maximal inspiratory pressures (ranging from -11 to -30 cm H(2)O) and inspiratory muscle endurance were found. Improvements in dyspnea and health-related quality of life were also observed. Inspiratory muscle training may result in improved exercise tolerance as measured using walking tests. High-intensity IMT resulted in improved training efficiency with respect to inspiratory muscle strength, but evidence of the effect of high-intensity IMT on other clinical outcomes is lacking.

Conclusion: Despite research spanning decades, there are numerous limitations in the literature regarding IMT. IMT appears to improve dyspnea, waking test distance, and health-related quality of life in individuals with COPD, but it is not clear whether this improvement is mediated through improved inspiratory muscle strength and endurance. This review discussed several considerations critical to the design of future trials.

Citing Articles

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Low-Medium and High-Intensity Inspiratory Muscle Training in Critically Ill Patients: A Systematic Review and Meta-Analysis.

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The Effectiveness of Home-Based Inspiratory Muscle Training on Small Airway Function and Disease-Associated Symptoms in Patients with Chronic Obstructive Pulmonary Disease.

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

Ammous O, Feki W, Lotfi T, Khamis A, Gosselink R, Rebai A Cochrane Database Syst Rev. 2023; 1:CD013778.

PMID: 36606682 PMC: 9817429. DOI: 10.1002/14651858.CD013778.pub2.

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