title: Target-flow inspiratory muscle training at home and during pulmonary rehabilitation in COPD patients with a ventilatory limitation during exercise.
abstract: The effects of a 10-week inspiratory muscle training (IMT) program at home were compared to IMT during a 10-week pulmonary rehabilitation program (PR) in 40 COPD patients with a ventilatory limitation of the exercise capacity. IMT was performed with a target-flow resistive device; the generated mouth pressure as well as the duty cycle were imposed. The mean age of the patients was 59, the mean FEV1 was 48% of predicted. In the training period the inspiratory muscle strength improved in both groups to the same degree. EMG fatigability of the diaphragm improved in the PR+ IMT group, but not in the IMT group. In the IMT group, the 12-min walking distance increased after the training period, but maximal workload (Wmax), VO2,max, and ADL scores did not change. In the PR + IMT group, however, Wmax, VO2,max, walking distance, and ADL scores improved significantly after the training period. Walking distance and ADL scores showed a significantly greater improvement in the PR + IMT group than in the IMT group. It is concluded that both isolated IMT and PR + IMT in COPD patients with a ventilatory limitation have a beneficial effect on inspiratory muscle strength, but PR + IMT improves the physical exercise capacity significantly more than IMT alone.
authors.affiliation: Department of Pulmonary Diseases, University of Nijmegen, Medical Center Dekkerswald, Groesbeek, The Netherlands.
authors.forename: P N
authors.initials: PN
authors.lastname: Dekhuijzen
authors.forename: H T
authors.initials: HT
authors.lastname: Folgering
authors.forename: C L
authors.initials: CL
authors.lastname: van Herwaarden
mesh_terms: D000203:Activities of Daily Living; D001945:Breathing Exercises; D003131:Combined Modality Therapy; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007320:Inspiratory Capacity; D008173:Lung Diseases, Obstructive / Q000534:rehabilitation*; D008176:Lung Volume Measurements; D008297:Male; D008875:Middle Aged