title: Cycle ergometer and inspiratory muscle training in chronic obstructive pulmonary disease.
abstract: In patients with chronic obstructive pulmonary disease (COPD) the intensity of aerobic training is limited by dyspnea. Improving strength of the inspiratory muscles could enhance aerobic exercise training by reducing exercise-related dyspnea. We examined effects of home-based inspiratory muscle training (IMT) and cycle ergometry training (CET) in 53 patients with moderate to severe COPD (FEV(1)% pred, 50 +/- 17 [mean +/- SD]). Patients were randomly assigned to 4 mo of training in one of four groups: IMT, CET, CET + IMT, or health education (ED). Patients were encouraged to train to the limits of their dyspnea. Inspiratory muscle strength and endurance increased in IMT and CET + IMT groups compared with CET and ED groups (p < 0. 01). Peak oxygen uptake increased and heart rate, minute ventilation, dyspnea, and leg fatigue decreased at submaximal work rates in the CET and CET + IMT groups compared with the IMT and ED groups (p < 0. 01). There were no differences between the CET and CET + IMT groups. Home-based CET produced a physiological training effect and reduced exercise-related symptoms while IMT increased respiratory muscle strength and endurance. The combination of CET and IMT did not produce additional benefits in exercise performance and exercise-related symptoms. This is the first study to demonstrate a physiological training effect with home-based exercise training.
authors.affiliation: University of Illinois at Chicago, Chicago, Illinois, USA. JLLarson@uic.edu
authors.forename: J L
authors.initials: JL
authors.lastname: Larson
authors.forename: M K
authors.initials: MK
authors.lastname: Covey
authors.forename: S E
authors.initials: SE
authors.lastname: Wirtz
authors.forename: J K
authors.initials: JK
authors.lastname: Berry
authors.forename: C G
authors.initials: CG
authors.lastname: Alex
authors.forename: W E
authors.initials: WE
authors.lastname: Langbein
authors.forename: L
authors.initials: L
authors.lastname: Edwards
mesh_terms: D000368:Aged; D001945:Breathing Exercises; D003131:Combined Modality Therapy; D004417:Dyspnea / Q000503:physiopathology / Q000534:rehabilitation; D005080:Exercise Test; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D006266:Health Education; D006801:Humans; D007320:Inspiratory Capacity / Q000502:physiology*; D008173:Lung Diseases, Obstructive / Q000503:physiopathology / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D010807:Physical Endurance / Q000502:physiology; D010809:Physical Fitness / Q000502:physiology; D012132:Respiratory Muscles / Q000503:physiopathology*; D016037:Single-Blind Method; D014797:Vital Capacity / Q000502:physiology