title: Respiratory muscle endurance training in chronic obstructive pulmonary disease: impact on exercise capacity, dyspnea, and quality of life.
abstract: Inspiratory muscle training may have beneficial effects in certain patients with chronic obstructive pulmonary disease (COPD). Because of the lack of a home training device, normocapnic hyperpnea has rarely been used as a training mode for patients with COPD, and is generally considered unsuitable to large-scale application. To study the effects of hyperpnea training, we randomized 30 patients with COPD and ventilatory limitation to respiratory muscle training (RMT; n = 15) with a new portable device or to breathing exercises with an incentive spirometer (controls; n = 15). Both groups trained twice daily for 15 min for 5 d per week for 8 wk. Training-induced changes were significantly greater in the RMT than in the control group for the following variables: respiratory muscle endurance measured through sustained ventilation (+825 +/- 170 s [mean +/- SEM] versus -27 +/- 61 s, p < 0.001), inspiratory muscle endurance measured through incremental inspiratory threshold loading (+58 +/- 10 g versus +21.7 +/- 9.5 g, p = 0.016), maximal expiratory pressure (+20 +/- 7 cm H(2)O versus -6 +/- 6 cm H(2)O, p = 0.009), 6-min walking distance (+58 +/- 11 m versus +11 +/- 11 m, p = 0.002), V O(2peak) (+2.5 +/- 0.6 ml/kg/min versus -0.3 +/- 0.9 ml/kg/min, p = 0.015), and the SF-12 physical component score (+9.9 +/- 2.7 versus +1.8 +/- 2.4, p = 0.03). Changes in dyspnea, maximal inspiratory pressure, treadmill endurance, and the SF-12 mental component score did not differ significantly between the RMT and control groups. In conclusion, home-based respiratory muscle endurance training with the new device used in this study is feasible and has beneficial effects in subjects with COPD and ventilatory limitation.
authors.affiliation: Department of Internal Medicine, Triemli Hospital, Zurich, Switzerland. thsche@swissonline.ch
authors.forename: T A
authors.initials: TA
authors.lastname: Scherer
authors.forename: C M
authors.initials: CM
authors.lastname: Spengler
authors.forename: D
authors.initials: D
authors.lastname: Owassapian
authors.forename: E
authors.initials: E
authors.lastname: Imhof
authors.forename: U
authors.initials: U
authors.lastname: Boutellier
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001945:Breathing Exercises; D004417:Dyspnea / Q000209:etiology; D017079:Exercise Tolerance; D005260:Female; D006801:Humans; D008173:Lung Diseases, Obstructive / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012132:Respiratory Muscles / Q000503:physiopathology*; D012138:Respiratory Therapy / Q000295:instrumentation*; D016037:Single-Blind Method; D013147:Spirometry