Comparison of effectiveness of pressure threshold and targeted resistance devices for inspiratory muscle training in patients with chronic obstructive pulmonary disease.
OBJECTIVE
Previous studies have provided little information about the comparative efficacy of treatment with pressure threshold and targeted resistive inspiratory muscle training devices. This study compared the efficacy of these two types of inspiratory muscle training (IMT) devices on inspiratory muscle function, exercise capacity, and quality of life in patients with chronic obstructive pulmonary disease (COPD).


METHODS
Forty two patients with moderate to severe COPD were randomly assigned to either a control group, a group receiving pressure threshold inspiratory muscle training, or a group receiving targeted resistive inspiratory muscle training. The training intensity was 50% of patients' maximal inspiratory pressure (MIP). Home-based training comprised two 15-minute sessions a day, 5 days a week for 8 weeks. Inspiratory muscle function measurement included MIP and inspiratory muscle endurance.


RESULTS
Thirty patients completed the program, 10 from each group. Twelve patients were excluded because of changes in pharmacological regimen or admission to the hospital (n = 5), study withdrawal (n = 4), or poor compliance with the training program (n = 3). After training, a significant increase in endurance time was found for the threshold group and targeted resistive group (4.4 +/- 3.2 min and 3.0 +/- 2.9 min, respectively, both p < 0.05 vs control), with no significant difference between the 2 training groups. The 6-minute walking distance also increased significantly in both training groups (p < 0.05).


CONCLUSIONS
Targeted resistive IMT with a controlled training load has a similar efficacy to the more popularly used pressure threshold IMT and can be incorporated in the treatment of COPD patients. The targeted resistance device offers a less expensive and easily used treatment choice.
Hsiao
Shu Fang
SF
Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taiwan.
Wu
Ying Tai
YT
Wu
Huey Dong
HD
Wang
Tyng Guey
TG
D000368:Aged; D001945:Breathing Exercises; D005260:Female; D006801:Humans; D007320:Inspiratory Capacity; D008297:Male; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology* / Q000534:rehabilitation*; D011788:Quality of Life; D012129:Respiratory Function Tests; D012132:Respiratory Muscles / Q000503:physiopathology*; D018709:Statistics, Nonparametric; D016896:Treatment Outcome