Dyspnoea in COPD: can inspiratory muscle training help?
Chronic obstructive pulmonary disease (COPD) is a progressive, common and costly condition. Dyspnoea frequently limits activity and reduces health-related quality of life. In addition to impaired lung function, peripheral muscle deconditioning and respiratory muscle dysfunction also contribute to dyspnoea and reduced exercise capacity. Pulmonary rehabilitation using whole body exercise training improves peripheral muscle function and reduces dyspnoea but does not improve respiratory muscle function. Providing that adequate training intensities are utilised, specific loading of the inspiratory muscles with commercially available hand-held devices can improve inspiratory muscle strength and endurance. Several studies have investigated the effects of inspiratory muscle training on dyspnoea in COPD subjects. Results of these studies are conflicting, most likely reflecting methodological shortcomings including insufficient training load, insensitive outcome measures, and inadequate statistical power. This paper describes the origin of dyspnoea in COPD, with particular attention given to the role of inspiratory muscle dysfunction in its genesis and its possible amelioration through inspiratory muscle training.
Hill
Kylie
K
Department of Pulmonary Physiology, Sir Charles Gairdner Hospital, Nedlands, WA 6009, Australia.
Jenkins
Sue C
SC
Hillman
David R
DR
Eastwood
Peter R
PR
D001945:Breathing Exercises; D004417:Dyspnea / Q000209:etiology* / Q000503:physiopathology / Q000534:rehabilitation*; D006801:Humans; D001239:Inhalation; D026741:Physical Therapy Modalities; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications* / Q000503:physiopathology / Q000534:rehabilitation*; D012132:Respiratory Muscles / Q000503:physiopathology