title: Inspiratory muscle training in adults with chronic obstructive pulmonary disease: a systematic review.
abstract: The purpose of this study was to conduct a systematic review to determine the effect of inspiratory muscle training (IMT) on inspiratory muscle strength and endurance, exercise capacity, dyspnea and quality of life for adults with chronic obstructive pulmonary disease (COPD). A systematic review of the literature was conducted according the Cochrane Collaboration protocol using Medline and CINAHL. Nineteen of 274 extracted articles met the inclusion criteria and addressed comparisons of interest which included: IMT versus sham; IMT versus no intervention; low- versus high-intensity IMT; and two different modes of IMT. Thirteen meta-analyses were reported. Results indicate that targeted resistive or threshold IMT was associated with significant improvements in some outcomes of inspiratory muscle strength (PI(max) (cm H2O)) and endurance (Inspiratory Threshold Loading (kPa)), exercise capacity (Borg Scale for Respiratory Effort (modified Borg scale), Work Rate maximum (Watts)), and dyspnea (Transition Dyspnea Index), whereas IMT without a target or not using threshold training did not show improvement in these variables. There was no conclusive evidence regarding quality of life measures. IMT is effective for adults with COPD when using threshold or targeted devices that control or provide a target for training intensity.
authors.affiliation: School of Rehabilitation Science, IAHS-Room 403, McMaster University, 1400 Main Street West, Hamilton, Ont., Canada L8S 1C7. geddesl@mcmaster.ca
authors.forename: E Lynne
authors.initials: EL
authors.lastname: Geddes
authors.forename: W Darlene
authors.initials: WD
authors.lastname: Reid
authors.forename: Jean
authors.initials: J
authors.lastname: Crowe
authors.forename: Kelly
authors.initials: K
authors.lastname: O'Brien
authors.forename: Dina
authors.initials: D
authors.lastname: Brooks
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004417:Dyspnea / Q000534:rehabilitation; D017079:Exercise Tolerance; D006801:Humans; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000534:rehabilitation*; D011788:Quality of Life; D012132:Respiratory Muscles / Q000503:physiopathology; D012138:Respiratory Therapy / Q000379:methods*