title: Clinical outcomes of expiratory muscle training in severe COPD patients.
abstract: The most common symptoms in chronic obstructive pulmonary disease (COPD) patients are breathlessness and exercise limitation. Although both general and inspiratory muscle training have shown clinical benefits, the effects of specific expiratory muscle training remain controversial.
  
  
  OBJECTIVE
  To investigate the effects of expiratory training on lung function, exercise tolerance, symptoms and health-related quality of life in severe COPD patients.
  
  
  METHODS
  Sixteen patients (FEV(1), 28+/-8% pred.) were randomised to either expiratory muscle or sham training groups, both completing a 5-week programme (30 min sessions breathing through an expiratory threshold valve 3 times per week) (50% of their maximal expiratory pressure (MEP) vs. placebo, respectively). Lung function, exercise capacity (bicycle ergometry and walking test), and clinical outcomes (dyspnoea and quality of life (St. George Respiratory Questionnaire (SGRQ)) were evaluated both at baseline and following the training period.
  
  
  RESULTS
  Although lung function remained roughly unchanged after training, exercise capacity, symptoms and quality of life significantly improved. The improvement in both walking distance and the SGRQ score significantly correlated with changes in MEP.
  
  
  CONCLUSIONS
  Our results confirm that a short outpatient programme of expiratory training can improve symptoms and quality of life in severe COPD patients. These effects could be partially explained by changes in expiratory muscle strength.
authors.affiliation: Departament de Pneumologia, Hospital de la Santa Creu i de Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Susana
authors.initials: S
authors.lastname: Mota
authors.forename: Rosa
authors.initials: R
authors.lastname: Güell
authors.forename: Esther
authors.initials: E
authors.lastname: Barreiro
authors.forename: Ingrid
authors.initials: I
authors.lastname: Solanes
authors.forename: Alba
authors.initials: A
authors.lastname: Ramírez-Sarmiento
authors.forename: Mauricio
authors.initials: M
authors.lastname: Orozco-Levi
authors.forename: Pere
authors.initials: P
authors.lastname: Casan
authors.forename: Joaquim
authors.initials: J
authors.lastname: Gea
authors.forename: Joaquín
authors.initials: J
authors.lastname: Sanchis
mesh_terms: D000368:Aged; D004417:Dyspnea / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation; D005080:Exercise Test / Q000379:methods; D005081:Exercise Therapy / Q000379:methods*; D006801:Humans; D008168:Lung / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000503:physiopathology / Q000534:rehabilitation*; D011788:Quality of Life; D012129:Respiratory Function Tests / Q000379:methods; D012132:Respiratory Muscles / Q000503:physiopathology*; D016896:Treatment Outcome; D016138:Walking / Q000502:physiology