title: Effects of Inspiratory Muscle Training and Calisthenics-and-Breathing Exercises in COPD With and Without Respiratory Muscle Weakness.
abstract: BACKGROUND
  Patients with COPD may experience respiratory muscle weakness. Two therapeutic approaches to the respiratory muscles are inspiratory muscle training and calisthenics-and-breathing exercises. The aims of the study are to compare the effects of inspiratory muscle training and calisthenics-and-breathing exercises associated with physical training in subjects with COPD as an additional benefit of strength and endurance of the inspiratory muscles, thoracoabdominal mobility, physical exercise capacity, and reduction in dyspnea on exertion. In addition, these gains were compared between subjects with and without respiratory muscle weakness.
  
  
  METHODS
  25 subjects completed the study: 13 composed the inspiratory muscle training group, and 12 composed the calisthenics-and-breathing exercises group. Subjects were assessed before and after training by spirometry, measurements of respiratory muscle strength and test of inspiratory muscle endurance, thoracoabdominal excursion measurements, and the 6-min walk test. Moreover, scores for the Modified Medical Research Council dyspnea scale were reported.
  
  
  RESULTS
  After intervention, there was a significant improvement in both groups of respiratory muscle strength and endurance, thoracoabdominal mobility, and walking distance in the 6-min walk test. Additionally, there was a decrease of dyspnea in the 6-min walk test peak. A difference was found between groups, with higher values of respiratory muscle strength and thoracoabdominal mobility and lower values of dyspnea in the 6-min walk test peak and the Modified Medical Research Council dyspnea scale in the inspiratory muscle training group. In the inspiratory muscle training group, subjects with respiratory muscle weakness had greater gains in inspiratory muscle strength and endurance.
  
  
  CONCLUSIONS
  Both interventions increased exercise capacity and decreased dyspnea during physical effort. However, inspiratory muscle training was more effective in increasing inspiratory muscle strength and endurance, which could result in a decreased sensation of dyspnea. In addition, subjects with respiratory muscle weakness that performed inspiratory muscle training had higher gains in inspiratory muscle strength and endurance but not of dyspnea and submaximal exercise capacity. (ClinicalTrials.gov registration NCT01510041.).
authors.affiliation: Spirometry and Respiratory Physiotherapy Laboratory (LEFiR), Universidade Federal de São Carlos (UFSCar), São Carlos, São Paulo, Brazil. renata.fisio@gmail.com.
authors.forename: Renata P
authors.initials: RP
authors.lastname: Basso-Vanelli
authors.affiliation: Universidade Federal de São Carlos (UFSCar), São Carlos, São Paulo, Brazil.
authors.forename: Valéria A Pires
authors.initials: VA
authors.lastname: Di Lorenzo
authors.affiliation: Spirometry and Respiratory Physiotherapy Laboratory (LEFiR), Universidade Federal de São Carlos (UFSCar), São Carlos, São Paulo, Brazil.
authors.forename: Ivana G
authors.initials: IG
authors.lastname: Labadessa
authors.affiliation: Centro Universitário UNIFAFIBE, Bebedouro, São Paulo and Centro Universitário Claretiano, Batatais, São Paulo, Brazil.
authors.forename: Eloisa M G
authors.initials: EM
authors.lastname: Regueiro
authors.affiliation: Universidade Federal de São Carlos (UFSCar), São Carlos, São Paulo, Brazil.
authors.forename: Mauricio
authors.initials: M
authors.lastname: Jamami
authors.affiliation: Universidade Nove de Julho-UNINOVE, São Paulo, SP, Brazil.
authors.forename: Evelim L F D
authors.initials: EL
authors.lastname: Gomes
authors.affiliation: Universidade Federal de São Carlos (UFSCar), São Carlos, São Paulo and Universidade Nove de Julho-UNINOVE, São Paulo, SP, Brazil.
authors.forename: Dirceu
authors.initials: D
authors.lastname: Costa
mesh_terms: D000005:Abdomen / Q000503:physiopathology; D000368:Aged; D001945:Breathing Exercises; D004417:Dyspnea / Q000209:etiology; D005080:Exercise Test; D017079:Exercise Tolerance; D005260:Female; D006173:Gymnastics / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009068:Movement; D053580:Muscle Strength; D018908:Muscle Weakness / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D064797:Physical Conditioning, Human / Q000502:physiology; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000503:physiopathology / Q000534:rehabilitation*; D012132:Respiratory Muscles / Q000503:physiopathology*; D012720:Severity of Illness Index; D013909:Thorax / Q000503:physiopathology; D016138:Walking / Q000502:physiology
keywords: COPD; breathing exercises; dyspnea; physical therapy; respiratory muscles