title: [Inspiratory muscle training followed by non-invasive positive pressure ventilation in patients with severe chronic obstructive pulmonary disease: a randomized controlled trial].
abstract: OBJECTIVE
  To investigate the effects of inspiratory muscle training followed by non-invasive positive pressure ventilation in patients with severe chronic obstructive pulmonary disease (COPD).
  
  
  METHODS
  This investigator-initiated randomized, controlled trial recruited 88 patients with stable GOLD stage IV COPD, who were randomized into 4 equal groups to continue oxygen therapy (control group) or to receive inspiratory muscle training followed by non-invasive positive pressure ventilation (IMT-NPPV group), inspiratory muscle training only (IMT group), or noninvasive positive pressure ventilation only (NPPV group) for at least 8 weeks. The outcomes of the patients were assessed including the quality of life (SRI scores), maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP), dyspnea (MRC scores), 6-min walking distance (6MWD) and lung function.
  
  
  RESULTS
  s Compared to baseline values, SRI scores, 6MWT and MRC scores increased significantly after 8 weeks in IMT-NPPV, IMT and NPPV groups, and the improvements were significantly greater in IMT-NPPV group than in IMT and NPPV groups (P<0.05 for all). In IMT-NPPV and IMT groups, MIP and MEP increased significantly after the training (P<0.05), and the improvement was more prominent in IMT-NPPV group (P<0.05). No significant changes were found in pulmonary functions in the groups after 8 weeks of treatment (P>0.05).
  
  
  CONCLUSIONS
  Inspiratory muscle training followed by non-invasive positive pressure ventilation, compared with inspiratory muscle training or non-invasive positive pressure ventilation alone, can better enhance the quality of life, strengthen the respiratory muscles, improve exercise tolerance and relieve the dyspnea in patients with COPD.
authors: Frist Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China. E-mail: zhlx09@163.com.
authors: Lu-Qian
authors: LQ
authors: Zhou
authors: Xiao-Ying
authors: XY
authors: Li
authors: Yun
authors: Y
authors: Li
authors: Bing-Peng
authors: BP
authors: Guo
authors: Li-Li
authors: LL
authors: Guan
authors: Xin
authors: X
authors: Chen
authors: Yu-Wen
authors: YW
authors: Luo
authors: Peng
authors: P
authors: Luo
authors: Rong-Chang
authors: RC
authors: Chen
mesh_terms: D004417:Dyspnea / Q000628:therapy; D017079:Exercise Tolerance; D006801:Humans; D008168:Lung / Q000503:physiopathology; D063087:Noninvasive Ventilation; D064797:Physical Conditioning, Human; D011175:Positive-Pressure Respiration; D029424:Pulmonary Disease, Chronic Obstructive / Q000628:therapy*; D011788:Quality of Life; D012132:Respiratory Muscles / Q000503:physiopathology*