New Trial into Effects of IMT in COPD Patients

A new clinical trial will be looking at the effects of inspiratory muscle training (IMT) on shortness of breath (dyspnea) and postural control in patients with COPD.

Shortness of breath in patients with COPD

Patients with chronic obstructive pulmonary disorder (COPD) experience shortness of breath, or dyspnea, during physical activity. It is related to weakness of their respiratory muscles. There is much evidence of IMT improving breathing muscle function and reducing the intensity of dyspnea.

Balance impairment in patients with COPD

Patients with COPD and pronounced respiratory muscle weakness also show impaired postural balance. But improvements in respiratory muscle function might improve balance control in patients.

Purpose of the controlled trial

The trial will consider whether eight week’s of controlled IMT will reduce the intensity and feeling of dyspnea. It will also investigate if it improves postural control. And finally it will look to see if IMT improves blood flow and oxygen delivery to a patient’s limb muscles too.

Inspiratory muscle training intervention

The trial will use the POWERbreathe KHP2 Inspiratory Muscle Training device for monitoring breathing parameters. And patients will each use a POWERbreathe Medic Plus twice a day, mostly in their home and without supervision. However they will perform one training session each week under supervision, during which the training load will be increased. A sham group will perform three daily sessions of 30 breaths and will train at a constant inspiratory load of no more than 10% of their initial Pi,max.

The Principal Investigator is Rik Gosselink, PT, PhD. The trial is open to all sexes ageing from 40 to 90 years of age. It will take place at the University Hospital Leuven, Belgium. And the estimated completion date for the trial is January 31st 2018.

POWERbreathe Medic helps patients with breathing problems AND saves NHS money and resources

Health bosses announced back in October 2014 that the NHS in England needed extra money and an overhaul to services in order for patient care not to suffer.

When it comes to respiratory care the NHS could save both money and resources if they prescribed POWERbreathe Medic Respiratory Muscle Training (RMT) for patients with medical conditions such as COPD, Heart Failure, Asthma, Thoracic Surgery, Ventilator Weaning, Cystic Fibrosis and Neuromuscular Disease.

In a 2005 study of the benefits of a 12-month programme of POWERbreathe RMT, researchers observed significant reductions in the use of healthcare resources.1

POWERbreathe RMT for COPD

Accordingly to Professor Peter Calverley (Lung Report III. British Lung Foundation), in the average PCT serving 250,000 people, there would be 14,200 GP consultations per year for chronic obstructive pulmonary disease (COPD), and 9,600 inpatient bed days. Reducing length of hospital stay is an NHS productivity indicator.

POWERbreathe reduced hospital bed days by 29% and GP consultations by 23% compared with placebo (see table above).

POWERbreathe RMT for Asthma

In another study, Weiner et al2 observed an 86% reduction in hospitalisations/emergency room visits following respiratory muscle training in moderate/severe asthmatics (from 1.4 to 0.2 per 3 months per patient).

And in three separate studies, Weiner et al. observed an average 51% reduction in β2-agonist consumption (from 3.9 to 1.6 puffs per day)2,3,4 after respiratory muscle training, and in one study3, corticosteroid use decreased ~80%.

How POWERbreathe Medic could save NHS money & resources

In 2005 when this study was conducted, the total potential annual savings derived from POWERbreathe Medic prescription per average PCT due to reduced hospital bed days and medication consumption (not including savings due to reduction in GP consultations) were substantial.

The POWERbreathe Medic offers an evidence-based, drug-free treatment for patients with medical conditions such as COPD, Heart Failure, Asthma, Thoracic Surgery, Ventilator Weaning, Cystic Fibrosis and Neuromuscular Disease. It is the only Inspiratory Muscle Training device for RMT available for prescription that has been used in research into the benefits of IMT for a variety of medical conditions and prescribed by medical professionals as either a standalone intervention or as part of a rehabilitation programme.

For respiratory care professionals there is a POWERbreathe Medic Try-Before-You-Prescribe demonstration kit; an educational tool designed to help healthcare professionals and patients understand and experience the effect POWERbreathe Medic has on the respiratory muscles.

Since the approval of the POWERbreathe Medic for prescription in 2006, POWERbreathe has introduced the revolutionary, electronic POWERbreathe KH1, intended for use by healthcare professionals for respiratory muscle training and assessment in patients with dyspnoea, including patients with asthma, COPD, bronchitis, cystic fibrosis, emphysema, heart disease, neuromuscular disease, Parkinson’s disease and spinal injury.

The POWERbreathe KH1 is also suitable for use with disposable TrySafe filters and can be used bedside, on the ward, as part of a pulmonary program, or for single patient use at home under medical supervision.

Launched after the POWERbreathe Medic, following the latest technological advances in research and design, is the next generation POWERbreathe Medic: the POWERbreathe Medic Plus for patients to use at home, straight out of the box, with improved airflow dynamics and a more comfortable user experience. And for healthcare professionals (and their patients), is the new POWERbreathe KH2 with Breathe-Link Medic Live Feedback Software.

References:

  1. Beckerman M, Magadle R, Weiner M, Weiner P. The effects of 1 year of specific inspiratory muscle training in patients with COPD. Chest. 2005 Nov;128(5):3177-82.
  2. Weiner P, Azgad Y, Ganam R, Weiner M. Inspiratory muscle training in patients with bronchial asthma. Chest. 1992;102(5):1357-61.
  3. Weiner P, Berar-Yanay N, Davidovich A, Magadle R, Weiner M. Specific inspiratory muscle training in patients with mild asthma with high consumption of inhaled beta(2)-agonists. Chest. 2000;117(3):722-7.
  4. Weiner P, Magadle R, Massarwa F, Beckerman M, Berar-Yanay N. Influence of gender and inspiratory muscle training on the perception of dyspnea in patients with asthma. Chest. 2002;122(1):197-201.

Impact Of IMT In Patients With COPD: What Is The Evidence?

“Meta-analysis including 32 randomised controlled trials on the effects of inspiratory muscle training (IMT) in chronic obstructive pulmonary disease (COPD) patients was performed.”

Conclusion:

“In conclusion, IMT is an effective treatment modality in COPD patients to improve respiratory muscle strength and endurance, resulting in reductions of dyspnoea and improvement in functional exercise capacity and health-related quality of life. Patients with more advanced muscle weakness seem to be better responders, especially when considering IMT in addition to general exercise training.”

Read Impact of inspiratory muscle training in patients with COPD: what is the evidence? >

The Effects Of 1 Year Of Specific Inspiratory Muscle Training In Patients With COPD

“The aim of this study was to assess the long-term benefits of inspiratory muscle training (IMT) on inspiratory muscle strength, exercise capacity, the perception of dyspnea, quality of life, primary care use, and hospitalizations in patients with significant COPD.”

Conclusion:

“The study showed that during IMT in patients with significant COPD, there is an increase in exercise capacity, improvement in quality of life, and decrease in dyspnea. The study also provides evidence that long-term IMT can decrease the use of health services and hospitalization days.”

Read The effects of 1 year of specific inspiratory muscle training in patients with COPD >

Inspiratory Muscle Training In Pulmonary Rehabilitation Program In COPD Patients

“Most pulmonary rehabilitation programs do not currently incorporate Inspiratory Muscle Training (IMT) in their pulmonary rehabilitation programs for COPD patients. The aim of the present study was to assess the influence of adding IMT to the patients already involved in a rehabilitation program.”

Conclusion:

“IMT provides additional benefits to patients undergoing pulmonary rehabilitation program and is worthwhile even in patients who have already undergone a general exercise reconditioning (GER) program.”

Read Inspiratory muscle training in pulmonary rehabilitation program in COPD patients >

Measurement Validity Of KH1 During Breathing Task In Patients With COPD

This paper studies the validity of the POWERbreathe KH1 – a recently introduced, handheld, electronic loading device. It looks at how well it provides automatically processed information on external inspiratory work, power and breathing pattern during loaded breathing tasks in patients with COPD.

Intervention: POWERbreathe KH1

Conclusion:

“The handheld device provides automatically processed and valid estimates of physical units of energy during loaded breathing tasks. This enables health care providers to quantify the load on inspiratory muscles during these tests in daily clinical practice.”

Measurement validity of an electronic inspiratory loading device during a loaded breathing task in patients with COPD >

IMT Protocol For Patients With Chronic Obstructive Pulmonary Disease (IMTCO study)

“Inspiratory muscle training (IMT) has been applied during pulmonary rehabilitation in patients with chronic obstructive pulmonary disease (COPD). However, it remains unclear if the addition of IMT to a general exercise training programme leads to additional clinically relevant improvements in patients with COPD.

This randomised controlled trial will investigate whether the addition of IMT to a general exercise training programme improves 6 min walking distance, health-related quality of life, daily physical activity and inspiratory muscle function in patients with COPD with inspiratory muscle weakness.”

Go to Inspiratory muscle training protocol for patients with chronic obstructive pulmonary disease (IMTCO study): a multicentre randomised controlled trial >

Comparing Inspiratory Resistive Muscle Training with Incentive Spirometry on Rehabilitation of COPD Patients

“The purpose of this randomised controlled trial was to examine the effect of incentive spirometry in pulmonary rehabilitation of chronic obstructive pulmonary disease (COPD) patients and compare its efficacy with inspiratory resistive muscle training (IMT) technique.”

Conclusion:

“Both techniques improved the mean values of all respiratory function tests (p≤.01). The IMT technique was more effective to improve MVV and PImax (p≤.05). PEFR was better improved in the incentive spirometry group (p≤.05). There was no significant difference for other spirometric parameters between two groups. Incentive spirometry can be considered as an effective component for pulmonary rehabilitation in COPD patients.”

Read Comparing Inspiratory Resistive Muscle Training with Incentive Spirometry on Rehabilitation of COPD Patients >

Effects of IMT on Dyspnea in COPD During Pulmonary Rehabilitation: Randomized Controlled Trial

The purpose of this trial is to demonstrate that Inspiratory Muscle Training associated with a conventional pulmonary rehabilitation program allows a significant improvement of dyspnea in subjects with severe or very severe COPD than a conventional pulmonary rehabilitation program alone.”

Go to Effects of IMT on Dyspnea in COPD During Pulmonary Rehabilitation: Randomized Controlled Trial >