Hospitalised Patients Benefit from POWERbreathe IMT

A new clinical trial in Brazil has found that POWERbreathe IMT improves inspiratory muscle strength and shortens the length of stay in hospitalised patients.

Objective

The aim of this double-blind randomised controlled trial is to assess the impact of IMT on hospitalised patients. IMT stands for Inspiratory Muscle Training. It trains the inspiratory muscles (the ones we use to breathe in) to become stronger and more resistant to fatigue. IMT is undertaken using the POWERbreathe Plus IMT device.

Proposed Outcomes for Hospitalised Patients

Hospitalised patients, with no existing respiratory issues, may encounter inpatient complications.

The clinical trial believes that, if implemented early, POWERbreathe IMT could prevent in-hospital adverse outcomes. These may, or may not, be directly associated with the loss of respiratory muscle mass inherent to a prolonged hospital stay.

Trial Method

Subjects are randomly assigned to either an IMT intervention group or an IMT sham group. Both groups were also to undergo conventional physiotherapy interventions.

The IMT intervention group performs IMT using the POWERbreathe Plus. Each patient trains against a load equivalent to 50% of their maximum inspiratory pressure. Maximum inspiratory pressure, or MIP, is a marker of respiratory muscle function and strength. All they need to do is breathe in through the device for 30 breaths. And they do this twice a day for 4 weeks.

Trial Results

Results show that patients in the IMT intervention group had a significantly shorter length of stay in hospital. They also show a lower risk of endotracheal intubation, muscle weakness and mortality.

Findings

The trial’s findings demonstrate that POWERbreathe IMT is a safe addition to physiotherapy. Results also show that it improves inspiratory muscle strength and functional status, as well as a shortened length of hospital stay.

Conclusion

This clinical trial shows that early implementation of POWERbreathe IMT is effective at preventing complications due to prolonged hospitalisation. It is also effective at reducing associated in-hospital mortality rates. Its therapeutic use is safe and well-tolerated in the hospital environment, providing respiratory gain and improving functional capacity.

Full details of this clinical trial are freely available for all to read on the internet. Safety and efficacy of inspiratory muscle training for preventing adverse outcomes in patients at risk of prolonged hospitalisation.

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.

Efficacy of Inspiratory Muscle Training on Elite Swimmers (PEAK)

This study is a randomized controlled trial. Firstly it will look at the efficacy of inspiratory muscle training using POWERbreathe. Furthermore it will asses the swimming performance, airway dysfunction and perceived breathlessness in the elite swimmers recruited for the trial. Finally the trial will recruit participants from the elite competitive Futebol Clube do Porto swimming team.

Intervention used in swimming trial

    • POWERbreathe IMT

ClinicalTrials.gov identifier: NCT03062735

Protocol for a Randomized Controlled Trial Evaluating the Efficacy of Inspiratory Muscle Training on Swimming Performance, Airway Dysfunction and Perceived Breathlessness in Elite Swimmers >

Effects Of IMT On Exercise Capacity And Spontaneous Physical Activity In Elderly Subjects

“Inspiratory muscle training (IMT) has been shown to improve exercise capacity in diseased populations. We chose to examine the effects of eight weeks of IMT on exercise capacity and spontaneous physical activity in elderly individuals.”

Conclusion:

“IMT may be a useful technique for positively influencing exercise capacity and physical activity in elderly individuals.”

Read Effects of inspiratory muscle training on exercise capacity and spontaneous physical activity in elderly subjects: a randomized controlled pilot trial >

Abdominal Surgery

‘Pre-Operative IMT Preserves Postoperative Inspiratory Muscle Strength Following Major Abdominal Surgery’

“The aim of this pilot study was to assess the effect of pre-operative inspiratory muscle training (IMT) on respiratory variables in patients undergoing major abdominal surgery.”

Conclusion:

“Pre-operative specific IMT improves (maximum inspiratory pressure (MIP) pre-operatively and preserves it postoperatively. Further studies are required to establish if this is associated with reduced pulmonary complications.”

Read Pre-operative inspiratory muscle training preserves postoperative inspiratory muscle strength following major abdominal surgery – a randomised pilot study >

Lung Cancer Surgery

‘Respiratory Muscle Strength, Functional Capacity and Subjective Outcome – Effects of IMT After Lung Cancer Surgery’

“The purpose of this study is to evaluate the effects of postoperative inspiratory muscle training on the recovery of respiratory muscle strength in high risk patients referred for lung cancer surgery. Furthermore, to assess longitudinal changes in respiratory muscle strength, physical capacity and health-related quality of life after lung cancer surgery.”

Go to Respiratory Muscle Strength, Functional Capacity and Subjective Outcome – Effects of Inspiratory Muscle Training After Lung Cancer Surgery, a Randomized Controlled Trial >

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 >

Respiratory Muscle Specific Warm-Up And Elite Swimming Performance

“Inspiratory muscle training has been shown to improve performance in elite swimmers, when used as part of routine training, but its use as a respiratory warm-up has yet to be investigated. The aim of this study was to determine the influence of inspiratory muscle exercise (IME) as a respiratory muscle warm-up in a randomised controlled cross-over trial.”

Conclusion:

“Using IME combined with a standard swimming warm-up significantly improves 100 m freestyle swimming performance in elite swimmers.”

Read Respiratory muscle specific warm-up and elite swimming performance >

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 >