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.
“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.”
“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 >
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 >
“Understanding sex differences in the qualitative dimensions of exertional dyspnea may provide insight into why women are more affected by this symptom than men. This study explored the evolution of the qualitative dimensions of dyspnea in 70 healthy, young, physically active adults.”
“Findings suggest that men and women do not differ in their perceived quality of dyspnea during submaximal exercise, but subjective differences appear at maximal exercise and may be related, at least in part, to underlying sex differences in breathing patterns and operating lung volumes during exercise.”
Read Sex differences in the intensity and qualitative dimensions of exertional dyspnea in physically active young adults >
“There is considerable evidence that respiratory muscle training improves pulmonary function, quality of life and exercise performance in healthy athletic populations. The benefits for wheelchair athletes are less well understood. This study examined the influence of inspiratory muscle training (IMT) upon respiratory function and repetitive propulsive sprint performance in wheelchair basketball players.”
“Although there was no improvement in sprint performance, participants in both the IMT and sham-IMT reported an improved respiratory muscle function and quality of life.”
Read Effects of inspiratory muscle training on respiratory function and repetitive sprint performance in wheelchair basketball players >
“Specific inspiratory muscle training (IMT) has been shown to significantly attenuate the fall in arterial oxygen saturation (SpO2) during exhaustive exercise while breathing a hypoxic gas mixture of 14% oxygen. The aim of this study was to assess the impact of IMT on resting oxygen saturation over a range of altitudes in healthy individuals.”
“IMT can attenuate the fall in resting oxygen saturation, but only at altitudes of 4880m and above. Conversely, IMT had no effect on resting levels of dyspnea as measured by the Borg Score.”
Read Inspiratory Muscle Training, Altitude, and Arterial Oxygen Desaturation: A Preliminary Investigation >
“The purpose of this study was to determine the effect of respiratory muscle training on intermittent exercise performance, respiratory muscle strength, respiratory muscle fatigue, and dyspnea in soccer athletes.”
“Respiratory Muscle Training improved intermittent exercise performance in these soccer athletes. The mechanisms by which RMT improves performance warrant further study.”
Read The influence of respiratory muscle training upon intermittent exercise performance >
“An overview of the literature that rationalizes contradictory findings about respiratory muscle training in healthy people.”
“It is likely that the ergogenic effect of respiratory muscle training (RMT) has a multifactorial etiology that may include:
- The direct effect of RMT upon respiratory muscle fatigue
- RMT’s indirect effects upon improving blood flow distribution to limb locomotor muscles in heavy exercise
- RMT’s direct and indirect effect upon the intensity with which both respiratory and peripheral efforts are perceived.”
Read Respiratory Muscle Training in Healthy Humans: Resolving the Controversy >
“The purpose of this study was to investigate the effects of a period of resistive inspiratory muscle training (IMT) upon rowing performance.”
“IMT improves rowing performance on the 6-min all-out effort and the 5000-m trial.”
Read Inspiratory Muscle Training Improves Rowing Performance >
Sex differences in the intensity and qualitative dimensions of exertional dyspnea in physically active young adults
Julia M. Cory, Michele R. Schaeffer, Sabrina S. Wilkie et al
The purpose of this study was to explore the development of qualitative dimensions of dyspnea in a group of 70 physically active, healthy young adults.
The young participants were asked to record two things throughout each stage of a symptom limited incremental cycle exercise test:
1. Intensity of their breathing discomfort using the Borg 0-10 scale.
2. Select a phrase that best described their breathing from a standardized list (“work/effort”, “unsatisfied inspiration”, “unsatisfied expiration”).
During the study, at peak exercise women were significantly more likely to select the phrases: “my breathing feels shallow”, “I cannot get enough air in”, “I cannot take a deep breath in”, and “my breath does not go in all the way”.
Findings from the study suggested that men and women do not differ in their perceived quality of dyspnea during submaximal exercise, but subjective differences appear at maximal exercise and may be related, perhaps in part, to underlying differences in breathing patterns and operating lung volumes during exercise.
Read the full study here >