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.
“Meta-analysis including 32 randomised controlled trials on the effects of inspiratory muscle training (IMT) in chronic obstructive pulmonary disease (COPD) patients was performed.”
“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? >
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.
“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 >
“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 >
“While in some surgical centers inspiratory muscle training is already used in the preoperative phase in patients undergoing esophageal resection, the added value of this intervention on the reduction of pulmonary complications has not yet been investigated in large surgical populations other than cardiac surgery in a randomized and controlled study design.
The effect of a preoperative inspiratory muscle training program on the incidence of postoperative pneumonia in patients undergoing esophageal resection will be studied in a single blind multicenter randomized controlled trial (the PREPARE study).”
Read Preoperative IMT to prevent postoperative pulmonary complications in patients undergoing esophageal resection (PREPARE study): study protocol for a randomized controlled trial >
Inspiratory muscle training protocol for patients with chronic obstructive pulmonary disease (IMTCO study): a multicentre randomised controlled trial
Noppawan Charususin, Rik Gosselink, Marc Decramer, et al
Published 5 August 2013
The latest paper on the Inspiratory Muscle Training Protocol for Patients with COPD (IMTCO) study design has just been published in Respiratory Medicine on BMJ Open. This study used the POWERbreathe KH1 for home-based IMT. It is suggested that the results of the study could be incorporated into evidence-based treatment recommendations for clinical practice. ClinicalTrials.gov NCT01397396.
Aims of the study:
“This study will examine the effects of adding a well-controlled, high-intensity IMT programme to a 3-month general exercise training programme, using a large, multicentre, randomised controlled design, in patients with COPD and inspiratory muscle weakness. Outcomes will be exercise capacity (primary outcome), inspiratory muscle function, health-related quality of life (HRQL) and participation in daily physical activity.”
Read the full Open Access article online.