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High-intensity inspiratory muscle training in COPD

Depts of ¹ Pulmonary Physiology and, ² Physiotherapy, Sir Charles Gairdner Hospital, and ³ Asthma and Allergy Research Institute, and ⁴ School of Human Movement and Exercise Science, and, ⁵ School of Anatomy and Human Biology, University of Western Australia, Nedlands, and ⁶ School of Physiotherapy, Curtin University of Australia, Bentley, Australia.

CORRESPONDENCE: P. R. Eastwood, Dept of Pulmonary Physiology, Sir Charles Gairdner Hospital, Hospital Avenue, Nedlands, Western Australia, 6009 Australia, Fax: 61 893462034. E-mail: peter.eastwood{at}health.wa.gov.au

Keywords: Chronic obstructive pulmonary disease, inspiratory muscle training

Received: September 8, 2005
Accepted February 5, 2006

The aim of the present study was to investigate the effects of an interval-based high-intensity inspiratory muscle training (H-IMT) programme on inspiratory muscle function, exercise capacity, dyspnoea and health-related quality of life (QoL) in subjects with chronic obstructive pulmonary disease.

A double-blind randomised controlled trial was performed. Sixteen subjects (11 males, mean forced expiratory volume in one second (FEV₁) 37.4±12.5%) underwent H-IMT performed at the highest tolerable inspiratory threshold load (increasing to 101% of baseline maximum inspiratory pressure). Seventeen subjects (11 males, mean FEV₁ 36.5±11.5%) underwent sham inspiratory muscle training (S-IMT) at 10% of maximum inspiratory pressure. Training took place three times a week for 8 weeks and was fully supervised. Pre- and post-training measurements of lung function, maximum inspiratory pressure, maximum threshold pressure, exercise capacity, dyspnoea and QoL (Chronic Respiratory Disease Questionnaire; CRDQ) were obtained.

H-IMT increased maximum inspiratory pressure by 29%, maximum threshold pressure by 56%, 6-min walk distance by 27 m, and improved dyspnoea and fatigue (CRDQ) by 1.4 and 0.9 points per item, respectively. These changes were significantly greater than any seen following S-IMT.

In conclusion, high-intensity inspiratory muscle training improves inspiratory muscle function in subjects with moderate-to-severe chronic obstructive pulmonary disease, yielding meaningful reductions in dyspnoea and fatigue.

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