Abstract
Battaglia E, Fulgenzi A, Ferrero ME. Rationale of the combined use of inspiratory
and expiratory devices in improving maximal inspiratory pressure and maximal expiratory
pressure of patients with chronic obstructive pulmonary disease.
Objective
To examine the rationale of the combined use of a new expiratory device in association
with a previously assessed inspiratory device in improving 3 indicators of the respiratory
muscle strength, for example, maximal inspiratory pressure (MIP), maximal expiratory
pressure (MEP), and dyspnea grade.
Design
Randomized trial.
Setting
Home-based pulmonary rehabilitation.
Participants
Adults (N=32; mean age, 68y).
Main Outcome Measure
We instructed 32 patients with mild to very severe COPD to use the devices, and randomized
them in a 1:1 ratio: they were assigned to the sham training control group (16 patients
who trained at a load not able to improve MIP and MEP) or to the training group (16
patients). The patients trained at home twice daily for 15 minutes, 7 days a week,
for 12 months. MIP and MEP as well as dyspnea perception were evaluated at 1, 6, and
12 months from the beginning of the training. The impact of additional work of breathing
was measured at baseline and after the use of the expiratory device.
Results
The patients who performed the respiratory training showed significant and progressive
improvements of MIP (81±4 at 12 months vs 57±7 as basal values expressed in cm H2O; P<.05) and MEP (97±2 at 12 months vs 62±4 as basal values; P<.05) at the end of the training. In addition, they showed a significant reduction
of dyspnea perception (1.18±0.29 vs 2.93±0.32 as basal values; P<.05) at the end of the training.
Conclusions
This study suggests that home exercise with the combined use of our expiratory and
inspiratory devices leads to a significant improvement of respiratory muscle function
in patients with mild to very severe COPD.
Key Words
List of Abbreviations:
ANOVA (analysis of variance), COPD (chronic obstructive pulmonary disease), FEV1 (forced expiratory volume in 1 second), GOLD (Global Initiative for Chronic Obstructive Lung Disease), IMT (inspiratory muscle training), MEP (maximal expiratory pressure), MIP (maximal inspiratory pressure), QOL (quality of life), WBimp (work of breathing)To read this article in full you will need to make a payment
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Article Info
Footnotes
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.
Identification
Copyright
© 2009 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
