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Targeted Inspiratory Muscle Training Improves Respiratory Muscle Function and Reduces Dyspnea in Patients with Chronic Obstructive Pulmonary Disease

Andrew Harver, PhD; Donald A. Mahler, MD; and J. Andrew Daubenspeck, PhD
[+] Article, Author, and Disclosure Information

Grant Support: Supported by a grant from the American Lung Association of New Hampshire and by grants HL07449 and HL29068 from the National Heart, Lung, and Blood Institute.

Requests for Reprints: Andrew Harver, PhD, Department of Psychology, SUNY Stony Brook, Stony Brook, NY 11794-2500.

Current Author Addresses: Dr. Harver: Department of Psychology, SUNY Stony Brook, Stony Brook, NY 11794.

Dr. Mahler: Department of Medicine, Dartmouth Medical School, Hanover, NH 03756.

Dr. Daubenspeck: Department of Physiology, Dartmouth Medical School, Hanover, NH 03756.

© 1989 American College of PhysiciansAmerican College of Physicians

Ann Intern Med. 1989;111(2):117-124. doi:10.7326/0003-4819-111-2-117
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Study Objective: To examine the effects of targeted inspiratory muscle training on respiratory muscle function, clinical ratings of dyspnea, and perception of resistive loads in symptomatic patients with chronic obstructive pulmonary disease.

Design: Randomized, placebo-controlled trial with an 8-week treatment period.

Setting: Outpatient pulmonary clinic and pulmonary function laboratory.

Participants: We studied 19 patients with moderate to severe chronic obstructive pulmonary disease, assigning 10 patients to an experimental group and 9 to a control group.

Interventions: Patients in both groups trained for 15 minutes twice each day using a device that provided breath-to-breath visual feedback of training intensity. Patients in the experimental group trained at six increasing levels of inspiratory resistance, whereas the patients in the control group trained at a constant, nominal level of resistance.

Measurements and Results: Although there was no statistically discernible difference in the effects of targeted muscle training on the mean difference in maximal inspiratory pressures between the two groups (9.83 cm H2O; 95% CI, - 7.37 to 27.03), patients in the experimental group did show a significant increase in inspiratory muscle strength (15.03 cm H2O; P = 0.01). Experimental subjects also had decreased dyspnea after 8 weeks of training compared with control subjects (P = 0.003). Improvements in physiologic values and in dyspnea ratings were correlated. The perception of added resistive loads was not affected by inspiratory muscle training.

Conclusions: Targeted inspiratory muscle training may enhance respiratory muscle function and reduce dyspnea in symptomatic patients with moderate to severe chronic obstructive pulmonary disease.





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