Am. J. Respir. Crit. Care Med., Volume 162, Number 5, November 2000, 1709-1714

Respiratory Muscle Endurance Training in Chronic Obstructive Pulmonary Disease
Impact on Exercise Capacity, Dyspnea, and Quality of Life

THOMAS A. SCHERER, CHRISTINA M. SPENGLER, DOMINIK OWASSAPIAN, EDELBERT IMHOF, and URS BOUTELLIER

Department of Internal Medicine, Triemli Hospital, Zurich, and Department of Exercise Physiology, Federal Institute of Technology and University of Zurich, Switzerland

Inspiratory muscle training may have beneficial effects in certain patients with chronic obstructive pulmonary disease (COPD). Because of the lack of a home training device, normocapnic hyperpnea has rarely been used as a training mode for patients with COPD, and is generally considered unsuitable to large-scale application. To study the effects of hyperpnea training, we randomized 30 patients with COPD and ventilatory limitation to respiratory muscle training (RMT; n = 15) with a new portable device or to breathing exercises with an incentive spirometer (controls; n = 15). Both groups trained twice daily for 15 min for 5 d per week for 8 wk. Training-induced changes were significantly greater in the RMT than in the control group for the following variables: respiratory muscle endurance measured through sustained ventilation (+825 ± 170 s [mean ± SEM] versus 27 ± 61 s, p < 0.001), inspiratory muscle endurance measured through incremental inspiratory threshold loading (+58 ± 10 g versus +21.7 ± 9.5 g, p = 0.016), maximal expiratory pressure (+20 ± 7 cm H₂O versus 6 ± 6 cm H₂O, p = 0.009), 6-min walking distance (+58 ± 11 m versus +11 ± 11 m, p = 0.002), O_2peak (+2.5 ± 0.6 ml/kg/min versus 0.3 ± 0.9 ml/kg/min, p = 0.015), and the SF-12 physical component score (+9.9 ± 2.7 versus +1.8 ± 2.4, p = 0.03). Changes in dyspnea, maximal inspiratory pressure, treadmill endurance, and the SF-12 mental component score did not differ significantly between the RMT and control groups. In conclusion, home-based respiratory muscle endurance training with the new device used in this study is feasible and has beneficial effects in subjects with COPD and ventilatory limitation.

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