Comparison of inspiratory muscle strength training effects between older subjects with and without chronic obstructive pulmonary disease.

BACKGROUND/PURPOSE Inspiratory muscle strength training (IMST) has been traditionally recommended for patients with chronic obstructive pulmonary disease (COPD) to improve respiratory strength. Respiratory strength is reduced as age increases. However, few studies have focused on the effects of IMST on older adults without COPD. METHODS Subjects were divided into training non-COPD (TNC, n = 24) and training COPD (TC, n = 12) according to their forced expiratory volume in 1 second (% predicted). Both groups received 6 weeks of IMST, with training at 75-80% of maximal inspiratory pressure using pressure threshold trainers. A second group of COPD subjects served as controls (CC, n = 24), which received no training. Dyspnea was measured using the basic dyspnea index. Health-related quality of life was measured using the SF-36. The SF-36 subcategories, physical component summary and mental component summary were compared. A 6-minute walk test was performed to determine functional status. Two-way repeated measures analysis of variance was used to compare group effects and training effects of IMST. RESULTS Maximal inspiratory pressure was increased in both training groups (TNC: 59.1 cmH(2)O pre-IMST to 82.5 cmH(2)O post-IMST; TC: 53.2 to 72.6), but not in the CC group. Therefore, the basic dyspnea index was improved in both training groups (TNC: 9.6 to 10.8; TC: 6.2 to 7.3). Functional status was improved in the TNC group (TNC: 392.1 m to 436.3 m), but not in the TC or CC groups. Quality of life was improved in the physical component summary in both training groups. CONCLUSION IMST increases maximal inspiratory pressure, relieves dyspnea and improves health-related quality of life in older adults. IMST especially improves functional status in subjects without COPD. IMST benefits subjects with COPD and those without COPD. Therefore, IMST as a treatment tool is not confined to patients with COPD.

[1]  G. Guyatt,et al.  Interpretation of treatment changes in 6-minute walk distance in patients with COPD , 2008, European Respiratory Journal.

[2]  A. Sheel.  Respiratory Muscle Training in Healthy Individuals , 2002, Sports medicine.

[3]  A. Murphy,et al.  The effects of respiratory-muscle training on exercise in older women. , 2008, Journal of aging and physical activity.

[4]  J. Fozard,et al.  Determinants of maximal inspiratory pressure. The Baltimore Longitudinal Study of Aging. , 1998, American journal of respiratory and critical care medicine.

[5]  Y. T. Wang,et al.  Lung function and respiratory muscle strength after propranolol in thyrotoxicosis. , 1986, Australian and New Zealand journal of medicine.

[6]  Murray D. Altose,et al.  Dyspnea. Mechanisms, assessment, and management: a consensus statement. American Thoracic Society. , 1999, American journal of respiratory and critical care medicine.

[7]  C. Lisboa,et al.  Effect of inspiratory muscle training with an intermediate load on inspiratory power output in COPD. , 1998, The European respiratory journal.

[8]  ATS statement: guidelines for the six-minute walk test. , 2002, American journal of respiratory and critical care medicine.

[9]  Y. Wu,et al.  Comparison of effectiveness of pressure threshold and targeted resistance devices for inspiratory muscle training in patients with chronic obstructive pulmonary disease. , 2003, Journal of the Formosan Medical Association = Taiwan yi zhi.

[10]  C. Spengler,et al.  Respiratory muscle endurance training in chronic obstructive pulmonary disease: impact on exercise capacity, dyspnea, and quality of life. , 2000, American journal of respiratory and critical care medicine.

[11]  J. Pretto,et al.  Threshold pressure training, breathing pattern, and exercise performance in chronic airflow obstruction. , 1989, Chest.

[12]  M. Moy,et al.  Health-related quality of life improves following pulmonary rehabilitation and lung volume reduction surgery. , 1999, Chest.

[13]  D. Mahler,et al.  Evaluation of the Short-Form 36-Item Questionnaire to Measure Health-Related Quality of Life in Patients With COPD , 1995 .

[14]  D. Leith,et al.  Ventilatory muscle strength and endurance training. , 1976, Journal of applied physiology.

[15]  B. O'brien,et al.  Relationship between symptoms and health-related quality of life in chronic lung disease , 2007, Journal of General Internal Medicine.

[16]  G. Heiss,et al.  Demographic and anthropometric correlates of maximum inspiratory pressure: The Atherosclerosis Risk in Communities Study. , 1999, American journal of respiratory and critical care medicine.

[17]  M. Decramer,et al.  Six minute walking distance in healthy elderly subjects. , 1999, The European respiratory journal.

[18]  B. Celli,et al.  Inspiratory capacity, dynamic hyperinflation, breathlessness, and exercise performance during the 6-minute-walk test in chronic obstructive pulmonary disease. , 2001, American journal of respiratory and critical care medicine.

[19]  S. Redline,et al.  Effects of changes in inspiratory muscle strength on the sensation of respiratory force. , 1991, Journal of applied physiology.

[20]  J. Hankinson,et al.  Standardisation of spirometry , 2005, European Respiratory Journal.

[21]  D. Hillman,et al.  Dyspnoea in COPD: can inspiratory muscle training help? , 2004, The Australian journal of physiotherapy.

[22]  J. Maurer.  High-intensity inspiratory muscle training in COPD , 2008 .

[23]  B. Celli,et al.  Validation and comparison of reference equations for the 6-min walk distance test , 2008, European Respiratory Journal.

[24]  K. Kida,et al.  The impact of dyspnoea and leg fatigue during exercise on health‐related quality of life in patients with COPD , 2005, Respirology.

[25]  C. Chan,et al.  Transdiaphragmatic pressure in young adult Singaporean subjects--normal values and a comparison between different respiratory manoeuvres. , 1996, Australian and New Zealand journal of medicine.

[26]  J. Roca,et al.  Testing the measurement properties of the Spanish version of the SF-36 Health Survey among male patients with chronic obstructive pulmonary disease. Quality of Life in COPD Study Group. , 1998, Journal of clinical epidemiology.

[27]  G. Misuri,et al.  Breathlessness and control of breathing in patients with COPD. , 1997, Monaldi archives for chest disease = Archivio Monaldi per le malattie del torace.

[28]  J. Fuh,et al.  Psychometric evaluation of a Chinese (Taiwanese) version of the SF-36 health survey amongst middle-aged women from a rural community , 2004, Quality of Life Research.

[29]  B. Celli,et al.  The 6‐min walk distance: change over time and value as a predictor of survival in severe COPD , 2004, European Respiratory Journal.

[30]  J. Neder,et al.  Reference values for lung function tests. II. Maximal respiratory pressures and voluntary ventilation. , 1999, Brazilian journal of medical and biological research = Revista brasileira de pesquisas medicas e biologicas.

[31]  D L Sherrill,et al.  Reference equations for the six-minute walk in healthy adults. , 1998, American journal of respiratory and critical care medicine.

[32]  P. Davenport,et al.  Effect of inspiratory muscle strength training on inspiratory motor drive and RREP early peak components. , 2003, Journal of applied physiology.

[33]  P. Weiner,et al.  Maintenance of inspiratory muscle training in COPD patients: one year follow-up , 2004, European Respiratory Journal.