EFFECTS OF COMBINED INSPIRATORY MUSCLE AND CYCLE ERGOMETER TRAINING ON EXERCISE PERFORMANCE IN PATIENTS WITH COPD

Cycle ergometer training plays an important role in the rehabilitation of patients with chronic obstructive pulmonary disease (COPD), but th e usefulness of specific inspiratory muscle training as part of pulmon ary rehabilitation remains uncertain. To determine whether inspiratory muscle training could intensify the known beneficial effects of cycle ergometer training on exercise performance in these patients, we comp ared the effect of an 8 week inspiratory muscle training combined with cycle ergometer training with that of an 8 week cycle ergometer train ing alone on inspiratory muscle performance and general exercise capac ity. Patients were randomly assigned to the two training groups; 21 pa tients received additional inspiratory muscle training (Group 1) and 2 1 did not (Group 2). Maximal sniff assessed oesophageal and transdiaph ragmatic pressures served as parameters for global inspiratory muscle strength and diaphragmatic strength, respectively. The duration for wh ich the patient could breathe against a constant inspiratory pressure load was used as an index of inspiratory muscle endurance. Exercise ca pacity was determined by an incremental symptom-limited cycle ergomete r test. After the training period, inspiratory muscle performance impr oved significantly in the patients with inspiratory muscle training, b ut not in those without. Both training regimens increased maximal powe r output and oxygen uptake, but this improvement was significantly gre ater in the patients with inspiratory muscle training than in those wi thout. We conclude that inspiratory muscle training in addition to cyc le ergometer training, can intensify the beneficial effects of cycle e rgometer training on exercise performance in COPD patients.