C. Lisboa et al., INSPIRATORY MUSCLE TRAINING IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY-DISEASE, Revista Medica de Chile, 126(5), 1998, pp. 563-568
We analyze the effect of inspiratory muscle training (IMT) in patients
with chronic obstructive pulmonary disease (COPD), with special empha
sis on its effects on inspiratory, muscle function and clinical outcom
es. We reviewed only randomized, controlled studies that have either c
ontrolled both the load a?ld the breathing pattern when using resistiv
e training or have employed a threshold trainer in which the load is i
ndependent of the pattern of breathing, since methodological aspects m
ay explain inconsistent results in the literature. In these circumstan
ces, most of the studies demonstrated positive effects on inspiratory
muscle function. Clinical effects were seldom evaluated; limited avail
able data showed a reduction in dyspnea that was related to an increas
e in maximal inspiratory pressures (PIMax). When exercise capacity was
evaluated through the distance the patients were able to walk in 6 or
12 minutes, most studies demonstrated a significant increase. Other r
eported positive effects were improvement in nocturnal SaO(2), inspira
tory muscle power output and maximal inspiratory flow rate. Based in t
his review, a recommended training regime appears to be an intermediat
e load (30-40% PIMax) using a threshold device for 30 minutes daily fo
r at least 5 weeks. Although in the literature the criteria for select
ing patients are not always well defined, we consider IMT as a helpful
procedure for pulmonar rehabilitation in those patients with a modera
tely severe inspiratory muscle dysfunction presenting dyspnea during d
aily living activities despite optimal therapy.