Cycle ergometer and inspiratory muscle training in chronic obstructive pulmonary disease

In patients with chronic obstructive pulmonary disease (COPD) the intensity of aerobic training is limited by dyspnea. Improving strength of the inspi ratory muscles could enhance aerobic exercise training by reducing exercise -related dyspnea. We examined effects of home-based inspiratory muscle trai ning (IMT) and cycle ergometry training (CET) in 53 patients with moderate to severe COPD (FEV1% pred, 50 +/- 17 [mean +/- SD]). Patients were randoml y assigned to 4 mo of training in one of four groups: IMT, GET, CET + IMT, or health education (ED). Patients were encouraged to train to the limits o f their dyspnea. Inspiratory muscle strength and endurance increased in IMT and CET + IMT groups compared with CET and ED groups (p < 0.01). Peak oxyg en uptake increased and heart rate, minute ventilation, dyspnea, and leg fa tigue decreased at submaximal work rates in the CET and CET + IMT groups co mpared with the IMT and ED groups (p < 0.01). There were no differences bet ween the CET and CET + IMT groups. Home-based CET produced a physiological training effect and reduced exercise-related symptoms while IMT increased r espiratory muscle strength and endurance. The combination of CET and IMT di d not produce additional benefits in exercise performance and exercise-rela ted symptoms. This is the first study to demonstrate a physiological traini ng effect with home-based exercise training.