Respiratory Medicine
Volume 99, Issue 11 , Pages 1440-1458, November 2005

Inspiratory muscle training in adults with chronic obstructive pulmonary disease: A systematic review

  • E. Lynne Geddes

      Affiliations

    • School of Rehabilitation Science, IAHS—Room 403, McMaster University, 1400 Main Street West, Hamilton, Ont., Canada L8S 1C7
    • Corresponding Author InformationCorresponding author. Tel.: +9055259140x27813; fax: +9055240069.
    • ,
  • W. Darlene Reid

      Affiliations

    • Division of Physical Therapy, School of Rehabilitation Sciences, T325-2211 Wesbrook Mall, University of British Columbia, Vancouver, BC V6T 2B5
    • ,
  • Jean Crowe

      Affiliations

    • School of Rehabilitation Science, IAHS—Room 403, McMaster University, 1400 Main Street West, Hamilton, Ont., Canada L8S 1C7
    • ,
  • Kelly O’Brien

      Affiliations

    • Department of Physical Therapy, University of Toronto, 500 University Avenue, Room 160, Toronto, Ont., M5G 1V7
    • ,
  • Dina Brooks

      Affiliations

    • Department of Physical Therapy, University of Toronto, 500 University Avenue, Room 160, Toronto, Ont., M5G 1V7

Received 8 July 2004 published online 16 May 2005.

Summary 

The purpose of this study was to conduct a systematic review to determine the effect of inspiratory muscle training (IMT) on inspiratory muscle strength and endurance, exercise capacity, dyspnea and quality of life for adults with chronic obstructive pulmonary disease (COPD).

A systematic review of the literature was conducted according the Cochrane Collaboration protocol using Medline and CINAHL. Nineteen of 274 extracted articles met the inclusion criteria and addressed comparisons of interest which included: IMT versus sham; IMT versus no intervention; low- versus high-intensity IMT; and two different modes of IMT. Thirteen meta-analyses were reported.

Results indicate that targeted resistive or threshold IMT was associated with significant improvements in some outcomes of inspiratory muscle strength (PImax (cm H2O)) and endurance (Inspiratory Threshold Loading (kPa)), exercise capacity (Borg Scale for Respiratory Effort (modified Borg scale), Work Rate maximum (Watts)), and dyspnea (Transition Dyspnea Index), whereas IMT without a target or not using threshold training did not show improvement in these variables. There was no conclusive evidence regarding quality of life measures.

IMT is effective for adults with COPD when using threshold or targeted devices that control or provide a target for training intensity.

Keywords: Respiratory muscles, Inspiratory muscle training, Breathing exercises, Lung diseases, Obstructive, Chronic obstructive pulmonary disease, Pulmonary rehabilitation

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PII: S0954-6111(05)00100-9

doi:10.1016/j.rmed.2005.03.006

Respiratory Medicine
Volume 99, Issue 11 , Pages 1440-1458, November 2005

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