Inspiratory muscle training protocol using a pressure threshold device: effect on dyspnea in chronic obstructive pulmonary disease.

Abstract

To evaluate the ability of patients with chronic obstructive pulmonary disease (COPD) to accomplish 6 weeks of inspiratory muscle training (IMT) using a pressure threshold device, and to observe how the training affected inspiratory muscle strength and dyspnea. Pilot study comparing baseline values with posttest values. Four adults with severe COPD (the mean of the forced expiratory volume in 1 second [FEV1] was 28% of predicted value). Daily IMT sessions of 5 to 30 minutes' duration and weekly training load increments of -2 to -4cmH2O over a 6-week period with the training device at loads of >30% of baseline maximal inspiratory pressure (PImax). Dyspnea measures were Mahler's Baseline and Transition Dyspnea Index and the Borg category-ratio scale administered during a submaximal exercise protocol. All subjects tolerated the training load, improved their inspiratory muscle strength, and reported reduced dyspnea. Using a constant-load pressure threshold device to attain loads of >30% of the patient's baseline PImax is a feasible way to accomplish inspiratory muscle training in adults with severe COPD.