Mejdi Aliu1, Joana Xhema2, Sylejman Miftari1
1University of Prishtina “Hasan Prishtina”, Faculty of Medicine, Department of Physiotherapy, Prishtina, Kosovo
2University of Medicine, Tirana, Faculty of Technical Medical Sciences, Tirana, Albania
Effectiveness of Inspiratory Muscle Training among Chronic Obstructive Pulmonary Disease Patients: A Systematic Review
Sport Mont 2023, 21(3), 123-128 | DOI: 10.26773/smj.231019
Abstract
Inspiratory muscle training (IMT) has been shown to be effective for some types of illnesses or conditions, including respiratory problems, cardiac disorders, and neuromuscular disorders. Reduced exercise capacity and health-related quality of life, weakness of respiratory muscles, and complaints of dyspnea are all frequent among COPD patients. This study aimed to investigate whether the use of IMT can alter the consequences of COPD in patients and provide an updated understanding of the effects of IMT in COPD patients. The specific objectives of the study were to evaluate the effectiveness of IMT on respiratory muscle strength, exercise tolerance, dyspnea, and health-related quality of life in COPD patients. Included databases were the Physiotherapy Evidence Database (PEDro), Google Scholar, and PubMed. A preliminary selection of papers was produced using inclusion/exclusion criteria. Subsequently, a final selection was made based on the quality of the studies assessed using the PEDro scale. For the realization of this systematic review, seven studies were involved. According to the evidence gathered from the literature review, IMT therapy has been shown to improve respiratory muscle strength, exercise tolerance, perception of dyspnea, and health-related quality of life in COPD patients. It is necessary to conduct studies using high-quality, evidence-based data to draw more definitive conclusions about the effectiveness of IMT in COPD patients. Future research should examine whether these improvements are applicable to all COPD patient groups. Additionally, it should explore the long-term effectiveness of these therapeutic improvements and determine which IMT treatment protocol provides the most significant clinical benefits.
Keywords
respiratory muscle strength, exercise tolerance, dyspnea perception, quality of life
View full article
(PDF – 115KB)
References
Beaumont, M., Forget, P., Couturaud, F., & Reychler, G. (2018). Effects of inspiratory muscle training in COPD patients: A systematic review and meta‐analysis. The Clinical Respiratory Journal, 12(7), 2178–2188. https://doi.org/10.1111/crj.12905
Beaumont, M., Mialon, P., Ber-Moy, C. L., Lochon, C., Péran, L., Pichon, R., … & Couturaud, F. (2015). Inspiratory muscle training during pulmonary rehabilitation in chronic obstructive pulmonary disease: A randomized trial. Chronic Respiratory Disease, 12(4), 305–312. https://doi.org/10.1177/1479972315594625
Calverley, P. M. A., & Georgopoulos, D. (2006). Chronic obstructive pulmonary disease: symptoms and signs. European Respiratory Monograph, 38, 7. https://doi.org/10.1183/1025448x.00038002
Corhay, J. L., Dang, D. N., Van Cauwenberge, H., & Louis, R. (2014). Pulmonary rehabilitation and COPD: Providing patients a good environment for optimizing therapy. International Journal of Chronic Obstructive Pulmonary Disease, 9, 27–39. https://doi.org/10.2147/COPD.S52012
Dellweg, D., Reissig, K., Hoehn, E., Siemon, K., & Haidl, P. (2017). Inspiratory muscle training during rehabilitation in successfully weaned hypercapnic patients with COPD. Respiratory Medicine, 123, 116–123. https://doi.org/10.1016/j.rmed.2016.12.006
Dsouza, F. V., Amaravadi, S. K., Samuel, S. R., Raghavan, H., & Ravishankar, N. (2021). Effectiveness of inspiratory muscle training on respiratory muscle strength in patients undergoing cardiac surgeries: A systematic review with meta-analysis. Annals of Rehabilitation Medicine, 45(4), 264–273. https://doi.org/10.5535/arm.21027
Elmorsi, A. S., Eldesoky, M. E., Mohsen, M. A. A., Shalaby, N. M., & Abdalla, D. A. (2016). Effect of inspiratory muscle training on exercise performance and quality of life in patients with chronic obstructive pulmonary disease. Egyptian Journal of Chest Diseases and Tuberculosis, 65(1), 41–46. https://doi.org/10.1016/j.ejcdt.2015.10.006
Geddes, E. L., O’Brien, K., Reid, W. D., Brooks, D., & Crowe, J. (2008). Inspiratory muscle training in adults with chronic obstructive pulmonary disease: An update of a systematic review. Respiratory Medicine, 102(12), 1715–1729. https://doi.org/10.1016/j.rmed.2008.07.005
Geddes, E. L., Reid, W. D., Crowe, J., O’Brien, K., & Brooks, D. (2005). Inspiratory muscle training in adults with chronic obstructive pulmonary disease: A systematic review. Respiratory Medicine, 99(11), 1440–1458. https://doi.org/10.1016/j.rmed.2005.03.006
Gloeckl, R., Marinov, B., & Pitta, F. (2013). Practical recommendations for exercise training in patients with COPD. European Respiratory Review, 22(128), 178–186. https://doi.org/10.1183/09059180.00000513
Gosselink, R., De Vos, J., Van Den Heuvel, S. P., Segers, J., Decramer, M., & Kwakkel, G. (2011). Impact of inspiratory muscle training in patients with COPD: What is the evidence? The European Respiratory Journal, 37(2), 416–425. https://doi.org/10.1183/09031936.00031810
Langer, D., Ciavaglia, C., Faisal, A., Webb, K. A., Neder, J. A., Gosselink, R., ... & O’Donnell, D. E. (2018). Inspiratory muscle training reduces diaphragm activation and dyspnea during exercise in COPD. Journal of Applied Physiology, 125(2), 381–392. https://doi.org/10.1152/japplphysiol.01078.2017
Lötters, F., Van Tol, B., Kwakkel, G., & Gosselink, R. (2002). Effects of controlled inspiratory muscle training in patients with COPD: A meta-analysis. The European Respiratory Journal, 20(3), 570–577. https://doi.org/10.1183/09031936.02.00237402
Magadle, R., McConnell, A. K., Beckerman, M., & Weiner, P. (2007). Inspiratory muscle training in pulmonary rehabilitation program in COPD patients. Respiratory Medicine, 101(7), 1500–1505. https://doi.org/10.1016/j.rmed.2007.01.010
Minoguchi, H., Shibuya, M., Miyagawa, T., Kokubu, F., Yamada, M., Tanaka, H., … & HoMMA, I. (2002). Cross-over comparison between respiratory muscle stretch gymnastics and inspiratory muscle training. Internal Medicine, 41(10), 805–812. https://doi.org/10.2169/internalmedicine.41.805
Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G. & PRISMA Group. (2009). Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. PloS Medicine, 6(7), e1000097. https://doi.org/10.1371/journal.pmed.1000097
Pereira, M. C., Dacha, S., Testelmans, D., Gosselink, R., & Langer, D. (2019). Assessing the effects of inspiratory muscle training in a patient with unilateral diaphragm dysfunction. Breathe, 15(2), e90–e96. https://doi.org/10.1183/20734735.0129-2019
Petrovic, M., Reiter, M., Zipko, H., Pohl, W., & Wanke, T. (2012). Effects of inspiratory muscle training on dynamic hyperinflation in patients with COPD. International Journal of Chronic Obstructive Pulmonary Disease, 7, 797–805. https://doi.org/10.2147/COPD.S23784
Riera, H. S., Rubio, T. M., Ruiz, F. O., Ramos, P. C., Otero, D. D. C., Hernandez, T. E., & Gomez, J. C. (2001). Inspiratory muscle training in patients with COPD: Effect on dyspnea, exercise performance, and quality of life. Chest, 120(3), 748–756. https://doi.org/10.1378/chest.120.3.748
Schultz, K., Jelusic, D., Wittmann, M., Krämer, B., Huber, V., Fuchs, S., … & Schuler, M. (2018). Inspiratory muscle training does not improve clinical outcomes in 3-week COPD rehabilitation: Results from a randomised controlled trial. The European Respiratory Journal, 51(1), 1702000. https://doi.org/10.1183/13993003.02000-2017
Shahin, B., Germain, M., Kazem, A., & Annat, G. (2008). Benefits of short inspiratory muscle training on exercise capacity, dyspnea, and inspiratory fraction in COPD patients. International Journal of Chronic Obstructive Pulmonary Disease, 3(3), 423–427. https://doi.org/10.2147/copd.s1822
Shoemaker, M. J., Donker, S., & LaPoe, A. (2009). Inspiratory muscle training in patients with chronic obstructive pulmonary disease: The state of the evidence. Cardiopulmonary Physical Therapy Journal, 20(3), 5.
Tkáč, J., Man, S. P., & Sin, D. D. (2007). Systemic consequences of COPD. Therapeutic Advances in Respiratory Disease, 1(1), 47–59. https://doi.org/10.1177/1753465807082374
Viegi, G., Pistelli, F., Sherrill, DL, Maio, S., Baldacci, S., & Carrozzi, L. (2007). Definition, epidemiology and natural history of COPD. The European Respiratory Journal, 3(1), 5–26. https://doi.org/10.1183/09031936.00082507
Vogelmeier, C. F., Criner, G. J., Martinez, F. J., Anzueto, A., Barnes, P. J., Bourbeau, J., ... & Agusti, A. (2017). Global strategy for the diagnosis, management, and prevention of chronic obstructive lung disease 2017 report. GOLD executive summary. American Journal of Respiratory and Critical Care Medicine, 195(5), 557–582. https://doi.org/10.1164/rccm.201701-0218PP
Wang, K., Zeng, G. Q., Li, R., Luo, Y. W., Wang, M., Hu, Y. H., ... & Chen, X. (2017). Cycle ergometer and inspiratory muscle training offer modest benefit compared with cycle ergometer alone: A comprehensive assessment in stable COPD patients. International Journal of Chronic Obstructive Pulmonary Disease, 12, 2655–2668. https://doi.org/10.2147/COPD.S140093