Effects of inspiratory muscle training in COPD patients: A systematic review and meta-analysis. 2018

Marc Beaumont, and Patrice Forget, and Francis Couturaud, and Gregory Reychler
Pulmonary Rehabilitation Unit, Morlaix Hospital Centre, European University of Occidental Brittany, Brest, France.

OBJECTIVE In chronic obstructive pulmonary disease (COPD), quality of life and exercise capacity are altered in relationship to dyspnea. Benefits of inspiratory muscle training (IMT) on quality of life, dyspnea, and exercise capacity were demonstrated, but when it is associated to pulmonary rehabilitation (PR), its efficacy on dyspnea is not demonstrated. The aim of this systematic review with meta-analysis was to verify the effect of IMT using threshold devices in COPD patients on dyspnea, quality of life, exercise capacity, and inspiratory muscles strength, and the added effect on dyspnea of IMT associated with PR (vs. PR alone). METHODS This systematic review and meta-analysis was conducted on the databases from PubMed, Science direct, Cochrane library, Web of science, and Pascal. Following key words were used: inspiratory, respiratory, ventilatory, muscle, and training. The searching period extended to December 2017. Two reviewers independently assessed studies quality. RESULTS Forty-three studies were included in the systematic review and thirty-seven studies in the meta-analysis. Overall treatment group consisted of six hundred forty two patients. Dyspnea (Baseline Dyspnea Index) is decreased after IMT. Quality of life (Saint George's Respiratory Questionnaire), exercise capacity (6 min walk test) and Maximal inspiratory pressure were increased after IMT. During PR, no added effect of IMT on dyspnea was found. CONCLUSIONS IMT using threshold devices improves inspiratory muscle strength, exercise capacity and quality of life, decreases dyspnea. However, there is no added effect of IMT on dyspnea during PR (compared with PR alone).

UI MeSH Term Description Entries
D008297 Male Males
D011788 Quality of Life A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral, social environment as well as health and disease. HRQOL,Health-Related Quality Of Life,Life Quality,Health Related Quality Of Life
D012132 Respiratory Muscles These include the muscles of the DIAPHRAGM and the INTERCOSTAL MUSCLES. Ventilatory Muscles,Respiratory Muscle,Muscle, Respiratory,Muscle, Ventilatory,Muscles, Respiratory,Muscles, Ventilatory,Ventilatory Muscle
D001945 Breathing Exercises Therapeutic exercises aimed to deepen inspiration or expiration or even to alter the rate and rhythm of respiration. Respiratory Muscle Training,Exercise, Breathing,Muscle Training, Respiratory,Training, Respiratory Muscle
D004417 Dyspnea Difficult or labored breathing. Orthopnea,Platypnea,Recumbent Dyspnea,Rest Dyspnea,Trepopnea,Breathlessness,Shortness of Breath,Breath Shortness,Dyspnea, Recumbent,Dyspnea, Rest,Dyspneas, Rest
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000070857 Walk Test A measure of endurance tests that show how far and fast an individual can walk without stopping within a certain period of time. 6-Min Walk Test,Six-Minute Walk Test,6-Minute Walk Test,Endurance Shuttle Walk Test,Incremental Shuttle Walk Test,6 Min Walk Test,6 Minute Walk Test,6-Min Walk Tests,6-Minute Walk Tests,Six Minute Walk Test,Six-Minute Walk Tests,Test, 6-Min Walk,Test, 6-Minute Walk,Test, Six-Minute Walk,Test, Walk,Tests, 6-Min Walk,Tests, 6-Minute Walk,Tests, Six-Minute Walk,Tests, Walk,Walk Test, 6-Min,Walk Test, 6-Minute,Walk Test, Six-Minute,Walk Tests,Walk Tests, 6-Min,Walk Tests, 6-Minute,Walk Tests, Six-Minute
D029424 Pulmonary Disease, Chronic Obstructive A disease of chronic diffuse irreversible airflow obstruction. Subcategories of COPD include CHRONIC BRONCHITIS and PULMONARY EMPHYSEMA. Airflow Obstruction, Chronic,COAD,COPD,Chronic Airflow Obstruction,Chronic Obstructive Airway Disease,Chronic Obstructive Lung Disease,Chronic Obstructive Pulmonary Disease,Chronic Obstructive Pulmonary Diseases,Airflow Obstructions, Chronic,Chronic Airflow Obstructions

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