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

OBJECTIVE

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.

DESIGN

Pilot study comparing baseline values with posttest values.

SUBJECTS

Four adults with severe COPD (the mean of the forced expiratory volume in 1 second [FEV1] was 28% of predicted value).

METHODS

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).

OUTCOME MEASURES

Dyspnea measures were Mahler's Baseline and Transition Dyspnea Index and the Borg category-ratio scale administered during a submaximal exercise protocol.

RESULTS

All subjects tolerated the training load, improved their inspiratory muscle strength, and reported reduced dyspnea.

CONCLUSION

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.