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Randomised controlled trial of adjunctive inspiratory muscle training for patients with COPD

(2018) THORAX. 73(10). p.942-950
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Abstract
Background: This study aimed to investigate whether adjunctive inspiratory muscle training (IMT) can enhance the well-established benefits of pulmonary rehabilitation (PR) in patients with COPD. Methods: 219 patients with COPD (FEVI: 42%+/- 16% predicted) with inspiratory muscle weakness (Plmax: 51 +/- 15 cm H2O) were randomised into an intervention group (IMT+PR; n=110) or a control group (ShamIMT- PR; n=109) in this double-blind, multicentre randomised controlled trial between February 2012 and October 2016 (ClinicalTrials.gov NCT01397396). Improvement in 6 min walking distance (6MWD) was a priori defined as the primary outcome. Prespecified secondary outcomes included respiratory muscle function and endurance cycling time. Findings: No significant differences between the intervention group (n=89) and the control group (n=85) in improvements in 6MWD were observed (0.3 m, 95% CI 13 to 14, p=0.967). Patients who completed assessments in the intervention group achieved larger gains in inspiratory muscle strength (effect size: 1.07, p<0.001) and endurance (effect size: 0.79, p<0.001) than patients in the control group. 75s additional improvement in endurance cycling time (95% CI 1 to 149, p=0.048) and significant reductions in Borg dyspnoea score at isotime during the cycling test (95% CI 1.5 to 0.01, p=0.049) were observed in the intervention group. Interpretation: Improvements in respiratory muscle function after adjunctive IMT did not translate into additional improvements in 6MWD (primary outcome). Additional gains in endurance time and reductions in symptoms of dyspnoea were observed during an endurance cycling test (secondary outcome)
Keywords
OBSTRUCTIVE PULMONARY-DISEASE, IMPROVE EXERCISE TOLERANCE, RESPIRATORY MUSCLES, IMPORTANT DIFFERENCE, REHABILITATION, WALKING, DISORDERS, CAPACITY, DISTANCE, DYSPNEA

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Citation

Please use this url to cite or link to this publication:

Chicago
Charususin, Noppawan, Rik Gosselink, Marc Decramer, Heleen Demeyer, Alison McConnell, Didier Saey, François Maltais, et al. 2018. “Randomised Controlled Trial of Adjunctive Inspiratory Muscle Training for Patients with COPD.” Thorax 73 (10): 942–950.
APA
Charususin, N., Gosselink, R., Decramer, M., Demeyer, H., McConnell, A., Saey, D., Maltais, F., et al. (2018). Randomised controlled trial of adjunctive inspiratory muscle training for patients with COPD. THORAX, 73(10), 942–950.
Vancouver
1.
Charususin N, Gosselink R, Decramer M, Demeyer H, McConnell A, Saey D, et al. Randomised controlled trial of adjunctive inspiratory muscle training for patients with COPD. THORAX. 2018;73(10):942–50.
MLA
Charususin, Noppawan, Rik Gosselink, Marc Decramer, et al. “Randomised Controlled Trial of Adjunctive Inspiratory Muscle Training for Patients with COPD.” THORAX 73.10 (2018): 942–950. Print.
@article{8574530,
  abstract     = {Background: This study aimed to investigate whether adjunctive inspiratory muscle training (IMT) can enhance the well-established benefits of pulmonary rehabilitation (PR) in patients with COPD. 
Methods: 219 patients with COPD (FEVI: 42\%+/- 16\% predicted) with inspiratory muscle weakness (Plmax: 51 +/- 15 cm H2O) were randomised into an intervention group (IMT+PR; n=110) or a control group (ShamIMT- PR; n=109) in this double-blind, multicentre randomised controlled trial between February 2012 and October 2016 (ClinicalTrials.gov NCT01397396). Improvement in 6 min walking distance (6MWD) was a priori defined as the primary outcome. Prespecified secondary outcomes included respiratory muscle function and endurance cycling time. 
Findings: No significant differences between the intervention group (n=89) and the control group (n=85) in improvements in 6MWD were observed (0.3 m, 95\% CI 13 to 14, p=0.967). Patients who completed assessments in the intervention group achieved larger gains in inspiratory muscle strength (effect size: 1.07, p{\textlangle}0.001) and endurance (effect size: 0.79, p{\textlangle}0.001) than patients in the control group. 75s additional improvement in endurance cycling time (95\% CI 1 to 149, p=0.048) and significant reductions in Borg dyspnoea score at isotime during the cycling test (95\% CI 1.5 to 0.01, p=0.049) were observed in the intervention group. 
Interpretation: Improvements in respiratory muscle function after adjunctive IMT did not translate into additional improvements in 6MWD (primary outcome). Additional gains in endurance time and reductions in symptoms of dyspnoea were observed during an endurance cycling test (secondary outcome)},
  author       = {Charususin, Noppawan and Gosselink, Rik and Decramer, Marc and Demeyer, Heleen and McConnell, Alison and Saey, Didier and Maltais, Fran\c{c}ois and Derom, Eric and Vermeersch, Stefanie and Heijdra, Yvonne F and van Helvoort, Hanneke and Garms, Linda and Schneeberger, Tessa and Kenn, Klaus and Gloeckl, Rainer and Langer, Daniel},
  issn         = {0040-6376},
  journal      = {THORAX},
  language     = {eng},
  number       = {10},
  pages        = {942--950},
  title        = {Randomised controlled trial of adjunctive inspiratory muscle training for patients with COPD},
  url          = {http://dx.doi.org/10.1136/thoraxjnl-2017-211417},
  volume       = {73},
  year         = {2018},
}

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