Enhanced diaphragm excursion and exercise tolerance in COPD patients through inspiratory muscle training after standardised pulmonary rehabilitation: randomised controlled trial.

IF 4.3 3区医学 Q1 RESPIRATORY SYSTEM ERJ Open Research Pub Date : 2024-11-25 eCollection Date: 2024-11-01 DOI:10.1183/23120541.00035-2024

Masashi Shiraishi, Yuji Higashimoto, Ryuji Sugiya, Hiroki Mizusawa, Yu Takeda, Masaya Noguchi, Osamu Nishiyama, Ryo Yamazaki, Shintarou Kudo, Tamotsu Kimura, Hisako Matsumoto

{"title":"Enhanced diaphragm excursion and exercise tolerance in COPD patients through inspiratory muscle training after standardised pulmonary rehabilitation: randomised controlled trial.","authors":"Masashi Shiraishi, Yuji Higashimoto, Ryuji Sugiya, Hiroki Mizusawa, Yu Takeda, Masaya Noguchi, Osamu Nishiyama, Ryo Yamazaki, Shintarou Kudo, Tamotsu Kimura, Hisako Matsumoto","doi":"10.1183/23120541.00035-2024","DOIUrl":null,"url":null,"abstract":"Objective: Inspiratory muscle training (IMT) is used to improve inspiratory muscle strength in patients with COPD. However, the effect of IMT on diaphragmatic function has not yet been thoroughly evaluated. This study aimed to evaluate the effect of IMT on maximum diaphragmatic excursion (DEmax) using ultrasonography in patients with COPD.Methods: This was a single-centre, randomised, prospective, parallel-group, unblinded controlled trial involving 38 participants with stable COPD. Participants underwent a standardised 12-week pulmonary rehabilitation (PR) programme followed by a 12-week IMT programme, consisting of home-based IMT and low-frequency outpatient PR sessions supervised by physiotherapists (once every 2 weeks), versus low-frequency outpatient PR alone as a control. The DEmax and exercise tolerance were measured.Results: Out of the 38 patients initially enrolled in the PR programme, 33 successfully completed it and were subsequently randomised to the IMT programme. Finally, 15 (94%) and 14 (88%) patients from the IMT and control groups, respectively, completed the study. Following the IMT programme, DEmax increased in the IMT group (mean±sd 50.1±7.6 mm to 60.6±8.0 mm, p<0.001), but not in the control group (47.4±7.9 mm to 46.9±8.3 mm, p=0.10). Changes in DEmax and exercise tolerance (peak oxygen uptake) were greater in the IMT group than in the control group (both p<0.01).Conclusions: IMT following the PR programme improved DEmax and exercise tolerance. Therefore, DEmax may be an important outcome of IMT.","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":"10 6","pages":""},"PeriodicalIF":4.3000,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587166/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"ERJ Open Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1183/23120541.00035-2024","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/11/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"RESPIRATORY SYSTEM","Score":null,"Total":0}

引用次数: 0

Abstract

Objective: Inspiratory muscle training (IMT) is used to improve inspiratory muscle strength in patients with COPD. However, the effect of IMT on diaphragmatic function has not yet been thoroughly evaluated. This study aimed to evaluate the effect of IMT on maximum diaphragmatic excursion (DE_max) using ultrasonography in patients with COPD.

Methods: This was a single-centre, randomised, prospective, parallel-group, unblinded controlled trial involving 38 participants with stable COPD. Participants underwent a standardised 12-week pulmonary rehabilitation (PR) programme followed by a 12-week IMT programme, consisting of home-based IMT and low-frequency outpatient PR sessions supervised by physiotherapists (once every 2 weeks), versus low-frequency outpatient PR alone as a control. The DE_max and exercise tolerance were measured.

Results: Out of the 38 patients initially enrolled in the PR programme, 33 successfully completed it and were subsequently randomised to the IMT programme. Finally, 15 (94%) and 14 (88%) patients from the IMT and control groups, respectively, completed the study. Following the IMT programme, DE_max increased in the IMT group (mean±sd 50.1±7.6 mm to 60.6±8.0 mm, p<0.001), but not in the control group (47.4±7.9 mm to 46.9±8.3 mm, p=0.10). Changes in DE_max and exercise tolerance (peak oxygen uptake) were greater in the IMT group than in the control group (both p<0.01).

Conclusions: IMT following the PR programme improved DE_max and exercise tolerance. Therefore, DE_max may be an important outcome of IMT.

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

通过标准化肺康复训练后的吸气肌训练增强慢性阻塞性肺病患者的膈肌张力和运动耐受力：随机对照试验。

目的：吸气肌训练（IMT）用于改善慢性阻塞性肺病患者的吸气肌力量。然而，吸气肌训练对膈肌功能的影响尚未得到全面评估。本研究旨在通过超声波造影评估 IMT 对慢性阻塞性肺病患者膈肌最大偏移量（DEmax）的影响：这是一项单中心、随机、前瞻性、平行组、非盲对照试验，共有 38 名慢性阻塞性肺病患者参加。参加者接受了为期 12 周的标准化肺康复（PR）计划，随后又接受了为期 12 周的 IMT 计划，包括在家进行 IMT 和由物理治疗师监督的低频率门诊 PR 课程（每 2 周一次），与仅接受低频率门诊 PR 作为对照。结果：结果：在最初参加 PR 项目的 38 名患者中，33 人成功完成了项目，随后被随机分配到 IMT 项目。最后，IMT 组和对照组分别有 15 名（94%）和 14 名（88%）患者完成了研究。在实施 IMT 计划后，IMT 组的 DEmax 有所提高（平均值（±sd）从 50.1±7.6 mm 提高到 60.6±8.0 mm），IMT 组的 pmax 和运动耐量（峰值摄氧量）均高于对照组（均为 p结论：实施 PR 计划后，IMT 改善了 DEmax 和运动耐受性。因此，最大负重可能是 IMT 的一个重要结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

ERJ Open Research Medicine-Pulmonary and Respiratory Medicine

CiteScore

6.20

自引率

4.30%

发文量

273

审稿时长

8 weeks

期刊介绍： ERJ Open Research is a fully open access original research journal, published online by the European Respiratory Society. The journal aims to publish high-quality work in all fields of respiratory science and medicine, covering basic science, clinical translational science and clinical medicine. The journal was created to help fulfil the ERS objective to disseminate scientific and educational material to its members and to the medical community, but also to provide researchers with an affordable open access specialty journal in which to publish their work.