[Inspiratory muscle training combined with general exercise reconditioning in chronic obstructive pulmonary disease]

In a controlled clinical trial, we compared the effect of 6 months of specific inspiratory muscle training combined with general exercise reconditioning, with that of general exercise reconditioning alone. We measured the effects of the 2 regimens on inspiratory muscle strength, endurance, and exercise performance in patients with chronic obstructive pulmonary disease (COPD), 2 groups of 10 patients each. Inspiratory muscle strength (expressed as the PImax at RV) increased significantly from 43.2 +/- 3.0 to 67.8 +/- 2.9 cm H2O (p < 0.0001) and respiratory muscle endurance (expressed as the relationship between PmPeak, the pressure achieved with the heaviest load tolerated for at least 60 sec, and PI max) increased significantly from 60.2 +/- 2.5 to 85.6 +/- 2.8% (p < 0.001) in the first group (combined treatment). After the 6-month training period, in both groups there were significant increases in 12-minute walk and endurance work time at 2/3 of Wmax (maximal work each subject achieved on a progressive bicycle exercise test of maximum work load). However, those in the first group showed significantly greater improvement in distance walked and endurance time than the others. We conclude that specific inspiratory muscle training for 6 months improves inspiratory muscle strength and endurance in patients with COPD. This training, combined with general exercise reconditioning, also results in improvement in exercise tolerance significantly greater than that of general exercise reconditioning alone.