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

  • Charususin, Noppawan1, 2, 3
  • Gosselink, Rik1, 2
  • Decramer, Marc1
  • Demeyer, Heleen1, 2
  • McConnell, Alison4
  • Saey, Didier5
  • Maltais, François5
  • Derom, Eric6
  • Vermeersch, Stefanie6
  • Heijdra, Yvonne F7
  • van Helvoort, Hanneke7
  • Garms, Linda7
  • Schneeberger, Tessa8
  • Kenn, Klaus8, 9
  • Gloeckl, Rainer8, 10
  • Langer, Daniel1, 2
  • 1 Respiratory Rehabilitation and Respiratory Division, University Hospital Leuven, Leuven, Belgium. , (Belgium)
  • 2 KU Leuven - University of Leuven, Department of Rehabilitation Sciences, Faculty of Movement and Rehabilitation Sciences, Leuven, Belgium. , (Belgium)
  • 3 Department of Physical Therapy, Faculty of Allied Health Sciences, Thammasat University, Pathumthani, Thailand. , (Thailand)
  • 4 Department of Human Sciences and Public Health, Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, UK.
  • 5 Centre de recherche, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Quebec, Canada. , (Canada)
  • 6 Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium. , (Belgium)
  • 7 Department of Pulmonary Diseases, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. , (Netherlands)
  • 8 Department of Respiratory Medicine and Pulmonary Rehabilitation, Schoen Klinik Berchtesgadener Land, Schoenau am Koenigssee, Germany. , (Germany)
  • 9 German Center for Lung Research (DZL), Universities of Giessen and Marburg Lung Center (UGMLC), Giessen, Germany. , (Germany)
  • 10 Department of Prevention, Rehabilitation and Sports Medicine, Technical University of Munich (TUM), Munich, Germany. , (Germany)
Published Article
Publication Date
Oct 01, 2018
DOI: 10.1136/thoraxjnl-2017-211417
PMID: 29914940


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. 219 patients with COPD (FEV1: 42%±16% predicted) with inspiratory muscle weakness (PImax: 51±15 cm H2O) were randomised into an intervention group (IMT+PR; n=110) or a control group (Sham-IMT+PR; n=109) in this double-blind, multicentre randomised controlled trial between February 2012 and October 2016 ( 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. 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. 75 s 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. 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) TRIAL REGISTRATION NUMBER: NCT01397396; Results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

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