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 -4cmH(2)O 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 categoryratio scale administered during a submaximal exercise protocol. Results: AU. 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. (C) 1999 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation.