Inspiratory muscle strength in chronic obstructive pulmonary disease depending on disease severity

2007 ◽  
Vol 113 (5) ◽  
pp. 243-249 ◽  
Author(s):  
Hans-Joachim Kabitz ◽  
Stephan Walterspacher ◽  
David Walker ◽  
Wolfram Windisch
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Muscle Strength ◽  
Pulmonary Disease ◽  
Disease Severity ◽  
Inspiratory Muscle ◽  
Walking Distance ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Inspiratory Muscle Strength

Staging criteria for COPD (chronic obstructive pulmonary disease) include symptoms and lung function parameters, but the role of reduced inspiratory muscle strength related to disease severity remains unclear. Therefore the present study tested whether inspiratory muscle strength is reduced in COPD and is related to disease severity according to GOLD (Global Initiative for Chronic Obstructive Lung Disease) criteria and assessed its clinical impact. PImax (maximal inspiratory mouth occlusion pressure), SnPna (sniff nasal pressure) and TwPmo (twitch mouth pressure) following bilateral anterior magnetic phrenic nerve stimulation were assessed in 33 COPD patients (8 GOLD0, 6 GOLDI, 6 GOLDII, 7 GOLDIII and 6 GOLDIV) and in 28 matched controls. Furthermore, all participants performed a standardized 6 min walking test. In comparison with controls, PImax (11.6±2.5 compared with 7.3±3.0 kPa; P<0.001), SnPna (9.7±2.5 compared with 6.9±3.3 kPa; P<0.001) and TwPmo (1.6±0.6 compared with 0.8±0.4 kPa; P<0.001) were markedly lower in COPD patients. TwPmo decreased with increasing COPD stage. TwPmo was correlated with walking distance (r=0.75; P<0.001), dyspnoea (r=−0.61; P<0.001) and blood gas values following exercise (r>0.57; P<0.001). Inspiratory muscle strength, as reliably assessed by TwPmo, decreased with increasing severity of COPD and should be considered as an important factor in rating disease severity and to reflect burden in COPD.

scholarly journals Sternocleidomastoid muscle activation following inspiratory muscle training in patients with chronic obstructive pulmonary disease: a randomized clinical trial

2020 ◽  
Vol 27 (2) ◽  
pp. 133-139
Author(s):  
Diogo Fanfa Bordin ◽  
Dannuey Machado Cardoso ◽  
Litiele Evelin Wagner ◽  
Paula Regina Beckenkamp ◽  
Andrea Lúcia Gonçalves da Silva ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Muscle Strength ◽  
Pulmonary Disease ◽  
Inspiratory Muscle ◽  
Control Group ◽  
Chronic Obstructive ◽  
Electromyographic Activity ◽  
Muscle Training ◽  
Obstructive Pulmonary Disease ◽  
Inspiratory Muscle Strength

ABSTRACT This study aims to assess the effect of short-time low frequency inspiratory muscle trainer (Threshold IMT) on inspiratory muscle strength and electromyographic activity of the sternocleidomastoid (SCM) muscle in people with chronic obstructive pulmonary disease (COPD). People with COPD participating in a lung rehabilitation program were allocated to a control or inspiratory muscle training (IMT) group. The control group participated in the usual rehabilitation, whereas the other group received IMT (performed with a load of 50% maximal inspiratory pressure (MIP) adjusted weekly). Both interventions lasted for 2 months. Outcomes included electromyographic analysis of the SCM and MIP. In total, ten participants were allocated to each group. The IMT group presented an increase in absolute (p<0.001) and predicted (p<0.001) values of MIP and also in pre- and post-intervention variation between groups (p=0.003 and p=0.008, respectively). Such differences were not found in the control group. The SCM muscle activity decreased in the IMT post intragroup evaluation (p=0.008). IMT provided a reduction of the electromyographic activity of SCM in COPD patients, also increasing inspiratory muscle strength in the study participants.

scholarly journals Expiration Training Maneuver for Chronic Obstructive Pulmonary Disease with Congestive Heart Failure Grade II: A Case Report

2019 ◽  
Vol 7 (01) ◽  
pp. 28
Author(s):  
Nury Nusdwinuringtyas ◽  
Siti Chandra Widjanantie
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Muscle Strength ◽  
Pulmonary Disease ◽  
Respiratory Muscle ◽  
Walking Distance ◽  
Chronic Obstructive ◽  
Respiratory Muscle Strength ◽  
Obstructive Pulmonary Disease ◽  
Before And After ◽  
Grade Ii

Introduction: Chronic Obstructive Pulmonary Disease (COPD) was characteristic by the inflammatory process in the airway which causes air trapping and hyperinflation, then followed by decreasing the respiratory muscle strength. Breathing training using the positive expiratory pressure (PEP) increasing respiratory muscle strength.Methods: A case presentation of a male, age was 60 years old diagnosed as COPD by The Global Initiative for Chronic Obstructive Lung Disease (GOLD) grade 4 group D, and Chronic Heart Failure (CHF) grade II, with complication of excessive phlegm, underweight, and weakness of respiratory muscle, have PEP for 8 weeks.Results: Spirometry evaluation before and after eight week of PEP have found; FEV1 22.12 and 22.42%, FVC 34.24 and 56%, FEV1/FVC 76.8 and 64%. Respiratory muscle strength before and after PEP showed the Muscle Inspiratory Pressure (MIP) 46 and 71 cmH2O, Muscle Expiratory Pressure (MEP) 48 and 104 cmH2O.The values of Six Minute Walk Test (6MWT) evaluation by BORG modified scale before and after PEP were 11 and 13 ( efforts), 2 and 3 (dyspnea), 0 and 1 (Leg Fatigue). The six-minute walking distance (6MWD) before and after PED were 170 and 190 m, equation reference with Nury’s formula showed percentage prediction before and after PEP respectively 29.2 and 32%, VO2Max; 4.96 and 6L, METs; 1.41 and 1.7. The St GeorgeRespiratory Questionnaire (SGRQ) before and after PEP were 20.6 and 49.5% (symptom), 86.6 and 45.1% (activity), 45.5 and 18.4% (impact) and 53.6 and 42% for total.Conclusion: Positive airway pressure exercise had beneficial effect on reducing air-trapping process in COPD and increasing the respiratory muscle strength for both expiratory and inspiratory muscle strength.Keywords: Chronic obstructive pulmonary disease, positive expiratory pressure device, respiratory muscle strength, six minutes walking distance

scholarly journals Extracellular adenosine triphosphate is associated with airflow limitation severity and symptoms burden in patients with chronic obstructive pulmonary disease

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Iva Hlapčić ◽  
Andrea Hulina-Tomašković ◽  
Anita Somborac-Bačura ◽  
Marija Grdić Rajković ◽  
Andrea Vukić Dugac ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Disease Severity ◽  
Adenosine Triphosphate ◽  
Quantitative Polymerase Chain Reaction ◽  
Airflow Limitation ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Extracellular Adenosine ◽  
Copd Patients

Abstract Extracellular adenosine triphosphate (eATP)-driven inflammation was observed in chronic obstructive pulmonary disease (COPD) but was not investigated in patients’ blood. Therefore, this study aimed to investigate eATP concentration in plasma of COPD patients and its association with disease severity and smoking. Study included 137 patients with stable COPD and 95 control subjects. eATP concentration was determined in EDTA plasma by luminometric method, and mRNA expression of eATP receptors P2X7R and P2Y2R was analysed by quantitative polymerase chain reaction (qPCR). eATP concentration was increased in COPD patients compared to controls (P < 0.001). Moreover, it was increasing with disease severity (GOLD 2–4) as well as symptoms burden and exacerbations history (GOLD A–D) (P < 0.05). eATP in healthy smokers differed from healthy non-smokers (P < 0.05) but was similar to GOLD 2 and GOLD A patients. eATP showed great diagnostic performances (OR = 12.98, P < 0.001) and correctly classified 79% of study participants. It demonstrated association with FEV1 and multicomponent indices (ADO, BODEx, BODCAT, CODEx, DOSE). Regarding gene expression, P2Y2R was increased in the blood of COPD patients. Plasma eATP could become a diagnostic and/or prognostic biomarker in COPD, as it seems to be associated with patients’ condition, quality of life and disease progression.

scholarly journals Changes in Diaphragm Thickness and 6-min Walking Distance Improvement After Inspiratory Muscle Training in Patients With Chronic Obstructive Pulmonary Disease

2021 ◽  
Author(s):  
Tomomi Ichiba ◽  
Tetsuo Miyagawa ◽  
Toru Tsuda ◽  
Takeshi Kera
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Inspiratory Muscle ◽  
Walking Distance ◽  
Chronic Obstructive ◽  
Borg Scale ◽  
Muscle Training ◽  
Obstructive Pulmonary Disease ◽  
Significant Difference ◽  
Before And After

Abstract Background: The Global Initiative for Chronic Obstructive Lung Disease guidelines (http://www.goldcopd.org, accessed January 16, 2020) reported the use of inspiratory muscle training (IMT) as a part of comprehensive respiratory rehabilitation programs for patients with chronic obstructive pulmonary disease (COPD). However, some studies have indicated that the effect of such training is uncertain. Moreover, it is unclear whether IMT effects are caused by improvement in central or peripheral factors. Few studies examining IMT effects have used new evaluation items. We aimed to clarify the effects of IMT by additionally measuring the airway-occlusion pressure at 0.1 s after the start of inspiratory flow (P0.1), as an index of respiratory central output, and by evaluating diaphragm movement based on the thickness of the diaphragm muscle (Tdi) using ultrasound.Methods: Thirteen patients with COPD participated in the study. IMT was performed using the POWER breathe® Medic Plus breathing trainer in combination with each participant’s outpatient rehabilitation regimen. Starting at 20% of the maximal inspiratory pressure (PImax) and increasing to 50%, the participants performed 30 IMT repetitions twice a day for 2 months. Respiratory muscle strength, P0.1, 6-min walking distance (6MWD), and Tdi were measured before and after IMT. Dyspnea, lower limb fatigue (assessed using the Borg Scale), and respiratory rate (RR) were measured before and after the 6-min walk test (6MWT). Results: PImax and 6MWD significantly increased after training. Tdi at resting inspiration and expiration and maximal inspiration also significantly increased after training. In addition, the Borg Scale scores for dyspnea and leg fatigue and the RR of the 1-min recovery period after the 6MWT significantly decreased. There was no significant difference in P0.1.Conclusions: We examined the combined effects of IMT, incorporating the evaluation of P0.1 and Tdi. We found that the PImax, 6MWD, and Tdi significantly increased, but no significant difference was observed in P0.1 after training. These results suggest that the effects of IMT may be attributed to the improved peripheral factors rather than to the central factors.

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