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Inspiratory muscle training(IMT) was one of the widely used pulmonary rehabilitation method in COPD patients.However, when the respiratory muscles are fatigue without sufficient rest, IMT may increase muscle fatigue and aggravate muscle damage. Noninvasive positive pressure ventilation (NPPV) is another important strategy of pulmonary rehabilitation which could overcome airway resistance and reduce respiratory work, improve respiratory muscle fatigue. Therefore, the purpose of this study was to explore the effective of the "IMT - NPPV sequential" rehabilitation method, that is, first inspiratory muscle training, followed by respiratory muscle resting (non-invasive positive pressure ventilation).
Exploring the effects of the new rehabilitation method of "IMT - NPPV sequential", comparing with the single rehabilitation strategy such as inspiratory muscle training and non-invasive positive pressure ventilation.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| respiratory muscle weakness | Experimental | Patients with respiratory muscle weakness are performing the inspiratory pressure threshold device, combined CPAP and inspiratory pressure threshold device and continue oxygen therapy randomly. |
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| normal respiratory muscle | Experimental | Patients with normal respiratory muscle are performing the inspiratory pressure threshold device, combined CPAP and inspiratory pressure threshold device and continue oxygen therapy randomly. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| inspiratory pressure threshold device | Device | The threshold loading device is composed of a mouth -piece attached to a small plastic cylinder that contains a spring-loaded poppet value. The valve opens to permit inspiratory flow only once the person has generated adequate negative intrathoracic pressure to condense the spring. |
| Measure | Description | Time Frame |
|---|---|---|
| Respiratory muscle strength(composite outcome measure) | Currently, the maximal inspiratory pressure (PImax) and maximal expiratory pressures(PEmax) are measured by a digital manometer (AZ-8205, AZ Instrument, Taichung City, Taiwan)and combined to evaluate respiratory muscle function. | Change from baseline to 8 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Diaphragmatic function | Diaphragmatic function can be assessed by diaphragm electromyogram (EMGdi) measured by a high-performance data acquisition device (Powerlab 16/35; ADInstruments, Australia), which reflect the physiological activity of the diaphragm and indicate functional status of the central drive. | Change from baseline to 8 weeks |
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Inclusion Criteria:
Exclusion Criteria:
Patients with acute cardiovascular event and severe cor pulmonale. Patients with poor compliance. An Other causes of diaphragmatic dysfunction
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| Name | Affiliation | Role |
|---|---|---|
| Chen Xin, Doctor | Zhujiang Hospital,Southern Medical Unversity | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Zhujiang Hospital,Southern Medical Universicity | Guangzhou | Guangdong | 510282 | China |
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| Symptom Evaluation(composite outcome measure) |
Individuals with chronic respiratory disease often have symptoms such as dyspnea, fatigue, cough, weakness, sleeplessness, and psychological distress. Instruments for assessment of multiple symptoms include COPD Assessment Test (CAT) and Modified Medical British Research Council Scale(mMRC). |
| Change from baseline to 8 weeks |
| Pulmonary function(composite outcome measure) | Pulmonary function is measured using a spirometer(PonyFX 229, Cosmed, Rome, Italy) that is calibrated daily.The FEV1 and percent-of-predicted FEV1, FVC and percent-of-predicted FVC which are presented in one report are used to evaluate Pulmonary Function. | Change from baseline to 8 weeks |
| Exercise capacity | Exercise capacity is evaluated using the 6-min walking distance (6MWD) according to American Thoracic Society guidelines. | Change from baseline to 8 weeks |