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Inspiratory muscle weakness, limited functional exercise capacity and worse quality of life have been shown in patients with exacerbation of chronic obstructive pulmonary disease (COPD). Recommendations from clinical practice guideline state that promoting pulmonary rehabilitation after exacerbation can improve the conditions above. Inspiratory muscle training (IMT) has been proven to enhance inspiratory muscle strength and endurance in patient with stable COPD. However, there is less research on whether IMT in addition to pulmonary rehabilitation after exacerbation can benefit inspiratory muscle function, functional exercise capacity and quality of life in patients with COPD. The purpose of this study is to examine the effects of IMT in addition to pulmonary rehabilitation on respiratory muscle function, functional exercise capacity and quality of life in patients with exacerbation of chronic obstructive pulmonary disease.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Inspiratory muscle training combined pulmonary rehabilitation | Experimental |
| |
| Sham inspiratory muscle training combined pulmonary rehabilitation | Sham Comparator |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| inspiratory muscle training | Other | Intensity of inspiratory muscle training will be set at 30% of maximal inspiratory pressure. Subjects in intervention experimental group will perform 15 breaths per set, 6 sets per day on daily basis. The intervention will be last for 8 weeks. |
| Measure | Description | Time Frame |
|---|---|---|
| Diaphragm muscle activation | The surface electromyography (EMG) signal was analyzed in the time domain, calculating root mean square (RMS) amplitude with a time constant of 30 mini seconds. A 1.5 seconds window of diaphragm muscle signals at peak pressure during maximal inspiratory pressure test were obtained and calculated as maximal effort. Diaphragm activation were calculated using mean RMS values of each threshold loaded breathing test, and then normalized to maximal effort (%EMGDia). | 10 minutes |
| Sternocleidomastoid muscle activation | The surface electromyography (EMG) signal was analyzed in the time domain, calculating root mean square (RMS) amplitude with a time constant of 30 mini seconds. A 1.5 seconds window of SCM muscle signals at peak pressure during maximal inspiratory pressure test were obtained and calculated as maximal effort. SCM activation were calculated using mean RMS values of each threshold loaded breathing test, and then normalized to maximal effort (%EMGSCM). | 10 minutes |
| Measure | Description | Time Frame |
|---|---|---|
| The mean median frequency of diaphragm and sternocleidomastoid muscle | The power spectrum is divided into two equal areas of the frequency value by median frequency to exam muscle fatigue. | 10 minutes |
| Functional exercise capacity |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Li-Ying Wang, PhD | National Taiwan University | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| School and Graduate Institute of Physical Therapy of National Taiwan University | Taipei | Zhongzheng Dist | 100 | Taiwan |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 39774113 | Derived | Huang WY, Lee CT, Chien JY, Hsu M, Wang LY. Effects of Inspiratory Muscle Training in Patients With Chronic Obstructive Pulmonary Disease Exacerbations: A Randomized Controlled Trial. Am J Phys Med Rehabil. 2025 May 1;104(5):458-464. doi: 10.1097/PHM.0000000000002654. Epub 2024 Nov 11. |
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| pulmonary rehabilitation | Other | Pulmonary rehabilitation consists of aerobic exercise training, strength training, and education related to airway clearance and drug utilization. All of subjects will receive 8-week pulmonary rehabilitation. |
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Six-minute walking test will be performed to evaluate functional exercise capacity.
| Considering time of test and recovery, it will be expected to take totally 10 minutes. |
| Quality of life evaluation | St. George's Respiratory Questionnaire and COPD assessment test will be used to evaluate quality of life. | 10 minutes |