The Effect of Inspiratory Muscle Training on Respiratory Functions of Patients with Chronic Obstructive Pulmonary Diseases: A Systematic Review

Tuesday, 31 July 2012: 1:30 PM

Han Yu Chuang, BS, RN
School of Nursing, Mackay Memorial Hospital Tai Tung Branch & Fooyin University, Taitung City, Taiwan
Hsiu Wen Tsai, BS, RN
School of nurse, Kaohsiung Chang Gung Memorial Hospital/Fooyin University, Kaohsiung city, Taiwan
Yueh-Yen Fang, PhD, RN
School of Nursing, Fooyin University, Ta-liao, Kaohsiung, Taiwan
Hsiao-Yun Chang, PhD
School of Nursing, Fooyin University, Kaohsiung, Taiwan

Learning Objective 1: The learner will be able to understand the effects of inspiratoy muscle training on respiratory functions of patients with COPD.

Learning Objective 2: The learner will be able to understand the validity threats that could impede the generalization of inspiratory muscle training.

Purpose: The purpose of this systematic review was to examine the effect of inspiratory muscle training (IMT) on improving respiratory functions of patents with chronic obstructive pulmonary diseases (COPDs).

Methods: Two Chinese (CEPS and the National Digital Library of Theses and Dissertation in Taiwan) and four English (PubMed, the Cochrane Clinical Trials, Medline, and CINAHL) electronic databases were systematically searched to locate primary studies published before November, 2011. Search terms used were ‘inspiratory muscle training’, ‘COPD’, and ‘pulmonary disease, chronic obstructive’. The Boolean strategy was used to combine these terms. Included studies were independently reviewed by two reviewers. Disagreement in data extraction was resolved by a complete consensus among reviewers. The Johns Hopkins Evidence-Based Practice Rating Scale was used to evaluate study quality.

Results: Twenty studies (N=616) that met the inclusion criteria were identified from 405 articles. These articles contained 16 RCTs. All studies used Inspiratory Threshold Loading Device to perform IMF with a gradual increase of resistance up to 60% or 75%. The training time of each course was consistently 4 to 5 minutes across studies, but the training periods can vary from 5 weeks to 6 months. The inclusion of samples varied in bronchodilators taken. Results of included studies consistently supported IMF as an effective method to improve functional physical activity, inspiratory muscle strength, self-aware breathing difficulty, and quality of life

Conclusion: The systematic review supported IMT as an effective method to improve respiratory functions in COPD patients. Lack of control in length and types of COPD, as well as using of bronchodilators, may impede the validity of study results.  Lack of consensus among studies on the effective IMF training period is an important practice issue for the future studies to resolve.