Novel versus traditional inspiratory muscle training regimens in COPD

COPD patients often suffer from weakened inspiratory muscles, which can be addressed through inspiratory muscle training (IMT). Remotely controlled IMT is a new training approach to enhance home training programs. The study evaluates the efficacy of the Test of Incremental Respiratory Endurance (TIRE) as a remotely controlled IMT method, comparing it to threshold loading IMT. A prospective, controlled, and randomized trial involved subjects with COPD. Subjects were randomized into three groups: (1) TIRE - Pro2 device, (2) IMT – Threshold IMT, and (3) Sham – Threshold IMT at minimum resistance. We assessed sustained maximal inspiratory pressure (SMIP), maximal inspiratory pressure (MIP), and inspiratory duration (ID) during 8-week program. The mean±SD MIP, SMIP, and ID at baseline vs the end of training for the TIRE group were 72.7 ± 13.2 vs 98.0 ± 32.5 cmH2O, 441.6 ± 185.6 vs 559.1 ± 280.7 PTU, and 11.4 ± 4.6 vs 13.8 ± 4.4 s, respectively, with significantly greater MIP (p<.001) and SMIP (p=.002) at the end of the training program. In the IMT group, the mean±SD were 60.2 ± 16.8 vs 75.4 ± 21.4 cmH2O, 349.9 ± 117.3 vs 396.5 ± 132.2 PTU, 10.4 ± 2.5 vs 11.0 ± 2.3 s, with only MIP significantly (p=.017) greater. The increase of MIP in the first two groups was similar (p=.696). There were no significant changes in parameters in the Sham group. We found a significant and similar increase in MIP in the TIRE and IMT groups, meaning both methods are equally effective in increasing inspiratory muscle strength. The TIRE group showed a significant increase in SMIP, assessing the endurance of the inspiratory muscles, indicating the possibility of improving both strength and endurance of the inspiratory muscles when using Pro2. This study is supported by the Ministry of Health, Czech Republic - conceptual development of research organization (FNBr, 65269705).