Scholarlink

Background <p>Inspiratory muscle training combined with positive expiratory pressure (IMT/PEP) may improve outcomes in chronic obstructive pulmonary disease (COPD), but evidence in exacerbation‑prone (Group E) disease is limited. We evaluated the effects of IMT/PEP on pulmonary function, respiratory muscle strength, exercise capacity, and dyspnea in stable Group E COPD.</p> Methods <p>In this prospective randomized controlled trial, 62 stable Group E COPD patients were enrolled from June 2023 to September 2024 and randomized to IMT/PEP plus standard care or standard care alone. Pulmonary function tests, maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), six‑minute walk test (6MWT), oxygen saturation (SpO₂), and dyspnea scales (mMRC, CAT, MBS, VAS) were assessed at baseline, 1 month, and 3 months.</p> Results <p>At 1 month, compared with controls, the IMT/PEP group showed greater improvements in FEV₁/FVC, FEV₁, and FVC (all <i>p</i> &lt; 0.001), a smaller increase in RV/TLC (<i>p</i> &lt; 0.001), and higher SpO₂ and 6MWT distance (both <i>p</i> &lt; 0.001); MIP also increased (<i>p</i> = 0.01). By 3 months, FEV₁/FVC (<i>p</i> = 0.02), FEV₁ (L and % predicted; <i>p</i> = 0.01 and <i>p</i> = 0.04), FVC (L and % predicted; <i>p</i> = 0.04), and MEF25–75% (<i>p</i> = 0.01) were higher and RV/TLC was lower (<i>p</i> = 0.01) in the IMT/PEP group; MIP increased in absolute and % predicted terms (<i>p</i> = 0.001 and <i>p</i> = 0.002), whereas MEP did not change significantly. SpO₂ and 6MWT increased (both <i>p</i> &lt; 0.001), and MBS, mMRC, VAS, and CAT scores decreased (<i>p</i> &lt; 0.001 for each). In multivariable analyses, greater ΔMIP was associated with lower baseline MIP (<i>p</i> &lt; 0.001), lower baseline 6MWT (<i>p</i> = 0.033), lower baseline VAS (<i>p</i> = 0.016), and higher baseline MEP (<i>p</i> = 0.001).</p> Conclusions <p>In stable Group E COPD, adjunct IMT/PEP improved pulmonary function (FEV₁, FVC, FEV₁/FVC, MEF25–75%, RV/TLC), inspiratory muscle strength, oxygenation, and exercise capacity and reduced dyspnea over 3 months; benefits were most pronounced in patients with lower baseline inspiratory strength and limited functional capacity.</p> Trial registration <p>Registered at ClinicalTrials.gov (NCT07001462) on 3 June 2025. Retrospectively registered.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Effects of combined inspiratory muscle training and positive expiratory pressure therapy on pulmonary function, respiratory muscle strength, exercise capacity and dyspnea in stable group E COPD patients

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年3月6日

查看全文
  • Latifullah Jalal,
  • Alperen Aksakal,
  • Buğra Kerget,
  • Elif Yılmazel Uçar,
  • Ömer Araz,
  • Leyla Sağlam,
  • Metin Akgün

摘要

Background

Inspiratory muscle training combined with positive expiratory pressure (IMT/PEP) may improve outcomes in chronic obstructive pulmonary disease (COPD), but evidence in exacerbation‑prone (Group E) disease is limited. We evaluated the effects of IMT/PEP on pulmonary function, respiratory muscle strength, exercise capacity, and dyspnea in stable Group E COPD.

Methods

In this prospective randomized controlled trial, 62 stable Group E COPD patients were enrolled from June 2023 to September 2024 and randomized to IMT/PEP plus standard care or standard care alone. Pulmonary function tests, maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), six‑minute walk test (6MWT), oxygen saturation (SpO₂), and dyspnea scales (mMRC, CAT, MBS, VAS) were assessed at baseline, 1 month, and 3 months.

Results

At 1 month, compared with controls, the IMT/PEP group showed greater improvements in FEV₁/FVC, FEV₁, and FVC (all p < 0.001), a smaller increase in RV/TLC (p < 0.001), and higher SpO₂ and 6MWT distance (both p < 0.001); MIP also increased (p = 0.01). By 3 months, FEV₁/FVC (p = 0.02), FEV₁ (L and % predicted; p = 0.01 and p = 0.04), FVC (L and % predicted; p = 0.04), and MEF25–75% (p = 0.01) were higher and RV/TLC was lower (p = 0.01) in the IMT/PEP group; MIP increased in absolute and % predicted terms (p = 0.001 and p = 0.002), whereas MEP did not change significantly. SpO₂ and 6MWT increased (both p < 0.001), and MBS, mMRC, VAS, and CAT scores decreased (p < 0.001 for each). In multivariable analyses, greater ΔMIP was associated with lower baseline MIP (p < 0.001), lower baseline 6MWT (p = 0.033), lower baseline VAS (p = 0.016), and higher baseline MEP (p = 0.001).

Conclusions

In stable Group E COPD, adjunct IMT/PEP improved pulmonary function (FEV₁, FVC, FEV₁/FVC, MEF25–75%, RV/TLC), inspiratory muscle strength, oxygenation, and exercise capacity and reduced dyspnea over 3 months; benefits were most pronounced in patients with lower baseline inspiratory strength and limited functional capacity.

Trial registration

Registered at ClinicalTrials.gov (NCT07001462) on 3 June 2025. Retrospectively registered.