| Study characteristics |
| Methods |
Study design: RCT
Study grouping: parallel‐group |
| Participants |
Baseline characteristics
PR+IMT
N (randomized/analyzed): 8/7 Loss to follow‐up or excluded: 1 Age, mean (SD), in years: 67.0 (3.39) Gender (M/F): 4/4
PR
N (randomized/analyzed): 9/9 Loss to follow‐up or excluded: 0 Age, mean (SD), in years: 70.8 (4.8) Gender (M/F): 6/3
Overall
N (randomized/analyzed): 17/16 Loss to follow‐up or excluded: 1 Gender (M/F): 10/7 COPD stage (GOLD): moderate to severe
Included criteria
FEV1/FVC < 0.65; Dyspnea on exertion experienced during activities of daily living; A history of cigarette or tobacco smoke exposure > 20 pack‐years; The ability to self ambulate; Age > 60 years; Willingness to undergo testing and intervention procedures; COPD under appropriate medical management.
Excluded criteria
Significant cardiac disease; Orthopedic or neurologic impairment, serious renal, liver, or gastrointestinal disorders; current psychiatric illness or substance dependence; uncontrolled diabetes or hypertension; Current or previous (within 6 months) enrollment in a rehabilitation or exercise program; SaoO2 < 90% during exercise at a heart rate > 50% of age‐predicted maximum.
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| Interventions |
Intervention characteristics
PR+IMT
PR: the rehabilitation program involved walking, upper extremity strength training, and progressive IMT. Walking intensity was set at 50%‐75% of the participant's heart rate reserve. This prescription was based on the heart rate response from the participant's initial graded exercise test. The duration of walking was increased progressively throughout the intervention to a maximum of 20 min. Participants were taught to monitor their heart rate during walking by palpating their radial artery and to adjust their exercise intensity as needed. Heart rates were taken midway through and at the end of the walking sessions. Upper extremity weight‐training consisted of 5 different exercises. Participants performed 2 sets of 12 repetitions for each exercise with the weight being progressively increased as their strength increased. All walking and strength training was performed at the exercise center. IMT: was performed twice daily for a 15‐min period, 7 d/week, for 12 weeks, using threshold IMT device (Healthscan Products, Cedar Grove, NJ). The initial pressure setting was set at 15% of the participant's PImax for 2 weeks. During Weeks 3 and 4, the threshold pressure was increased to 30% of the participant's PImax. During weeks 5 and 6, the threshold pressure was increased to 60% of the participant's PImax. During Weeks 7 through 12, the threshold pressure was set at 80% of the participants PImax.
PR + sham IMT: this group underwent PR as described above, and IMT at 15% of PImax for the duration of the 12‐week study period. |
| Outcomes |
Dyspnea: Borg
Functional exercise capacity:
Respiratory muscle strength: PImax
Laboratory exercise test: VO2peak (mL/kg/min)
Respiratory muscle endurance: MVV
Respiratory function:
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| Identification |
Sponsorship source:
Country: USA
Setting: Wake Forest University
Author's name: MichaelJ.Berry
Institution: Department of Health and Sport Science
Address: P.O. Box 7234, Wake ForestUniversity, Winston‐Salem, NC 27109 |
| Notes |
All values are adjusted means ± SEM. Values were adjusted using pre‐intervention scores as the covariate. |
