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. 2023 Jan 6;2023(1):CD013778. doi: 10.1002/14651858.CD013778.pub2

Tounsi 2021.

Study characteristics
Methods Study design: RCT
Study grouping: parallel‐group
Participants Baseline characteristics
PR+IMT

  • N (randomized/analyzed): 17/16

  • Loss to follow‐up or excluded: 1

  • Age, mean (SD) in years: 62 (5)

  • Gender (M/F): 17/0

  • BMI, mean (SD), kg/m²: 23.13 (4.37)


PR

  • N (randomized): 18/16

  • Loss to follow‐up or excluded: 2

  • Age, mean (SD) in years: 63 (4)

  • Gender (M/F): 18/0

  • BMI, mean (SD), kg/m²: 23.41 (5.19)


Overall

  • N (randomized): 35/32

  • Loss to follow‐up or excluded: 3

  • Gender (M/F): 35/0

  • COPD stage (GOLD): moderate to very severe


Included criteria

  • patients with forced expiratory volume in 1 s (FEV1) <80% predicted and FEV1 /forced vital capacity (FVC) <70% 

  • Age between 45–75 years

  • Clinically stable


Exclusion criteria

  • Cardiovascular problem 

  • Psychiatric or cognitive disorders

  • Progressive neuromuscular diseases

  • Severe orthopedic problems with a significant impact on daily activities

  •  Prior inclusion in a rehabilitation program (<1 year)
Interventions Intervention characteristics
PR+IMT: 

  • PR:  an 8‐week program with three sessions per week. the training program consists of aerobic supervised exercise training. The training consisted of 30 min of supervised treadmill exercise per session. Each session ended with upper and lower limb stretching. Each participant received an individualized program based on 60% to 80% of the average speed achieved during the six‐minute walk test.

  • IMT: The training was performed once a day, 7 days per week for 8 weeks, using a handle device (PowerBreathe1 Medic, IMT Technologies Ltd, Birmingham, UK). The training consists in making two sets of 30 breaths (4–5 min/set) with 5–10 min of rest between each set. The Respiratory resistive load was set at 50% of the initial PImax and then increased by 10% of the initial PImax every two weeks of training. Part of the IMT was performed and well instructed in the pulmonary rehabilitation center (3 days/ week) for 8 weeks; the other part was home‐based training.


PR: this group received a similar training protocol as described above without IMT.
Outcomes Functional exercise capaticy: 6MWD
Respiratory muscle strength: PImax
Identification Sponsorship source: the authors received no funding for this work
Country: Tunisia
Setting: Farhat Hached Hospital of Sousse
Author's name: Bilel Tounsi
Institution: 1/ Laboratory of Exercise Physiology and Rehabilitation (APERE, UR‐EA 3300), Sport Sciences Department, Picardie Jules Verne University, Amiens, France, 2/ Research Laboratory of Exercise Physiology and
Pathophysiology: From Integral to Molecular Biology, Medicine and Health (LR19ES09), Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
Email: bilel.tounsi@u‐picardie.fr
Address: Department of sports sciences, Picardie Jules Verne University, Amiens, France
Clinical trial register:  NCT04084405
Notes