Loading…
Inspiratory muscle training reduces diaphragm activation and dyspnea during exercise in COPD
Among patients with COPD, those with the lowest maximal inspiratory pressures experience greater breathing discomfort (dyspnea) during exercise. In such individuals, inspiratory muscle training (IMT) may be associated with improvement of dyspnea but the mechanisms for this are poorly understood. The...
Saved in:
| Published in: | Journal of applied physiology (1985) 2018-08, Vol.125 (2), p.381-392 |
|---|---|
| Main Authors: | , , , , , , , , , |
| Format: | Article |
| Language: | English |
| Subjects: | |
| Citations: | Items that this one cites Items that cite this one |
| Online Access: | Get full text |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| cited_by | cdi_FETCH-LOGICAL-c456t-c4f59518216229ec3a29cf4139a8765f89d339ff940271c4b921226d6eeaa5bb3 |
|---|---|
| cites | cdi_FETCH-LOGICAL-c456t-c4f59518216229ec3a29cf4139a8765f89d339ff940271c4b921226d6eeaa5bb3 |
| container_end_page | 392 |
| container_issue | 2 |
| container_start_page | 381 |
| container_title | Journal of applied physiology (1985) |
| container_volume | 125 |
| creator | Langer, Daniel Ciavaglia, Casey E Faisal, Azmy Webb, Katherine A Neder, J Alberto Gosselink, Rik Dacha, Sauwaluk Topalovic, Marko Ivanova, Anna O'Donnell, Denis E |
| description | Among patients with COPD, those with the lowest maximal inspiratory pressures experience greater breathing discomfort (dyspnea) during exercise. In such individuals, inspiratory muscle training (IMT) may be associated with improvement of dyspnea but the mechanisms for this are poorly understood. Therefore, we aimed to identify physiological mechanisms of improvement in dyspnea and exercise endurance following inspiratory muscle training (IMT) in patients with COPD and low maximal inspiratory pressure (Pi,max). The effects of 8 weeks of controlled IMT on respiratory muscle function, dyspnea, respiratory mechanics, and diaphragm electromyography (EMGdi) during constant-work rate cycle exercise were evaluated in patients with activity-related dyspnea (Baseline Dyspnea Index |
| doi_str_mv | 10.1152/japplphysiol.01078.2017 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2014141741</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2104171902</sourcerecordid><originalsourceid>FETCH-LOGICAL-c456t-c4f59518216229ec3a29cf4139a8765f89d339ff940271c4b921226d6eeaa5bb3</originalsourceid><addsrcrecordid>eNpdkU1PwzAMhiMEYmPwFyASFy4bcZo0zRGNT2nSOMANqcrSdMvUpiVpEfv3ZGwghCzZBz9-bflF6ALIBIDT67Vq26pdbYJtqgkBIrIJJSAO0DB26RhSAodomAlOxoJnYoBOQlgTAoxxOEYDKjlLIGFD9PbkQmu96hq_wXUfdGVw55V11i2xN0WvTcCFVe3Kq2WNle7sh-ps47ByBS42oXVG4aL3W958Gq9tMNg6PJ0_356io1JVwZzt6wi93t-9TB_Hs_nD0_RmNtaMp13MJZccMgoppdLoRFGpSwaJVJlIeZnJIklkWUpGqADNFpICpWmRGqMUXyySEbra6ba-ee9N6PLaBm2qSjnT9CGPr2ExRJQcoct_6LrpvYvX5RRIZEASGimxo7RvQvCmzFtva-U3OZB8a0D-14D824DtFhEnz_f6_aI2xe_cz8eTL0W7hUE</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2104171902</pqid></control><display><type>article</type><title>Inspiratory muscle training reduces diaphragm activation and dyspnea during exercise in COPD</title><source>American Physiological Society:Jisc Collections:American Physiological Society Journals ‘Read Publish & Join’ Agreement:2023-2024 (Reading list)</source><source>American Physiological Society Free</source><creator>Langer, Daniel ; Ciavaglia, Casey E ; Faisal, Azmy ; Webb, Katherine A ; Neder, J Alberto ; Gosselink, Rik ; Dacha, Sauwaluk ; Topalovic, Marko ; Ivanova, Anna ; O'Donnell, Denis E</creator><creatorcontrib>Langer, Daniel ; Ciavaglia, Casey E ; Faisal, Azmy ; Webb, Katherine A ; Neder, J Alberto ; Gosselink, Rik ; Dacha, Sauwaluk ; Topalovic, Marko ; Ivanova, Anna ; O'Donnell, Denis E</creatorcontrib><description>Among patients with COPD, those with the lowest maximal inspiratory pressures experience greater breathing discomfort (dyspnea) during exercise. In such individuals, inspiratory muscle training (IMT) may be associated with improvement of dyspnea but the mechanisms for this are poorly understood. Therefore, we aimed to identify physiological mechanisms of improvement in dyspnea and exercise endurance following inspiratory muscle training (IMT) in patients with COPD and low maximal inspiratory pressure (Pi,max). The effects of 8 weeks of controlled IMT on respiratory muscle function, dyspnea, respiratory mechanics, and diaphragm electromyography (EMGdi) during constant-work rate cycle exercise were evaluated in patients with activity-related dyspnea (Baseline Dyspnea Index <9). Subjects were randomized to either IMT or a sham training control group (n=10 each). Twenty subjects (FEV
= 47±19 %predicted; Pi,max= -59±14 cmH
O; cycle ergometer peak work rate= 47±21 %predicted) completed the study; groups had comparable baseline lung function, respiratory muscle strength, activity-related dyspnea and exercise capacity. IMT, compared with control, was associated with greater increases in inspiratory muscle strength and endurance, with attendant improvements in exertional dyspnea and exercise endurance time (all p<0.05). After IMT, EMGdi expressed relative to its maximum (EMGdi/EMGdi,max) decreased (p<0.05) with no significant change in ventilation, tidal inspiratory pressures, breathing pattern and operating lung volumes during exercise. In conclusion, IMT improved inspiratory muscle strength and endurance in mechanically compromised patients with COPD and low Pi,max. The attendant reduction in EMGdi/EMGdi,max helped explain the decrease in perceived respiratory discomfort despite sustained high ventilation and intrinsic mechanical loading over a longer exercise duration.</description><identifier>ISSN: 8750-7587</identifier><identifier>EISSN: 1522-1601</identifier><identifier>DOI: 10.1152/japplphysiol.01078.2017</identifier><identifier>PMID: 29543134</identifier><language>eng</language><publisher>United States: American Physiological Society</publisher><subject>Breathing ; Chronic obstructive pulmonary disease ; Diaphragm ; Diaphragm (anatomy) ; Discomfort ; Durability ; Dyspnea ; Electromyography ; Endurance ; Exercise ; Indexing ; Lung diseases ; Lungs ; Mechanical loading ; Mechanical ventilation ; Muscle function ; Muscle strength ; Obstructive lung disease ; Pressure effects ; Respiration ; Respiratory function ; Training ; Ventilation</subject><ispartof>Journal of applied physiology (1985), 2018-08, Vol.125 (2), p.381-392</ispartof><rights>Copyright American Physiological Society Aug 2018</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c456t-c4f59518216229ec3a29cf4139a8765f89d339ff940271c4b921226d6eeaa5bb3</citedby><cites>FETCH-LOGICAL-c456t-c4f59518216229ec3a29cf4139a8765f89d339ff940271c4b921226d6eeaa5bb3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29543134$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Langer, Daniel</creatorcontrib><creatorcontrib>Ciavaglia, Casey E</creatorcontrib><creatorcontrib>Faisal, Azmy</creatorcontrib><creatorcontrib>Webb, Katherine A</creatorcontrib><creatorcontrib>Neder, J Alberto</creatorcontrib><creatorcontrib>Gosselink, Rik</creatorcontrib><creatorcontrib>Dacha, Sauwaluk</creatorcontrib><creatorcontrib>Topalovic, Marko</creatorcontrib><creatorcontrib>Ivanova, Anna</creatorcontrib><creatorcontrib>O'Donnell, Denis E</creatorcontrib><title>Inspiratory muscle training reduces diaphragm activation and dyspnea during exercise in COPD</title><title>Journal of applied physiology (1985)</title><addtitle>J Appl Physiol (1985)</addtitle><description>Among patients with COPD, those with the lowest maximal inspiratory pressures experience greater breathing discomfort (dyspnea) during exercise. In such individuals, inspiratory muscle training (IMT) may be associated with improvement of dyspnea but the mechanisms for this are poorly understood. Therefore, we aimed to identify physiological mechanisms of improvement in dyspnea and exercise endurance following inspiratory muscle training (IMT) in patients with COPD and low maximal inspiratory pressure (Pi,max). The effects of 8 weeks of controlled IMT on respiratory muscle function, dyspnea, respiratory mechanics, and diaphragm electromyography (EMGdi) during constant-work rate cycle exercise were evaluated in patients with activity-related dyspnea (Baseline Dyspnea Index <9). Subjects were randomized to either IMT or a sham training control group (n=10 each). Twenty subjects (FEV
= 47±19 %predicted; Pi,max= -59±14 cmH
O; cycle ergometer peak work rate= 47±21 %predicted) completed the study; groups had comparable baseline lung function, respiratory muscle strength, activity-related dyspnea and exercise capacity. IMT, compared with control, was associated with greater increases in inspiratory muscle strength and endurance, with attendant improvements in exertional dyspnea and exercise endurance time (all p<0.05). After IMT, EMGdi expressed relative to its maximum (EMGdi/EMGdi,max) decreased (p<0.05) with no significant change in ventilation, tidal inspiratory pressures, breathing pattern and operating lung volumes during exercise. In conclusion, IMT improved inspiratory muscle strength and endurance in mechanically compromised patients with COPD and low Pi,max. The attendant reduction in EMGdi/EMGdi,max helped explain the decrease in perceived respiratory discomfort despite sustained high ventilation and intrinsic mechanical loading over a longer exercise duration.</description><subject>Breathing</subject><subject>Chronic obstructive pulmonary disease</subject><subject>Diaphragm</subject><subject>Diaphragm (anatomy)</subject><subject>Discomfort</subject><subject>Durability</subject><subject>Dyspnea</subject><subject>Electromyography</subject><subject>Endurance</subject><subject>Exercise</subject><subject>Indexing</subject><subject>Lung diseases</subject><subject>Lungs</subject><subject>Mechanical loading</subject><subject>Mechanical ventilation</subject><subject>Muscle function</subject><subject>Muscle strength</subject><subject>Obstructive lung disease</subject><subject>Pressure effects</subject><subject>Respiration</subject><subject>Respiratory function</subject><subject>Training</subject><subject>Ventilation</subject><issn>8750-7587</issn><issn>1522-1601</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNpdkU1PwzAMhiMEYmPwFyASFy4bcZo0zRGNT2nSOMANqcrSdMvUpiVpEfv3ZGwghCzZBz9-bflF6ALIBIDT67Vq26pdbYJtqgkBIrIJJSAO0DB26RhSAodomAlOxoJnYoBOQlgTAoxxOEYDKjlLIGFD9PbkQmu96hq_wXUfdGVw55V11i2xN0WvTcCFVe3Kq2WNle7sh-ps47ByBS42oXVG4aL3W958Gq9tMNg6PJ0_356io1JVwZzt6wi93t-9TB_Hs_nD0_RmNtaMp13MJZccMgoppdLoRFGpSwaJVJlIeZnJIklkWUpGqADNFpICpWmRGqMUXyySEbra6ba-ee9N6PLaBm2qSjnT9CGPr2ExRJQcoct_6LrpvYvX5RRIZEASGimxo7RvQvCmzFtva-U3OZB8a0D-14D824DtFhEnz_f6_aI2xe_cz8eTL0W7hUE</recordid><startdate>20180801</startdate><enddate>20180801</enddate><creator>Langer, Daniel</creator><creator>Ciavaglia, Casey E</creator><creator>Faisal, Azmy</creator><creator>Webb, Katherine A</creator><creator>Neder, J Alberto</creator><creator>Gosselink, Rik</creator><creator>Dacha, Sauwaluk</creator><creator>Topalovic, Marko</creator><creator>Ivanova, Anna</creator><creator>O'Donnell, Denis E</creator><general>American Physiological Society</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7QR</scope><scope>7TK</scope><scope>7TS</scope><scope>7U7</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>20180801</creationdate><title>Inspiratory muscle training reduces diaphragm activation and dyspnea during exercise in COPD</title><author>Langer, Daniel ; Ciavaglia, Casey E ; Faisal, Azmy ; Webb, Katherine A ; Neder, J Alberto ; Gosselink, Rik ; Dacha, Sauwaluk ; Topalovic, Marko ; Ivanova, Anna ; O'Donnell, Denis E</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c456t-c4f59518216229ec3a29cf4139a8765f89d339ff940271c4b921226d6eeaa5bb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Breathing</topic><topic>Chronic obstructive pulmonary disease</topic><topic>Diaphragm</topic><topic>Diaphragm (anatomy)</topic><topic>Discomfort</topic><topic>Durability</topic><topic>Dyspnea</topic><topic>Electromyography</topic><topic>Endurance</topic><topic>Exercise</topic><topic>Indexing</topic><topic>Lung diseases</topic><topic>Lungs</topic><topic>Mechanical loading</topic><topic>Mechanical ventilation</topic><topic>Muscle function</topic><topic>Muscle strength</topic><topic>Obstructive lung disease</topic><topic>Pressure effects</topic><topic>Respiration</topic><topic>Respiratory function</topic><topic>Training</topic><topic>Ventilation</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Langer, Daniel</creatorcontrib><creatorcontrib>Ciavaglia, Casey E</creatorcontrib><creatorcontrib>Faisal, Azmy</creatorcontrib><creatorcontrib>Webb, Katherine A</creatorcontrib><creatorcontrib>Neder, J Alberto</creatorcontrib><creatorcontrib>Gosselink, Rik</creatorcontrib><creatorcontrib>Dacha, Sauwaluk</creatorcontrib><creatorcontrib>Topalovic, Marko</creatorcontrib><creatorcontrib>Ivanova, Anna</creatorcontrib><creatorcontrib>O'Donnell, Denis E</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Chemoreception Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Physical Education Index</collection><collection>Toxicology Abstracts</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of applied physiology (1985)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Langer, Daniel</au><au>Ciavaglia, Casey E</au><au>Faisal, Azmy</au><au>Webb, Katherine A</au><au>Neder, J Alberto</au><au>Gosselink, Rik</au><au>Dacha, Sauwaluk</au><au>Topalovic, Marko</au><au>Ivanova, Anna</au><au>O'Donnell, Denis E</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Inspiratory muscle training reduces diaphragm activation and dyspnea during exercise in COPD</atitle><jtitle>Journal of applied physiology (1985)</jtitle><addtitle>J Appl Physiol (1985)</addtitle><date>2018-08-01</date><risdate>2018</risdate><volume>125</volume><issue>2</issue><spage>381</spage><epage>392</epage><pages>381-392</pages><issn>8750-7587</issn><eissn>1522-1601</eissn><abstract>Among patients with COPD, those with the lowest maximal inspiratory pressures experience greater breathing discomfort (dyspnea) during exercise. In such individuals, inspiratory muscle training (IMT) may be associated with improvement of dyspnea but the mechanisms for this are poorly understood. Therefore, we aimed to identify physiological mechanisms of improvement in dyspnea and exercise endurance following inspiratory muscle training (IMT) in patients with COPD and low maximal inspiratory pressure (Pi,max). The effects of 8 weeks of controlled IMT on respiratory muscle function, dyspnea, respiratory mechanics, and diaphragm electromyography (EMGdi) during constant-work rate cycle exercise were evaluated in patients with activity-related dyspnea (Baseline Dyspnea Index <9). Subjects were randomized to either IMT or a sham training control group (n=10 each). Twenty subjects (FEV
= 47±19 %predicted; Pi,max= -59±14 cmH
O; cycle ergometer peak work rate= 47±21 %predicted) completed the study; groups had comparable baseline lung function, respiratory muscle strength, activity-related dyspnea and exercise capacity. IMT, compared with control, was associated with greater increases in inspiratory muscle strength and endurance, with attendant improvements in exertional dyspnea and exercise endurance time (all p<0.05). After IMT, EMGdi expressed relative to its maximum (EMGdi/EMGdi,max) decreased (p<0.05) with no significant change in ventilation, tidal inspiratory pressures, breathing pattern and operating lung volumes during exercise. In conclusion, IMT improved inspiratory muscle strength and endurance in mechanically compromised patients with COPD and low Pi,max. The attendant reduction in EMGdi/EMGdi,max helped explain the decrease in perceived respiratory discomfort despite sustained high ventilation and intrinsic mechanical loading over a longer exercise duration.</abstract><cop>United States</cop><pub>American Physiological Society</pub><pmid>29543134</pmid><doi>10.1152/japplphysiol.01078.2017</doi><tpages>12</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 8750-7587 |
| ispartof | Journal of applied physiology (1985), 2018-08, Vol.125 (2), p.381-392 |
| issn | 8750-7587 1522-1601 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2014141741 |
| source | American Physiological Society:Jisc Collections:American Physiological Society Journals ‘Read Publish & Join’ Agreement:2023-2024 (Reading list); American Physiological Society Free |
| subjects | Breathing Chronic obstructive pulmonary disease Diaphragm Diaphragm (anatomy) Discomfort Durability Dyspnea Electromyography Endurance Exercise Indexing Lung diseases Lungs Mechanical loading Mechanical ventilation Muscle function Muscle strength Obstructive lung disease Pressure effects Respiration Respiratory function Training Ventilation |
| title | Inspiratory muscle training reduces diaphragm activation and dyspnea during exercise in COPD |
| url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-24T15%3A40%3A11IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Inspiratory%20muscle%20training%20reduces%20diaphragm%20activation%20and%20dyspnea%20during%20exercise%20in%20COPD&rft.jtitle=Journal%20of%20applied%20physiology%20(1985)&rft.au=Langer,%20Daniel&rft.date=2018-08-01&rft.volume=125&rft.issue=2&rft.spage=381&rft.epage=392&rft.pages=381-392&rft.issn=8750-7587&rft.eissn=1522-1601&rft_id=info:doi/10.1152/japplphysiol.01078.2017&rft_dat=%3Cproquest_cross%3E2104171902%3C/proquest_cross%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c456t-c4f59518216229ec3a29cf4139a8765f89d339ff940271c4b921226d6eeaa5bb3%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2104171902&rft_id=info:pmid/29543134&rfr_iscdi=true |