Long-Term Efficacy of Novel and Traditional Home-Based, Remote Inspiratory Muscle Training in COPD: A Randomized Controlled Trial

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F65269705%3A_____%2F25%3A00082633" target="_blank" >RIV/65269705:_____/25:00082633 - isvavai.cz</a>

Nalezeny alternativní kódy

RIV/00216224:14110/25:00142216 RIV/00216208:11130/25:10503274

Výsledek na webu

<a href="https://www.mdpi.com/2077-0383/14/17/6099" target="_blank" >https://www.mdpi.com/2077-0383/14/17/6099</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.3390/jcm14176099" target="_blank" >10.3390/jcm14176099</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Long-Term Efficacy of Novel and Traditional Home-Based, Remote Inspiratory Muscle Training in COPD: A Randomized Controlled Trial

Popis výsledku v původním jazyce

Background: Chronic obstructive pulmonary disease (COPD) is a progressive condition leading to declining lung function, dyspnea, and reduced quality of life. Pulmonary rehabilitation (PR) remains a cornerstone in COPD management; however, access remains limited, with less than 3% of eligible patients participating. Inspiratory muscle training (IMT), especially through novel methods like the Test of Incremental Respiratory Endurance (TIRE), offers a potential home-based alternative to traditional rehabilitation services. Despite growing interest, a key knowledge gap persists: few randomized trials have directly compared TIRE with threshold loading IMT over extended, largely unsupervised home-based periods while concurrently evaluating inspiratory muscle endurance and adherence. This randomized controlled trial aimed to evaluate the long-term efficacy of TIRE IMT compared to traditional threshold IMT and sham training in COPD patients. The study also assessed adherence to these home-based interventions, focusing on unsupervised periods without additional motivational support. Methods: A total of 52 COPD patients were randomly assigned to one of three groups: TIRE IMT, Threshold IMT, or Sham IMT. The study consisted of an 8-week supervised Phase I followed by a 24-week unsupervised Phase II. Training details: TIRE-session template set to 50% of the day&apos;s maximal sustained effort; 6 levels x 6 inspirations (total 36) with preset inter-breath recoveries decreasing from 60 s to 10 s. Threshold IMT-spring-loaded valve set to 50% MIP (re-set at week 4); 36 inspirations completed within LESS-THAN OR EQUAL TO30 min. Sham-valve set to minimal resistance (9 cmH(2)O); 36 inspirations within LESS-THAN OR EQUAL TO30 min. Primary outcomes included changes in maximal inspiratory pressure (MIP) and sustained maximal inspiratory pressure. Secondary outcomes focused on adherence rates and correlations with functional capacity. Results: Of the 52 participants, 36 completed the study. Participant details: TIRE n = 12 (mean age 60.9 +- 12.9 years), Threshold n = 12 (67.4 +- 6.9 years), Sham n = 12 (67.3 +- 8.7 years); overall 21/36 (58%) men; mean BMI 30.0 +- 7.5 kg/m(2). The TIRE IMT group demonstrated significantly greater improvements in MIP (31.7%) and SMIP compared to both the Threshold and Sham groups at 24 weeks (p &lt; 0.05). Despite a decline in adherence during the unsupervised phase, the TIRE group maintained superior outcomes. No adverse events were reported during the intervention period. Conclusions: In this randomized trial, TIRE IMT was associated with greater improvements in inspiratory muscle performance than threshold and sham IMT. While adherence was higher in the TIRE group, it declined during the unsupervised phase. The clinical interpretation of these findings should consider the relatively wide confidence intervals and modest sample size. Nevertheless, the mean change in MIP in the TIRE arm exceeded a recently proposed minimal important difference for COPD, suggesting potential clinical relevance; however, no universally accepted minimal important difference exists yet for SMIP. Further adequately powered trials are warranted.

Název v anglickém jazyce

Long-Term Efficacy of Novel and Traditional Home-Based, Remote Inspiratory Muscle Training in COPD: A Randomized Controlled Trial

Popis výsledku anglicky

Background: Chronic obstructive pulmonary disease (COPD) is a progressive condition leading to declining lung function, dyspnea, and reduced quality of life. Pulmonary rehabilitation (PR) remains a cornerstone in COPD management; however, access remains limited, with less than 3% of eligible patients participating. Inspiratory muscle training (IMT), especially through novel methods like the Test of Incremental Respiratory Endurance (TIRE), offers a potential home-based alternative to traditional rehabilitation services. Despite growing interest, a key knowledge gap persists: few randomized trials have directly compared TIRE with threshold loading IMT over extended, largely unsupervised home-based periods while concurrently evaluating inspiratory muscle endurance and adherence. This randomized controlled trial aimed to evaluate the long-term efficacy of TIRE IMT compared to traditional threshold IMT and sham training in COPD patients. The study also assessed adherence to these home-based interventions, focusing on unsupervised periods without additional motivational support. Methods: A total of 52 COPD patients were randomly assigned to one of three groups: TIRE IMT, Threshold IMT, or Sham IMT. The study consisted of an 8-week supervised Phase I followed by a 24-week unsupervised Phase II. Training details: TIRE-session template set to 50% of the day&apos;s maximal sustained effort; 6 levels x 6 inspirations (total 36) with preset inter-breath recoveries decreasing from 60 s to 10 s. Threshold IMT-spring-loaded valve set to 50% MIP (re-set at week 4); 36 inspirations completed within LESS-THAN OR EQUAL TO30 min. Sham-valve set to minimal resistance (9 cmH(2)O); 36 inspirations within LESS-THAN OR EQUAL TO30 min. Primary outcomes included changes in maximal inspiratory pressure (MIP) and sustained maximal inspiratory pressure. Secondary outcomes focused on adherence rates and correlations with functional capacity. Results: Of the 52 participants, 36 completed the study. Participant details: TIRE n = 12 (mean age 60.9 +- 12.9 years), Threshold n = 12 (67.4 +- 6.9 years), Sham n = 12 (67.3 +- 8.7 years); overall 21/36 (58%) men; mean BMI 30.0 +- 7.5 kg/m(2). The TIRE IMT group demonstrated significantly greater improvements in MIP (31.7%) and SMIP compared to both the Threshold and Sham groups at 24 weeks (p &lt; 0.05). Despite a decline in adherence during the unsupervised phase, the TIRE group maintained superior outcomes. No adverse events were reported during the intervention period. Conclusions: In this randomized trial, TIRE IMT was associated with greater improvements in inspiratory muscle performance than threshold and sham IMT. While adherence was higher in the TIRE group, it declined during the unsupervised phase. The clinical interpretation of these findings should consider the relatively wide confidence intervals and modest sample size. Nevertheless, the mean change in MIP in the TIRE arm exceeded a recently proposed minimal important difference for COPD, suggesting potential clinical relevance; however, no universally accepted minimal important difference exists yet for SMIP. Further adequately powered trials are warranted.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30218 - General and internal medicine

Projekt

<a href="/cs/project/NU21J-09-00004" target="_blank" >NU21J-09-00004: Srovnání nových a tradičních metod tréninku inspiračního svalstva u pacientů s CHOPN založených na vzdáleném monitorování</a><br>

Návaznosti

P - Projekt vyzkumu a vyvoje financovany z verejnych zdroju (s odkazem do CEP)<br>I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2025

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

Journal of Clinical Medicine

ISSN

2077-0383

e-ISSN

2077-0383

Svazek periodika

14

Číslo periodika v rámci svazku

17

Stát vydavatele periodika

CH - Švýcarská konfederace

Počet stran výsledku

14

Strana od-do

6099

Kód UT WoS článku

001571379400001

EID výsledku v databázi Scopus

2-s2.0-105015977099