Chronic Obstructive Pulmonary Disease (COPD) ,the fourth leading cause of death in the world, represents an important public health challenge. It is also a major cause of chronic morbidity, mortality and disability throughout the world, leading to a heavy social and economic burden. For a long time, treatment of COPD mainly focus on drug therapy. Recently, pulmonary rehabilitation is recognized as a core component of the management of individuals with chronic respiratory disease, which has been clearly demonstrated to reduce dyspnea, increase exercise capacity, and improve quality of life. Exercise training, widely regarded as the cornerstone of pulmonary rehabilitation , is one of the best available means of improving muscle function in COPD.The most commonly form is cycle training. Inspiratory Muscle Training (IMT) as an adjunct to exercise training has an additional benefit on inspiratory muscle strength, endurance and exercise capacity in patient with COPD. There is insufficient evidence demonstrate greater benefits from combined inspiratory muscle training and cycle training. This study will evaluate the effects of combined inspiratory muscle training and cycle training in patients with COPD.
The patients with COPD will participate in a rehabilitation program for 8 weeks. Participants in the proposed study will be randomly programmed into one of three intervention groups: 1. Cycle training program alone (performing on calibrated stationary cycle ergometer). 2. Combined cycle training and inspiratory muscle training(performing on calibrated stationary cycle ergometer and threshold loading device). 3. Neither cycle training nor inspiratory muscle training.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
90
Neither cycle training nor inspiratory muscle training.
The most common device to proform cycle training is calibrated cycle ergometer.
Combined cycle training and inspiratory muscle training.The threshold loading device is composed of a mouth -piece attached to a small plastic cylinder that contains a spring-loaded poppet value. The valve opens to permit inspiratory flow only once the person has generated adequate negative intrathoracic pressure to condense the spring.
Zhujiang Hospital,Southern Medical Universtiy
Guangzhou, Guangdong, China
Exercise Performance (composite outcome measure)
Exercise performance tests include field walking tests and cycle ergometer tests.
Time frame: The groups will be assessed at baseline (time zero) and at the end of the training protocol (week 8)
Health-related quality (composite outcome measure)
Health-related quality is a component of the broader concept of quality of life and is defined as satisfaction with health.The St. George's Respiratory Questionnaire (SGRQ) and Chronic Respiratory Disease Questionnaire (CRQ); and its self-reported version are the most widely used disease-specific questionnaires.
Time frame: The groups will be assessed at baseline (time zero) and at the end of the training protocol (week 8)
inspiratory muscle function (composite outcome measure)
Currently, a variety of methods can be used to evaluate respiratory muscle function, including maximal inspiratory (PImax),expiratory pressures(PEmax) and inspiratory muscle endurance.
Time frame: The groups will be assessed at baseline (time zero) and at the end of the training protocol (week 8)
Symptom Evaluation (composite outcome measure)
Individuals with chronic respiratory disease often have symptoms such as dyspnea, fatigue, cough, weakness, sleeplessness,and psychological distress.Instruments for assessment of multiple symptoms include COPD Assessment Test (CAT) and Modified Medical British Research Council Scale(mMRC).
Time frame: The groups will be assessed at baseline (time zero) and at the end of the training protocol (week 8)
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