Inspiratory muscle training in bronchiectasis patients: a prospective randomized controlled study

Abstract

Objective: To investigate the efficacy and feasibility of home-based inspiratory muscle training in patients with bronchiectasis. Design: A prospective, single-blind, randomized, controlled study. Setting: Outpatient clinic of a tertiary care medical centre. Methods: Twenty-six patients with bronchiectasis were randomly divided into inspiratory muscle training and control groups. In the inspiratory muscle training group (n = 13), the training programme started with an intensity of 30% maximal inspiratory pressure (MIP), which was increased by 2 cmH2O each week, for 30 minutes daily, 5 days a week for eight weeks. The control group (n = 13) did not receive inspiratory muscle training. Main outcome measures included spirometry, resting oxyhaemoglobin saturation by pulse oximetry (SpO2), lowest SpO2 and Borg Scale during 6-minute walking tests, 6-minute walking distance (6MWD), 6-minute walking work (6Mwork), MIP, maximal expiratory pressure (MEP) and St George’s Respiratory Questionnaire. Results: There were significant differences in change from baseline in 6MWD (411.9 (133.5) vs. 473.2 (117.2) m, P = 0.021), 6Mwork (21 051.0 (8286.7) vs. 23 915.5 (8343.0) kg-m, P = 0.022), MIP (60.8 (21.8) vs. 84.6 (29.0) cmH2O, P = 0.004), and MEP (72.3 (31.1) vs. 104.2 (35.7) cmH2O, P = 0.004) in the inspiratory muscle training group. Significant improvements in both MIP (23.8 (25.3) vs. 2.3 (16.4) cmH2O, adjusted P-value = 0.005) and MEP (31.9 (30.8) vs. 11.5 (20.8) cmH2O, adjusted P-value = 0.038) levels after adjusting for age by linear regression analysis were observed between groups. Conclusions: An eight-week home-based inspiratory muscle training is feasible and effective in improving both inspiratory and expiratory muscle strength, but has no effect on respiratory function and quality of life in patients with bronchiectasis.