Efeitos do treinamento muscular inspiratório sobre a dispneia, a capacidade de exercício e o controle postural em pacientes com DPOC

Abstract

Inspiratory muscle training (IMT) is an important tool to optimize functional gains in respiratory muscle function in patients with COPD and respiratory muscle weakness. The aim of this study was to verify if inspiratory muscle training can improve exercise capacity, postural control, and quality of life in patients with COPD and inspiratory muscle weakness. We conducted a randomised controlled trial with concealed allocation, blinded assessors, and intention-to-treat analysis was conducted with thirty-eight stable COPD patients with inspiratory muscle weakness, composed of eight weeks of IMT or sham IMT twice a day. The intervention group showed statistically significant improvements compared to the sham intervention group in the 6MWD (39 m; 95% CI, 22 to 57), PImax (29 cmH2O; 95% CI, 19 to 39), mMRC (-1.1; 95% CI, -1.7 to -0.5), functional reach test (FRT) (2.8 cm; 95% CI, 1 to 5), COPD Assessment Test (CAT) (-6.7; 95% CI, -9.3 to -4.2), and Patient Health Questionnaire-9 (PHQ-9) scores (-2.9; 95% CI, -5.3 to -0.5) (p < 0.05 for all). Significant correlations were observed between the changes in the PImax and scores on the 6MWD (r = 0.537; p < 0.001), mMRC (r = -0.564; p < 0.001), CAT (r= -0.880; p < 0.001), handgrip strength (r = 0.342; p = 0.035), FRT (r = 0.371, p = 0.021), and PHQ-9 (r = -0.353; p = 0.029). Inspiratory muscle training performed as a standalone intervention improves exercise capacity, postural control, and quality of life in patients with COPD with inspiratory muscle weakness.