Cycle ergometer and inspiratory muscle training in chronic obstructive pulmonary disease

Am J Respir Crit Care Med. 1999 Aug;160(2):500-7. doi: 10.1164/ajrccm.160.2.9804067.


In patients with chronic obstructive pulmonary disease (COPD) the intensity of aerobic training is limited by dyspnea. Improving strength of the inspiratory muscles could enhance aerobic exercise training by reducing exercise-related dyspnea. We examined effects of home-based inspiratory muscle training (IMT) and cycle ergometry training (CET) in 53 patients with moderate to severe COPD (FEV(1)% pred, 50 +/- 17 [mean +/- SD]). Patients were randomly assigned to 4 mo of training in one of four groups: IMT, CET, CET + IMT, or health education (ED). Patients were encouraged to train to the limits of their dyspnea. Inspiratory muscle strength and endurance increased in IMT and CET + IMT groups compared with CET and ED groups (p < 0. 01). Peak oxygen uptake increased and heart rate, minute ventilation, dyspnea, and leg fatigue decreased at submaximal work rates in the CET and CET + IMT groups compared with the IMT and ED groups (p < 0. 01). There were no differences between the CET and CET + IMT groups. Home-based CET produced a physiological training effect and reduced exercise-related symptoms while IMT increased respiratory muscle strength and endurance. The combination of CET and IMT did not produce additional benefits in exercise performance and exercise-related symptoms. This is the first study to demonstrate a physiological training effect with home-based exercise training.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • Breathing Exercises*
  • Combined Modality Therapy
  • Dyspnea / physiopathology
  • Dyspnea / rehabilitation
  • Exercise Test*
  • Female
  • Forced Expiratory Volume / physiology
  • Health Education
  • Humans
  • Inspiratory Capacity / physiology*
  • Lung Diseases, Obstructive / physiopathology
  • Lung Diseases, Obstructive / rehabilitation*
  • Male
  • Middle Aged
  • Physical Endurance / physiology
  • Physical Fitness / physiology
  • Respiratory Muscles / physiopathology*
  • Single-Blind Method
  • Vital Capacity / physiology