inspiratory muscle training in chronic obstructive pulmonary disease oxygen-dependent patients: a randomized controlled trial

INTERVENTION: Device E02.760.169.063.500.387 G11.427.410.698.277 The experimental group will have 30 individuals that will receive home‐based inspiratory muscle training,seven days perweek, over four weeks. The daily training will be split into two daily sessions (i.e., morning and afternoon).Each daily session will be comprised of 4 four‐minute sets of respiratory training with one‐minute rest intervals betweeneach set. The resistance will be provided by the Power Breathe Classic, which allows individuals to exercise the inspiratory muscles during the training session. Training will be individually tailored for each participant. The initial training load for each participant will beset at 50% of his/her maximal baseline inspiratory strength for inspiratory strength training. The participants will be trained and instructed to do the exercise program on their own with no supervision.Once a week, during the physical therapist’s home visit, the clinician will determine the new values for maximal inspiratory strength, and will adjust the load to 50% of the new values. The device will be covered with opaque material, so that participants will be blinded to the training load.The control group with 30 individuals will receive a sham intervention. Sham respiratory muscle training will be delivered using a Power Breathe with no resistance (0 cmH2O) or progression, over the 4 weeks period, 40 min per day, seven days per week. The placebo group will receive the same train‐ing and testing schedule as the experimental group CONDITION: chronic obstrutive pulmonary disease ; J44.9 PRIMARY OUTCOME: increase of maximal inspiratory pressure in cmH2O evaluated by digital manovacuometer,identified by a variation at least 10% before and after intervention SECONDARY OUTCOME: Increase of capacity of do acitivies daily living evaluated by variation of London chest activity of daily linving scale in 4 points before and after intervention increase of maximumm oxygen uptake and decrease of VE/VCO2 evaluated by expired gas analysis during maximal exercise testing at least 20% before and after intervention INCLUSION CRITERIA: individuals with chronic obstructive pulmonary disease; both genders; stable clinical condition; witohut cardiac disease (heart failure, angina pectoris); and no history od respiratory infection at least 30 days before inclusion of study.