Effects of a simple prototype respiratory muscle trainer on respiratory muscle strength, quality of life and dyspnea, and oxidative stress in COPD patients: a preliminary study

Abstract

Background: The aim of this study was to evaluate the efficiency of a simple prototype device for training respiratory muscles in lung function, respiratory muscle strength, walking capacity, quality of life (QOL), dyspnea, and oxidative stress in patients with COPD.

Methods: Thirty COPD patients with moderate severity of the disease were randomized into three groups: control (n=10, 6 males and 4 females), standard training (n=10, 4 males and 6 females), and prototype device (n=10, 5 males and 5 females). Respiratory muscle strength (maximal inspiratory pressure [PImax] and maximal expiratory pressure [PEmax]), lung function (forced vital capacity [FVC], percentage of FVC, forced expiratory volume in 1 second [FEV₁], percentage of FEV₁ [FEV₁%], and FEV₁/FVC), 6-minute walking distance (6MWD), QOL, and oxidative stress markers (total antioxidant capacity [TAC]), glutathione (GSH), malondialdehyde (MDA), and nitric oxide (NO) were evaluated before and after 6 weeks of training. Moreover, dyspnea scores were assessed before; during week 2, 4, and 6 of training; and at rest after training.

Results: All parameters between the groups had no statistical difference before training, and no statistical change in the control group after week 6. FVC, FEV₁/FVC, PImax, PEmax, QOL, MDA, and NO showed significant changes after 6 weeks of training with either the standard or prototype device, compared to pre-training. FEV₁, FEV₁%, 6MWD, TAC, and GSH data did not change statistically. Furthermore, the results of significant changes in all parameters were not statistically different between training groups using the standard and prototype device. The peak dyspnea scores increased significantly in week 4 and 6 when applying the standard or prototype device, and then lowered significantly at rest after 6 weeks of training, compared to pre-training.

Conclusion: This study proposes that a simple prototype device can be used clinically in COPD patients as a standard device to train respiratory muscles, improving lung function and QOL, as well as involving MDA and NO levels.

Keywords: COPD; PImax; lung function; oxidative stress; prototype simple training device; quality of life.

Figure 1

Standard RMT device (Smiths Medical ASD, Inc.) (A) and a prototype respiratory muscle trainer with PVC plastic water pipe and plastic caps (B). Abbreviations: RMT, respiratory muscle training; PVC, polyvinyl chloride.

Figure 2

Dyspnea score between the three groups; control and standard and prototype RMT device groups before training (Pre), at week 2 (w2), week 4 (w4), week 6 (w6), and at rest after completing the study (Post). *P<0.01 was compared to pre-training (Pre) using the post hoc Bonferroni test. Abbreviation: RMT, respiratory muscle training.