Long-Term Efficacy of Novel and Traditional Home-Based, Remote
Inspiratory Muscle Training in COPD: A Randomized Controlled
Trial

J 2025

Long-Term Efficacy of Novel and Traditional Home-Based, Remote Inspiratory Muscle Training in COPD: A Randomized Controlled Trial

DOSBABA, Filip; Martin HARTMAN; Magno F FORMIGA; Daniela VLAŽNÁ; Jitka MINÁRIKOVÁ et. al.

Základní údaje

Originální název

Long-Term Efficacy of Novel and Traditional Home-Based, Remote Inspiratory Muscle Training in COPD: A Randomized Controlled Trial

Autoři

DOSBABA, Filip (203 Česká republika, domácí); Martin HARTMAN (203 Česká republika, domácí); Magno F FORMIGA; Daniela VLAŽNÁ (703 Slovensko, domácí); Jitka MINÁRIKOVÁ (203 Česká republika); Marek PLUTINSKÝ (703 Slovensko, domácí); Kristián BRAT (703 Slovensko, domácí); Jing Jing SU; Lawrence P CAHALIN a Ladislav BAŤALÍK (203 Česká republika, domácí)

Vydání

Journal of Clinical Medicine, BASEL, MDPI, 2025, 2077-0383

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30218 General and internal medicine

Stát vydavatele

Švýcarsko

Utajení

není předmětem státního či obchodního tajemství

Odkazy

URL

Impakt faktor

Impact factor: 2.900 v roce 2024

Organizační jednotka

Lékařská fakulta

DOI

https://doi.org/10.3390/jcm14176099

UT WoS

001571379400001

EID Scopus

2-s2.0-105015977099

Klíčová slova anglicky

chronic obstructive pulmonary disease; inspiratory muscle training; test of incremental respiratory endurance; home-based rehabilitation; adherence; maximal inspiratory pressure; sustained maximal inspiratory pressure

Štítky

14110234, 14110525, 14110614, rivok

Příznaky

Mezinárodní význam, Recenzováno

Změněno: 6. 10. 2025 12:52, Mgr. Tereza Miškechová

Anotace

V originále

Background: Chronic obstructive pulmonary disease (COPD) is a progressive condition leading to declining lung function, dyspnea, and reduced quality of life. Pulmonary rehabilitation (PR) remains a cornerstone in COPD management; however, access remains limited, with less than 3% of eligible patients participating. Inspiratory muscle training (IMT), especially through novel methods like the Test of Incremental Respiratory Endurance (TIRE), offers a potential home-based alternative to traditional rehabilitation services. Despite growing interest, a key knowledge gap persists: few randomized trials have directly compared TIRE with threshold loading IMT over extended, largely unsupervised home-based periods while concurrently evaluating inspiratory muscle endurance and adherence. This randomized controlled trial aimed to evaluate the long-term efficacy of TIRE IMT compared to traditional threshold IMT and sham training in COPD patients. The study also assessed adherence to these home-based interventions, focusing on unsupervised periods without additional motivational support. Methods: A total of 52 COPD patients were randomly assigned to one of three groups: TIRE IMT, Threshold IMT, or Sham IMT. The study consisted of an 8-week supervised Phase I followed by a 24-week unsupervised Phase II. Training details: TIRE-session template set to 50% of the day's maximal sustained effort; 6 levels x 6 inspirations (total 36) with preset inter-breath recoveries decreasing from 60 s to 10 s. Threshold IMT-spring-loaded valve set to 50% MIP (re-set at week 4); 36 inspirations completed within <= 30 min. Sham-valve set to minimal resistance (9 cmH(2)O); 36 inspirations within <= 30 min. Primary outcomes included changes in maximal inspiratory pressure (MIP) and sustained maximal inspiratory pressure. Secondary outcomes focused on adherence rates and correlations with functional capacity. Results: Of the 52 participants, 36 completed the study. Participant details: TIRE n = 12 (mean age 60.9 +/- 12.9 years), Threshold n = 12 (67.4 +/- 6.9 years), Sham n = 12 (67.3 +/- 8.7 years); overall 21/36 (58%) men; mean BMI 30.0 +/- 7.5 kg/m(2). The TIRE IMT group demonstrated significantly greater improvements in MIP (31.7%) and SMIP compared to both the Threshold and Sham groups at 24 weeks (p < 0.05). Despite a decline in adherence during the unsupervised phase, the TIRE group maintained superior outcomes. No adverse events were reported during the intervention period. Conclusions: In this randomized trial, TIRE IMT was associated with greater improvements in inspiratory muscle performance than threshold and sham IMT. While adherence was higher in the TIRE group, it declined during the unsupervised phase. The clinical interpretation of these findings should consider the relatively wide confidence intervals and modest sample size. Nevertheless, the mean change in MIP in the TIRE arm exceeded a recently proposed minimal important difference for COPD, suggesting potential clinical relevance; however, no universally accepted minimal important difference exists yet for SMIP. Further adequately powered trials are warranted.

Citovat

DOSBABA, Filip; Martin HARTMAN; Magno F FORMIGA; Daniela VLAŽNÁ; Jitka MINÁRIKOVÁ; Marek PLUTINSKÝ; Kristián BRAT; Jing Jing SU; Lawrence P CAHALIN a Ladislav BAŤALÍK. Long-Term Efficacy of Novel and Traditional Home-Based, Remote Inspiratory Muscle Training in COPD: A Randomized Controlled Trial. Journal of Clinical Medicine. BASEL: MDPI, 2025, roč. 14, č. 17, s. 1-14. ISSN 2077-0383. Dostupné z: https://doi.org/10.3390/jcm14176099.

@article{2523938,
   author = {Dosbaba, Filip and Hartman, Martin and Formiga, Magno F and Vlažná, Daniela and Mináriková, Jitka and Plutinský, Marek and Brat, Kristián and Su, Jing Jing and Cahalin, Lawrence P and Baťalík, Ladislav},
   article_location = {BASEL},
   article_number = {17},
   doi = {https://doi.org/10.3390/jcm14176099},
   keywords = {chronic obstructive pulmonary disease; inspiratory muscle training; test of incremental respiratory endurance; home-based rehabilitation; adherence; maximal inspiratory pressure; sustained maximal inspiratory pressure},
   language = {eng},
   issn = {2077-0383},
   journal = {Journal of Clinical Medicine},
   title = {Long-Term Efficacy of Novel and Traditional Home-Based, Remote Inspiratory Muscle Training in COPD: A Randomized Controlled Trial},
   url = {https://www.mdpi.com/2077-0383/14/17/6099},
   volume = {14},
   year = {2025}
}

TY  - JOUR
ID  - 2523938
AU  - Dosbaba, Filip - Hartman, Martin - Formiga, Magno F - Vlažná, Daniela - Mináriková, Jitka - Plutinský, Marek - Brat, Kristián - Su, Jing Jing - Cahalin, Lawrence P - Baťalík, Ladislav
PY  - 2025
TI  - Long-Term Efficacy of Novel and Traditional Home-Based, Remote Inspiratory Muscle Training in COPD: A Randomized Controlled Trial
JF  - Journal of Clinical Medicine
VL  - 14
IS  - 17
SP  - 1-14
EP  - 1-14
PB  - MDPI
SN  - 20770383
KW  - chronic obstructive pulmonary disease
KW  - inspiratory muscle training
KW  - test of incremental respiratory endurance
KW  - home-based rehabilitation
KW  - adherence
KW  - maximal inspiratory pressure
KW  - sustained maximal inspiratory pressure
UR  - https://www.mdpi.com/2077-0383/14/17/6099
N2  - Background: Chronic obstructive pulmonary disease (COPD) is a progressive condition leading to declining lung function, dyspnea, and reduced quality of life. Pulmonary rehabilitation (PR) remains a cornerstone in COPD management; however, access remains limited, with less than 3% of eligible patients participating. Inspiratory muscle training (IMT), especially through novel methods like the Test of Incremental Respiratory Endurance (TIRE), offers a potential home-based alternative to traditional rehabilitation services. Despite growing interest, a key knowledge gap persists: few randomized trials have directly compared TIRE with threshold loading IMT over extended, largely unsupervised home-based periods while concurrently evaluating inspiratory muscle endurance and adherence. This randomized controlled trial aimed to evaluate the long-term efficacy of TIRE IMT compared to traditional threshold IMT and sham training in COPD patients. The study also assessed adherence to these home-based interventions, focusing on unsupervised periods without additional motivational support. Methods: A total of 52 COPD patients were randomly assigned to one of three groups: TIRE IMT, Threshold IMT, or Sham IMT. The study consisted of an 8-week supervised Phase I followed by a 24-week unsupervised Phase II. Training details: TIRE-session template set to 50% of the day's maximal sustained effort; 6 levels x 6 inspirations (total 36) with preset inter-breath recoveries decreasing from 60 s to 10 s. Threshold IMT-spring-loaded valve set to 50% MIP (re-set at week 4); 36 inspirations completed within <= 30 min. Sham-valve set to minimal resistance (9 cmH(2)O); 36 inspirations within <= 30 min. Primary outcomes included changes in maximal inspiratory pressure (MIP) and sustained maximal inspiratory pressure. Secondary outcomes focused on adherence rates and correlations with functional capacity. Results: Of the 52 participants, 36 completed the study. Participant details: TIRE n = 12 (mean age 60.9 +/- 12.9 years), Threshold n = 12 (67.4 +/- 6.9 years), Sham n = 12 (67.3 +/- 8.7 years); overall 21/36 (58%) men; mean BMI 30.0 +/- 7.5 kg/m(2). The TIRE IMT group demonstrated significantly greater improvements in MIP (31.7%) and SMIP compared to both the Threshold and Sham groups at 24 weeks (p < 0.05). Despite a decline in adherence during the unsupervised phase, the TIRE group maintained superior outcomes. No adverse events were reported during the intervention period. Conclusions: In this randomized trial, TIRE IMT was associated with greater improvements in inspiratory muscle performance than threshold and sham IMT. While adherence was higher in the TIRE group, it declined during the unsupervised phase. The clinical interpretation of these findings should consider the relatively wide confidence intervals and modest sample size. Nevertheless, the mean change in MIP in the TIRE arm exceeded a recently proposed minimal important difference for COPD, suggesting potential clinical relevance; however, no universally accepted minimal important difference exists yet for SMIP. Further adequately powered trials are warranted.
ER  -

DOSBABA, Filip; Martin HARTMAN; Magno F FORMIGA; Daniela VLAŽNÁ; Jitka MINÁRIKOVÁ; Marek PLUTINSKÝ; Kristián BRAT; Jing Jing SU; Lawrence P CAHALIN a Ladislav BAŤALÍK. Long-Term Efficacy of Novel and Traditional Home-Based, Remote Inspiratory Muscle Training in COPD: A Randomized Controlled Trial. \textit{Journal of Clinical Medicine}. BASEL: MDPI, 2025, roč.~14, č.~17, s.~1-14. ISSN~2077-0383. Dostupné z: https://doi.org/10.3390/jcm14176099.

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