Inspiratory muscle training (IMT) with normocapnic hyperpnea improves respiratory muscle strenght and exercise performance in COPD patients.

IMT by means of normocapnic hyperventilation (NH) is effective in improving exercise endurance in healthy subjects but few data are availabale for COPD patients. We aimed to assess the effect of 4 weeks NH training by means of Spirotiger® on: Pimax, spirometry, exercise capacity (6MWD and CPET endurance), physical activity (Armband®), quality of life (St George Questionnaire) in 14 moderate/severe COPD patients (13M, 1F, age 42-80, FEV1 58.1%±6). After 1 month of weekly supervised training, the patients trained at home for 1 month: 10 minutes twice a day at a breathing rate of 28/min with a volume equal to 50% of Vital Capacity. 6 patients (42.8%) dropped out due to poor tolerance to the instrument (2), poor compliance to the training (3),excessive fatigue due to a very severe respiratory function (1). Results. Results FEV1 % FVC% Pimax (KPa) 6MWD (m) QoL (total) Endurance (min) pre 57.9±7.6 82±10 8.5±0.7 370±13 28.5±5.7 7.1±0.6 post 58.9±6.8 81.7±9.9 9.3±0.8 * 387±19 16.2±3.5 * 10.5±0.5 * * p<0.05 The ventilatory pattern shows a trend of increase in tidal volume rather than breathing rate during exercise but the values do not reach the statistical significance.We conclude that a short IMT by means of NH is effective in improving Pimax,quality of life and exercise endurance in COPD patients. The high withdrawal rate suggests that a careful recruitment of subjects in term of compliance and motivation is needed to avoid early dropout