The Effects of IMT on Physical Activity and Quality of Life in LTx Candidates
Condition: Lung Transplantation; Inspiratory Muscle Training
MeSH terms: Respiratory Aspiration
Study type: Interventional

Summary: 
      Inspiratory Muscle Training (IMT), which is used to strengthen the respiratory muscles, is
      one of the techniques used in PR. It is mostly used in patients with chronic obstructive
      pulmonary disease, and has been shown to be beneficial for functionality and also for
      relieving dyspnea perception. It is reported in the guidelines that IMT has additional
      benefit for endurance in COPD patients. However, there are no studies related to its use and
      effectiveness in lung transplantation. In this study, investigators hoped to increase these
      known benefits by adding IMT to the standard Pulmonary Rehabilitation.

      There are two main objectives of this study:

        -  to examine the effect of inspiratory muscle training on physical activity status and
           quality of life in lung transplantation candidates,

        -  to compare physical activity and quality of life changes between the IMT+PR group and
           the PR group
    

Detailed description: 
      The patients in the lung transplantation waiting list were included the study. These patients
      were with severe lung disease requiring transplantation, and that the intervention was
      undertaken before any lung transplantation. The patients were eligible for inclusion if
      participitants have: a diagnosis of terminally severe lung disease, being listed for lung
      transplantation, medically stable, had no orthopedic or cardiac problems that would prevent
      them from exercising and had no transfer problem to the PR centre.

      Participants who meet the study inclusion criteria and complete the baseline assessments were
      randomly allocated into one of the two groups: namely Pulmonary Rehabilitation plus
      Inspiratory Muscle Training Group (IMT+PR) or Pulmonary Rehabilitation Group (PR) using a
      numbered series of 34 prefilled envelops specifying group assignment generated by a
      computer-based program.

      All patients underwent supervised PR program on 2 days per week for 3 months. Apart from
      that, participitant were asked to perform the home exercise program which was scheduled as 3
      days per week and fill out the exercise follow-up form. The study group was provided with IMT
      in addition to the standard program.
    

Intervention name(s): Inspiratory muscle training; Pulmonary rehabilitation
Intervention type(s): Other; Other
Intervention description(s): Inspiratory Muscle Training was performed with an exercise tool (Powerbreath®) with a resistance range of 0-90. The training intensity was started with 30% of the Maximum Inspiratory Pressure (MIP) value obtained as a result of the mouth pressure measurement, training was progressively increased from 30% to 60% considering that they were terminal-stage pulmonary disease patients. Patients were asked to perform IMT for 15 minutes, twice a day, 7 days a week, for 3 months.; Aerobic training:The aerobic exercise program consists of treadmill walking, cycle ergometer and arm ergometer training. Group exercises were performed in sets of 15 minutes each with three exercise modalities.
Strength training:It is recommended that resistance targets are set at loads equivalent to 20 to 40% of a 1-repetition maximum (1RM) maneuver and performed between 8 to 12 repetitions for 1 to 2 sets per session.
Home exercise programme:The program included breathing exercises (local expansion exercises, diaphragmatic breathing and pursed lip breathing), free walking, upper and lower extremity strengthening exercises with Thera-Band
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Participants who meet the study inclusion criteria and complete the baseline assessments were randomly allocated into one of the two groups: namely Pulmonary Rehabilitation plus Inspiratory Muscle Training Group (IMT+PR) or Pulmonary Rehabilitation Group (PR).
Masking: None (Open Label)
Primary purpose: Supportive Care
Keywords: lung transplantation; inspiratory muscle training; pulmonary rehabilitation; quality of life; physical activity