PULMONARY REHABILITATIONInspiratory Muscle Training Compared With Other Rehabilitation Interventions in Chronic Obstructive Pulmonary Disease A SYSTEMATIC REVIEW UPDATEO'Brien, Kelly BScPT; Geddes, E. Lynne MRE; Reid, W. Darlene PhD; Brooks, Dina PhD; Crowe, Jean MHScAuthor Information Department of Physical Therapy, University of Toronto, Toronto (Ms O'Brien and Dr Brooks), and School of Rehabilitation Science, McMaster University, Hamilton (Ms Geddes and Ms Crowe), Ontario, Canada; and Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada (Dr Reid). Corresponding Author: Kelly O'Brien, BScPT, Department of Physical Therapy, University of Toronto, 500 University Ave, Room 160, Toronto, Ontario, Canada M5G 1V7 ([email protected]). This article is an update of an original systematic review: Crowe J, Reid WD, Geddes L, O'Brien K, Brooks D. Inspiratory muscle training compared with other rehabilitation interventions in adults with chronic obstructive pulmonary disease. COPD: J COPD. 2005;3:319–329. Journal of Cardiopulmonary Rehabilitation and Prevention: March 2008 - Volume 28 - Issue 2 - p 128-141 doi: 10.1097/01.HCR.0000314208.40170.00 Buy Metrics AbstractIn Brief PURPOSE To determine the effect of inspiratory muscle training (IMT) (alone or combined with exercise and/or pulmonary rehabilitation) and compare with other rehabilitation interventions among adults with chronic obstructive pulmonary disease (COPD). METHODS We conducted a systematic review, using Cochrane Collaboration protocol. We included randomized controlled trials, published in English, comparing IMT or combined IMT and exercise/pulmonary rehabilitation with other rehabilitation interventions among adults with COPD. Abstracts were reviewed independently by 2 investigators to determine study eligibility up to December 2005. Data were abstracted and methodological quality of included studies was assessed. RESULTS A total of 156 additional articles were retrieved. Two new studies met the inclusion criteria and were included with 16 studies in the original review. Results highlight updated subgroup analyses comparing (1) IMT versus exercise and (2) combined IMT and exercise versus exercise alone. Fourteen meta-analyses were performed for outcomes of inspiratory muscle strength, exercise tolerance, and quality of life. Results showed significant improvements in maximum inspiratory pressure and maximum exercise tidal volume favoring combined IMT and exercise compared with exercise alone. CONCLUSIONS Performing a combination of IMT plus exercise may lead to significant improvements in inspiratory muscle strength and one outcome of exercise tolerance for individuals with COPD. Meta-analyses were performed to determine the effect of inspiratory muscle training (IMT) compared with other rehabilitation interventions among adults with chronic obstructive pulmonary disease (COPD). Results suggest that performing a combination of IMT plus exercise may lead to significant improvements in inspiratory muscle strength and exercise tolerance for individuals with COPD. © 2008 Lippincott Williams & Wilkins, Inc.