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Effect Of Inspiratory Muscle Training On Exercise Tolerance And Quality Of Life In Post Covid-19 COPD Patients
International Journal of Allied Medical Sciences and Clinical Research,
Vol. 13 No. 1 (2025): 2025 Volume -13 - Issue 1
Abstract
Chronic Obstructive Pulmonary Disease (COPD) is a chronic inflammatory lung disease that leads to obstructed airflow from the lungs caused by long term exposure to irritating gases or particulate matter. Diaphragm muscle, the main inspiratory muscle, is associated with weakness in COPD patients. On the other hand, patients who are currently having COPD with a history of Covid-19 has more negative impact on the diaphragm muscle thereby limiting the exercise tolerance in patients due to dyspnoea and hence, will ultimately reduce the quality of life. Therefore, this study aim to evaluate the effectiveness of inspiratory muscle training on exercise tolerance and quality of life in post covid-19 COPD patients. Forty-one subjects with an age group of 45-60 years having post covid-19 COPD were recruited for the study. Pre and post evaluation of 6MWT and SGRQ-C for exercise tolerance and QOL respectively was taken from each patient at the baseline and at the end of 4th week. For both the outcomes, the p-value comparing pre-test and post-test results of post Covid-19 COPD patients is <0.001, indicating a statistically significant difference within the group.
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- Agustí A, Celli BR, Criner GJ, Halpin D, Anzueto A, Barnes P, et al. Global Initiative for Chronic Obstructive Lung Disease 2023 Report: GOLD Executive Summary. Am J Respir Crit Care Med. 2023 Apr 1;207(7):819–37.
- Brandsma C, Van Den Berge M, Hackett T, Brusselle G, Timens W. Recent advances in chronic obstructive pulmonary disease pathogenesis: from disease mechanisms to precision medicine. The Journal of Pathology. 2020 Apr 250(5):624–35
- Hillegass E. Essentials of Cardiopulmonary Physical Therapy - E-Book. Elsevier Health Sciences; 2016. 736 p
- Barberà JA, Blanco I. Chronic obstructive pulmonary disease (COPD). In: Pulmonary Circulation. CRC Press; 2016 p. 497–508.
- Figueiredo RI, Azambuja AM, Cureau FV, Sbruzzi G. Inspiratory muscle training in COPD. Respiratory Care. 2020. 65(8):1189–201.
- Main E, Denehy L. Cardiorespiratory physiotherapy: adults and paediatrics: formerly Physiotherapy for Respiratory and Cardiac problems. Elsevier Health Sciences; 2016.
- Bourdin A, Burgel PR, Chanez P, Garcia G, Perez T, Roche N. Recent advances in COPD: pathophysiology, respiratory physiology and clinical aspects, including comorbidities. European Respiratory Review. 2009 Dec 1;18(114):198-212.
- Cao Y, Li P, Wang Y, Liu X, Wu W. Diaphragm dysfunction and rehabilitation strategy in patients with chronic obstructive pulmonary disease. Frontiers in Physiology. 2022 May 2;13:872277.
- Rajabi H, Mortazavi D, Konyalilar N, Aksoy GT, Erkan S, Korkunc SK, et al. Forthcoming complications in recovered COVID-19 patients with COPD and asthma; possible therapeutic opportunities. Cell Communication and Signaling. 2022 Nov 1;20(1):173.
- Torres-Castro R, Vasconcello-Castillo L, Alsina-Restoy X, Solis-Navarro L, Burgos F, Puppo H, Vilaró J. Respiratory function in patients’ post-infection by COVID-19: a systematic review and meta-analysis. Pulmonology. 2021 Jul 1;27(4):328-37.
- Chen H, Shi H, Liu X, Sun T, Wu J, Liu Z. Effect of pulmonary rehabilitation for patients with post-COVID-19: a systematic review and meta-analysis. Frontiers in medicine. 2022 Feb 21;9:837420.
- Severin R, Franz CK, Farr E, Meirelles C, Arena R, Phillips SA, et al. The effects of COVID-19 on respiratory muscle performance: making the case for respiratory muscle testing and training. European Respiratory Review. 2022 Dec 31;31(166).
- Elimy DA, Ezzelregal HG, Elsayed MM. Influence of manual diaphragm release technique combined with inspiratory muscle training on selected persistent symptoms in men with post-Covid-19 syndrome: a randomized controlled trial. Journal of rehabilitation medicine. 2022;54.
- Alqahtani JS, Oyelade T, Aldhahir AM, Alghamdi SM, Almehmadi M, Alqahtani AS, et al. Prevalence, severity and mortality associated with COPD and smoking in patients with COVID- 19: a rapid systematic review and meta-analysis. PloS one. 2020 May 11;15(5):e0233147.
- McNarry MA, Berg RM, Shelley J, Hudson J, Saynor ZL, Duckers J, et al. Inspiratory muscle training enhances recovery post-COVID-19: a randomised controlled trial. European Respiratory Journal. 2022 Oct 1;60(4).
- Giannitsi S, Bougiakli M, Bechlioulis A, Kotsia A, Michalis LK, Naka KK. 6-minute walking test: a useful tool in the management of heart failure patients. Therapeutic advances in cardiovascular disease. 2019 Aug;13 :1753944719870084.
- Rehman AU, Hassali MA, Harun SN, Abbas S, Muneswarao J, Ali IA, et al. Validation and clinical interpretation of the St George’s respiratory questionnaire for COPD (SGRQ-C) after adaptation to Malaysian language and culture, in patients with COPD. Health and quality of life outcomes. 2020 Dec; 18:1-2.
- Jones PW. St George’s respiratory questionnaire for COPD patients (SGRQ-C). Structure. 2008; 44:1-7.
References
Agustí A, Celli BR, Criner GJ, Halpin D, Anzueto A, Barnes P, et al. Global Initiative for Chronic Obstructive Lung Disease 2023 Report: GOLD Executive Summary. Am J Respir Crit Care Med. 2023 Apr 1;207(7):819–37.
Brandsma C, Van Den Berge M, Hackett T, Brusselle G, Timens W. Recent advances in chronic obstructive pulmonary disease pathogenesis: from disease mechanisms to precision medicine. The Journal of Pathology. 2020 Apr 250(5):624–35
Hillegass E. Essentials of Cardiopulmonary Physical Therapy - E-Book. Elsevier Health Sciences; 2016. 736 p
Barberà JA, Blanco I. Chronic obstructive pulmonary disease (COPD). In: Pulmonary Circulation. CRC Press; 2016 p. 497–508.
Figueiredo RI, Azambuja AM, Cureau FV, Sbruzzi G. Inspiratory muscle training in COPD. Respiratory Care. 2020. 65(8):1189–201.
Main E, Denehy L. Cardiorespiratory physiotherapy: adults and paediatrics: formerly Physiotherapy for Respiratory and Cardiac problems. Elsevier Health Sciences; 2016.
Bourdin A, Burgel PR, Chanez P, Garcia G, Perez T, Roche N. Recent advances in COPD: pathophysiology, respiratory physiology and clinical aspects, including comorbidities. European Respiratory Review. 2009 Dec 1;18(114):198-212.
Cao Y, Li P, Wang Y, Liu X, Wu W. Diaphragm dysfunction and rehabilitation strategy in patients with chronic obstructive pulmonary disease. Frontiers in Physiology. 2022 May 2;13:872277.
Rajabi H, Mortazavi D, Konyalilar N, Aksoy GT, Erkan S, Korkunc SK, et al. Forthcoming complications in recovered COVID-19 patients with COPD and asthma; possible therapeutic opportunities. Cell Communication and Signaling. 2022 Nov 1;20(1):173.
Torres-Castro R, Vasconcello-Castillo L, Alsina-Restoy X, Solis-Navarro L, Burgos F, Puppo H, Vilaró J. Respiratory function in patients’ post-infection by COVID-19: a systematic review and meta-analysis. Pulmonology. 2021 Jul 1;27(4):328-37.
Chen H, Shi H, Liu X, Sun T, Wu J, Liu Z. Effect of pulmonary rehabilitation for patients with post-COVID-19: a systematic review and meta-analysis. Frontiers in medicine. 2022 Feb 21;9:837420.
Severin R, Franz CK, Farr E, Meirelles C, Arena R, Phillips SA, et al. The effects of COVID-19 on respiratory muscle performance: making the case for respiratory muscle testing and training. European Respiratory Review. 2022 Dec 31;31(166).
Elimy DA, Ezzelregal HG, Elsayed MM. Influence of manual diaphragm release technique combined with inspiratory muscle training on selected persistent symptoms in men with post-Covid-19 syndrome: a randomized controlled trial. Journal of rehabilitation medicine. 2022;54.
Alqahtani JS, Oyelade T, Aldhahir AM, Alghamdi SM, Almehmadi M, Alqahtani AS, et al. Prevalence, severity and mortality associated with COPD and smoking in patients with COVID- 19: a rapid systematic review and meta-analysis. PloS one. 2020 May 11;15(5):e0233147.
McNarry MA, Berg RM, Shelley J, Hudson J, Saynor ZL, Duckers J, et al. Inspiratory muscle training enhances recovery post-COVID-19: a randomised controlled trial. European Respiratory Journal. 2022 Oct 1;60(4).
Giannitsi S, Bougiakli M, Bechlioulis A, Kotsia A, Michalis LK, Naka KK. 6-minute walking test: a useful tool in the management of heart failure patients. Therapeutic advances in cardiovascular disease. 2019 Aug;13 :1753944719870084.
Rehman AU, Hassali MA, Harun SN, Abbas S, Muneswarao J, Ali IA, et al. Validation and clinical interpretation of the St George’s respiratory questionnaire for COPD (SGRQ-C) after adaptation to Malaysian language and culture, in patients with COPD. Health and quality of life outcomes. 2020 Dec; 18:1-2.
Jones PW. St George’s respiratory questionnaire for COPD patients (SGRQ-C). Structure. 2008; 44:1-7.