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• W2164420794 abstract "I speak not to disprove what Brutus spoke, But here I am to speak what I do know. William Shakespeare. Julius Caesar . Act 3, Scene 2, line 100–101.Pulmonary rehabilitation is a cornerstone for the management of chronic obstructive pulmonary disease (COPD), since treatments other than smoking cessation and long-term oxygen therapy are merely symptomatic [1]. The current recommendations in the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines are that all stages of the disease may benefit from such programmes 1. The most effective component of these programmes is peripheral (preferably lower limbs) muscle exercise training, whereas the role of inspiratory muscle training (IMT) of patients with stable COPD remains controversial 2–5.The American Thoracic Society/European Respiratory Society statement on pulmonary rehabilitation suggested that “although the data are inconclusive, IMT could be considered as adjunctive therapy in pulmonary rehabilitation, primarily in patients with suspected or proven respiratory muscle weakness” 4. The Joint American College of Chest Physicians/American Association of Cardiovascular and Pulmonary Rehabilitation evidence-based clinical practice guidelines panel 5, (including some of the most respected contributors to the previous statement 4) recommended that “IMT be considered in selected patients with COPD who have decreased inspiratory muscle strength and breathlessness despite receiving optimal medical therapy.” That panel suggested that a large-scale, multicentre randomised controlled trial (RCT) should be performed with appropriate statistical power to more completely examine the role of IMT in treating patients with COPD, concluding that “the scientific evidence does not support the routine use of IMT as an essential component of pulmonary rehabilitation” (grade of recommendation 1B) 5. However, why should “inconclusive data” 4 or “grade of recommendation 1B” 5 be considered synonymous with “ineffective”, or prevent a treatment modality in the individual patient 6? Clinical practice …" @default.
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• W2164420794 date "2011-01-31" @default.
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• W2164420794 title "The case for inspiratory muscle training in COPD" @default.
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• W2164420794 doi "https://doi.org/10.1183/09031936.00131210" @default.
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