Pulmonary Rehabilitation in Patients with COPD (3)
Pulmonary Rehabilitation Program: For a period of ten weeks, all patients participated in the outpatient PR program, five days a week, two hours every day. This program consisted of exercise training, ie, cycling, walking, and training of back, shoulder, and abdominal muscles. The intensity of the exercise training was determined by the symptoms of the patients. Moreover, the heart rate during these exercises did not exceed 80 percent of the maximal heart rate reached during the maximal bicycle ergometer test. Other parts of the PR program were calisthenics, conventional physiotherapy (breathing retraining, relaxation exercises), and education about the pulmonary disease and the purpose and use of the Canadian medications.
Target-Flow Inspiratory Muscle Training: In addition to the PR program, 20 patients participated in a specific training program for the inspiratory muscles. An incentive flowmeter (Inspirx, Intertech Resources Inc) with an added resistance was used for TF-IMT.
The patients were instructed to generate an inspiratory flow rate at which the ball in the flowmeter reached the top of the device (the target-flow). The adjustable leak in the flowmeter was set by the physiotherapist, so that the patient had to generate 70 percent of his maximal inspiratory mouth pressure (PImax) to keep the ball at the top of the flowmeter.