04 Mar

Pulmonary Rehabilitation in Patients with COPD (8)

Data Analysis
The baseline parameters of the two groups were compared by means of the Wilcoxon test. The changes during the training period within one group were also compared by the Wilcoxon test. Differences in response to treatment between the two groups were analyzed by means of the Mann-Whitney U test (MWU). All selected patients completed the study. There were no significant differences between the two groups with regard to age, sex distribution, body measures, and pulmonary function indices (Table 1). Pulmonary medications were not changed during the study period. Also, there were no changes in static or dynamic lung volumes before and after the training period. After the training, PImax increased in both groups (p<0.01) (Fig 1). Additional TF-IMT resulted in a significantly greater increase compared with the group without additional TF-IMT (p<0.001). ampicillin antibiotic
The endurance time (Ttm) during the endurance test increased in both groups (p<0.01), with no significant differences between the two groups (Table 2). The reasons for terminating the endurance test are also listed in Table 2. Although there were more patients in the PR + IMT group than in the PR group who were able to sustain the target pressure for ten minutes, these differences were not statistically significant.

Table 1—Patient Characteristics

PR(n = 20) PR + IMT(n = 20)
Age, yr 60 + 7 58±8
Sex, M:F 16:4 14:6
Height, m 1.71 ±6 1.71±7
Weight, kg 72.6 ±13.9 72.1 ±11.8
FEV„ %pred 51.7 + 17.0 46.9 ±14.0
FRC%TC, %pred 115.1 ±19.5 127.0 ±24.9
TLC, pred 99.5± 11.5 103.7 ±14.0

Table 2—Endurance Time and Reasons for Terminating the Endurance Test in the Two Groups

Baseline 4 wk 10 wk
PR 130 (43) 135(40) 149 (33)
PR-t-IMT 124(37) 145 (41) 158 (29)
Reasons for terminating the endurance test, No. of patients
Decrease of generated PI with more than 20% of initial value
PR 17 16 12
PR + IMT 18 13 7
Duration = 10 minutes
PR 3 4 8
PR + IMT 2 7 13


Figure 1. Maximal inspiratory mouth pressure (PImax) during the training period in the pulmonary rehabilitation (PR) group (filled bars) and in the PR + IMT (PR + inspiratory muscle training) group (hatched bars). Asterisk, compared with baseline: p<0.05; two asterisks, p<0.01; circle, PR + IMT compared with PR: p<0.001.

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