Pulmonary Disease, Chronic Obstructive Clinical Trial
Official title:
Feasibility of Inspiratory Muscle Training in People With Chronic Obstructive Pulmonary Disease (COPD) Who Decline Pulmonary Rehabilitation
The feasibility study will involve mixed methods, this means interviews as well as
assessment of treatment with inspiratory muscle training therapy (IMT). There are two
pathways within the study depending on whether people want to have inspiratory muscle
training. People who accept to have inspiratory muscle training will have assessments before
training, after 8 weeks of training and at 6 month follow up in addition to interviews
before and after the study (at 6 months). For those who choose not to have the inspiratory
muscle training the investigators will offer them an interview so that the investigators can
find out more about what might have made the study more appealing or what treatments they
would have preferred. The investigators will also ask if they wish to be followed up with
baseline assessments for the study period and if the investigators can access health
records.
Interviews
Semi-structured interviews lasting approximately an hour will be performed at the beginning
of the study with participants who accept the IMT pathway and those who decline IMT until no
knew themes are raised. These interviews will be used to provide information on reasons for
declining pulmonary rehabilitation, attitudes to exercise, attitudes to IMT, treatment
preferences and opinions regarding study design and outcome measures (see Interview Topic
guide). The interviews will be taped and transcribed verbatim. A follow up interview with
study participants who have received IMT will be conducted at 6 months addressing attitudes
to IMT and study design and whether they have decided that they wish to engage with other
services (such as pulmonary rehabilitation and smoking cessation).
Inspiratory Muscle Training (IMT) method
Participants will perform 8 weeks of IMT strength training using the Powerbreathe Kinetic
device (Powerbreathe). Training will progress to 60% maximum inspiratory pressure (PiMax).
This means that each breath in through the device is set at 60% of the maximum force you are
able to create when you breathe in rather than at full force. 30 breaths are performed at
high velocity (paced initially over a period of 15 minutes to allow recovery between each
breath through the device). Once established it is anticipated that each training session
should take no more than five minutes. Training is performed twice a day, 5 days per week
for the first 8 weeks. Training will be titrated (set to a level suitable for the
participant) and supervised weekly for the first 8 weeks by a physiotherapist. After 8 weeks
training the participants are advised to continue training unsupervised, twice a day, 3
times per week for a further 18 weeks.
n/a
Allocation: Non-Randomized, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Health Services Research
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