Inspiratory muscle training for adults with CAP
Research type
Research Study
Full title
Inspiratory muscle training for adults discharged from hospital with community acquired pneumonia – a pilot study
IRAS ID
204371
Contact name
Wei Shen Lim
Contact email
Sponsor organisation
Nottingham University Hospitals R&D
Clinicaltrials.gov Identifier
researchregistry1897, Research Registry
Duration of Study in the UK
1 years, 2 months, 20 days
Research summary
Community-acquired pneumonia (CAP) causes up to 5% of acute medical admissions to UK hospitals, resulting in over 100,000 hospital admissions in England and Wales annually. Morbidity typically persists long after clinical and radiographic resolution, and beyond “clinical cure” as rated by physicians. One potential mechanism for slow recovery in patients with CAP is abnormal respiratory muscle function and/or respiratory physiological parameters in the post-pneumonia period.
Respiratory muscle strength has been implicated in perception of breathlessness and fatigue. Inspiratory muscle training (IMT) is a technique aimed at increasing the strength of the respiratory muscles. Use of a specialised device requires the participant to produce a negative pressure that is sufficient to overcome a pre-set threshold load (30–80% maximal inspiratory pressure (MIP)) and permits inspiration through the opening of a spring loaded solenoid valve. Once the pressure cannot be sustained, the valve closes and passive expiration ensues.
No studies to date have examined the use of IMT in patients recovering from CAP. In healthy populations use of an IMT device for five to nine weeks has been shown to consistently reduce perception of dyspnoea and discomfort, and improves lung volumes, respiratory muscle strength, and exercise capacity. It is similarly effective in improving exercise capacity in the elderly, and patients with cystic fibrosis, weaning from mechanical ventilation, rehabilitation from chronic medical conditions, and preventing pneumonia after major operations.
We aim to investigate the value of inspiratory muscle training in the management and rehabilitation of adults hospitalised with CAP, in particular, does it lead to improvements in resolution of symptoms and return to normal activity, and does it increase inspiratory muscle strength and submaximal exercise tolerance?. To inform this question, pilot data are required regarding the tolerability and acceptability of IMT, prior to undertaking a randomised controlled trial to answer this question.
REC name
East of England - Cambridge Central Research Ethics Committee
REC reference
17/EE/0043
Date of REC Opinion
9 Feb 2017
REC opinion
Further Information Favourable Opinion