{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T16:51:07Z","timestamp":1791910267725,"version":"4.3.4"},"reference-count":54,"publisher":"American Physiological Society","issue":"2","funder":[{"name":"Ontario Thoracic Society grant-in-aid","award":["Year 2014-15"],"award-info":[{"award-number":["Year 2014-15"]}]},{"name":"William Spear\/Richard Start Endowment Fund, Queen's University","award":["Year 2014-15"],"award-info":[{"award-number":["Year 2014-15"]}]},{"DOI":"10.13039\/501100003130","name":"Research Foundation Flanders","doi-asserted-by":"crossref","award":["Post-doctoral fellowship and travel grant"],"award-info":[{"award-number":["Post-doctoral fellowship and travel grant"]}],"id":[{"id":"10.13039\/501100003130","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Applied Physiology"],"published-print":{"date-parts":[[2018,8,1]]},"abstract":"<jats:p>\n                    Among patients with chronic obstructive pulmonary disease (COPD), those with the lowest maximal inspiratory pressures experience greater breathing discomfort (dyspnea) during exercise. In such individuals, inspiratory muscle training (IMT) may be associated with improvement of dyspnea, but the mechanisms for this are poorly understood. Therefore, we aimed to identify physiological mechanisms of improvement in dyspnea and exercise endurance following inspiratory muscle training (IMT) in patients with COPD and low maximal inspiratory pressure (Pi\n                    <jats:sub>max<\/jats:sub>\n                    ). The effects of 8 wk of controlled IMT on respiratory muscle function, dyspnea, respiratory mechanics, and diaphragm electromyography (EMGdi) during constant work rate cycle exercise were evaluated in patients with activity-related dyspnea (baseline dyspnea index &lt;9). Subjects were randomized to either IMT or a sham training control group ( n = 10 each). Twenty subjects (FEV\n                    <jats:sub>1<\/jats:sub>\n                    \u2009=\u200947\u2009\u00b1\u200919% predicted; Pi\n                    <jats:sub>max<\/jats:sub>\n                    \u2009=\u2009\u221259\u2009\u00b1\u200914 cmH\n                    <jats:sub>2<\/jats:sub>\n                    O; cycle ergometer peak work rate\u2009=\u200947\u2009\u00b1\u200921% predicted) completed the study; groups had comparable baseline lung function, respiratory muscle strength, activity-related dyspnea, and exercise capacity. IMT, compared with control, was associated with greater increases in inspiratory muscle strength and endurance, with attendant improvements in exertional dyspnea and exercise endurance time (all P &lt; 0.05). After IMT, EMGdi expressed relative to its maximum (EMGdi\/EMGdi\n                    <jats:sub>max<\/jats:sub>\n                    ) decreased ( P &lt; 0.05) with no significant change in ventilation, tidal inspiratory pressures, breathing pattern, or operating lung volumes during exercise. In conclusion, IMT improved inspiratory muscle strength and endurance in mechanically compromised patients with COPD and low Pi\n                    <jats:sub>max<\/jats:sub>\n                    . The attendant reduction in EMGdi\/EMGdi\n                    <jats:sub>max<\/jats:sub>\n                    helped explain the decrease in perceived respiratory discomfort despite sustained high ventilation and intrinsic mechanical loading over a longer exercise duration.\n                  <\/jats:p>\n                  <jats:p>NEW &amp; NOTEWORTHY In patients with COPD and low maximal inspiratory pressures, inspiratory muscle training (IMT) may be associated with improvement of dyspnea, but the mechanisms for this are poorly understood. This study showed that 8 wk of home-based, partially supervised IMT improved respiratory muscle strength and endurance, dyspnea, and exercise endurance. Dyspnea relief occurred in conjunction with a reduced activation of the diaphragm relative to maximum in the absence of significant changes in ventilation, breathing pattern, and operating lung volumes.<\/jats:p>","DOI":"10.1152\/japplphysiol.01078.2017","type":"journal-article","created":{"date-parts":[[2018,3,15]],"date-time":"2018-03-15T11:11:19Z","timestamp":1521112279000},"page":"381-392","source":"Crossref","is-referenced-by-count":174,"title":["Inspiratory muscle training reduces diaphragm activation and dyspnea during exercise in COPD"],"prefix":"10.1152","volume":"125","author":[{"given":"Daniel","family":"Langer","sequence":"first","affiliation":[{"name":"Respiratory Investigation Unit, Queen\u2019s University and Kingston Health Sciences Centre, Kingston, Ontario, Canada"},{"name":"Faculty of Kinesiology and Rehabilitation Sciences, Department of Rehabilitation Sciences, Research Group for Cardiovascular and Respiratory Rehabilitation, KU Leuven-University of Leuven, and Respiratory Rehabilitation and Respiratory Division, University Hospital Leuven, Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Casey","family":"Ciavaglia","sequence":"additional","affiliation":[{"name":"Respiratory Investigation Unit, Queen\u2019s University and Kingston Health Sciences Centre, Kingston, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Azmy","family":"Faisal","sequence":"additional","affiliation":[{"name":"Respiratory Investigation Unit, Queen\u2019s University and Kingston Health Sciences Centre, Kingston, Ontario, Canada"},{"name":"Faculty of Physical Education for Men, Alexandria University, Alexandria, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine A.","family":"Webb","sequence":"additional","affiliation":[{"name":"Respiratory Investigation Unit, Queen\u2019s University and Kingston Health Sciences Centre, Kingston, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. 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