PURPOSE: To evaluate the effectiveness of a home-based inspiratory muscle training (IMT) programme using multiple inspiratory muscle tests. METHOD: Sixty-eight patients (37 M) with moderate to severe chronic obstructive pulmonary disease (COPD) (mean (SD), FEV1 36.1 (13.6) % pred; FEV1/FVC 35.7% (11.2)) were randomised into an experimental or control group and trained with a threshold loading device at intensity > 30% maximum inspiratory pressure (PImax) or < 15% PImax, respectively, for 7 weeks. Thirty-nine patients (23 M) completed the study. The following measures were assessed pre- and post-IMT: PImax, sniff inspiratory nasal pressure (SNIP), diaphragm contractility (Pdi, tw), incremental shuttle walk test (ISWT), respiratory muscle endurance (RME), chronic respiratory disease questionnaire (CRDQ), the hospital anxiety and depression scale (HADS) and the SF-36. Between-group changes were assessed using one-way analysis of variance (ANOVA). RESULTS: PImax and perception of well-being improved significantly post-IMT (p = 0.04 and < 0.05 in four domains, respectively). This was not reflected in SNIP (p = 0.7), Pdi, tw (p = 0.8), RME (p = 0.9) or ISWT (p = 0.5). CONCLUSIONS: A seven-week, community-based IMT programme, with realistic use of health-care resources, improves PImax and perception of well-being but a different design may be required for improvement in other measures. Multiple tests provide a more comprehensive evaluation of changes in muscle function post-IMT.

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