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Peer-reviewedCC BY-NCInternational journal of chronic obstructive pulmonary disease

Acute Effects of Inspiratory Muscle Training with Different Loads on Peripheral Muscle Oxygenation Kinetics and Autonomic Response in Patients with COPD: A Protocol for a Randomized Crossover Study.

4 affiliations
  1. 1Postgraduate Program in Physiotherapy, Federal University of Paraíba, João Pessoa, PB, Brazil.
  2. 2Department of Physiotherapy, Federal University of Rio Grande Do Norte, Natal, RN, Brazil.
  3. 3Department of Physiotherapy, Federal University of Paraíba, João Pessoa, PB, Brazil.
  4. 4Department of Physiotherapy, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil.

Abstract

Background

Chronic obstructive pulmonary disease (COPD) leads to inspiratory muscle weakness, which may contribute to an altered cardiovascular response during the respiratory cycle. In this context, inspiratory muscle training (IMT) emerges as one of the available tools for the treatment and monitoring of patients with respiratory muscle dysfunction.Methods

This is a randomized crossover study, with blinding of both the evaluator and the researcher responsible for statistical analysis. The study will evaluate the acute effects of IMT on peripheral muscle metabolism and the autonomic response in 30 patients with COPD. The primary outcomes will be peripheral muscle oxygenation kinetics, assessed by near-infrared spectroscopy (NIRS), and autonomic response, assessed through heart rate variability (HRV). Participants will be randomly assigned to undergo three different intervention conditions at separate times, with a minimum interval of 48 hours between each session: IMT-S (Strength), aimed at improving inspiratory muscle strength; IMT-E (Endurance), focused on enhancing inspiratory muscle endurance; and Sham, consisting of a Sham IMT intervention. For statistical analysis, continuous variables will be presented as mean ± standard deviation, and data normality will be assessed using histograms and the Shapiro-Wilk test. All analyses will follow the intention-to-treat principle. In cases of missing data due to dropouts or absence in crossover sessions, participants with incomplete data will be retained in the analysis, assuming that data are missing at random. Between-intervention differences will be analyzed using mixed linear models with Bonferroni adjustment for multiple comparisons. The level of statistical significance will be set at 0.05.Conclusion

This study may help to better understand the effects of IMT performed at different loads on peripheral muscle oxygenation behavior, as well on the autonomic response in patients with COPD. These findings may improve the understanding of the physiological impacts of this therapy and support its application in pulmonary rehabilitation programs.Trial registration

Clinical Trial Registry NCT06827379.

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BibTeX
@article{borges2026acute,
  title = {{Acute Effects of Inspiratory Muscle Training with Different Loads on Peripheral Muscle Oxygenation Kinetics and Autonomic Response in Patients with COPD: A Protocol for a Randomized Crossover Study.}},
  author = {Natália Mota da Silva Borges and Patrícia Angélica de Miranda Silva Nogueira and Dyego Tavares de Lima and Annicia Lins Freitas and Hellen Maria Lacerda de Oliveira Carneiro and Tatiana Onofre Gama and Danielle Aparecida Gomes Pereira and José Heriston de Morais Lima Snr and Rafaela Pedrosa and Eduardo Eriko Tenório de França},
  journal = {International journal of chronic obstructive pulmonary disease},
  year = {2026},
  month = oct,
  doi = {10.2147/copd.s557387},
  url = {https://europepmc.org/article/MED/42904147},
  note = {CC BY-NC},
}
RIS
TY  - JOUR
TI  - Acute Effects of Inspiratory Muscle Training with Different Loads on Peripheral Muscle Oxygenation Kinetics and Autonomic Response in Patients with COPD: A Protocol for a Randomized Crossover Study.
AU  - Natália Mota da Silva Borges
AU  - Patrícia Angélica de Miranda Silva Nogueira
AU  - Dyego Tavares de Lima
AU  - Annicia Lins Freitas
AU  - Hellen Maria Lacerda de Oliveira Carneiro
AU  - Tatiana Onofre Gama
AU  - Danielle Aparecida Gomes Pereira
AU  - José Heriston de Morais Lima Snr
AU  - Rafaela Pedrosa
AU  - Eduardo Eriko Tenório de França
PY  - 2026
DA  - 2026/10/16
JO  - International journal of chronic obstructive pulmonary disease
DO  - 10.2147/copd.s557387
UR  - https://europepmc.org/article/MED/42904147
AB  - Background  Chronic obstructive pulmonary disease (COPD) leads to inspiratory muscle weakness, which may contribute to an altered cardiovascular response during the respiratory cycle. In this context, inspiratory muscle training (IMT) emerges as one of the available tools for the treatment and monitoring of patients with respiratory muscle dysfunction.Methods  This is a randomized crossover study, with blinding of both the evaluator and the researcher responsible for statistical analysis. The study will evaluate the acute effects of IMT on peripheral muscle metabolism and the autonomic response in 30 patients with COPD. The primary outcomes will be peripheral muscle oxygenation kinetics, assessed by near-infrared spectroscopy (NIRS), and autonomic response, assessed through heart rate variability (HRV). Participants will be randomly assigned to undergo three different intervention conditions at separate times, with a minimum interval of 48 hours between each session: IMT-S (Strength), aimed at improving inspiratory muscle strength; IMT-E (Endurance), focused on enhancing inspiratory muscle endurance; and Sham, consisting of a Sham IMT intervention. For statistical analysis, continuous variables will be presented as mean ± standard deviation, and data normality will be assessed using histograms and the Shapiro-Wilk test. All analyses will follow the intention-to-treat principle. In cases of missing data due to dropouts or absence in crossover sessions, participants with incomplete data will be retained in the analysis, assuming that data are missing at random. Between-intervention differences will be analyzed using mixed linear models with Bonferroni adjustment for multiple comparisons. The level of statistical significance will be set at 0.05.Conclusion  This study may help to better understand the effects of IMT performed at different loads on peripheral muscle oxygenation behavior, as well on the autonomic response in patients with COPD. These findings may improve the understanding of the physiological impacts of this therapy and support its application in pulmonary rehabilitation programs.Trial registration  Clinical Trial Registry NCT06827379.
SN  - 1176-9106
SN  - 1178-2005
ER  -