Inspiratory Muscle Training Immediately After Lung Transplantation

NCT ID: NCT05309551

Last Updated: 2025-12-18

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

ACTIVE_NOT_RECRUITING

Clinical Phase

NA

Total Enrollment

90 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-04-20

Study Completion Date

2026-05-31

Brief Summary

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Following lung transplantation (LTX), patients may exhibit respiratory and skeletal muscle weakness that will affect exercise capacity, increase dyspnea and fatigue, limit activities of daily living (ADL) and decrease quality of life.

Inspiratory muscle training (IMT) has been extensively studied in a variety of non-LTX populations and research has shown that IMT improves exercise capacity, diaphragmatic thickness, and reduced dyspnea during activities of daily living and improved quality of life in patients with advanced lung disease.

The aim of this randomized controlled study is to investigate the benefits of providing inspiratory muscle training via use of an inspiratory muscle trainer device in addition to standard physical therapy in the acute phase of rehabilitation following LTX. Patients targeted for enrollment will be those with any type of advanced lung disease requiring LTX with the objective of demonstrating improvements in respiratory muscle recovery, perceived dyspnea, severity of fatigue, and overall functional status following the transplant procedure.

Detailed Description

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Conditions

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Lung Transplantation Chronic Lung Disease Muscle Weakness Rehabilitation

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

DOUBLE

Participants Outcome Assessors

Study Groups

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Inspiratory Muscle training- Intervention group

Along with standard post-transplant physical therapy, the intervention group will begin daily respiratory exercise training utilizing the IMT trainer device (POWERbreathe Medic Plus®) with weekly incremental increases in respiratory load. Patients will be asked to use the IMT device twice per day, 7 days per week, for 8 weeks.

Group Type EXPERIMENTAL

IMT- Intervention group

Intervention Type DEVICE

The resistive load will be readjusted weekly to reach 50% of maximal inspiratory pressure (MIP).

Inspiratory Muscle training - Placebo group

Along with standard post-transplant physical therapy, the placebo group will begin daily respiratory exercise training utilizing the IMT trainer device (POWERbreathe Medic Plus®) with no increase of respiratory load. Patients will be asked to use the IMT device twice per day, 7 days per week, for 8 weeks.

Group Type SHAM_COMPARATOR

IMT- Placebo group

Intervention Type DEVICE

The inspiratory resistive load will be adjusted to the minimum value of the device (9 cm H2O) during all inspiratory muscle training sessions.

Usual care group

Patients will only participate in standard post-transplant physical therapy.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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IMT- Intervention group

The resistive load will be readjusted weekly to reach 50% of maximal inspiratory pressure (MIP).

Intervention Type DEVICE

IMT- Placebo group

The inspiratory resistive load will be adjusted to the minimum value of the device (9 cm H2O) during all inspiratory muscle training sessions.

Intervention Type DEVICE

Other Intervention Names

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POWERBreathe Medic Plus® POWERBreathe Medic Plus®

Eligibility Criteria

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Inclusion Criteria

* Participant has personally signed and dated informed consent form indicating understanding of all pertinent aspects of the study
* Active on the waiting list for lung transplantation
* Able to ambulate pre-transplant (not bed/wheelchair bound) with or without assistive device

Exclusion Criteria

* Already participating in a regular IMT program
* Impaired cognition with inability to follow commands
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Ohio State University

OTHER

Sponsor Role lead

Responsible Party

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Cristiane Meirelles, PT, PhD

Associate Professor-Clinical

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Cristiane Meirelles, PT, PhD

Role: PRINCIPAL_INVESTIGATOR

School of Health and Rehabilitation Sciences- Physical Therapy Division

Locations

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The Ohio State University Wexner Medical Center

Columbus, Ohio, United States

Site Status

Countries

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United States

References

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Evans JA, Whitelaw WA. The assessment of maximal respiratory mouth pressures in adults. Respir Care. 2009 Oct;54(10):1348-59.

Reference Type BACKGROUND
PMID: 19796415 (View on PubMed)

ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories. ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med. 2002 Jul 1;166(1):111-7. doi: 10.1164/ajrccm.166.1.at1102. No abstract available.

Reference Type BACKGROUND
PMID: 12091180 (View on PubMed)

Brocki BC, Andreasen JJ, Langer D, Souza DS, Westerdahl E. Postoperative inspiratory muscle training in addition to breathing exercises and early mobilization improves oxygenation in high-risk patients after lung cancer surgery: a randomized controlled trial. Eur J Cardiothorac Surg. 2016 May;49(5):1483-91. doi: 10.1093/ejcts/ezv359. Epub 2015 Oct 20.

Reference Type BACKGROUND
PMID: 26489835 (View on PubMed)

Hanada M, Kasawara KT, Mathur S, Rozenberg D, Kozu R, Hassan SA, Reid WD. Aerobic and breathing exercises improve dyspnea, exercise capacity and quality of life in idiopathic pulmonary fibrosis patients: systematic review and meta-analysis. J Thorac Dis. 2020 Mar;12(3):1041-1055. doi: 10.21037/jtd.2019.12.27.

Reference Type BACKGROUND
PMID: 32274173 (View on PubMed)

Bissett B, Gosselink R, van Haren FMP. Respiratory Muscle Rehabilitation in Patients with Prolonged Mechanical Ventilation: A Targeted Approach. Crit Care. 2020 Mar 24;24(1):103. doi: 10.1186/s13054-020-2783-0.

Reference Type BACKGROUND
PMID: 32204719 (View on PubMed)

Hoffman M, Augusto VM, Eduardo DS, Silveira BMF, Lemos MD, Parreira VF. Inspiratory muscle training reduces dyspnea during activities of daily living and improves inspiratory muscle function and quality of life in patients with advanced lung disease. Physiother Theory Pract. 2021 Aug;37(8):895-905. doi: 10.1080/09593985.2019.1656314. Epub 2019 Aug 20.

Reference Type BACKGROUND
PMID: 31429627 (View on PubMed)

Spruit MA, Singh SJ, Garvey C, ZuWallack R, Nici L, Rochester C, Hill K, Holland AE, Lareau SC, Man WD, Pitta F, Sewell L, Raskin J, Bourbeau J, Crouch R, Franssen FM, Casaburi R, Vercoulen JH, Vogiatzis I, Gosselink R, Clini EM, Effing TW, Maltais F, van der Palen J, Troosters T, Janssen DJ, Collins E, Garcia-Aymerich J, Brooks D, Fahy BF, Puhan MA, Hoogendoorn M, Garrod R, Schols AM, Carlin B, Benzo R, Meek P, Morgan M, Rutten-van Molken MP, Ries AL, Make B, Goldstein RS, Dowson CA, Brozek JL, Donner CF, Wouters EF; ATS/ERS Task Force on Pulmonary Rehabilitation. An official American Thoracic Society/European Respiratory Society statement: key concepts and advances in pulmonary rehabilitation. Am J Respir Crit Care Med. 2013 Oct 15;188(8):e13-64. doi: 10.1164/rccm.201309-1634ST.

Reference Type BACKGROUND
PMID: 24127811 (View on PubMed)

Bernabeu-Mora R, Medina-Mirapeix F, Llamazares-Herran E, Garcia-Guillamon G, Gimenez-Gimenez LM, Sanchez-Nieto JM. The Short Physical Performance Battery is a discriminative tool for identifying patients with COPD at risk of disability. Int J Chron Obstruct Pulmon Dis. 2015 Dec 3;10:2619-26. doi: 10.2147/COPD.S94377. eCollection 2015.

Reference Type BACKGROUND
PMID: 26664110 (View on PubMed)

Bestall JC, Paul EA, Garrod R, Garnham R, Jones PW, Wedzicha JA. Usefulness of the Medical Research Council (MRC) dyspnoea scale as a measure of disability in patients with chronic obstructive pulmonary disease. Thorax. 1999 Jul;54(7):581-6. doi: 10.1136/thx.54.7.581.

Reference Type BACKGROUND
PMID: 10377201 (View on PubMed)

Talwar A, Sahni S, John S, Verma S, Cardenas-Garcia J, Kohn N. Effects of pulmonary rehabilitation on Fatigue Severity Scale in patients with lung disease. Pneumonol Alergol Pol. 2014;82(6):534-40. doi: 10.5603/PiAP.2014.0070.

Reference Type BACKGROUND
PMID: 25339563 (View on PubMed)

Dowman L, McDonald CF, Hill CJ, Lee A, Barker K, Boote C, Glaspole I, Goh N, Southcott A, Burge A, Ndongo R, Martin A, Holland AE. Reliability of the hand held dynamometer in measuring muscle strength in people with interstitial lung disease. Physiotherapy. 2016 Sep;102(3):249-55. doi: 10.1016/j.physio.2015.10.002. Epub 2015 Oct 22.

Reference Type BACKGROUND
PMID: 26596172 (View on PubMed)

Singer JP, Chen J, Blanc PD, Leard LE, Kukreja J, Chen H. A thematic analysis of quality of life in lung transplant: the existing evidence and implications for future directions. Am J Transplant. 2013 Apr;13(4):839-850. doi: 10.1111/ajt.12174. Epub 2013 Feb 22.

Reference Type BACKGROUND
PMID: 23432992 (View on PubMed)

Other Identifiers

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2021H0310

Identifier Type: -

Identifier Source: org_study_id