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Other possible program inclusions

See below for some of the other possible inclusions into PR with current seminal studies as a platform for further research:

Inspiratory Muscle Training  in COPD

Inspiratory muscle training (IMT), performed in isolation using a threshold loading device or target-flow resistive device at loads equal to or greater than 30% of an individual’s maximum inspiratory pressure generated against an occluded airway (PImax) has been shown to increase inspiratory muscle strength and endurance and reduce dyspnoea in patients with COPD. Training may also result in modest improvements in 6 minute walking distance and health-related quality of life. However, it remains unclear whether IMT combined with a program of whole-body exercise training confers additional benefits in dyspnoea, exercise capacity or health-related quality of life in patients with COPD. At present, the evidence does not support the routine use of IMT as an essential component of pulmonary rehabilitation program.

  • Hill, K. et al., 2006. High-intensity inspiratory muscle training in COPD. European Respiratory Journal, June, 27(6), pp. 1119-1128
  • Gosselink, R. et al., 2011. Impact of inspiratory muscle training in patients with COPD: what is the evidence. European Respiratory Journal, 31 January, 37(2), pp. 416-425.

Single leg cycling

  • Evans, R. A. et al., 2015. One-Legged Cycle Training for Chronic Obstructive Pulmonary Disease. A Pragmatic Study of Implementation to Pulmonary Rehabilitation. Annals of the American Thoracic Society, October, 12(10), pp. 1490-1497.

Water-based exercise training

Water-based exercise training has been shown to be beneficial for people with COPD who have co-existing physical impairments.

  • McNamara, R. J., McKeough, Z. J., McKenzie, D. K. & Alison, J. A., 2013. Water-based exercise training for chronic obstructive pulmonary disease. Cochrane Database Systematic Review, 18 December, Issue 12.

Non-invasion ventilation (NIV) (severe disease)

  • Menadue, C., Piper, A. J., van ‘t Hul, A. J. & Wong, K. K., 2014. Non-invasive ventilation during exercise training for people with chronic obstructive pulmonary disease. Cochrane Database Systematic Reviews, 14 May , Issue 5.


  • Eves, N. D. et al., 2009. Helium-hyperoxia: a novel intervention to improve the benefits of pulmonary rehabilitation for patients with COPD. Chest, March, 135(3), pp. 609-618.