Biomedical subjects

Paltiel Weiner

Publications and source records attributed to Paltiel Weiner.

18 recordsLinked to original sources

PubMed2005

Inspiratory muscle training may increase peak inspiratory flow in chronic obstructive pulmonary disease.

BACKGROUND: When choosing a specific inhalation device for a chronic obstructive pulmonary disease (COPD) patient, the internal airflow resistance and the ability of the patient to overcome it and to create an optimal inspiratory flow are essential. OBJECTIVES: The purpose of the present study was to investigate: (1) the peak inspiratory flow (PIF) that a patient with COPD can generate while breathing through two dry powder inhalers and (2) whether in patients with low PIF specific inspiratory muscle training (SIMT) will increase the PIF and exceed the minimal PIF that is considered necessary to guarantee optimal lung deposition of the drug. METHODS: Inspiratory muscle strength and PIFs were measured in 60 patients with COPD. Then 28 patients with severe COPD and low PIF were randomized to receive SIMT or to a control group. RESULTS: With the Turbuhaler, 12 patients (20%) could not generate the optimal flow of 60 l/min. PIF correlated very well with maximal inspiratory mouth pressure (PI(max)) for the Diskus and the Turbuhaler, as well as for both males and females (p < 0.001). Following the training period, there was a statistically significant increase in the PI(max) in the training group. This increase was associated with a significant increase in the PIF. All patients overcame the minimal threshold PIF following the training. CONCLUSIONS: Some patients with severe COPD are not able to generate adequate flow to secure optimal lung deposition of the inhalation with the Turbuhaler. SIMT improves inspiratory muscle strength as well as PIF. Following 8 weeks of training, the optimal PIF enabling adequate lung deposition of the drug was attained in all the trained patients.

Aged↗

PubMed2005

Inspiratory muscle training and the perception of dyspnea in Parkinson's disease.

BACKGROUND: Pulmonary and respiratory muscle function impairment are common in patients with Parkinson's disease (PD). Inspiratory muscle training may improve strength, dyspnea and functional capacity in healthy subjects and in those with chronic obstructive pulmonary disease. This study investigated the effect of specific inspiratory muscle training (SIMT) on pulmonary functions, inspiratory muscle performance, dyspnea and quality of life, in patients with PD. PATIENTS AND METHODS: Twenty patients with PD (stage II and III Hoehn and Yahr scale) were recruited for the study and were divided into two groups: (a) ten patients who received SIMT and (b) ten patients who received sham training, for three months. Pulmonary functions, the respiratory muscle strength and endurance, the perception of dyspnea (POD) and the quality of life were studied before and within one week after the training period. All subjects trained daily, six times a week, each session consisting of 1/2 hour, for 12 weeks. RESULTS: Following the training period, there was a significant improvement, in the training group but not in the control group, in the following parameters: inspiratory muscle strength, (PImax, increased from 62.0 +/- 8.2 to 78.0 +/- 7.5 cm of H2O (p < 0.05), inspiratory muscle endurance (increased from 20.0 +/- 2.8 to 29.0 +/- 3.0 cm of H2O (p < 0.05), and the POD (decreased from 17.9 +/- 3.2 to 14.0 +/- 2.4 units (p < 0.05). There was a close correlation between the increase in the inspiratory muscle performance and the decrease in the POD. CONCLUSIONS: The inspiratory muscle performance may be improved by SIMT in patients with PD. This improvement is associated with a significant decrease in their POD.

Aged↗

PubMed2005

Respiratory muscle training in chronic obstructive pulmonary disease: inspiratory, expiratory, or both?

PURPOSE OF REVIEW: Most patients with significant chronic obstructive pulmonary disease (COPD) have inspiratory and expiratory muscle weakness. In addition, hyperinflation induces functional weakening of the inspiratory muscles, increased elastic load to breathing, and intrinsic positive end expiratory pressure (PEEPi). Therefore, it was rational to expect that patients with COPD would benefit from specific inspiratory or expiratory muscle training (SIMT, SEMT respectively). However, the functional benefits of SIMT have remained equivocal. In recent years, a number of studies have demonstrated that, when training loads are controlled, SIMT results in important functional benefits. The role of SEMT is still unclear. RECENT FINDINGS: Well-controlled SIMT in patients with COPD leads to relief of dyspnea, during both daily activities and during physical activity. This yields increased exercise tolerance, and thus the capacity to walk, improving health related quality of life. We argue that there is now evidence that SIMT is an important addition to pulmonary rehabilitation programs for patients with COPD. Although two recent studies have shown that SEMT also provides a beneficial effect in patients with COPD, this does not appear to be supplementary to the effect to SIMT. SUMMARY: Inspiratory and expiratory muscles can be specifically trained yielding improvements in both strength and endurance. The improvement in inspiratory muscle performance is associated with an improvement in the sensation of dyspnea, exercise tolerance, and quality of life. When the expiratory muscles are specifically trained, a significant increase in exercise performance has also been shown. However, there is probably no additional benefit in combining SEMT with SIMT.

Breathing Exercises↗

PubMed2005

The effects of 1 year of specific inspiratory muscle training in patients with COPD.

AIM: We assessed the long-term benefits of inspiratory muscle training (IMT) on inspiratory muscle strength, exercise capacity, the perception of dyspnea, quality of life, primary care use, and hospitalizations in patients with significant COPD. PATIENTS: Forty-two consecutive COPD patients with FEV(1) < 50% of predicted were randomized into a group that received IMT for 1 year, and a control group that received training with a very low load. RESULTS: There was a statistically significant increase in inspiratory muscle strength (at the end of the third month of training) as assessed by maximal inspiratory pressure (from 71 +/- 4.9 to 90 +/- 5.1 cm H(2)O [+/- SEM], p < 0.005) and 6-min walk distance (at the end of the third month of training; from 256 +/- 41 to 312 +/- 54 m; p < 0.005), a decrease in the mean Borg score during breathing against resistance (at the end of the ninth month of training), improvement in the health-related quality-of-life scores (at the end of the sixth month of training) in the training group but not in the control group. At the end of the training year, these changes were maintained; in addition, a decrease in primary health-care use and hospitalization days was observed. CONCLUSIONS: Our study shows that during IMT in patients with significant COPD, there is an increase in exercise capacity, improvement in quality of life, and decrease in dyspnea. Our study also provides evidence that long-term IMT can decrease the use of health services and hospitalization days.

Aged↗

PubMed2003

The perception of dyspnea after bronchoconstriction and bronchodilation in patients with asthma.

BACKGROUND: It is well documented that the perception of dyspnea (POD), subjectively reported by patients, is an important index used to guide treatment. The severity of dyspnea following methacholine-induced bronchoconstriction and added mechanical loads is increasing in popular. No formal attention has been addressed to the reduction in dyspnea following bronchodilators. STUDY OBJECTIVE: To investigate if the magnitude of dyspnea perceived by a subject is independent on the direction (e.g., bronchoconstriction or bronchodilation) of the change in airway resistance. METHODS: The POD was measured in 26 mild moderate asthmatic patients following bronchodilation, using beta2-agonists, and following bronchoconstriction, induced by methacholine challenge, to almost the same magnitude. RESULTS: The increase in forced expiratory volume in 1 s (FEV1), 30 min after the inhalation of beta2-agonist (mean +/- SEM 22.3 +/- 0.8%), was associated with a statistically significant decrease (P < 0.005) in the POD. The mean decrease in FEV1 following methacoline challenge, was 23 +/- 0.7% and was followed by a statistically significant increase (P < 0.005) in the POD. The magnitude of the decrease in the POD following albuterol was almost identical to the magnitude of the increase in the POD following methacholine. CONCLUSIONS: In stable mild-moderate asthmatic patients, the changes in the magnitude of dyspnea, perceived by a subject, is independent on the direction of the change in the FEV1.

Adrenergic beta-2 Receptor Antagonists↗

PubMed2003

Specific expiratory muscle training in COPD.

BACKGROUND: There are several reports showing that expiratory muscle strength and endurance can be impaired in patients with COPD. This muscle weakness may have clinically relevant implications. Expiratory muscle training tended to improve cough and to reduce the sensation of respiratory effort during exercise in patients other than those with COPD. METHODS: Twenty-six patients with COPD (FEV(1) 38% predicted) were recruited for the study. The patients were randomized into two groups: group 1, 13 patients were assigned to receive specific expiratory muscle training (SEMT) daily, six times a week, each session consisting of 1/2 h of training, for 3 months; and group 2, 13 patients were assigned to be a control group and received training with very low load. Spirometry, respiratory muscle strength and endurance, 6-min walk test, Mahler baseline dyspnea index (before), and the transitional dyspnea index (after) were measured before and after training. RESULTS: The training-induced changes were significantly greater in the SEMT group than in the control group for the following variables: expiratory muscle strength (from 86 +/- 4.1 to 104 +/- 4.9 cm H(2)O, p < 0.005; mean difference from the control group, 24%; 95% confidence interval, 18 to 32%), expiratory muscle endurance (from 57 +/- 2.9% to 76 +/- 4.0%, p < 0.001; mean difference from the control group, 29%; 95% confidence interval, 21 to 39%), and in the distance walked in 6 min (from 262 +/- 38 to 312 +/- 47 m, p < 0.05; mean difference from the control group, 14%; 95% confidence interval, 9 to 20%). There was also a small but not significant increase (from 5.1 +/- 0.9 to 5.6 +/- 0.7, p = 0.14) in the dyspnea index. CONCLUSIONS: The expiratory muscles can be specifically trained with improvement of both strength and endurance in patients with COPD. This improvement is associated with increase in exercise performance and no significant change in the sensation of dyspnea in daily activities.

Dyspnea↗

PubMed2003

Comparison of specific expiratory, inspiratory, and combined muscle training programs in COPD.

BACKGROUND: Respiratory muscle weakness may contribute to dyspnea and exercise limitation in patients with significant COPD. In an attempt to reduce the severity of breathlessness and to improve exercise tolerance, inspiratory muscle training has been applied in many COPD patients. On the other hand, there is a paucity of data related to expiratory muscle performance and training in COPD. METHODS: Thirty-two patients with significant COPD (ie, mean FEV(1), 37% of predicted) were recruited for the study. The patients were randomized into four groups: eight patients were assigned to receive specific expiratory muscle training (SEMT); eight patients received specific inspiratory muscle training (SIMT); eight patients received SEMT and SIMT (ie, the SEMT + SIMT group); and eight patients who were assigned to a control group received training with very low load. All patients trained daily, six times a week, with each session consisting of one half hour of training, for 3 months. Spirometry, respiratory muscle strength and endurance, 6-min walk test distance, the perception of dyspnea, and the Mahler baseline dyspnea index (BDI) were measured before and following training. RESULTS: Training caused a statistically significant specific increase in the expiratory muscle strength and endurance (in the SEMT and SEMT + SIMT groups) and in the inspiratory muscle strength and endurance (in the SIMT and SEMT + SIMT groups). There was significant increase in the distance walked in 6 min in the SEMT, SIMT, and SEMT + SIMT groups. However, the increase in the SIMT and SEMT + SIMT groups was significantly greater than that in the SEMT group. There was a statistically significant increase in the BDI, and a decrease in the mean Borg score during breathing against resistance in the SIMT and SEMT + SIMT groups, with no changes in the SEMT and control groups. CONCLUSIONS: The inspiratory and expiratory muscles can be specifically trained with improvement of both muscle strength and endurance. The improvement in the inspiratory muscle performance is associated with an increase in the 6-min walk test distance and the sensation of dyspnea. There is no additional benefit gained by combining SIMT with SEMT, compared to using SIMT alone.

Aged↗

PubMed2003

[The effect of time on the perception of dyspnea following inhaled long-acting bronchodilator].

STUDY OBJECTIVES: To assess the effect of time on the change in the perception of dyspnea (POD) following inhalation of long-acting bronchodilator. PATIENTS AND METHODS: Spirometry and the POD were measured in 32 asthmatic patients, with moderate asthma, before and following inhalation of placebo, and salmeterol. The POD was measured while breathing against progressive loads, using a visual analogue scale (VAS). RESULTS: The highest FEV1 levels and the lowest POD were measured one hour after salmeterol inhalation. Although the mean FEV1 remained close to its peak value for at least six hours following the inhalation of salmeterol, there was a gradual statistically significant increase in the POD. CONCLUSIONS: Following inhalation of long-acting bronchodilator (LABD) there is relationship between the increase in the FEV1 and the decrease in POD. With time there is a gradual increase in the perception of dyspnea regardless of the FEV1.

Administration, Inhalation↗

PubMed2002

C-reactive protein as a marker for active coronary artery disease in patients with chest pain in the emergency room.

BACKGROUND: Markers of inflammation, such as C-reactive protein (CRP), were found to be related to risk for cardiovascular disease (CVD) events in patients with angina pectoris. In addition, recent studies have shown that, in the case of atherosclerosis, increased CRP concentration reflects the inflammatory condition of the vascular wall. HYPOTHESIS: The study was undertaken to determine whether CRP levels in individuals with chest pain attending the emergency room (ER) may be used as a marker of active CVD. METHODS: Serum CRP level was measured in 226 of 326 consecutive patients (128 men, 98 women; mean age 61.3 +/- 5.9 years; range 19-87 years) referred to the ER with chest pain. The decision whether to admit orrelease the subjects was determined without taking the CRP level into account. Follow-up was then performed for 1 year. RESULTS: Eighty-four patients were admitted to the hospital. Of these, 9 with acute coronary syndrome (ACS) had very high levels of CRP (25-40 mg/l), 35 had had an acute coronary event within the preceding 3 months, with levels of CRP 14-20 mg/l. Only eight patients with nonsignificant CVD had elevated CRP levels. Twenty-eight subjects who were released from the ER had elevated CRP levels (7-14 mg/l); 8 of these, in addition to 4 subjects with normal CRP levels, had a late coronary event. CONCLUSION: This study indicates that in patients referred to the ER with chest pain and no other indication for hospitalization, a normal level of CRP suggests safe release. Most hospitalized patients with normal CRP will not have acute coronary syndrome. Patients who will develop early coronary events have very high CRP levels. High serum CRP level, after excluding other inflammatory sources, was proven to be a sensitive diagnostic and prognostic marker for significant coronary disease.

Adult↗

PubMed2002

Respiratory muscle performance and the Perception of dyspnea in Parkinson's disease.

BACKGROUND: Pulmonary and respiratory muscle function impairment are common in patients with Parkinson's disease (PD). However, dyspnea is not a frequent complaint among these patients, although it is well documented that the intensity of dyspnea is related to the activity and the strength of the respiratory muscles. PATIENTS AND METHODS: We studied pulmonary function, respiratory muscle strength and endurance and the perception of dyspnea (POD) in 20 patients with PD (stage II and III Hoehn and Yahr scale) before and after their first daily L-dopa dose. Respiratory muscle strength was assessed by measuring the maximal inspiratory and expiratory mouth pressures (PImax and PEmax), at residual volume (RV) and total lung capacity (TLC) respectively. The POD was measured while the subject breathed against progressive load and dyspnea was rated using a visual analog scale. RESULTS: Respiratory muscle strength and endurance were decreased and the POD was increased during the off medication period compared to normal subjects. There was a nonsignificant trend to an increase in Plmax, PEmax and endurance after L-dopa intake. The POD of PD patients decreased (p<0.05) following medication, although, it remained increased (p<0.01) as compared to the normal subjects. Even if patients had spirometry data showing a mild restrictive pattern, before medication, both forced vital capacity (FVC) and forced expiratory volume (FEV)1 remained almost identical after L-dopa intake. CONCLUSIONS: Patients with PD have higher POD, compared to normal subjects and this increased perception is attenuated when the patients are on dopaminergic medication. The change in the POD is not related to changes in respiratory muscle performance or pulmonary functions. A central effect or a correction of uncoordinated respiratory movements by L-dopa may contribute to the decrease in POD following L-dopa treatment.

Aged↗

PubMed2002

The risk of hospitalization and near-fatal and fatal asthma in relation to the perception of dyspnea.

BACKGROUND: A life-threatening asthma attack is still of major concern. One of the main goals in treating patients with asthma is identification of the patients at risk of having these attacks. It has been shown that patients who have a near-fatal asthma attack have a blunted perception of dyspnea (POD). The purpose of this study is to measure the POD in patients with asthma, and to relate POD to life-threatening attacks within a 24-month follow-up period. METHODS: The POD was scored using the Borg scale during breathing against a progressive load at 1-min intervals, in order to achieve mouth pressure up to 30 cm H(2)O, in 113 consecutive asthmatic patients with stable asthma attending an outpatient clinic. All patients were invited to regular follow-up every 3 months for up to 24 months, and all hospitalizations and near-fatal and fatal asthma attacks were recorded. The prebronchodilator morning peak expiratory flow rate (PEFR), daily regular treatment, and beta(2)-agonist consumption were recorded in a diary card for the first 4 weeks. RESULTS: Seventeen patients (15%) had high POD compared to the normal subjects, 67 patients (59%) had POD within the normal range, and 29 patients (26%) had lower-than-normal POD. In the patients with low POD, there was a tendency for higher age, higher female/male ratio, and a longer duration of disease. The rate of severe asthma was higher in the low-POD group than in the normal-POD group, but did not differ from the rate in the high-POD group. The mean daily beta(2)-agonist consumption in the patients with low POD was significantly lower (p < 0.01) than in the patients with high POD, although the mean PEFR was lower in the low-POD group. During the 2 years of follow-up, the patients in the low-POD group had statistically significantly more emergency department (ED) visits, hospitalizations, near-fatal asthma attacks, and deaths compared to the normal-POD and high-POD groups. CONCLUSIONS: Approximately 26% of the referral subjects with asthma had low POD when compared to healthy matched subjects. Patients with low POD had statistically significantly more ED visits, hospitalizations, near-fatal asthma attacks, and deaths during the follow-up period. Reduced POD may predispose patients to a life-threatening attack.

Adult↗

PubMed2002

Influence of gender and inspiratory muscle training on the perception of dyspnea in patients with asthma.

BACKGROUND: Men and women respond differently to asthma. PATIENTS AND METHODS: Maximal inspiratory mouth pressure (P(Imax)), beta(2)-agonist consumption, and perception of dyspnea (POD) were measured in 22 women and 22 men with mild persistent-to-moderate asthma. Next, the women were randomized into two groups: those who received inspiratory muscle training and those who received sham training. The training ended when the P(Imax) of the training group was equal to that of the male subjects. POD was then measured once again. RESULTS: Baseline P(Imax) was significantly lower (p < 0.01) while POD and mean daily beta(2)-agonist consumption were significantly higher in the female subjects. P(Imax) reached the level of the male subjects at the end of the 20th week of training. The increase in the P(Imax) was associated with a statistically significant decrease in mean daily beta(2)-agonist use and in POD to a similar level as in male subjects. CONCLUSIONS: POD and mean daily beta(2)-agonist consumption in asthmatic women are significantly higher, and the P(Imax) significantly lower, than that of their male counterparts. When the P(Imax) of female subjects following training is equal to that in male subjects, the differences in POD and mean daily beta(2)-agonist consumption disappear.

Adult↗

PubMed2002

Polycystic kidney disease as a new risk factor for coronary events.

BACKGROUND: The association between coronary and/or other arterial aneurysms and polycystic kidney disease is well known. While myocardial infarction is a possible complication of atheroscletotic coronary aneurysms, it is reasonable to assume that CA in patients with PKD may make them prone for a similar complication. OBJECTIVE: To evaluate the possible occurrence of CA and MI in first-order relatives of a patient with PKD, CA and MI. PATIENTS: We studied 12 family members: 2 parents, 8 sisters and 2 brothers of a young woman who was incidentally diagnosed as having a MI, while her mother was known to have PKD. We used electrocardiogram, thallium-image test, and transthoracic echocardiography to determine MI, ultrasonography of the kidney to determine PKD, and coronary angiography and ventriculography to determine CA and MI, respectively. RESULTS: PKD was detected in seven family members, while CA and MI were found in five and three of them, respectively. CONCLUSIONS: In a family with PKD we detected a high prevalence of CA, with MI as a complication of the latter.

Adult↗

PubMed2002

[Fatal attack in patients with bronchial asthma].

What is most notable about asthma deaths is that they continue to occur despite increased understanding of the pathophysiology of asthma, more effective treatment and improvements in asthma education. Studies of fatal and near fatal asthma revealed two distinct groups of patients. The first is a "slow onset-late arrival" group (type I) in whom the final common pathway is a period of poor asthma control, increased use of bronchodilators, late arrival for care of the final attack and underutilization of glucocorticosteroids. This group of patients is characterized by the presence of eosinophilia in the airways. The second group (type II), includes only the minority of death cases. These patients have a sudden, unexpected and rapidly progressive attack. This group of patients is characterized by the presence of neutrophilia in the airways. Two cases of death due to asthma attach, one presenting type I patients and the second type II patients, are described.

Adrenal Cortex Hormones↗

PubMed2002

[The influence of gender on the perception of dyspnea in patients with mild-moderate asthma].

BACKGROUND: Men and women respond differently to asthma. Current data suggest that there are more hospital admissions, decreased quality of life (QOL) and increased use of MDIs, in asthmatic females compared to males. PATIENTS AND METHODS: Respiratory muscle strength, 2-agonists consumption, the QOL and the perception of dyspnea (POD) were measured in 20 asthmatic females and 20 males, with mild-persistent to moderate asthma. The results were compared to 40 normal subjects (20 females and 20 males), age matched, who served as a control group. RESULTS: Inspiratory and expiratory muscle strength were significantly lower (p < 0.01), while the POD and the mean daily 2-agonist consumption were significantly higher (p < 0.005 and p < 0.001, respectively), in the females. The females also had significantly lower QOL compared to their male counterparts. CONCLUSIONS: The POD and the mean daily 2-agonist consumption, in asthmatic females, are significantly higher and the QOL significantly lower than that of their male counterparts. The females also had weaker respiratory muscles. Hence, knowing the relation between the POD and the respiratory muscles it can be assumed that this deference in strength may play a role in the gender differences in the response to asthma.

Adult↗

PubMed2002

[Chronic cough].

The discomfort caused by persistent cough compels a great number of patients to seek medical aid. Persistent cough interferes with the patient's sleep, professional and social activities. The pathogenic triad of asthma, post nasal drip syndrome and gastroesophageal reflux disease, alone or in combination, is responsible for the majority of cases of chronic cough. Investigation of chronic cough, according to a rational protocol leads to the identification of the cause for chronic cough in approximately 90% of the cases.

Asthma↗

PubMed2002

[The relation between the perception of dyspnea and beta 2-agonists consumption in patients with mild-moderate asthma].

It is well documented that, in patients with asthma, there is a considerable variation in the severity of breathlessness for any particular degree of airflow obstruction. The factors underlying this variability are still to be explored. The consumption of beta 2-agonists and the perception of dyspnea were assessed in eighty asthmatic patients, with mild-moderate asthma, attending the asthma clinic. The perception of dyspnea was compared to sixty normal subjects. All patients received treatment with inhaled corticosteroid and beta 2-agonists as needed. Nine patients were excluded from the study, hence the data reported relates to 71 patients. In 55% of the patients the mean score of the perception of dyspnea during breathing against resistance was normal, it was low in 20 (28%) and high in the remaining 12 (17%). There was no correlation between the FEV1 and the perception of dyspnea. The mean +/- SEM beta 2-agonists consumption was 2.9 +/- 0.4 puffs/day (range 0-7.2). There was a statistically significant difference in beta 2-agonists consumption between the mid asthmatic and the moderate asthmatic groups (p < 0.01). In both groups the mean beta 2-agonists consumption was significantly higher in the high preception of dyspnea group than in the normal (p < 0.05) and the low (p < 0.01) perception of dyspnea groups. We conclude that about half of mild-moderate asthmatic patients have normal perception of dyspnea while the other half have either high or low perception of dyspnea. More obstructed patients have higher beta 2-agonists consumption. However, in every degree of severity there is a close relation between the perception of dyspnea and the beta 2-agonists consumption.

Adrenergic beta-Agonists↗

PubMedDate not supplied

The relationship among inspiratory muscle strength, the perception of dyspnea and inhaled beta2-agonist use in patients with asthma.

BACKGROUND: It is well documented that the perception of dyspnea (POD), subjectively reported by patients, is related to the activity and strength of the inspiratory muscles, and influences the use of 'as needed' beta2-agonists. STUDY OBJECTIVE: To investigate the relationship among the increase in inspiratory muscle strength after specific inspiratory muscle training, beta2-agonist consumption and the POD in patients with persistent, mild to moderate asthma. METHODS: Inspiratory muscle strength, daily beta2-agonist consumption and the POD were measured in 30 patients with mild to moderate asthma. Patients were then randomly assigned to two groups: one group received specific inspiratory muscle training until an increase of more than 20 cm H2O was reached, and one group was a control group and received sham training. Inspiratory muscle strength, the POD and daily beta2-agonist consumption were assessed during and after the training period. RESULTS: There was no good correlation between the baseline maximal inspiratory pressure and the POD, or between the baseline maximal inspiratory pressure and the mean daily beta2-agonist consumption. However, there was a significant correlation between the POD and the mean daily beta2-agonist consumption. The increase in inspiratory muscle strength after the inspiratory muscle training was closely correlated with the decrease in the POD (P<0.001) and the decrease in beta2-agonist consumption (P<0.001). CONCLUSIONS: The present study shows that, in patients with mild to moderate, persistent asthma, there is a correlation between the POD and the mean daily beta2-agonist consumption. When the inspiratory muscles are strengthened, there is a significant decrease in the POD and in beta2-agonist consumption.

Adrenergic beta-Agonists↗