IMT Study
Pre-Operative Inspiratory Muscle Training in Lung Transplant Candidates with Interstitial Lung Disease
Study Investigators
Dr. Dmitry Rozenberg (dmitry.rozenberg@unh.ca)
Dr. Ewan Goligher (ext. 6810, ewan.goligher@uhn.ca)
Dr. John Granton
Study Contact
Jenna Wong (ext. 7613, jenna.wong@uhn.ca)
Samira Fard (samira.fard@uhn.ca)
Study Summary
Inspiratory muscle training will be performed by the participants with advanced ILD awaiting lung transplant.
Study Population
16 stable idiopathic interstitial pneumonia lung transplant candidates undergoing pre-transplant rehabilitation three times per week, which is standard of care at out center.
Study Objectives
To assess the feasibility onf IMT in lung transplant candidates with severe interstitial lung disease over a 6-week period.
To characterize the changes in diaphragm structure, strength, endurance, total workload, and dyspnea over 6-week of IMT.
As an exploratory aim, to assess the association of pre-transplant diaphragm strength and endurance with early post-transplant outcomes.
Study Interventions
Inspiratory muscle training will be applied using the POWERbreathe®K5 IMT device. Participants will perform two daily IMT sessions of 30 breaths, 5 days per week, up to 6 weeks while awaiting LTx. The resting and post IMT Borg dyspnea scores will be recorded. Measurements will be collected at baseline, and at 3 and 6 weeks of IMT: twitch airway pressure during bilateral magnetic phrenic nerve stimulation; diaphragm thickness and thickening fraction; and endurance time during threshold loading. Hand-grip strength, Qualitative Dyspnea Perception and Medical Research Council Dyspnea Scale will also be collected.
Why it Matters
Diaphragm structure and function at the start of mechanical ventilation is key determinant of outcomes of respiratory failure. IMT may be proved to be a pre-transplant intervention to preventing post-transplant morbidity in patients with advanced ILD awaiting lung transplant. These findings will then support the development of future clinical trials designed to evaluate the impact of pre-operative IMT on major post-transplant outcomes including symptom severity, quality of life, functional status, and survival.