Inspiratory muscle strength in chronic obstructive pulmonary disease.

Chronic obstructive pulmonary disease is associated with a functional weakness of the inspiratory muscles. Multiple factors contribute to the decline in functional strength including hyperinflation of the chest, deterioration in nutritional status, and the indirect effects of an exacerbation. The decreased inspiratory muscle strength contributes to sensations of dyspnea and places individuals at risk for respiratory muscle fatigue. The worsening dyspnea causes individuals to reduce their physical activities and ultimately become physically deconditioned. Maximal inspiratory pressure is commonly used to measure functional strength of the inspiratory muscles, and interventions to minimize the extent of decline include inspiratory muscle training, aerobic exercise training, nutritional supplementation, and methods to prevent exacerbations. In the critical care unit, multiple comorbid conditions contribute to further decline in inspiratory muscle strength, making it important to assess respiratory muscle function regularly.