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This prospective study aims to evaluate the effects of inspiratory muscle training (IMT) combined with positive expiratory pressure (PEP) therapy on respiratory function, muscle strength, and symptom burden in patients with Group E chronic obstructive pulmonary disease (COPD). The primary objective is to compare the predictive value of the GOLD and STAR classification systems in identifying patients who respond better to IMT/PEP therapy. A total of 61 patients will receive standard COPD treatment along with IMT/PEP twice daily for 12 weeks. Pulmonary function tests, dyspnea scores, and 6-minute walk test results will be assessed at baseline, at 1 month, and at 3 months. Regression analysis will be used to determine the independent predictors of treatment response.
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Inclusion criteria
Age ≥ 40 years
Diagnosis of Group E COPD according to GOLD 2023 criteria
Post-bronchodilator FEV₁/FVC < 0.70 and FEV₁ < 50% predicted
mMRC score ≥ 2 or CAT score ≥ 10
History of ≥2 exacerbations or ≥1 hospitalization in the past year
Stable clinical condition (no exacerbation in the past 2 weeks)
Ability and willingness to perform IMT/PEP therapy
Provided written informed consent
Exclusion criteria
Acute exacerbation of COPD at time of enrollment
Contraindications to pulmonary function testing or 6-minute walk test (e.g., recent myocardial infarction, unstable angina)
Inability to perform inspiratory or expiratory maneuvers reliably (e.g., due to cognitive or neuromuscular disorders)
Significant orofacial muscle weakness unresponsive to modified mouthpiece
Participation in another interventional study within the past 3 months
Nonadherence to COPD treatment plan
Any condition deemed by investigators to interfere with study participation
61 participants in 1 patient group
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Data sourced from clinicaltrials.gov
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