Exploratory evaluation of STAR and GOLD classifications in relation to physiological changes during IMT/PEP follow-up in COPD KOAH'ta IMT/PEP takibi sırasında ortaya çıkan fizyolojik değişikliklerle ilişkili STAR ve GOLD sınıflamalarının keşifsel analizi
Tuberkuloz ve Toraks, cilt.74, sa.3, ss.138-147, 2026 (ESCI, Scopus, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 74 Sayı: 3
- Basım Tarihi: 2026
- Doi Numarası: 10.5578/tt.2026031290
- Dergi Adı: Tuberkuloz ve Toraks
- Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus, Central & Eastern European Academic Source (CEEAS), EMBASE, TR DİZİN (ULAKBİM), Biomedical Reference Collection: Corporate Edition (EBSCO)
- Sayfa Sayıları: ss.138-147
- Anahtar Kelimeler: COPD classification, inspiratory muscle training, pulmonary rehabilitation
- Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
- Atatürk Üniversitesi Adresli: Evet
Özet
Introduction: Inspiratory muscle training (IMT), particularly when combined with positive expiratory pressure (PEP), has been associated with improved respiratory outcomes in Chronic Obstructive Pulmonary Disease (COPD). This study aimed to explore physiological changes observed during IMT/PEP follow-up in COPD patients and to compare the associations of Global Initiative for Chronic Obstructive Lung Disease (GOLD) and Staging of Airflow Obstruction by Ratio (STAR) classifications with these changes. Materials and Methods: Sixty-one Group E COPD patients received standard treatment and IMT/PEP therapy twice daily for 12 weeks. They were classified by GOLD and STAR systems, and assessed via pulmonary function, muscle strength, dyspnea scores, and six-minute walk test (6MWT) at baseline, week 4, and week 12. (NCT07001462). Results: During the 12-week follow-up, significant within-patient changes were observed in Forced expiratory volume in 1 second (FEV1), FEV1/ Forced vital capacity, diffusing capacity for carbon monoxide (DLCO), maximal mid-expiratory flow between 25% and 75% of forced vital capacity (MEF25–75) and maximal inspiratory pressure (MIP) (all p< 0.05). These findings should be interpreted cautiously given the absence of a control or sham group. Dyspnea scores improved across scales (modified medical research council dyspnea, COPD Assessment Test, Borg, visual analog scale; all p< 0.001). STAR classification was an independent predictor of residual volume (RV) change (p< 0.001, β= –0.660), with strong model fit (R²= 0.687), while GOLD was not predictive (p= 0.186). STAR showed stronger correlations than GOLD with ΔRV (R= –0.568 vs. –0.506) and ΔMIP (R= 0.495 vs. 0.388). In multivariable regression for Δ6MWT, DLCO (p= 0.032) was a significant predictor. Conclusion: In this exploratory single-arm cohort study, several physiological and symptom-related parameters changed during IMT/PEP follow-up in Group E COPD patients. STAR classification demonstrated stronger associations with selected physiological changes than GOLD classification and may war-rant further evaluation in controlled studies.