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In Reply: The letters of Dr Nava, Drs Culp and Beyer, and Dr Takagi and colleagues request further details concerning the IMT, surgical procedures, and data analysis as used in our clinical trial.

Inspiratory muscle training was well tolerated, devoid of adverse events, and well appreciated by the patients, none of whom dropped out during the training period.¹ Those participants who did not initially tolerate 20 minutes of IMT (n = 5) started with an interval scheme as recommended by McConnell et al² and gradually tolerated the full length of an IMT session.

The immediate effects of IMT were monitored with the use of inspiratory muscle strength (P_i-max) measurements, assessed with a handheld pressure gauge (Micro Medical MPM, PT Medical BV, Leek, the Netherlands) at residual volume as described by Black and Hyatt.³ Standardization of the respiratory muscle force tests was performed as described by Clanton and Diaz.⁴ Norm values for . . . [Full Text of this Article]

Erik H. J. Hulzebos, PT, MSc, PhD
h.hulzebos@umcutrecht.nl

Paul J. M. Helders, PT, PhD; Nine J. Favié, PT, MSc
University Medical Center Utrecht

Rob A. De Bie, PT, PhD
Maastricht University
Maastricht

Aart Brutel de la Riviere, MD, PhD
Onze Lieve Vrouwe Gasthuis
Amsterdam

Nico L. U. Van Meeteren, PT, PhD
University Medical Center Utrecht
Utrecht, the Netherlands

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RELATED LETTERS

Preoperative Inspiratory Muscle Training and Postoperative Complications
Stefano Nava
JAMA. 2007;297(7):697.
EXTRACT | FULL TEXT  

Preoperative Inspiratory Muscle Training and Postoperative Complications
William C. Culp, Jr and Erik A. Beyer
JAMA. 2007;297(7):697-698.
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Preoperative Inspiratory Muscle Training and Postoperative Complications
Hisato Takagi, Norikazu Kawai, and Takuya Umemoto
JAMA. 2007;297(7):698.
EXTRACT | FULL TEXT  

RELATED ARTICLE

Preoperative Intensive Inspiratory Muscle Training to Prevent Postoperative Pulmonary Complications in High-Risk Patients Undergoing CABG Surgery: A Randomized Clinical Trial
Erik H. J. Hulzebos, Paul J. M. Helders, Nine J. Favié, Rob A. De Bie, Aart Brutel de la Riviere, and Nico L. U. Van Meeteren
JAMA. 2006;296(15):1851-1857.
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