[{"id":71,"user_id":1,"title":"Respiratory Rehabilitation After COVID-19: Efficacy of Inspiratory Muscle Training on Lung Function, Quality of Life and Sleep Quality: A Randomized Clinical Trial","summary":"In this context, inspiratory muscle training (IMT) may improve lung function and functional capacity in various clinical conditions. This training increases the strength and endurance of respiratory muscles, reduces dyspnea, and improves functional capacity and quality of life. This study analyzed respiratory muscle performance, lung function, functional capacity, sleep quality, and quality of life in individuals with post-COVID-19 syndrome before and after an eight-week IMT program.","fulltext":"# Respiratory Rehabilitation After COVID-19: Efficacy of Inspiratory Muscle Training on Lung Function, Quality of Life and Sleep Quality: A Randomized Clinical Trial\r\n\r\n**Authors:** Jose Carlos Nóbrega Júnior¹, Daniella Brandão¹, Daiara Xavier¹, Roberta Torres¹, Simone Soares Brandão², Magno Formiga³, James B. Fink⁴, Arzu Ari⁴, Shirley Campos¹, Armèle Dornelas de Andrade¹*\r\n\r\n¹ Department of Physical Therapy, Federal University of Pernambuco, Recife 50740, Pernambuco, Brazil  \r\n² Department of Nuclear Medicine, Federal University of Pernambuco, Recife 50740, Pernambuco, Brazil  \r\n³ Department of Physical Therapy, Federal University of Ceará, Fortaleza 60440, Ceará, Brazil  \r\n⁴ Department of Respiratory Care, Texas State University, Round Rock, TX 78665, USA\r\n\r\n*Corresponding author\r\n\r\n**Journal:** COVID 2026, 6(1), 22  \r\n**DOI:** https://doi.org/10.3390/covid6010022  \r\n**Published:** 19 January 2026  \r\n**Received:** 18 December 2025 | Revised: 29 December 2025 | Accepted: 9 January 2026\r\n\r\n---\r\n\r\n## Abstract\r\n\r\n**Background and Purpose:** Post-COVID-19 syndrome significantly impacts respiratory function and quality of life. Inspiratory muscle training (IMT) has been proposed as a potential intervention to improve respiratory muscle strength and overall recovery. This study aimed to evaluate the effects of IMT on respiratory muscle performance, lung function, functional capacity, sleep quality, and quality of life in individuals with post-COVID-19 syndrome.\r\n\r\n**Methods:** Nineteen individuals with post-COVID-19 syndrome were randomized into an IMT group (N = 10) or a sham group (N = 9). The IMT group performed eight weeks of training at 50% of maximal inspiratory pressure (MIP), while the sham group used a non-load device. Outcomes included MIP (cm H₂O), functional capacity (6MWT), lung function (spirometry), sleep quality (PSQI), and quality of life (SF-36).\r\n\r\n**Results:** The IMT group showed significant improvements in MIP (125.50 ± 22.50 vs. 93.67 ± 20.87 cm H₂O; p = 0.036; Cohen's d = 0.50), PSQI (4.40 ± 2.50 vs. 9.00 ± 2.80; p = 0.011; Cohen's d = 0.60), and SF-36 (p = 0.030). The IMT group also increased 6MWT distance by 58.36 ± 25.10 m.\r\n\r\n**Conclusions:** IMT significantly improved respiratory muscle strength, sleep quality, and quality of life in post-COVID-19 syndrome. These findings suggest that IMT may be an effective intervention, warranting further studies to confirm long-term benefits.\r\n## Introduction\r\n\r\nPost-COVID-19 syndrome is characterized by the persistence of multiple symptoms for weeks or months after acute SARS-CoV-2 infection, which may impair the pulmonary, cardiovascular, nervous, and metabolic systems. Common symptoms include persistent fatigue, dyspnea, chest pain, palpitations, cognitive disorders, headache, sleep disturbances, anxiety, and depression. Several mechanisms have been proposed to explain the multifactorial etiology of post-COVID-19 syndrome, including persistent immunologic dysfunction, chronic low-grade inflammation, endothelial dysfunction, neuroinvasive effects, and direct or indirect tissue damage. Genetic predisposition, preexisting comorbidities, and environmental factors may also increase susceptibility to and severity of post-COVID-19 syndrome.\r\n\r\nPrevious studies have demonstrated that individuals who have recovered from COVID-19 often experience impairments in lung function and diffusion capacity, resulting in reduced functional capacity. In addition, neuromuscular and inflammatory alterations induced by viral infection may cause insomnia, sleep apnea, and daytime fatigue, thereby affecting sleep quality. These conditions reduce lung function and quality of life, hindering daily activities and psychological well-being. However, the mechanisms underlying chronic symptoms and the efficacy of different interventions remain unclear.\r\n\r\nIn this context, inspiratory muscle training (IMT) may improve lung function and functional capacity in various clinical conditions. This training increases the strength and endurance of respiratory muscles, reduces dyspnea, and improves functional capacity and quality of life. However, the benefits of IMT for individuals with post-COVID-19 syndrome remain unclear because existing studies show divergence in several factors (e.g., heterogeneity of protocols, inclusion of individuals without a diagnosis confirmed by reverse transcription polymerase chain reaction [RT-PCR], and combination of IMT with other exercise modalities), which limits adequate comparison. Therefore, this study aimed to analyze respiratory muscle performance, lung function, functional capacity, sleep quality, and quality of life in individuals with post-COVID-19 syndrome before and after an eight-week IMT program.\r\n\r\n---\r\n\r\n## Results\r\n\r\nChanges in MIP were significantly higher in the IMT group than in the sham group (mean difference: 31.83 cm H₂O; 95% CI: 2.43 to 61.32; p = 0.036, Cohen's d = 0.50). Subjective sleep quality (PSQI) was significantly higher in the IMT group (mean difference: −4.60; 95% CI: −7.99 to −1.20; p = 0.011, Cohen's d = 0.60). Although the changes in the distance walked and percentage values of the distance walked demonstrated a moderate effect size after the intervention (mean difference: 58.36 m; 95% CI: −13.08 to 129.81; p = 0.103, Cohen's d = 0.40, and mean difference: 10.23%; 95% CI: −0.37 to 20.84; p = 0.058, Cohen's d = 0.50, respectively), values were not significantly different between groups. Changes in sleep efficiency (actigraphy) showed significant differences between the groups (mean difference: 8.42; 95% CI: 2.97 to 13.88; p = 0.005, Cohen's d = 0.60). \r\n\r\nThe IMT group showed statistically significant improvements compared to the sham group in MIP (125.50 vs. 93.67 cm H₂O, p = 0.036 Cohen's d = 0.50), sleep efficacy (90.48 vs. 82.06%, p = 0.005; Cohen's d = 0.62), and PSQI scores (4.40 vs. 9.0, p = 0.011; Cohen's d = 0.60), as shown in **Table 2**.\r\n\r\nThe analysis revealed a significant interaction between time and group (p = 0.030), indicating that the impact of the intervention on quality of life was statistically different between groups.\r\n\r\n[Read More](https://www.mdpi.com/2673-8112/6/1/22)\r\n","category":1,"position":1,"created_at":"2026-03-16T00:27:53.122Z","updated_at":"2026-03-16T00:27:53.122Z","url":"https://www.pro2health.com/articles/71.json"},{"id":70,"user_id":1,"title":"Inspiratory Muscle Training Enhances Functional Sitting Balance More Than Usual Care in Individuals With Spinal Cord Injury: A Randomized Controlled Trial","summary":"Our RCT has demonstrated, for the first time, that integrating IMT with conventional care significantly improves FSB along with inspiratory function in individuals with SCI. The improvements seen in inspiratory performance were significantly related to the change in FSB, strengthening the relationship of these outcomes in SCI population.","fulltext":"Kanishka Gambhir, Shambhovi Mitra, Anne E Palermo\r\n\r\nObjective: To evaluate the effect of inspiratory muscle training (IMT) on functional sitting balance (FSB) in individuals with spinal cord injury (SCI).\r\n\r\nDesign: Rater-masked, parallel, 2-group randomized clinical trial.\r\n\r\nSetting: Tertiary care SCI rehabilitation hospital.\r\n\r\nParticipants: Forty-four participants (N=44) (aged 18-60) with C4-T6 injuries (American Spinal Injury Association Impairment Scale A-C) (cervical-SCI=25, thoracic-SCI=19, American Spinal Injury Association Impairment Scale A=33, B=11, C=0) in their first SCI-specific inpatient rehabilitation were randomly assigned into experimental and control groups.\r\n\r\nInterventions: Both groups received standard respiratory care and physiotherapy. The experimental group received additional flow-resistive IMT sessions over 6 weeks.\r\n\r\nMain outcome measures: FSB was measured using the Function in Sitting Test-SCI, and respiratory function was assessed via maximal inspiratory pressure, sustained maximal inspiratory pressure, and Fatigue Index Test score at baseline, 4 weeks and 6 weeks. Data were analyzed using repeated measures general linear model framework in IBM SPSS version 21.\r\n\r\nResults: Analysis showed significant improvements in FSB for both groups (P\u003c.001). Sustained maximal inspiratory pressure, maximal inspiratory pressure, and Fatigue Index Test scores improved only for the experimental group (P\u003c.05). Post-hoc analyses of interaction effects showed significantly greater improvements in all variables in the experimental group.\r\n\r\nConclusions: This study is the first to show that FSB improves more with addition of IMT to standard care in individuals with SCI.\r\n\r\n[Read More](https://pubmed.ncbi.nlm.nih.gov/41038425/)\r\n","category":1,"position":2,"created_at":"2026-03-15T23:56:29.724Z","updated_at":"2026-03-16T00:27:53.126Z","url":"https://www.pro2health.com/articles/70.json"},{"id":69,"user_id":1,"title":"Novel Measures of Inspiratory Muscle Function in Chronic Obstructive Pulmonary Disease: Assessment and Training Implications","summary":"- **Established psychometric properties of PrO2 device for COPD assessment**\r\n- TIRE IMT produces greater improvements in inspiratory muscle function than traditional methods\r\n- Sustained efforts throughout full inspiratory range differentiate PrO2 from threshold devices\r\n- Progressive, incremental protocol structure optimizes training adaptations\r\n- Novel measures beyond peak MIP provide clinically relevant information","fulltext":"**Authors:** Formiga MF  \r\n**Year:** 2019  \r\n**Journal/Type:** Doctoral Dissertation, University of Miami  \r\n**Link:** https://scholarship.miami.edu/esploro/outputs/doctoral/Novel-Measures-of-Inspiratory-Muscle-Function/991031447405002976\r\n\r\n**Summary:**\r\nComprehensive doctoral dissertation examining the PrO2 device's assessment capabilities and TIRE training methodology in COPD patients.\r\n\r\n**Key Findings:**\r\n- **Established psychometric properties of PrO2 device for COPD assessment**\r\n- TIRE IMT produces greater improvements in inspiratory muscle function than traditional methods\r\n- PrO2 measures (MIP, SMIP, ID) provide comprehensive performance assessment\r\n- Sustained efforts throughout full inspiratory range differentiate PrO2 from threshold devices\r\n- Progressive, incremental protocol structure optimizes training adaptations\r\n- Novel measures beyond peak MIP provide clinically relevant information\r\n\r\n**Clinical Implications:**\r\n- PrO2 provides validated assessment tool for COPD population\r\n- TIRE methodology represents advancement over traditional IMT approaches\r\n- Multiple outcome measures enable comprehensive treatment evaluation\r\n- Academic validation supports clinical and research applications\r\n- Establishes theoretical and practical foundation for PrO2 use in COPD","category":1,"position":3,"created_at":"2026-03-06T00:15:37.315Z","updated_at":"2026-03-16T00:27:53.126Z","url":"https://www.pro2health.com/articles/69.json"},{"id":68,"user_id":1,"title":"Inspiratory Muscle Training and Endurance Performance in Hypoxia","summary":"- **IMT with PrO2 trainer in hypoxia examined for athletic performance**\r\n- Participants instructed on use of PrO2 inspiratory muscle trainer \r\n- PrO2 training increased oxygen diffusing capacity according to previous research\r\n- Investigates respiratory muscle training as ergogenic aid for hypoxic environments\r\n- Relevant for altitude training and high-elevation athletic performance","fulltext":"**Authors:** Hursh D  \r\n**Year:** 2017  \r\n**Journal/Type:** Master's Thesis, Indiana University  \r\n**Link:** https://scholarworks.iu.edu/iuswrrest/api/core/bitstreams/251c5b06-cb47-4e3d-8223-b2dc0ceebabb/content\r\n\r\n**Summary:**\r\nStudy examining the effects of inspiratory muscle training using PrO2 device on endurance performance in hypoxic (altitude) conditions.\r\n\r\n**Key Findings:**\r\n- **IMT with PrO2 trainer in hypoxia examined for athletic performance**\r\n- Participants instructed on use of PrO2 inspiratory muscle trainer (PrO2 Health, Inc., Smithfield)\r\n- IMT increased oxygen diffusing capacity according to previous research\r\n- Explores potential for IMT to improve altitude adaptation\r\n- Investigates respiratory muscle training as ergogenic aid for hypoxic environments\r\n- Relevant for altitude training and high-elevation athletic performance\r\n\r\n**Clinical Implications:**\r\n- PrO2 training may benefit athletes training or competing at altitude\r\n- Respiratory muscle conditioning relevant for hypoxic environments\r\n- Potential application for mountaineering, high-altitude sports, military\r\n- May improve oxygen delivery capacity in reduced oxygen conditions\r\n- Adds performance dimension beyond sea-level applications","category":1,"position":4,"created_at":"2026-03-06T00:14:11.394Z","updated_at":"2026-03-16T00:27:53.126Z","url":"https://www.pro2health.com/articles/68.json"},{"id":67,"user_id":1,"title":"Remote Respiratory Resistance Exercise Training Improves Respiratory Function in VCP Multisystem Proteinopathy","summary":"- **Remote IMT improved respiratory function in rare neuromuscular disease**\r\n- VCP multisystem proteinopathy causes progressive respiratory muscle weakness and early mortality from respiratory failure\r\n- Weeks of inspiratory muscle training produced measurable improvements\r\n- Remote administration feasible for patients with complex medical needs\r\n- Demonstrates PrO2 applications beyond common pulmonary and cardiac conditions","fulltext":"**Authors:** Halseth M, Mahoney R, Hsiou J, Jones HN, et al.  \r\n**Year:** 2024  \r\n**Journal:** Neuromuscular Disorders  \r\n**Link:** https://www.sciencedirect.com/science/article/pii/S0960896623008118\r\n\r\n**Summary:**\r\nStudy investigating remotely administered inspiratory muscle training in patients with VCP multisystem proteinopathy, a rare neuromuscular disease causing progressive respiratory muscle weakness.\r\n\r\n**Key Findings:**\r\n- **Remote IMT improved respiratory function in rare neuromuscular disease**\r\n- VCP multisystem proteinopathy causes progressive respiratory muscle weakness and early mortality from respiratory failure\r\n- Weeks of inspiratory muscle training produced measurable improvements\r\n- Remote administration feasible for patients with complex medical needs\r\n- Demonstrates PrO2 applications beyond common pulmonary and cardiac conditions\r\n- First study examining IMT in this rare disease population\r\n\r\n**Clinical Implications:**\r\n- IMT may benefit rare neuromuscular diseases with respiratory involvement\r\n- Remote delivery enables treatment for homebound patients with complex needs\r\n- Potential to delay respiratory failure progression\r\n- Establishes proof-of-concept for other neuromuscular conditions\r\n- Expands therapeutic applications of respiratory muscle training\r\n","category":1,"position":5,"created_at":"2026-03-06T00:12:07.751Z","updated_at":"2026-03-16T00:27:53.126Z","url":"https://www.pro2health.com/articles/67.json"},{"id":66,"user_id":1,"title":"Heterogeneous Treatment Effects Following Inspiratory Muscle Training During Recovery from Post-Acute COVID-19 Syndrome","summary":"**Key Findings:**\r\n- **IMT delivered using PrO2 improved inspiratory muscle strength following Long-COVID**\r\n- Identified patient characteristics predicting better IMT response:\r\n  - More severe baseline dyspnea predicted greater improvement\r\n  - Initiating IMT \u003e3 months post-infection associated with better outcomes\r\n- Individual treatment effects varied based on symptom severity and timing","fulltext":"**Authors:** Metcalfe RS, Swinton PA, et al.  \r\n**Year:** 2023  \r\n**Journal:** Exercise and Science in Sports and Medicine  \r\n**Citations:** 4  \r\n**Link:** https://pubmed.ncbi.nlm.nih.gov/37170947/\r\n\r\n**Summary:**\r\nStudy investigating individual response variability to IMT in post-acute COVID-19 syndrome (Long-COVID) patients using PrO2 device.\r\n\r\n**Key Findings:**\r\n- **IMT delivered using PrO2 improved inspiratory muscle strength following Long-COVID**\r\n- Identified patient characteristics predicting better IMT response:\r\n  - More severe baseline dyspnea predicted greater improvement\r\n  - Initiating IMT \u003e3 months post-infection associated with better outcomes\r\n- Individual treatment effects varied based on symptom severity and timing\r\n- Personalized treatment approaches may optimize outcomes\r\n- PrO2 training addresses persistent respiratory symptoms in COVID-19 recovery\r\n\r\n**Clinical Implications:**\r\n- Patient selection and timing matter for IMT effectiveness in Long-COVID\r\n- More symptomatic patients may benefit most from PrO2 training\r\n- Later intervention (\u003e3 months) may be more effective than early intervention\r\n- Supports personalized rehabilitation approach based on symptom severity\r\n- PrO2 provides objective measurement to track individual treatment response","category":1,"position":6,"created_at":"2026-03-06T00:03:20.268Z","updated_at":"2026-03-16T00:27:53.126Z","url":"https://www.pro2health.com/articles/66.json"},{"id":65,"user_id":1,"title":"Long-Term Efficacy of Novel and Traditional Home-Based Remote Inspiratory Muscle Training in COPD: RCT","summary":"- **TIRE IMT with PrO2 demonstrated sustained long-term improvements**\r\n- Significant changes in maximal inspiratory pressure (MIP) and sustained maximal inspiratory pressure (SMIP)\r\n- Superior adherence rates with TIRE methodology compared to traditional threshold training\r\n- Strong correlations with functional capacity improvements\r\n- Remote monitoring via PrO2 cloud system enables effective home-based training\r\n\r\n","fulltext":"**Authors:** Dosbaba F, Hartman M, Formiga MF, Vlazna D, et al.  \r\n**Year:** 2025  \r\n**Journal:** Journal of Clinical Medicine  \r\n**Link:** https://www.mdpi.com/2077-0383/14/17/6099\r\n\r\n**Summary:**\r\nRecent randomized controlled trial comparing long-term efficacy of PrO2 TIRE training versus traditional threshold IMT in COPD patients through remote monitoring.\r\n\r\n**Key Findings:**\r\n- **TIRE IMT with PrO2 demonstrated sustained long-term improvements**\r\n- Significant changes in maximal inspiratory pressure (MIP) and sustained maximal inspiratory pressure (SMIP)\r\n- Superior adherence rates with TIRE methodology compared to traditional threshold training\r\n- Strong correlations with functional capacity improvements\r\n- Remote monitoring via PrO2 cloud system enables effective home-based training\r\n- On-screen training template set at 50% of MIP/SMIP with six progressive levels (A-F)\r\n- Up to 36 efforts per session with pre-set recovery times\r\n\r\n**Clinical Implications:**\r\n- TIRE methodology provides advantages for long-term COPD management\r\n- Remote monitoring makes home-based training viable and effective\r\n- Better patient adherence compared to traditional methods\r\n- Progressive protocol structure maximizes therapeutic gains\r\n- Cloud-based tracking enables clinician oversight without in-person visits","category":1,"position":7,"created_at":"2026-03-06T00:00:50.207Z","updated_at":"2026-03-16T00:27:53.126Z","url":"https://www.pro2health.com/articles/65.json"},{"id":64,"user_id":1,"title":"Inspiratory Muscle Training in COPD as Part of Respiratory Rehabilitation Program Implementation","summary":"- **IMT with PrO2 Fit significantly improves respiratory muscle strength in COPD**\r\n- Enhanced outcomes when integrated into comprehensive respiratory rehabilitation\r\n- Demonstrates practical implementation of PrO2-based IMT in clinical rehabilitation settings\r\n- Improved inspiratory muscle performance correlates with better functional capacity\r\n- Home-based training with PrO2 provides measurable clinical benefits\r\n","fulltext":"\r\n**Authors:** Vazquez-Gandullo E, Hidalgo-Molina A, et al.  \r\n**Year:** 2022  \r\n**Journal:** International Journal of Environmental Research and Public Health\r\n**Link:** https://www.mdpi.com/1660-4601/19/9/5564\r\n\r\n**Summary:**\r\nImplementation study examining the effect of inspiratory muscle training using the PrO2 Fit device as part of comprehensive respiratory rehabilitation programs for COPD patients.\r\n\r\n**Key Findings:**\r\n- **IMT with PrO2 Fit significantly improves respiratory muscle strength in COPD**\r\n- Enhanced outcomes when integrated into comprehensive respiratory rehabilitation\r\n- Demonstrates practical implementation of PrO2-based IMT in clinical rehabilitation settings\r\n- Improved inspiratory muscle performance correlates with better functional capacity\r\n- Home-based training with PrO2 provides measurable clinical benefits\r\n\r\n**Clinical Implications:**\r\n- PrO2 training is effective as standalone therapy and as part of comprehensive rehabilitation\r\n- Can be successfully implemented in diverse rehabilitation program structures\r\n- Provides objective outcome measures for tracking patient progress\r\n- Addresses respiratory muscle weakness, a key factor in COPD disability\r\n- Suitable for both clinic-based and home-based rehabilitation protocols","category":1,"position":8,"created_at":"2026-03-05T23:56:18.193Z","updated_at":"2026-03-16T00:27:53.126Z","url":"https://www.pro2health.com/articles/64.json"},{"id":62,"user_id":null,"title":"Home-Based Inspiratory Muscle Training as Stand-Alone Therapy in COPD: A Randomized Sham-Controlled Trial Assessing Novel and Established Training Methods","summary":"This randomized controlled trial evaluated the effectiveness of two home-based, stand-alone inspiratory muscle training (IMT) modalities - inspiratory flow-resistive loading with biofeedback (IRFL) and mechanical threshold loading (MTL) - compared to a sham MTL group for improving inspiratory muscle performance and functional exercise capacity in COPD patients. ","fulltext":"Martin Hartman, Filip Dosbaba, Ladislav Batalik, Daniela Vlazna, Marek Plutinsky, Kristian Brat, Roberta Catunda Costa, Artur Solon Lima, Lawrence P Cahalin, Magno F Formiga\r\n\r\nThis randomized controlled trial evaluated the effectiveness of two home-based, stand-alone inspiratory muscle training (IMT) modalities - inspiratory flow-resistive loading with biofeedback (IRFL) and mechanical threshold loading (MTL) - compared to a sham MTL group for improving inspiratory muscle performance and functional exercise capacity in COPD patients. \r\n\r\nThirty-six COPD patients trained at home for 8 weeks under remote monitoring. Primary outcomes included inspiratory muscle performance assessed via the Test of Incremental Respiratory Endurance (TIRE), functional exercise capacity, lung function, and other COPD-related measures. Both the TIRE IRFL and MTL groups showed significant improvements in inspiratory muscle strength compared to the sham MTL group (p \u003c 0.05). Additionally, the IRFL with biofeedback group demonstrated significant gains in inspiratory muscle work capacity and 6MWT distance compared to both the MTL and sham groups (p \u003c 0.05). No adverse events were reported, and adherence to training protocols was high across all groups. This study supports home-based IMT as a feasible, effective stand-alone intervention for COPD patients, particularly for those who face barriers in accessing traditional pulmonary rehabilitation programs. TIRE IFRL showed superior benefits in enhancing inspiratory muscle function and overall functional exercise capacity compared to fixed-load IMT.\r\n\r\nKeywords: Chronic obstructive pulmonary disease; biofeedback; exercise capacity; home-based rehabilitation; inspiratory muscles.\r\n\r\nhttps://www.tandfonline.com/doi/full/10.1080/15412555.2025.2487473?rfr_dat=cr_pub++0pubmed\u0026url_ver=Z39.88-2003\u0026rfr_id=ori%3Arid%3Acrossref.org#d1e1214","category":1,"position":9,"created_at":"2025-05-22T01:44:58.957Z","updated_at":"2026-03-16T00:27:53.126Z","url":"https://www.pro2health.com/articles/62.json"},{"id":24,"user_id":null,"title":"Novel versus Traditional Inspiratory Muscle Training Regimens as Home-Based, Stand-Alone Therapies in COPD: Protocol for a Randomized Controlled Trial ","summary":"While we acknowledge the value of threshold loading IMT protocols, we believe that the PrO2 TIRE training method has the potential to provide additional clinical benefits in COPD given its sophisticated remote tracking system and ability to modulate all aspects of muscular performance, including not only strength but also endurance, power and work capacity, allowing users to achieve considerably higher inspiratory pressures throughout the full range of inspiration when compared to other more traditionally used IMT methods.","fulltext":"Magno F Formiga, Filip Dosbaba, Martin Hartman, Ladislav Batalik, Marek Plutinsky, Kristian Brat, Ondrej Ludka, Lawrence P Cahalin\r\n\r\n**Background**: Subjects with COPD frequently develop considerable weakness and deconditioning of the inspiratory musculature, which can be corrected with inspiratory muscle training (IMT). While rehabilitation centers may be able to provide IMT as part of the rather complex management of COPD, there is currently a lack of rehabilitation services in the Czech Republic. Remote IMT may then benefit subjects with COPD who are unable to attend or do not have access to rehabilitation programs. We aim at evaluating the utility of the test of incremental respiratory endurance (TIRE) as an at-home IMT method in subjects with COPD, while comparing the effectiveness of this novel training approach to the outcomes of traditional, threshold loading IMT protocols.\r\n\r\n**Methods/design**: This prospective, randomized controlled trial will comprise 8 weeks of at-home IMT sessions with remote supervision followed by 4 months of unsupervised, independent IMT. Eligible subjects will be randomly assigned to one of the following three distinct home-based IMT protocols: (1) TIRE, (2) Threshold loading, and (3) Sham training. Subjects allocated to the TIRE group will train once daily using an advanced IMT electronic system (PrO2), while the other two groups will receive threshold devices. Study outcomes will include measures of inspiratory muscle strength and endurance, pulmonary function, COPD-specific symptomatology, functional exercise capacity, surrogate markers of mortality risk, mental health status and health-related quality of life.\r\n\r\n**Discussion**: While we acknowledge the value of threshold loading IMT protocols, we believe that the TIRE training method has the potential to provide additional clinical benefits in COPD given its sophisticated remote tracking system and ability to modulate all aspects of muscular performance, including not only strength but also endurance, power and work capacity, allowing users to achieve considerably higher inspiratory pressures throughout the full range of inspiration when compared to other more traditionally used IMT methods.\r\n\r\n[Read the full study](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7494397/)","category":1,"position":10,"created_at":"2024-07-31T02:25:07.762Z","updated_at":"2026-03-16T00:27:53.126Z","url":"https://www.pro2health.com/articles/24.json"}]