The TIRE IMT regimen has been successful in multiple investigations and publications due to the individual load governed by capacity, which is reassessed at each training session to ensure that the IMT is progressive. The default is IMT at 80% of SMIP to failure within a high-intensity interval training regime. The interval loads are characterized by rests between breaths over six levels, shortening from 40 seconds at level A to 5 seconds at level F.

In addition, the training adheres to the tenets of skeletal muscle training as a high-intensity intervention governed by individual capability/capacity. Offering the flow resistance to loading through the range with biofeedback on-screen aids compliance while addressing specificity and overload as applied to all skeletal muscle training.

The frequency of IMT is suggested to be undertaken three times a week, initially for 6-8 weeks, before reducing to 1 or 2 times a week for maintenance. This differs from most IMT regimes, which require a set number of breaths or time daily, many for two periods. These time requirements are challenging in sports and diseases, which could negatively influence medium to long-term compliance/adherence.

Skeletal muscle training is generally undertaken at a frequency suggested in the TIRE IMT default regime and used in many previously published trials using the TIRE. An important finding is an overall benefit beyond dependent variables of higher numbers associated with the IMT undertaken. Many users report that their progress on inspiratory muscle performance has led to lifestyle changes, other exercises, and improved cognitive function and well-being. This has been seen across a spectrum of users, from elite international athletes to ventilated patients. Some of the commonly stated improvements include:

• Cardiorespiratory Efficiency
• Lower Lactate in Treadmill Tests
• Reduced Breathlessness
• Diminished Fatigue
• Improved Quality of Life (QoL)
• Enhanced Exercise Capabilities

This leads to the critical consideration of IMT health benefits supported by the lifelong use of specific IMT geared to individual capacity. It is noteworthy that several users of the TIRE/PrO2 have now been following the prescribed regime in both health and disease for over a decade. Avoiding reversibility in this way is a further vital element of successful IMT programs.