Time to Move Beyond a “One-Size Fits All” Approach to Inspiratory Muscle Training

Abstract

Inspiratory muscle training (IMT) has been studied as a rehabilitation tool and ergogenic aid in clinical, athletic, and healthy populations. This technique aims to improve respiratory muscle strength and endurance, which has been seen to enhance respiratory pressure generation, respiratory muscle weakness, exercise capacity, and quality of life. However, the effects of IMT have been discrepant between populations, with some studies showing improvements with IMT and others not. This may be due to the use of standardized IMT protocols which are uniformly applied to all study participants without considering individual characteristics and training needs. As such, we suggest that research on IMT veer away from a standardized, one-size-fits-all intervention, and instead utilize specific IMT training protocols. In particular, a more personalized approach to an individual’s training prescription based upon goals, needs, and desired outcomes of the patient or athlete. In order for the coach or practitioner to adjust and personalize a given IMT prescription for an individual, factors, such as frequency, duration, and modality will be influenced, thus inevitably affecting overall training load and adaptations for a projected outcome. Therefore, by integrating specific methods based on optimization, periodization, and personalization, further studies may overcome previous discrepancies within IMT research.

Effect of Threshold Inspiratory Muscle Training on Functional Fitness and Respiratory Muscle Strength Compared to Incentive Spirometry in Children and Adolescents With Obesity: A Randomized Controlled Trial

“…Previous RCTs in obese adults (15)(16)(17)40) that reported substantial benefit after threshold IMT all commented on the importance of periodic adjustment of the training load to yield optimal training outcomes. Concerning other useful recommendations for improving respiratory muscles in clinical practice, Shei et al (12) recommended that the training session be personalized, and to consider setting training goals, such as improving RMS and/or endurance, to facilitate longer training sessions.…”

“…The other study found significant improvement in 6-MWT distance after IS training ( 18 ). The mechanism of increased RMS after IMT may be multifactorial ( 12 ). The proposed mechanisms include increased proportion and size of type II muscle fibers ( 16 , 41 , 42 ), promoted diaphragm hypertrophy, attenuated respiratory muscle metaboreflex, and enhanced respiratory muscle economy.…”

“…This mechanism is like weight or resistance training exercise for inspiratory muscles, which is similar to weightlifting for strengthening extremity muscles. The main advantages of resistance training include improving muscle strength and endurance, enhancing the oxygen uptake of exercising muscles, and reducing muscle fatigue – all of which will improve functional fitness ( 12 , 42 , 43 ). By way of comparison, the IS device is a volume-based loading device.…”

“…Inspiratory muscle training (IMT) helps to improve both RMS and functional exercise capacity. The devices used for IMT mainly include pressure-based and volume-based loading type devices ( 12 ). Threshold IMT is a pressure-based loading device, and is the most commonly used inspiratory muscle trainer for improving the strength and edurance of the respiratory muscles ( 13 ).…”

Efecto del entrenamiento de los músculos inspiratorios sobre la condición física y fuerza de los músculos respiratorios en niños y adolescentes con obesidad

“…El entrenamiento de los músculos inspiratorios (inspiratory muscle training, IMT) es una herramienta de rehabilitación que ayuda a mejorar la fuerza y la resistencia de los músculos respiratorios, así como la capacidad de ejercicio funcional y la calidad de vida. Los dispositivos utilizados para IMT incluyen dispositivos de carga basados en presión (Threshold IMT) y volumen (espirómetro de incen-tivo (incentive spirometer, IS)), el más utilizado en la actualidad son los dispositivos de carga basado en presión [4].Existe mucha información sobre IMT en pacientes adultos con obesidad con buenos resultados en la función pulmonar, en población pediátrica se usa el IMT en otras enfermedades no relacionadas con la obesidad. De ahí la importancia de este artículo, porque el IMT podría ser otra herramienta más para que nuestros niños obesos puedan reincorporarse a la actividad física regular, al mejora la función y resistencia de los músculos respiratorios y la tolerancia al ejercicio.…”