For information about inspiratory muscle training in specific conditions, please click on the condition of interest:

Inspiratory muscle training has been most widely used in patients with COPD. The rationale is particularly strong in this patient group, as they have primary weakness of their inspiratory muscles (Levine et al., 2003), mechanical abnormalities of their chest wall (hyperinflation due to expiratory flow limitation), and a disproportionately high demand for ventilation during exertion (Casaburi et al., 1991).

A meta-analysis undertaken in 2002 concluded that "Both IMT alone and IMT as an adjunct to general exercise reconditioning significantly increased inspiratory muscle strength and endurance. A significant effect was found for dyspnoea at rest and during exercise" (Lotters et al., 2002). Further, the authors also concluded that "inspiratory muscle training is an important addition to a pulmonary rehabilitation programme directed at chronic obstructive pulmonary disease patients".

Thanks to this analysis, and subsequent randomised controlled trials reporting improvements following IMT, current guidelines such as those issued in 2004 by NICE for the management of COPD, as well as the recent Clinical Evidence Review on the management of COPD from the BMJ (Kerstjens et al., 2005), acknowledge the that IMT has a part to play in the management of COPD.

The most recent randomised controlled trial of IMT encapsulates the already well-established benefits of the treatment (reduces dyspnoea, improves exercise tolerance, and enhances quality of life), as well as adding new evidence that the use of healthcare resources is reduced by around 25% after IMT (see figures 1 to 3) (Beckerman et al., 2005).

Fig.1 Reduction in primary care consultations

Fig.2 Improvement in Quality of Life

Fig.3 Improvement in dyspnoea score

POWERbreathe training is 10 times more effective than oxitropium bromide for improving exercise tolerance and quality of life in patients with COPD (Oga et al., 2000; Beckerman et al., 2005).