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

Abstract

BackgroundTo determine the effect of threshold inspiratory muscle training (IMT) on functional fitness and respiratory muscle strength (RMS) compared to incentive spirometry (IS) in children/adolescents with obesity.MethodsA total of 60 obese children/adolescents aged 8–15 years were randomized into the threshold IMT group (n = 20), the IS group (n = 20), or the control group (n = 20). The IMT group performed 30 inspiratory breaths with the intensity set at 40% of baseline maximal inspiratory pressure (MIP) twice daily for 8 weeks; the IS group performed 30 breaths with sustained maximum inspiration twice daily for 8 weeks; and, the control group was assigned no training device for 8 weeks. Six-min walk test (6-MWT), RMS, and spirometry were compared between baseline and 8 weeks.ResultsSix-MWT distance (528.5 ± 36.2 vs. 561.5 ± 35.2 m, p = 0.002) and MIP (121.2 ± 26.8 vs. 135.3 ± 32.1%Predicted, p = 0.03) were significantly improved after 8 weeks of IMT training. There was no significant difference in any evaluated pulmonary function parameters between baseline and 8 weeks in the IS or control groups; however, 6-MWT distance demonstrated a trend toward significant improvement in the IS group (526.9 ± 59.1 vs.549.0 ± 50.6 m, p = 0.10). No significant difference among groups was found for any variable relative to change from baseline to post-training.ConclusionEight weeks of threshold IMT training significantly improved both inspiratory muscle strength (MIP) and functional fitness (6-MWT) in children/adolescents with obesity. Eight weeks of IS training yielded a trend toward significantly improved functional fitness.

Inspiratory muscle training in patients with obesity: a systematic review and meta-analysis

“…Of these, 10 were excluded for wrong intervention, seven for conference abstract, two for wrong population, and two for wrong study design. Ultimately, eight studies met the criteria for eligibility and were included in the review ( 17 , 28–34 ). The flowchart of the study selection process is shown in Figure 1 .…”

“…Three studies were conducted in Brazil ( 28–30 ), one in Spain ( 31 ), Australia ( 32 ), Egypt ( 33 ), Taiwan ( 34 ), and Thailand ( 17 ). All studies were published after 2011.…”

“…Sample sizes varied from 14 ( 30 ) to 67 ( 32 ) participants. The studies included 151 (56%) males and 118 (44%) females, with mean ages varying between 11.2 ± 2.6 ( 17 ) and 48 ± 11 ( 32 ) years. One study did not report the male/female distribution ( 30 ).…”

“…Additionally, regular physical activity and exercise are essential components of obesity treatment, promoting energy expenditure and maintaining muscle mass ( 15 ). Specific exercises that target the respiratory muscles, such as inspiratory muscle training (IMT), have shown potential benefits in improving respiratory function in individuals with obesity ( 16 , 17 ).…”

Effects of an incentive spirometer versus a threshold inspiratory muscle trainer on lung functions in Parkinson’s disease patients: a randomized trial

“…Its primary usage principle is inspiration up to the TLC level, but the inspiration is not directed against resistance. As a result, the TIMT is more successful at increasing respiratory muscle strength than the IS, which results in a smaller increase in functional fitness 58 .…”