Inspiratory Muscle Training: A Review of Current Evidence for Use in Practice

Overview

Inspiratory Muscle Training (IMT): A Review of Current Evidence for Use in Practice is an evidence-based online course designed for physiotherapists and cardiorespiratory clinicians. IMT is a specialized form of respiratory muscle training that strengthens the inspiratory muscles—particularly the diaphragm—through targeted resistance, improving their strength, endurance, and functional capacity.

This course provides a comprehensive review of IMT mechanisms, clinical efficacy, safety considerations, and practical implementation across diverse populations, including patients with COPD, restrictive lung disease, neuromuscular disorders, post-stroke conditions, and critically ill ICU patients. Participants will learn how to integrate IMT into rehabilitation programs to reduce dyspnea, enhance exercise capacity, and improve quality of life.

Learning Objectives

Upon completing this course, participants will be able to:

1. Explain the physiological principles of IMT, including muscle hypertrophy, endurance adaptation, and metaboreflex modulation.

2. Compare pressure threshold loading and flow resistive loading, understanding the clinical advantages of each.

3. Assess inspiratory muscle strength using objective measures such as maximal inspiratory pressure (MIP) and tailor individualized training protocols.

4. Apply evidence-based IMT protocols to various clinical populations, including COPD, restrictive lung disease, neuromuscular disorders, and post-ICU patients.

5. Recognize contraindications and precautions, including pneumothorax, pulmonary hypertension, severe osteoporosis, cardiac conditions, and active infections.

6. Integrate IMT into comprehensive cardiorespiratory rehabilitation, monitoring outcomes such as dyspnea, exercise tolerance, and quality of life.

7. Discuss emerging evidence of IMT in cardiovascular health, postoperative recovery, and pediatric neuromuscular populations.

Audience

This course is ideal for:

• Physiotherapists and physical therapists in cardiorespiratory rehabilitation

• Pulmonologists, respiratory therapists, and ICU clinicians

• Clinicians working with neuromuscular or post-stroke populations

• Healthcare professionals seeking evidence-based approaches for inspiratory muscle strengthening and improved patient outcomes

• Practitioners aiming to enhance clinical skills and CPD credentials

Why This Course Matters

Respiratory muscle weakness is a significant contributor to dyspnea, exercise intolerance, and reduced quality of life across many clinical populations. IMT provides a targeted, measurable, and clinically effective intervention to address these deficits.

Evidence shows that IMT can:

• Increase diaphragm thickness by up to 12%

• Improve inspiratory muscle strength by 24–41%

• Reduce peripheral fatigue through metaboreflex modulation

• Enhance exercise tolerance and daily function

With a growing body of research supporting IMT across COPD, restrictive lung disease, neuromuscular conditions, ICU rehabilitation, and emerging cardiovascular applications, clinicians are now equipped to integrate IMT safely and effectively into practice. Understanding proper screening, individualized protocol design, and patient education ensures maximal benefit and safety.

About the Presenter

Jessica DeMars, BScPT (Distinction)

Jessica graduated from the University of Alberta in 1998 with a Bachelor of Science in Physical Therapy and is the founder of Breathe Well Physio. She has pursued extensive post-graduate training in manual therapy, myofascial release, acupuncture, and, most notably, breathing retraining.

In 2010, Jessica became certified in the BradCliff Method® in New Zealand, focusing on breathing biofeedback and functional respiratory patterns. She further advanced her expertise with certificates from the Graduate School of Behavioural Health Sciences under Peter Litchfield, emphasizing the behavioral aspects of dysfunctional breathing.

Jessica’s clinical and research work includes investigating links between dysfunctional breathing and asthma in children, as well as presenting nationally and internationally on respiratory health, including at the Saskatchewan Lung Association Conference and the International Association for Dance Medicine & Science Conference.

She frequently integrates Inspiratory Muscle Training (IMT) in her practice across diverse patient populations and advocates for IMT as an easy-to-implement, effective tool to improve respiratory function and overall quality of life.

Course Highlights

• Mechanisms of IMT: Muscle hypertrophy, endurance, and metaboreflex modulation

• Training Modalities: Pressure threshold vs. flow resistive loading

• Clinical Populations: COPD, ILD, neuromuscular disorders, post-stroke, ICU patients, and emerging cardiovascular applications

• Evidence-Based Protocols: Training load determination, frequency, intensity, and monitoring

• Safety & Contraindications: Screening, precautions, and patient education

• Outcome Monitoring: Dyspnea scales, exercise tolerance, quality of life, and MIP measures

• Integration into Practice: Combining IMT with broader pulmonary rehabilitation and interdisciplinary care