Search Results (126)

Background: Aerobic capacity and respiratory efficiency are critical determinants of performance in elite female football, characterized by repeated high-intensity efforts and rapid recovery demands. Halotherapy, involving the inhalation of dry salt aerosol, has been shown to improve pulmonary health; however, its effects on exercise-related outcomes in athletic populations remain insufficiently investigated. This study aimed to examine the effects of a 12-week post-training halotherapy intervention on respiratory muscle strength, pulmonary function, and aerobic performance in elite female football players. Methods: Twenty-eight elite female football players competing in the Turkish Women’s First League were randomly assigned to a halotherapy group (HG, n = 14) or a control group (CG, n = 14). Both groups completed an identical preseason training program, while the HG additionally performed 45 min halotherapy sessions three times per week in a controlled halochamber. Pre- and post-intervention assessments included maximal inspiratory and expiratory pressures (MIP, MEP), spirometric parameters (FVC, FEV₁, PEF, MVV), and maximal oxygen uptake (VO₂max) estimated using the Yo-Yo Intermittent Recovery Test Level 1 (Yo-Yo IRT1), along with total distance covered. A 2 × 2 mixed-model ANOVA was used to assess time and group × time interaction effects. Results: Significant group × time interactions were observed for MIP, MEP, VO₂max, FEV₁, PEF, MVV, and Yo-Yo IRT1 performance (p < 0.05), with large effect sizes (ηp² = 0.269–0.924), favoring the halotherapy group. Forced vital capacity (FVC) increased over time in both groups (p = 0.141), with no significant interaction effect. Changes in the control group were comparatively smaller across most outcomes. Conclusion: Post-training halotherapy was associated with improvements in respiratory muscle strength, ventilatory function, aerobic capacity, and intermittent running performance in elite female football players. These findings suggest that halotherapy may be considered as a complementary, non-invasive strategy to support respiratory and aerobic adaptations. Further research is required to confirm these findings and to clarify the underlying physiological mechanisms. Trial registration: NCT07406386; 6 February 2026. Full article

Background: Inspiratory training after stroke has been used to improve muscle function and strength; however, its acute effects under different inspiratory loads are not well understood. Aim: To assess inspiratory muscle activation under different incremental inspiratory loads in individuals with hemiparetic stroke and healthy controls and to compare muscle activation between hemibodies and sexes in post-stroke subjects using surface electromyography. Methods: Individuals with stroke and healthy controls were recruited. An incremental inspiratory load test was performed using the Threshold^® IMT device, with progressive increases of 15%, 30%, 45%, and 60% of maximal inspiratory pressure (MIP) or up to the maximal device load based. Muscle activation of the scalene, sternocleidomastoid, and lowest intercostal space was recorded bilaterally using surface electromyography. Results: The sample consisted of 32 stroke participants (11 females and 21 males) and 14 healthy controls (six females and eight males). Muscle activity was decreased in stroke subjects in comparison to healthy individuals (p < 0.05). The paretic side showed decreased muscle activity when compared to the healthy side in all muscles during different incremental loads and maximal inspiratory pressure (p < 0.05), mainly in males. Females with stroke showed decreased activity in sternocleidomastoid (15% of MIP) and scalene (15% of MIP and MIP) (p < 0.05) compared to controls. Stroke males showed decreased diaphragm activity during 60% or maximal device load of MIP compared to controls (p < 0.05). Conclusions: Incremental inspiratory loads increased muscle activity in both stroke subjects and controls of both sexes, although in different patterns. Reduced inspiratory muscle activity on the paretic side suggests an influence of stroke on muscular function and should be considered during rehabilitation. Full article

Background and Objectives: Amputee soccer places exceptional demands on lumbopelvic stability and upper extremity capacity due to unilateral lower limb amputation and forearm crutch use. This cross-sectional study examined associations between core stabilization, core endurance, respiratory muscle strength, isokinetic knee muscle strength, and dominant handgrip strength with physical performance in amputee soccer players, and examined which physiological variables were most strongly associated with performance. Materials and Methods: Fifteen male amputee soccer players (age: 27.4 ± 5.6 years; BMI: 20.8 ± 1.4 kg/m²) competing in the Turkish Amputee Football Super League were included. Core stabilization was assessed by the pressure biofeedback unit (PBU), core endurance by the McGill Core Endurance Battery, respiratory muscle strength by maximal inspiratory and expiratory pressures (MIP and MEP), isokinetic knee muscle strength at 60°/s, 180°/s, and 240°/s using the IsoMed 2000 dynamometer, and dominant handgrip strength by a hydraulic hand dynamometer. Physical performance outcomes were single-leg triple hop test (THT) distance, 10-m sprint time, and Closed Kinetic Chain Upper Extremity Stability Test (CKCUEST) score. Results: PBU score was negatively correlated with THT distance (r = −0.928, p < 0.001) and 10-m sprint time (r = −0.580, p = 0.023). McGill total score was correlated with THT distance (r = 0.561, p = 0.030), and dominant handgrip strength with CKCUEST score (r = 0.634, p = 0.011). No significant associations were found for respiratory muscle strength or isokinetic knee muscle strength. Separate regression models showed that PBU score explained variance in THT distance (R² = 0.861, p < 0.001) and 10-m sprint time (R² = 0.336, p = 0.023); McGill total score explained variance in THT distance (R² = 0.315, p = 0.030). Conclusions: Core stabilization and endurance appear to be primary factors associated with physical performance in amputee soccer and warrant targeted assessment and training. Full article

Background: Breathing exercises and respiratory muscle training (RMT) are accessible, low-cost interventions that may improve both physical and psychological health through respiratory and autonomic regulation. Despite growing interest in respiratory interventions, their combined effects on physical performance, sleep quality, and perceived stress in healthy university students remain poorly understood. Methods: This pilot pre-post experimental study was conducted in Saudi Arabia. Students aged 18–25 years with a BMI < 29.9 kg/m² participated in a 4-week intervention consisting of diaphragmatic breathing, pursed-lip breathing, and threshold-loaded inspiratory and expiratory muscle training (40–60% maximal inspiratory pressure), performed five days per week. Outcomes assessed before and after the intervention included chest expansion, breath-holding time, Timed Up-and-Go (TUG), Sit-to-Stand (STS), Pittsburgh Sleep Quality Index (PSQI), and Perceived Stress Scale (PSS). Paired statistical analyses and correlation tests were performed. Results: Forty participants (50% female; median age 22 years; BMI 23.14 ± 4.05 kg/m²) completed the study. Breath-holding time increased by 132% (p < 0.001, r = 0.87). Functional performance improved significantly, with TUG decreasing by 9% (d_z = 1.01) and STS improving by 12% (d_z = 1.12) (p < 0.001). Sleep quality improved by 26%, while perceived stress decreased by 19% (p ≤ 0.001). Significant exploratory correlations were observed between TUG and STS change scores (r = 0.49), PSQI and PSS changes (r = 0.33), and STS and PSS changes (r = 0.33). Conclusions: Participation in a four-week combined breathing exercise and respiratory muscle training program was associated with favorable within-group changes in breath-holding time, functional performance, sleep quality, and perceived stress among healthy university students. Given the single-arm design, these findings should be considered preliminary and hypothesis-generating. Randomized controlled studies are needed to determine efficacy and causal relationships. Full article

Background: Type 2 diabetes mellitus (T2DM) is associated with impaired skeletal muscle mass and function; however, respiratory muscle involvement has not been fully investigated, particularly in Japanese patients. This study aimed to evaluate respiratory muscle strength and identify its associated factors in Japanese patients with T2DM. Methods: This cross-sectional study included 55 patients with T2DM without respiratory disease. Maximal inspiratory pressure (PImax) and maximal expiratory pressure (PEmax) were measured and expressed as percentages of the predicted values (PImax %pred and PEmax %pred). Clinical variables, including age, sex, body mass index (BMI), diabetic polyneuropathy (DPN), skeletal muscle index (SMI), handgrip strength, and 6-min walk distance (6MWD), were assessed. Correlation and multiple regression analyses were performed to identify factors associated with PImax %pred. Results: PImax %pred was significantly lower than the predicted value (69.5% [95% CI: 63.1–75.9], p < 0.001), whereas PEmax %pred did not differ significantly from the predicted value (95.6% [95% CI: 86.8–104.3]). PImax %pred was significantly associated with age, BMI, SMI, handgrip strength, and 6MWD. In multiple regression analysis, age, sex, BMI, and handgrip strength were independently associated with PImax %pred, whereas DPN was not. These findings remained unchanged after adjusting for smoking habits. Conclusions: Inspiratory muscle strength was selectively reduced in Japanese patients with T2DM and was independently associated with general physical characteristics and overall muscle strength. Inspiratory muscle weakness may reflect generalized skeletal muscle dysfunction rather than solely a neuropathic impairment. This assessment of respiratory muscle strength may provide additional insights into the physical function of patients with T2DM. Full article

Background: Patients with prolonged mechanical ventilation (PMV) frequently require tracheostomy due to failure to wean, yet the pathway from ventilator dependence to successful decannulation remains complex and poorly standardised. Comprehensive respiratory rehabilitation is recognised as a core strategy for improving decannulation outcomes, but no unified, evidence-based guidelines currently exist for this population. This review addresses that gap by synthesising current evidence on respiratory rehabilitation and decannulation strategies for tracheostomized PMV patients. Methods: A narrative review was conducted through a systematic search of PubMed/MEDLINE covering publications indexed from May 2019 to February 2026, supplemented by targeted searches of Embase and the Cochrane Library. The search combined free-text keywords and Medical Subject Headings (MeSH) terms across eight search string combinations. Following title and abstract screening of 830 deduplicated records, 51 studies met eligibility criteria and were included in the final narrative synthesis. Results: Six core rehabilitation intervention domains were identified: respiratory muscle training, physical rehabilitation and nutritional optimisation, sedation and delirium management, speaking valve use, airway complication management, and ventilator mode optimisation. High-intensity inspiratory muscle training at no less than 50% of maximal inspiratory pressure is currently supported by the strongest available evidence among the interventions reviewed, although this threshold derives primarily from general ICU populations and has not been specifically validated in heterogeneous tracheostomized PMV cohorts. Decannulation readiness assessment may benefit from evaluating five core domains—neurological readiness, secretion management capacity (suctioning ≤ 4 times/24 h), cough efficacy (peak cough flow > 160 L/min), safe swallowing confirmed by instrumental assessment, and upper airway patency confirmed by fiberoptic bronchoscopy—using a structured multidisciplinary framework. Conclusions: Successful decannulation in tracheostomized PMV patients requires integration of evidence-based rehabilitation interventions, structured multidisciplinary assessment, and a patient-centred outcome framework that extends beyond physiological endpoints to encompass voice restoration, psychological well-being, and social reintegration. Significant evidence gaps remain—particularly for expiratory muscle training, population-specific decannulation protocols, and adapted rehabilitation models for resource-limited settings—representing priority areas for future research. Full article

Background/Objectives: Pulmonary complications and respiratory muscle weakness are common in individuals with type 2 diabetes mellitus (Type 2 DM). Physical inactivity may further contribute to impaired respiratory muscle performance and reduced cough effectiveness in this population. The aim of this study was to examine the relationship between physical activity level, respiratory muscle strength, and cough strength in individuals with Type 2 DM. This study was an observational cross-sectional study. Methods: Thirty individuals with Type 2 DM and thirty age- and sex-matched healthy controls were included. Their physical activity level was assessed using the International Physical Activity Questionnaire (IPAQ), and respiratory muscle strength was evaluated using maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP), whereas cough strength was assessed using a peak expiratory flow meter. Group comparisons were performed using the Mann–Whitney U test, and associations were analyzed using Spearman’s correlation coefficients. Additional multivariable regression analyses were conducted after adjustment for body mass index (BMI) and waist circumference. Results: Physical activity level, respiratory muscle strength, and cough strength were significantly lower in individuals with Type 2 DM than in healthy controls (p < 0.05). Within the Type 2 DM group, IPAQ scores were positively correlated with MIP (r = 0.438, p = 0.016), MEP (r = 0.581, p = 0.001), and cough strength (r = 0.619, p < 0.001), and diabetes duration was negatively correlated with MIP (r = −0.412, p = 0.024). After adjustment for BMI and waist circumference, Type 2 DM status remained independently associated with lower MIP (B = −15.69, 95% CI: −26.58 to −4.80, p = 0.006) and lower cough strength (B = −90.51, 95% CI: −161.52 to −19.50, p = 0.013). Conclusions: Individuals with Type 2 DM demonstrated lower physical activity levels, respiratory muscle strength, and cough strength than healthy controls. Higher physical activity levels were associated with better respiratory muscle strength and cough strength, whereas longer diabetes duration was associated with lower inspiratory muscle strength. These findings suggest that respiratory muscle function and cough performance may be adversely affected in individuals with Type 2 DM, warranting further investigation in larger longitudinal studies. Full article

Objectives: This systematic review and meta-analysis aimed to evaluate the efficacy and safety of phrenic nerve stimulation (PNS) in mechanically ventilated adult patients. Methods: PubMed, Web of Science, Embase, and the Cochrane Library were searched for randomized controlled trials (RCTs) up to 21 February 2026, without language restrictions. Two reviewers independently screened studies, extracted data, and evaluated the risk of bias using the Cochrane RoB 2 tool. The certainty of evidence for each outcome was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework. Odds ratios (ORs) and mean differences (MDs) with 95% confidence intervals (CIs) were pooled using fixed-effects or random-effects models according to heterogeneity. Results: Five RCTs involving 431 patients were included. PNS was associated with a higher weaning success rate (OR = 2.96, 95% CI: 1.04 to 8.40, p = 0.04), a shorter duration of mechanical ventilation (MD = −2.63, 95% CI: −3.90 to −1.35, p < 0.001), higher maximal inspiratory pressure (MD = 2.95, 95% CI: 1.10 to 4.79, p = 0.002), and higher diaphragm thickening fraction (MD = 15.67, 95% CI: 4.84 to 26.50, p = 0.005). No statistically significant differences were observed in ICU length of stay, rapid shallow breathing index, or tracheostomy rate. Noninvasive stimulation was generally tolerated in the included studies, whereas transvenous stimulation was associated with procedure-related serious adverse events. The certainty of evidence ranged from high to low across outcomes. Conclusions: PNS was associated with improved weaning outcomes and diaphragm function in mechanically ventilated patients. However, the evidence remains limited by the small number of RCTs, clinical heterogeneity, and uncertainty regarding long-term outcomes. Further large-scale, multicenter RCTs with standardized protocols are needed to assess the efficacy and safety of PNS. Full article

Background: Respiratory muscle dysfunction is a recognized complication of multiple sclerosis (MS) and may contribute to functional decline. Sarcopenia related to neurological impairment may further impair respiratory muscle performance in MS. This study aimed to investigate the association between sarcopenia and respiratory function, respiratory muscle strength, and respiratory muscle endurance in patients with MS. Methods: This study was designed as a cross-sectional observational study. In this study, 52 MS patients (26 sarcopenic, 26 non-sarcopenic) were evaluated. Sarcopenia was assessed using the SARC-F questionnaire, handgrip strength, bioelectrical impedance analysis, calf circumference, and walking speed (6-m walk test). Pulmonary function was evaluated using spirometry. Respiratory muscle strength was assessed using maximal inspiratory and expiratory pressures (MIP, MEP), and respiratory muscle endurance was evaluated using a constant-load test. Results: Respiratory muscle endurance (p < 0.001), inspiratory volume (p < 0.001), and forced vital capacity (p = 0.003) were significantly lower in sarcopenic MS patients in the primary analyses. However, inspiratory volume and respiratory muscle endurance remained significant after age adjustment, while all three parameters remained significant after EDSS adjustment. No significant differences were observed between groups in other respiratory function parameters or respiratory muscle strength including MIP, and MEP (p > 0.05). Conclusions: Sarcopenia is associated with reduced respiratory muscle endurance and respiratory capacity in patients with MS. These findings suggest that respiratory muscle endurance assessment may help identify sarcopenic MS patients who warrant further respiratory evaluation. Incorporating respiratory muscle endurance assessment into routine evaluation and rehabilitation strategies may be beneficial in sarcopenic MS patients. Full article

Introduction: Coronavirus disease 2019 (COVID-19) can cause persistent cardiovascular alterations, including autonomic dysfunction. Heart rate (HR) recovery (HRR) after exercise is a simple marker of autonomic modulation associated with functional capacity and clinical prognosis. Evaluating HRR during the six-minute walk test (6MWT) may help identify residual functional limitations in diverse patients. Objective: To compare pulmonary function, maximal inspiratory pressure (MIP), functional capacity, dyspnea, fatigue, and functional status in post-COVID-19 patients. Methods: This cross-sectional study included 75 adults (mean age: 47.6 ± 13.1 years; 54.7% male) who recovered from COVID-19 divided into 2 groups based on HRR 1 min after the 6MWT: delayed (≤12 beats/min); and non-delayed (>12 beats/min). Pulmonary function, MIP, exercise capacity (via 6MWT), dyspnea, muscle fatigue, and functional status were assessed. Results: Based on HRR 1 min after 6MWT, 27 (36%) participants were classified with abnormal HRR and 48 (64%) with normal HRR. There were statistical differences between the groups regarding demographic or clinical characteristics, pulmonary function, MIP, muscle fatigue, or functional status (p > 0.05). The delayed HRR group exhibited a smaller reduction in HR in first minute of recovery (ΔHR = 6 vs. 23 beats/min), higher baseline HR (p = 0.010), and greater dyspnea (p = 0.020). Furthermore, this group exhibited worse functional performance in the 6MWT, with shorter distance walked (437.33 vs. 494.27 m; p = 0.019) and a lower percentage of predicted distance (74.66 ± 12.98% vs. 82.94 ± 15.71%; p = 0.023) compared with the non-delayed HRR group. Conclusion: Delayed HRR post-COVID-19 was associated with poorer functional performance and greater dyspnea, regardless of pulmonary function. The blunted reduction in HRR after exertion suggests impaired cardiovascular autonomic modulation, possibly related to attenuated vagal reactivation, which may contribute to exercise intolerance observed in this population. Full article

Background: Respiratory muscle strength (RMS) is a critical factor influencing athletic performance, particularly in high-intensity or prolonged activities. RMS encompasses inspiratory (IMs) and expiratory muscles (EMs), which differ in anatomical structure, fiber composition, and responsiveness to training. Methods: This pilot interventional within-subject study investigated the effects of two resistive respiratory muscle training (RMT) protocols on RMS and small airway function in eight physically active adults (two females, six males). Maximal inspiratory (MIP) and expiratory pressures (MEP), along with pulmonary function tests (PFTs), were measured using the Airofit PRO™ device and spirometry before and after two consecutive 7-day training protocols, with a 2-day break between interventions. The workload was progressively increased by lengthening the duration of forced inhalation and exhalation, while keeping the air resistance constant. Results: Results demonstrated significant improvements in MEP across both protocols and after a 10-day washout period (p < 0.001–0.03), whereas MIP showed no significant changes (p = 0.19–0.66). Moderate transient improvements were observed in small airway flow (MEF25%) following the first protocol (ES = 0.62), which regressed after the second. Conclusions: These outcomes suggest differential responsiveness of respiratory muscles to RMT; EMs, characterized by a higher proportion of fast-twitch type II fibers and a predominantly passive role in normal breathing, respond rapidly to short-duration, high-intensity forced expiration training through neuromuscular adaptations. Conversely, IMs, dominated by slow-twitch type I fibers, require longer-duration, higher-load training to elicit meaningful adaptations, explaining the limited changes in MIP. Small airway function appeared minimally trainable due to structural and physiological constraints, with short-term improvements likely reflecting effort-dependent factors rather than lasting adaptations. Finally, RMT can selectively enhance EM performance through appropriately designed short-duration, high-intensity interventions, while IMs may necessitate prolonged or higher-load stimuli. The findings highlight the importance of targeted training strategies, individualized to muscle fiber composition and functional demands, to optimize respiratory performance. Future research should investigate longer interventions, larger diverse cohorts, and precise measurement methods to further elucidate RMT’s effects on both respiratory muscles and small airway function. Full article

Background: Cardiovascular diseases are the main cause of mortality and morbidity in Portugal, with coronary artery bypass grafting (CABG) being one of the most performed surgeries in cardiothoracic centers. After cardiac surgery, patients often experience a decrease in physical capacity, which results in an increased risk of mortality or hospitalization expenditures. The objective of this systematic review was to characterize changes in respiratory function in patients undergoing CABG. Methods: This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. Web of Science, Pubmed, SCOPUS, and Sport Discus were searched using a predefined research strategy to identify relevant original studies published until August 2025. To be included, studies must have assessed adult patients submitted to CABG who evaluated the respiratory function before and after cardiac surgery. Studies that reported other types of cardiac surgery were excluded. The Risk of Bias in Non-randomized Studies-of-Exposure and the Cochrane risk-of-bias tool for randomized trials were used to analyze the risk of bias of the selected studies. Results: After screening 1184 potential articles, six studies met the inclusion criteria. The studies included participants who underwent CABG (n = 324), with a mean age ranging from 54.05 ± 13.6 to 67 ± 10 years. Conclusions: All included studies reported significant postoperative reductions in respiratory function following CABG, including forced vital capacity, forced expiratory volume in one second, maximal inspiratory pressure, and maximal expiratory pressure. Although these findings consistently indicate a decline in pulmonary function, the limited number of available studies limits the strength of the conclusions. This systematic review suggests that monitoring respiratory impairments after CABG may be clinically relevant to improve health-related quality of life. Full article

Background and Objectives: Obesity affects over 1.9 billion adults globally, with a disproportionately higher prevalence in Saudi Arabia among women. While excessive adiposity is known to impair respiratory mechanics and lung function, its relationship with respiratory muscle strength and exercise energy expenditure remains inadequately elucidated. This study examined differences in respiratory muscle strength, metabolic equivalents (METs) of physical activity, and energy expenditure during exercise between adults with normal and high body fat percentage (BF%) and explored the statistical role of body fat as a potential mediator in the cross-sectional association between respiratory muscle strength and energy expenditure. Methods: In this cross-sectional study, 126 Saudi women aged 18–45 years (mean age: 21.7 ± 4.2 years) were stratified into normal (n = 63) and high (n = 63) BF% groups. Body composition was assessed via bioelectrical impedance analysis, and respiratory muscle strength (MIP and MEP) was measured using a MicroRPM device. Peak oxygen consumption (VO_2peak) and energy expenditure were obtained through the Bruce Submaximal Treadmill Protocol, and physical activity was self-reported via the IPAQ. Hierarchical regression and structural equation modeling were used to examine variable associations and explore statistical mediation patterns. Results: Participants with high body fat demonstrated significantly low MIP (−26%) and MEP (−31%), low VO_2peak (−13%), and approximately 26% high energy expenditure during exercise compared to the normal-BF group (all p < 0.001), despite comparable self-reported physical activity levels. Body fat percentage was the most strongly associated with energy expenditure (β = 0.078, R² = 0.329), with maximal inspiratory pressure contributing an additional 7.3% of explained variance in hierarchical regression (total R² = 0.414). Mediation analyses revealed that body fat percentage was statistically consistent with a partial mediation model in the relationship between MIP and energy expenditure (indirect association = −0.016, p = 0.033), accounting for 27% of the total association, and between MEP and energy expenditure (indirect association = −0.013, p = 0.035), accounting for 38% of the total association. Conclusions: High BF% is independently associated with low respiratory muscle strength and high exercise metabolic cost. Body fat is statistically associated with (and consistent with a mediating role in) an inverse relationship between respiratory muscle strength and energy expenditure. Alternative directional relationships and shared underlying factors may explain these observations. Full article

Background and Objectives: The hypertrophic adaptation of the diaphragm to inspiratory muscle training (IMT) remains insufficiently characterized, particularly in healthy and athletic populations. To address this gap, we conducted a meta-analysis and meta-regression to evaluate the effects of IMT on diaphragm thickness and identify potential moderating factors. Materials and Methods: A systematic search was conducted across PubMed, MEDLINE, Embase, CINAHL, and SPORTDiscus as well as Google Scholar (gray literature) through November 2025. Eight studies involving 203 healthy participants met the inclusion criteria. A random-effects model was used to calculate pooled effect sizes and meta-regression estimates. Results: IMT produced a statistically significant moderate increase in diaphragm muscle thickness, with a standardized mean difference (SMD) of Hedges’ g = 0.52 (95% CI: 0.19 to 0.85; p < 0.05). Subgroup analyses indicated that IMT with 50% maximal inspiratory pressure (MIP) produces a statistically significant effect (p = 0.0069), whereas fitness status and age did not significantly influence outcomes (p = 0.589 and p = 0.126, respectively). Meta-regression analyses revealed that only baseline MIP value (β = 0.030; 95% CI: 0.009 to 0.050; p = 0.004) was associated with diaphragm hypertrophy. Conclusions: IMT with 50% of MIP elicits meaningful diaphragmatic hypertrophy in healthy individuals. This response appears independent of fitness status or age, but is significantly influenced by baseline inspiratory muscle strength (MIP). These findings support the utility of IMT in enhancing respiratory muscle morphology in health and performance contexts. Full article

Objectives: This study investigated the effects of trunk extension-based inspiratory muscle strengthening on respiratory function, balance, and gait in patients with stroke. Methods: Thirty stroke patients were randomly assigned to the study group (n = 15) or control group (n = 15). The study group performed inspiratory muscle strengthening exercises in a trunk extension posture, while the control group received conventional inspiratory muscle training. Both groups trained five times per week for six weeks. Outcome measures included maximal inspiratory pressure (MIP), maximal inspiratory flow rate (MIFR), maximal inspiratory volume (MIV), peak expiratory flow (PEF), forced expiratory volume in 1 s (FEV₁), Berg Balance Scale (BBS), weight distribution ratio (WDR), limits of stability (LOSs), Timed Up and Go (TUG), gait velocity, cadence, and stride length. Results: The study group showed significantly greater improvements in respiratory parameters (MIP, MIFR, MIV, PEF, FEV₁) and functional outcomes (WDR, LOS, BBS, TUG, gait velocity, cadence, stride length) compared to the control group. Conclusions: Trunk extension-based inspiratory muscle strengthening effectively improves respiratory function, balance, and gait in stroke patients, and may serve as a valuable addition to stroke rehabilitation programs. Full article