Effects of inspiratory muscle training on lung function, muscle oxygenation and functional capacity in older adults
DOI:
https://doi.org/10.47197/retos.v66.110752Keywords:
Exercise, NIRS, older adults, respiratory therapyAbstract
Background and objective. Inspiratory muscle training (IMT) generates positive effects on physical performance, but there is little evidence on the effects on muscle resaturation in older adults. The study aimed to assess the impact of a 4-week Inspiratory Muscle Training (IMT) program on peak dynamic inspiratory strength, lung function, muscle oxygenation and functional capacity in functionally independent older adults.
Material and methods. Twelve randomized older adults (EG= n6; 68.8 ± 2.6 years; SCG=n6, 71.5 ± 4.7years) completed the study. A 4-week IMT program was applied, along with general physical activity recommendations. Activities of daily living, lung flow and volumes, peak dynamic inspiratory force (S-index), peak inspiratory flow (MIF), muscle resaturation velocity (ΔTSIreoxy) by NIRS and the Senior Fitness Test battery were assessed pre and post intervention.
Results. Improvements in the EG in the Chair Stand Test (p=0.013; η²p=0.474), Biceps Curl Test (p=0.015; η²p=0.463) and 6 minutes walking test (p=0.011; η²p=0.495), while in the control group changes were observed only in Biceps Curl Test (p=0.004; η²p=0.589). An increase in EG was observed in the S-Index (p=0.038; η²p=0.363) with a high effect on peak inspiratory flow (MIF) (p=0.138; η²p=0.206), finally EG showed a high effect size on muscle resaturation velocity at the end of exercise (p=0.213; η²p=0.187; Δ=-31%).
Conclusions. Short IMT program increases S-index, physical capacity and muscle oxygenation velocity. IMT may be a complementary intervention strategy in older adults to improve their physical fitness and peripheral vascular response.
References
Bherer, L., Langeard, A., Kaushal, N., Vrinceanu, T., Desjardins-Crépeau, L., Langlois, F., & Kramer, A. (2021). Physical Exercise Training Effect and Mediation through Cardiorespiratory Fitness on Dual-Task Performances Differ in Younger–Old and Older–Old Adults. Journals Gerontol. Ser. B, 76(2), 219–228. https://doi.org/10.1093/geronb/gbz066
Carrion, B., Wells, A., Mayhew, J. & Koch, A. (2019). Concordance among Bioelectrical Impedance Anal-ysis Measures of Percent Body Fat in Athletic Young Adults. Int. J. Exerc. Sci., 12(4), 324-331. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6355131/
Chung, S., Rosenberry, R., Ryan, T., Munson, M., Dombrowsky, T., Park, S., Nasirian, A., Haykowsky, M. & Nelson, M. (2018). Near‐infrared Spectroscopy Detects Age‐related Differences in Skeletal Mus-cle Oxidative Function: Promising Implications for Geroscience. Physiol. Rep., 6(3), e13588. https://doi.org/10.14814/phy2.13588
Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed ed.). Hillsdale, NJ: Law-rence Erlbaum.
Cortopassi, F., Gurung, P. & Pinto-Plata, V. (2017). Chronic Obstructive Pulmonary Disease in Elderly Patients. Clin Geriatr Med., 33(4), 539-552. https://doi.org/10.1016/j.cger.2017.06.006
Ferraro, F., Gavin, J., Wainwright. T. & McConnell, A. (2022). Association Between Inspiratory Muscle Function and Balance Ability in Older People: A Pooled Data Analysis Before and After Inspira-tory Muscle Training. J. Aging Phys. Act., 30(3), 421–433. https://doi.org/10.1123/japa.2020-050
Fortes, J., Borges, M., Marques, M., Oliveira, R., Rocha, L., Castro, M., Esquivel, M & Borges, D. (2021). Effects of Inspiratory Muscle Training Using an Electronic Device on Patients Undergoing Car-diac Surgery: A Randomized Controlled Trial. Int. J. Cardiovasc. Sci., 34(1), 44–52. https://doi.org/10.36660/ijcs.20190093
Graham, B., Steenbruggen, I., Miller, M., Barjaktarevic, I., Cooper, B., Hall, G., Hallstrand, T., Kaminsky, D., McCarthy, K. & McCormack, M. (2019). Standardization of Spirometry 2019 Update. An Official American Thoracic Society and European Respiratory Society Technical Statement. Am. J. Respir. Crit. Care Med., 200(8), e70–e88. https://doi.org/10.1164/rccm.201908-1590ST
Guralnik, B., Hansen, O., Henrichsen, H., Beltrán-Pitarch, B., Østerberg, F., Shiv., L., Marangoni, T., Stilling-Andersen, A., Cagliani, A., Hansen, M., Nielsen, P., Oprins, H., Vermeersch, B., Adelmann, C., Dutta, S., Borup, K., Mihiretie, B. & Petersen, D. (2021). 3ω Correction Method for Eliminating Re-sistance Measurement Error Due to Joule Heating. Rev. Sci. Instrum. 92(9). https://doi.org/10.1063/5.0063998
Hamaoka, T., McCully, K., Niwayama, M. & Chance, B. (2011). The Use of Muscle Near-Infrared Spec-troscopy in Sport, Health and Medical Sciences: Recent Developments. Philos. Trans. R. Soc. A Math. Phys. Eng. Sci., 369(1955), 4591–4604. https://doi.org/10.1098/rsta.2011.0298
Hopman-Rock, M., van Hirtum, H., de Vreede, P. & Freiberger, E. (2019). Activities of Daily Living in Older Community-Dwelling Persons: A Systematic Review of Psychometric Properties of In-struments. Aging Clin. Exp. Res., 31, 917–925. https://doi.org/10.1007/s40520-018-1034-6
Hurst, C., Weston, K., McLaren, S. & Weston, M. (2019). The Effects of Same-Session Combined Exercise Training on Cardiorespiratory and Functional Fitness in Older Adults: A Systematic Review and Meta-Analysis. Aging Clin. Exp. Res. 31, 1701–1717. https://doi.org/10.1007/s40520-019-01124-7
Jones, B., Parry, D. & Cooper, C. (2018). Underwater Near-Infrared Spectroscopy Can Measure Training Adaptations in Adolescent Swimmers. PeerJ., 6, e4393. https://doi.org/10.7717/peerj.4393
Jones, S., Chiesa, S., Chaturvedi, N. & Hughes, A. (2016). Recent developments in near-infrared spectros-copy (NIRS) for the assessment of local skeletal muscle microvascular function and capacity to utilise oxygen. Artery Res., 16, 25-33. https://doi.org/10.1016/j.artres.2016.09.001
Joshi, P. (2024). Pulmonary Diseases in Older Patients: Understanding and Addressing the Challen-ges. Geriatrics (Basel), 9(2), 34. https://doi.org/10.3390/geriatrics9020034
Kim, S., Shin, M., Lee, J., Huh, S. & Shin, Y. (2022). Effects of a New Respiratory Muscle Training Device in Community-Dwelling Elderly Men: An Open-Label, Randomized, Non-Inferiority Trial. BMC Geriatr., 22, 155. https://doi.org/10.1186/s12877-022-02828-8
Kurzaj, M., Dziubek, W., Porębska, M. & Rożek-Piechura, K. (2019). Can Inspiratory Muscle Training Improve Exercise Tolerance and Lower Limb Function After Myocardial Infarction? Med. Sci. Monit. Int. Med. J. Exp. Clin. Res., 25, 5159–5169. https://doi.org/10.12659/MSM.914684
Labata-Lezaun, N., González-Rueda, V., Llurda-Almuzara, L., López-de-Celis, C., Rodríguez-Sanz, J., Bosch, J., Vicente-Rodríguez, G., Gorczakowska, D., Araluze-Arizti, P. & Pérez-Bellmut, A. (2023). Effectiveness of multicomponent training on physical performance in older adults: A systematic review and meta-analysis. Arch Gerontol Geriatr., 104:104838. https://doi.org/10.1016/j.archger.2022.104838
Labott, B., Held, S. & Donath, L. (2020). Grip Strength-Endurance in Ambitious and Recreational Climb-ers: Does the Strength Decrement Index Serve as a Feasible Measure? Int. J. Environ. Res. Public Health, 17(24), 9530. https://doi.org/10.3390/ijerph17249530
Lachman, M., Lipsitz, L., Lubben, J., Castaneda-Sceppa, C. & Jette, A. (2018). When Adults Don’t Exercise: Behavioral Strategies to Increase Physical Activity in Sedentary Middle-Aged and Older Adults. Innov. Aging, 2, igy007. https://doi.org/10.1093/geroni/igy007
Langhammer, B. & Stanghelle, J. (2015). The Senior Fitness Test. J Physiother, 61(3),163. https://doi.org/10.1016/j.jphys.2015.04.001
Mahoney, F. & Barthel. D. (1965). Functional Evaluation: The Barthel Index: A Simple Index of Inde-pendence Useful in Scoring Improvement in the Rehabilitation of the Chronically Ill. Md. State Med. J. https://www.kcl.ac.uk/nmpc/assets/rehab/tools-bi-functional-evaluation-the-barthel-index.pdf
Manifield, J., Winnard, A., Hume, E., Armstrong, M., Baker, K., Adams, N., Vogiatzis, I., & Barry, G. (2021). Inspiratory Muscle Training for Improving Inspiratory Muscle Strength and Functional Capacity in Older Adults: A Systematic Review and Meta-Analysis. Age Ageing, 50(3), 716–724. http://doi.org/10.1093/ageing/afaa221
Martin-Sanchez, C., Calvo-Arenillas, J., Barbero-Iglesias, F., Fonseca, E., Sanchez-Santos, J. & Martin-Nogueras, A. (2020). Effects of 12-Week Inspiratory Muscle Training with Low Resistance in Patients with Multiple Sclerosis: A Non-Randomised, Double-Blind, Controlled Trial. Mult. Scler. Relat. Disord., 46, 102574. https://doi.org/10.1016/j.msard.2020.102574
McCreery, J., Mackintosh, K., Mills-Bennett, R. & McNarry, M. (2021). The Effect of a High-Intensity PrO2Fit Inspiratory Muscle Training Intervention on Physiological and Psychological Health in Adults with Bronchiectasis: A Mixed-Methods Study. Int. J. Environ. Res. Public Health, 18(6), https://doi.org/10.3390/ijerph18063051
Mehani. S. (2017). Comparative Study of Two Different Respiratory Training Protocols in Elderly Pa-tients with Chronic Obstructive Pulmonary Disease. Clin. Interv. Aging., 1705–1715. https://doi.org/10.2147/CIA.S145688
Mehmet, H., Yang, A. & Robinson, S. (2020). Measurement of Hand Grip Strength in the Elderly: A Scop-ing Review with Recommendations. J. Bodyw. Mov. Ther., 24, 235–243. https://doi.org/10.1016/j.jbmt.2019.05.029
Mello, E., Oliveira, A., T. Santanna, T., Soares, P., Rodrigues. G. (2024). Updates in inspiratory muscle training for older adults: A systematic review. Arch Gerontol Geriatr, 127, 105579. https://doi.org/10.1016/j.archger.2024.105579
Mętel, S., Kostrzon, M., Adamiak, J. & Janus, P. (2023). Respiratory Muscle Function in Older Adults with Chronic Respiratory Diseases after Pulmonary Rehabilitation in Subterranean Salt Chambers. J. Clin. Med. 12, 5120. https://doi.org/10.3390/jcm12155120
Mikkelsen, M., Juhl, C., Lund, C., Jarden, M., Vinther, A., & Nielsen, D. (2020). The Effect of Exercise-Based Interventions on Health-Related Quality of Life and Physical Function in Older Patients with Cancer Receiving Medical Antineoplastic Treatments: A Systematic Review. Eur. Rev. Aging Phys. Act., 17(18), 1–15. https://doi.org/10.1186/s11556-020-00250-w
Miller, A. & Enright, P. (2012). PFT Interpretive Strategies: American Thoracic Society/European Res-piratory Society 2005 Guideline Gaps. Respir. Care, 57(1), 27–135. https://doi.org/10.4187/respcare.01503
Mills, D., Johnson, M., Barnett, Y., Smith, W., & Sharpe, G. (2015). The Effects of Inspiratory Muscle Training in Older Adults. Med. Sci. Sport. Exerc., 47(4), 691–697. https://doi.org/10.1249/MSS.0000000000000474
Nanda, R., Liu, M., Yau, C., Shatsky, R., Pusztai, L., Wallace, A., Chien, A., Forero-Torres, A., Ellis, E., Han, H., Clark, A., Albain, K., Boughey, J., Jaskowiak, N, Elias, A., Isaacs, C., Kemmer, K., Helsten, T., Ma-jure, M.,… Esserman, L. (2020). Effect of Pembrolizumab plus Neoadjuvant Chemotherapy on Pathologic Complete Response in Women with Early-Stage Breast Cancer: An Analysis of the Ongoing Phase 2 Adaptively Randomized I-SPY2 Trial. JAMA Oncol. 6(5), 676–684. https://doi.org/10.1001/jamaoncol.2019.6650
Nagano, A., Wakabayashi, H., Maeda, K., Yokura, Y., Miyazaki, S., Mori, T. & Fujiwara, D. (2021). Respira-tory Sarcopenia and Sarcopenic Respiratory Disability: Concepts, Diagnosis, and Treatment. J Nutr Health Aging, 25(4), 507-515. https://doi.org/10.1007/s12603-021-1587-5
Ostchega, Y., Dillon, C., Hughes, J., Carroll, M. & Yoon, S. (2007). Trends in Hypertension Prevalence, Awareness, Treatment, and Control in Older US Adults: Data from the National Health and Nu-trition Examination Survey 1988 to 2004. J. Am. Geriatr. Soc. 55 (7), 1056–1065. https://doi.org/10.1111/j.1532-5415.2007.01215.x
Shalaeva, E. & Messerli, F. (2023). What Is Resistant Arterial Hypertension? Blood Press, 32(1), 2185457. https://doi.org/10.1080/08037051.2023.2185457
Paradis-Deschênes, P., Joanisse, D., Mauriège, P., Billaut, F. (2020). Ischemic Preconditioning Enhances Aerobic Adaptations to Sprint-Interval Training in Athletes without Altering Systemic Hypoxic Signaling and Immune Function. Front. Sport. Act. Living, 2, 1-16. https://doi.org/10.3389/fspor.2020.00041
Perrey, S. & Ferrari, M. (2018). Muscle Oximetry in Sports Science: A Systematic Review. Sport. Med., 48, 597–616. https://doi.org/10.1007/s40279-017-0820-1
Richardson, J. (2011). Eta squared and partial eta squared as measures of effect size in educational re-search. Educ. Res. Rev., 6, 135–147. https://doi.org/10.1016/j.edurev.2010.12.001
Rodrigues, G., Dal Lago, P. & da Silva Soares, P. (2021). Time-Dependent Effects of Inspiratory Muscle Training and Detraining on Cardiac Autonomic Control in Older Women. Exp. Gerontol., 150, 111357. https://doi.org/10.1016/j.exger.2021.111357
Ryan, T., Southern, W., Reynolds, M. & McCully, K. (2013) A cross-validation of near-infrared spectros-copy measurements of skeletal muscle oxidative capacity with phosphorus magnetic resonance spectroscopy. J Appl Physiol (1985), 115(12), 1757-1766. https://doi.org/10.1152/japplphysiol.00835.2013
Seixas, M., Almeida, L., Trevizan, P., Martinez, D., Laterza, M., Vanderlei, L. & Silva, L. (2020). Effects of Inspiratory Muscle Training in Older Adults. Respir. Care, 65(4), 535–544. https://doi.org/10.4187/respcare.06945
Volianitis, s., McConnell, A. & Jones, A. (2001). Assessment of Maximum Inspiratory PressurePrior Submaximal Respiratory Muscle Activity (‘Warm-Up’) Enhances Maximum Inspiratory Activity and Attenuates the Learning Effect of Repeated Measurement. Respiration, 68(1), 22–27. https://doi.org/10.1159/000050458
Webb, K., Dominelli, P., Baker, S., Klassen, S., Joyner, M., Senefeld, J. & Wiggins, C. (2022). Influence of High Hemoglobin-Oxygen Affinity on Humans during Hypoxia. Front. Physiol., 12, 763933. https://doi.org/10.3389/fphys.2021.763933
Wearing, J., Konings, P., Stokes, M. & de Bruin, E. (2018). Handgrip Strength in Old and Oldest Old Swiss Adults–a Cross-Sectional Study. BMC Geriatr., 18, 1–9. https://doi.org/10.1186/s12877-018-0959-0
Wickerson, L. (2019). Oxygenation during Exercise in Individuals with Interstitial Lung Disease. Uni-versity of Toronto (Canada), ISBN 1088331440.
World Medical Association. (2013). Declaration of Helsinki: Ethical Principles for Medical Research Involving Human Subjects. JAMA, 310(20), 2191–2194. https://.doi:10.1001/jama.2013.281053
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Rodrigo Yáñez-Sepúlveda, Gladys Orellana-Lepe, Matías Monsalves-Álvarez, Marcelo Tuesta, Aldo Vásquez-Bonilla, Lilian Castro-Tapia, Pamela Ruiz, Jacqueline Páez-Herrera, Jorge Olivares-Arancibia, María Martínez-Olcina, Ildefonso Alvear-Órdenes, Alejandro Martínez-Rodríguez

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and ensure the magazine the right to be the first publication of the work as licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgment of authorship of the work and the initial publication in this magazine.
- Authors can establish separate additional agreements for non-exclusive distribution of the version of the work published in the journal (eg, to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
- Is allowed and authors are encouraged to disseminate their work electronically (eg, in institutional repositories or on their own website) prior to and during the submission process, as it can lead to productive exchanges, as well as to a subpoena more Early and more of published work (See The Effect of Open Access) (in English).
This journal provides immediate open access to its content (BOAI, http://legacy.earlham.edu/~peters/fos/boaifaq.htm#openaccess) on the principle that making research freely available to the public supports a greater global exchange of knowledge. The authors may download the papers from the journal website, or will be provided with the PDF version of the article via e-mail.