Inspiratory muscle training in children and adolescents living with neuromuscular diseases: A pre-experimental study
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Updated: Oct 20, 2025
A Murine Model of Muscle Training by Neuromuscular Electrical Stimulation
Published on: May 9, 2012
Anri Human1,2, Brenda M Morrow3
1Department of Physiotherapy, Faculty of Healthcare Sciences, Sefako Makgatho Health Sciences University, Garankuwa, Pretoria, South Africa.
Insights
Inspiratory muscle training (IMT) improved inspiratory muscle strength and upper limb function in children with neuromuscular diseases (NMD). This 6-week program was safe, feasible, and well-tolerated, suggesting potential as a respiratory management strategy.
Area of Science:
- Pediatric Pulmonology
- Rehabilitation Medicine
- Neuromuscular Disorders
Background:
- Children with neuromuscular diseases (NMD) face risks from progressive respiratory muscle weakness and ineffective cough.
- Inspiratory muscle training (IMT) aims to enhance respiratory muscle strength, potentially reducing illness and improving quality of life.
Purpose of the Study:
- To evaluate the safety and feasibility of a 6-week IMT program using an electronic threshold device in children with NMD.
- To assess changes in functional ability, respiratory function, and quality of life.
Main Methods:
- A pre-experimental, observational study involving eight children (median age 12.21 years) with various NMD.
- Participants completed 30 breaths, twice daily, 5 days a week for 6 weeks of IMT.
Main Results:
- Significant improvements were observed in inspiratory muscle strength (Pimax, strength-index) and peak inspiratory flow (PIF).
- Upper limb function and coordination also showed significant improvement (p=0.03).
- No adverse events were reported; adherence and satisfaction were high.
Conclusions:
- A 6-week IMT program (at 30% Pimax) is safe, feasible, and acceptable for children and adolescents with NMD.
- IMT demonstrated improvements in inspiratory muscle strength, PIF, and upper limb function.
- Further research via larger, longer-term randomized controlled trials is recommended to confirm IMT's efficacy in NMD management.
Background:
Children with neuromuscular diseases (NMD) are at risk of morbidity and mortality because of progressive respiratory muscle weakness and ineffective cough. Inspiratory muscle training (IMT) aims to preserve or improve respiratory muscle strength, thereby reducing morbidity and improving health-related quality of life (HRQoL).
Objectives:
To describe the safety and feasibility of a 6-week IMT programme using an electronic threshold device (Powerbreathe®). Any adverse events and changes in functional ability, spirometry, peak expiratory cough flow (PECF), inspiratory muscle strength and HRQoL (Pediatric Quality of Life [PedsQL]) were recorded.
Methods:
A convenience sample of eight participants (n = 4 boys; median [interquartile range {IQR}] age: 12.21 [9.63-16.05] years) with various NMD were included in a pre-experimental, observational pre-test post-test feasibility study. Training consisted of 30 breaths, twice daily, 5 days a week, for 6 weeks.
Results:
There were significant pre- to post-intervention improvements in upper limb function and coordination (p = 0.03) and inspiratory muscle strength: maximum inspiratory mouth pressure (Pimax) (p = 0.01); strength-index (p = 0.02); peak inspiratory flow (PIF) (p = 0.02), with no evidence of change in spirometry, PECF or HRQoL. No adverse events occurred and participant satisfaction and adherence levels were high.
Conclusion:
Inspiratory muscle training (at an intensity of 30% Pimax) appears safe, feasible and acceptable, in a small sample of children and adolescents with NMD and was associated with improved inspiratory muscle strength, PIF and upper limb function and coordination.
Clinical Implications:
Larger, longer-term randomised controlled trials are warranted to confirm the safety and efficacy of IMT as an adjunct respiratory management strategy in children with NMD.
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