Related Experiment Video
Updated: Apr 24, 2026
Inspiratory Muscle Training as an Adjunct to the Treatment of Weaning Failure in Critically Ill Patients: A Practical Guide
Published on: January 30, 2026
Mechanistic study of inspiratory training in childhood Asthma: Rationale and methods of a pediatric clinical trial
Dharini M Bhammar1,2, Harrison N Jones3, Tarig M Ali-Dinar4
1Division of Medical Oncology, Department of Internal Medicine, College of Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
Insights
Childhood asthma is worsened by obesity, causing breathing difficulties. Inspiratory training (IT) may improve lung function and reduce symptoms in obese children with asthma, offering a potential new therapy.
Area of Science:
- Pediatric pulmonology
- Respiratory medicine
- Obesity and asthma research
Background:
- Obesity in children is linked to a distinct, symptomatic asthma phenotype often resistant to standard treatments.
- The exact mechanisms connecting childhood obesity to asthma incidence, symptom severity, and treatment resistance are not fully understood.
- Altered breathing mechanics and inspiratory muscle fatigue in obese children may contribute to exertional dyspnea.
Purpose of the Study:
- To compare small airway dysfunction and inspiratory muscle function in obese versus non-obese children with asthma.
- To evaluate the effects of 8-week inspiratory training (IT) on small airway disease and inspiratory muscle function.
- To assess changes in physical fitness, activity levels, and exertional dyspnea following IT.
Main Methods:
- The Mechanistic Study of Inspiratory Training in Childhood Asthma (MICA) enrolled 76 children aged 6-17 with asthma.
- Participants were divided into obese (n=38) and non-obese (n=38) groups for baseline comparisons.
- An 8-week inspiratory training intervention was implemented, with subsequent assessments of respiratory function and symptoms.
Main Results:
- The study aims to establish baseline differences in respiratory mechanics between obese and non-obese pediatric asthma patients.
- It will quantify the impact of inspiratory training on small airway function and inspiratory muscle performance.
- Physical fitness, activity, and exertional dyspnea will be monitored to gauge the intervention's broader effects.
Conclusions:
- Inspiratory training shows promise as a novel therapeutic approach for pediatric asthma, particularly in obese children.
- IT may enhance quality of life by mitigating exertional symptoms and boosting activity levels in children with asthma and obesity.
- Findings will inform future large-scale trials on IT for childhood asthma, guiding dose selection and target populations.
Abstract:
Asthma is a common pediatric disease of the airways. Obesity among children increases the risk of asthma and is associated with a unique non-allergic asthma phenotype that is highly symptomatic and often unresponsive to conventional drugs. However, the mechanisms linking obesity with incident asthma, more frequent and severe symptoms, and resistance to conventional drugs remain unknown. Excess fat on the chest wall and abdomen forces children with obesity to breathe at lower lung volumes where small airway dysfunction is more likely to occur and where the normal length-tension relationship of the diaphragm is suboptimal; this leads to altered breathing mechanics and inspiratory muscle fatigue, which could lead to exertional dyspnea. While inspiratory training (IT) increases inspiratory muscle strength and endurance, improves exercise tolerance, and reduces exertional dyspnea, most research has focused on adults. The Mechanistic Study of Inspiratory Training in Childhood Asthma (MICA) study is designed with 2 objectives: (1) compare measures of small airway dysfunction and inspiratory muscle functioning between obese (n = 38) versus non-obese (n = 38) 6-17-year-olds with asthma and (2) measure small airway disease and inspiratory muscle function in response to 8 weeks of inspiratory training. We will also assess physical fitness, activity levels, and exertional dyspnea. This study will lay the foundation for dose selection and optimal target population of a larger trial. IT could represent a novel therapy to help children with asthma and obesity improve quality of life through reduced exertional symptoms and enhanced activity levels.
Related Concept Videos
01:30Mechanism of Breathing I: Inspiration
The respiratory system, an essential network for breathing, comprises the conducting and respiratory zones, each playing a crucial role in the overall process of respiration. Let us explore the detailed mechanism of inspiration, or inhalation, which is the first phase of the respiratory cycle.
Pathway of Air during Inspiration
During inspiration, air enters our body through the nose or mouth and moves through the conducting zone,...
01:28Asthma I: Introduction
01:13Asthma III: Clinical Manifestations
01:26Asthma-II: Pathophysiology and Classification
Additionally, environmental and genetic factors play crucial roles in determining an individual's susceptibility to asthma and the severity of their condition.
Critical processes in asthma pathophysiology include:
01:20Asthma: Pathogenesis and Management
Asthma is classified as allergic and non-allergic. Allergens such as dust mites, pollen, and pet dander trigger allergic asthma, while factors like cold air, intense emotions, or exercise can induce non-allergic asthma.
01:30Asthma-IV: Diagnostic and Management
Clinical Assessment for Asthma:
This is the first step in diagnosing and managing asthma. It includes: