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Inspiratory Muscle Training as an Adjunct to the Treatment of Weaning Failure in Critically Ill Patients: A Practical Guide

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Published on: January 30, 2026

Inspiratory Muscle Training in Older Patients With Acute Heart Failure: Design and Rationale of a Multi-Arm

Ren Takahashi^1,2, Junichi Yokota¹, Eiki Tsushima¹

¹Division of Comprehensive Rehabilitation Sciences, Hirosaki University Graduate School of Health Sciences Aomori Japan.

Circulation Reports

|June 11, 2026

Summary

This study investigates inspiratory muscle training (IMT) for older adults with acute heart failure (AHF) and inspiratory muscle weakness (IMW). The trial aims to determine the efficacy and safety of IMT in improving functional capacity for AHF patients.

Keywords:

Acute heart failure Cardiac rehabilitation Inspiratory muscle training

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Published on: July 5, 2017

Area of Science:

Cardiology
Pulmonology
Geriatrics

Background:

Approximately 70% of older patients with acute heart failure (AHF) experience inspiratory muscle weakness (IMW).
Evidence on the efficacy, safety, and optimal dosing of inspiratory muscle training (IMT) in this population is limited.
IMT holds potential for improving respiratory function and functional capacity in older AHF patients.

Purpose of the Study:

To verify the efficacy and safety of inspiratory muscle training (IMT) in older patients diagnosed with acute heart failure (AHF).
To provide evidence for the integration of IMT into cardiac rehabilitation programs for elderly AHF patients.

Main Methods:

A single-center, multi-arm, parallel-group randomized controlled trial (IMT-AHF) was conducted.
Older patients (≥65 years) with AHF and IMW, capable of independent ambulation, were enrolled.
Participants were randomized to high-intensity IMT (HI-IMT), low-intensity IMT (LI-IMT), or sham IMT, stratified by age, sex, and baseline 2-min walk distance (2MWD).
Training involved 5 sessions/week for 3 sets of 15 repetitions, with intensities set at 60% (HI-IMT), 30% (LI-IMT), and 0% (sham) of maximum inspiratory mouth pressure.
The primary endpoint was the change in 2MWD from baseline to discharge.

Main Results:

The primary endpoint is the change in 2-min walk distance (2MWD) from baseline to discharge.
Further analysis will determine the comparative effectiveness of HI-IMT, LI-IMT, and sham IMT on 2MWD.

Conclusions:

The IMT-AHF trial is expected to yield significant findings regarding the use of IMT in older patients with AHF.
Results will contribute to strengthening the evidence base for cardiac rehabilitation strategies.
The study aims to inform the optimal prescription of IMT for this specific patient demographic.