Background: Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality worldwide. The aim of this study was to investigate the effects of INSPIRATORY MUSCLE TRAINING ((IMT)) and aerobic exercise on healthrelated quality of life of patients with COPD. Materials and Methods: This randomized controlled clinical trial was conducted on 60 patients with moderate to severe COPD, who were referred to Imam Hossein Hospital of Tehran, Iran in 2016. The patients were randomly assigned to four groups and treated for eight weeks. Group 1 (n=16) participated in 16 sessions of (IMT) (15 minutes per session), group 2 (n=14) performed aerobic exercises twice a week (40 minutes per session), group 3 (n=15) performed (IMT) and aerobic exercises, and group 4 (n=15) received no intervention, except for routine treatments (control). Quality of life was evaluated based on the Saint George’ s Respiratory Questionnaire (SGRQ) at baseline, week 4, and week 8 after the intervention. Results: After eight weeks, all four groups experienced a significant improvement in their quality of life (P<0. 05), and group 3 ((IMT) and aerobic exercise) showed the greatest improvement. However, quality of life improvement in group 4 (control) was less than the other three groups (P<0. 05). Conclusion: Aerobic exercise and (IMT) were more effective than routine protocols in improving the quality of life of COPD patients. Furthermore, shortterm (IMT) plus aerobic exercise had the greatest impact on improving the health-related quality of life of COPD patients and could be used in the management of these patients.

Objectives: This review aimed to explore INSPIRATORY MUSCLE TRAINING ((IMT)) use in patients with mechanical ventilation (MV). The topics were related to its effect on the duration of MV or weaning, respiratory symptoms or lung function, INSPIRATORY MUSCLE strength (IMS) or endurance, functional ability, and quality of life (QoL). Methods: Articles published in the last ten years were reviewed narratively to obtain data about how INSPIRATORY MUSCLE TRAINING ((IMT)) can affect breathing MUSCLE strength in prolonged mechanically ventilated patients. Results: Eleven articles were relevant to the topic, including seven original articles and four systematic reviews. We also found one practical guide on (IMT) in intensive care unit (ICU) patients. Discussion: INSPIRATORY MUSCLE weakness is found in most intensive care unit (ICU) patients which further causes difficulty in weaning from MV. No standard protocol exists for the use of (IMT) in patients who failed to wean from MV. The use of (IMT) was found to be safe with the incidence of side effects or unexpected events was very rare. Several studies found various effects on the success of weaning after (IMT) administration, such as decreased MV and weaning duration or no effect on these parameters. Studies also found various effects on IMS or endurance although most investigators found increased IMS after (IMT) administration. These effects vary with exercise intensity and baseline maximum INSPIRATORY pressure (MIP). The (IMT) program improves lung function thereby reducing symptoms, leading to improved functional abilities and QoL.improved functional abilities and quality of life (QoL).

Background: INSPIRATORY MUSCLE TRAINING has been introduced as one of the effective methods in pulmonary rehabilitation, and attention to this technique in patients with COVID-19 is still being studied. Materials and Methods: In the present study 52 patients who have undergone the period of the COVID-19 disease were randomly divided into two groups. In the control group, in addition to the routine treatment prescribed by a specialist physician, rehabilitation was performed by performing diaphragmatic breathing exercises, pursed-lips breathing, chest expansion, and simple stretching exercises. In the intervention group in addition to the rehabilitation program provided to the control group, patients used an INSPIRATORY MUSCLE TRAINING device. This pulmonary rehabilitation program was performed twice a day and 30 repetitions each time with a two-minute rest after every 10 exercises. After 4 weeks, patients in both groups were referred to the hospital for reassessment of the distance of the 6-minute walk test, SF-12 questionnaire results, dyspnea, and S-index. To compare quantitative variables between the two groups we utilized a student t-test. Type one error was put at P≤, 0. 05. Results: The comparison of 6MWT values shows that the mean of this index in the intervention group is significantly higher than the control group (p = 0. 002). Also, the S-index of the two groups showed a significant difference (p=0. 024). Results show a significant increase in the SF-12 quality of life questionnaire in patients using (IMT) (p=0. 001). Conclusion: (IMT) improves pulmonary functions, 6MWT, and SF-12 Questionnaire in recovered COVID-19 patients.

Background: Hyper-kyphosis is one of the most common malalignments in adolescent boys and can affect their breathing. INSPIRATORY MUSCLE TRAINING ((IMT)) may improve the function of the respiratory MUSCLEs in adolescents and may influence their skeletal structure as well. So, this study aimed to examine the effects of INSPIRATORY MUSCLE TRAINING on the thoracic spine curve, INSPIRATORY volume and cardio-respiratory endurance in hyperkyphotic boys Methods: This study was a semi experimentally in design, pre and post-test design with a control group. Twenty-two 12-15 boys, with thoracic spine curve more than 49 degrees were randomly divided into control and experimental groups. Both groups performed the same corrective exercise for hyper-kyphosis, the experimental group also performed INSPIRATORY MUSCLE TRAINING five days a week using the power breathing device, based on the TRAINING protocol. Both groups were evaluated before and after 12 weeks of TRAINING in terms of the thoracic spine curve, INSPIRATORY volume, S-index, PIF, and cardiorespiratory endurance. Results: The data analysis showed that the thoracic spine curve decreased significantly in the (IMT) group (Pvalue=0. 025). The (IMT) group showed significantly increase in INSPIRATORY S-index (T=4. 058, Pvalue=0. 002), PIF (T=4. 06, Pvalue=0. 002) and cardio-respiratory endurance (T=2. 62, Pvalue=0. 050) at posttest in compare to control group. Conclusions: Based on the study findings, it can be concluded that respiratory MUSCLE strengthening alone may not be by itself sufficient for the improvement of Hyper-kyphosis, and corrective exercises can also be recommended along with it.

Background: The purpose of this study was to evaluate the effect of threshold INSPIRATORY MUSCLE TRAINING , ((IMT)) on the duration of weaning in intensive care unit ,(ICU)‑, admitted patients. Materials and Methods: This randomized clinical trial enrolled 79 ICU‑, admitted, mechanically ventilated patients in 2020–, 2021 in Imam Reza Hospital, Mashhad. Patients were randomly divided into intervention , (n , = , 40) and control , (n , = , 39) groups. The intervention group received threshold (IMT) and conventional chest physiotherapy, while the control group only received conventional chest physiotherapy once a day. Before and after the end of the intervention, the strength of INSPIRATORY MUSCLEs and the duration of weaning were measured in both the groups. Results: The duration of weaning was shorter in the intervention group , (8. 4 , ±,  , 1. 1 , days) versus the control group , (11. 2 , ±,  , 0. 6 , days) , (P , < , 0. 001). The rapid shallow breathing index decreased by 46. 5% in the intervention group and by 27. 3% in the control group after the intervention , (both P , < , 0. 001), and the between‑, group comparison showed a significantly higher reduction in the intervention group than control group , (P , < , 0. 001). The patients’,compliance after the intervention compared to the 1 st  , day increased to 16. 2 , ±,  , 6. 6 in the intervention group and 9. 6 , ±,  , 6. 8 in the control group , (both P , < , 0. 001), and the between‑, group comparison showed a significantly higher increase in the intervention group than control group. The maximum INSPIRATORY pressure increased by 13. 7 , ±,  , 6. 1 in the intervention group and by 9. 1 , ±,  , 6. 0 in the control group , (P , < , 0. 001). Furthermore, the weaning success was 54% more probable in the intervention group than control group , (P , < , 0. 05). Conclusion: The results of this study showed the positive effect of (IMT) with threshold (IMT) trainer on increased strength of respiratory MUSCLEs and reduced weaning duration.