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How Can We Effectively Identify and Address Inspiratory Muscle Weakness to Alleviate Shortness of Breath and Enhance Functional Capacity?

Jessica DeMars, BSc.P.T.

March 1, 2024

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Question

How Can We Effectively Identify and Address Inspiratory Muscle Weakness to Alleviate Shortness of Breath and Enhance Functional Capacity?

Answer

When contemplating inspiratory muscle training, the underlying consideration is the potential contribution of inspiratory muscle weakness to shortness of breath or functional limitations. It is important to remember that the diaphragm, being a skeletal muscle, is susceptible to weakness or dysfunction. Thus, it can significantly benefit from targeted strength training.

Identifying respiratory weakness may not be as conspicuous as recognizing, for instance, weakness in the quadriceps that hinders climbing stairs. It does not present itself prominently, except perhaps in certain clinical scenarios. However, this respiratory weakness can manifest in reduced exercise tolerance or exertional shortness of breath. The definition of respiratory muscle weakness lies in diminished muscle contractility, leading to an inability to generate normal pressure and airflow during breathing. Notably, this is not readily apparent without specific testing; it may not be the initial consideration.

In contrast, as a physiotherapist, pinpointing muscle weakness in other areas is often more straightforward. For instance, having someone attempt to walk up a staircase can quickly reveal muscular deficiencies. This lays the groundwork for the historical contemplation of inspiratory muscle training.

Inspiratory muscle testing involves assessing the strength and function of the muscles responsible for inhalation, specifically the muscles that help you breathe in air. It boils down to weight training for the inspiratory muscles. Training these respiratory muscles, particularly the inspiratory ones, necessitates an external load – a specific and targeted resistance. Placing a book on the belly, for instance, does not quite meet the criteria. This testing is often conducted to evaluate respiratory function and can be useful in assessing conditions such as respiratory muscle weakness or dysfunction.

One common method of inspiratory muscle testing is through the use of a device that measures the force generated during inhalation. This information can be valuable in understanding and managing respiratory health. Precision in resistance is key. The primary objective of IMT is to enhance the functionality of respiratory muscles through specialized loading. 

This Ask the Expert is an edited excerpt from the course, Inspiratory Muscle Training: A Review of the Evidencepresented by Jessica DeMars, BSc.P.T.


jessica demars

Jessica DeMars, BSc.P.T.

Jessica graduated from the University of Alberta in 1998 with a Bachelor of Science Degree in Physical Therapy (with distinction). She practiced in a private setting and continued her education with numerous post-graduate courses.  In 2006, her focus shifted toward learning about the impact breathing has on health.  Since that time, she has attended numerous courses and gained in-depth knowledge in treating breathing pattern disorders and unexplained breathlessness. 

With the onset of the COVID-19 pandemic, Jessica quickly recognized that infections were resulting in debilitating ongoing symptoms for many and that this would have a major impact on the population.  She has worked to improve her knowledge of other post-infectious and complex illnesses, from which we take our learning for Long COVID.  She has become an ally and an advocate and has been a part of the Long COVID Physio board since its inception in 2021.  Jessica has developed several courses and webinars on Long COVID to assist with knowledge translation to allied health professionals, in addition to creating programming for those living with Long COVID.
 


Related Courses

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