The effect of inspiratory muscle training in PCD and CF patients: A pilot study

Michal Gur, Eynav Manor, Moneera Hanna, Nadeen Simaan, Guy Gut, Yazeed Toukan, Fahed Hakim, Ronen Bar–Yoseph, Lea Bentur

Research output: Contribution to journalArticlepeer-review


Background: Effective work of breathing and bronchial hygiene requires synergy of inspiratory and expiratory muscles. Inspiratory muscle training (IMT) is a part of pulmonary rehabilitation in chronic obstructive pulmonary disease (COPD). There is some evidence of its efficacy in cystic fibrosis (CF) and, recently, in long COVID-19. We are not aware of studies on IMT in primary ciliary dyskinesia (PCD). Our aim was to assess the effect of IMT on respiratory muscle strength and pulmonary function in PCD and CF patients. Methods: A single center pilot study. Spirometry, lung clearance index (LCI), maximal inspiratory pressure (MIP), and maximal expiratory pressure (MEP) were measured at baseline (visit 1), after a month of IMT with ®POWERbreathe (visit 2), and at follow-up (visit 3). Results: The cohort included 27 patients (19 PCD, 8 CF); mean age 18.4 ± 9.8 years. After a month of IMT, there was a significant increase in MIP and MIP% (6.19–7.44, p =.015; and 81.85%–100.41%, p =.046, respectively), which was sustained at visit 3. Compliance ≥90% led to higher improvement in MIP. In sub-group analysis, improvement in MIP and MIP% remained significant for PCD patients (p =.026 and p =.049, respectively). No significant changes were found in spirometry, MEP or LCI. Conclusions: IMT was well-tolerated and led to improved inspiratory muscle strength in PCD patients. The clinical implication of improved MIP should be further investigated. Larger, long-term studies are needed to evaluate long-term effects of IMT on pulmonary function, respiratory muscle strength, pulmonary exacerbations, and quality of life.

Original languageEnglish
Pages (from-to)3264-3270
Number of pages7
JournalPediatric Pulmonology
Issue number11
StatePublished - Nov 2023
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2023 The Authors. Pediatric Pulmonology published by Wiley Periodicals LLC.


  • cystic fibrosis
  • inspiratory muscle training
  • maximal inspiratory pressure
  • primary ciliary dyskinesia


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