The Application of Inspiratory Muscle Training in Community-Dwelling Older Adults

Background: As individuals age, they experience a decline in muscle strength, particularly the respiratory muscles (such as the diaphragm), which not only affects respiratory efficiency but also may lead to postural instability and balance issues, limiting daily activity capacity. Inspiratory muscle training, by strengthening respiratory muscles like the diaphragm, improves breathing efficiency, reduces muscle fatigue and shortness of breath during exercise, and thus enhances physical performance and quality of life. Moreover, inspiratory muscle training has a significant impact on balance. The diaphragm plays an essential role in maintaining postural stability, and training it can enhance the core muscles' contribution to postural balance, improve spinal support, and reduce the risk of falls. This makes it a promising non-pharmacological therapy for older adults. Therefore, inspiratory muscle training is considered a solution to improve the daily functional capacity, respiratory efficiency, and physical performance of elderly individuals. Methods: This study is a pilot study aimed at comparing muscle training (inspiratory muscle training, IMT) and incentive spirometer (Triflow) on respiratory muscle strength, pulmonary function, functional exercise capacity, quality of life, and physical activity in healthy older adults in the community. Due to limitations in manpower and resources, a convenience sampling method will be used, and participants will be recruited from 6-8 community centers, with cluster randomization at the community level. Each community center is expected to recruit 10-15 participants, with a total of 80 participants. The experimental group will use a handheld threshold trainer (n = 40, starting at 40% of Maximum Inspiratory Pressure, MIP), while the control group will use an inducible spirometer (n = 40, with the goal of raising one or more balls to the top). This study will explore the differences and potential of these two training methods in improving respiratory muscle strength, daily living abilities, exercise performance, and quality of life.

Inclusion Criteria: 1. Aged ≥65 years. 2. Normal cognitive function 3. No psychiatric disorders or Alzheimer's disease. 4. Able to go out independently and perform self-care. 5. Willing and able to participate throughout the health-promotion program. Exclusion Criteria: 1. Individuals whom a physician has determined have a serious illness for which exercise is not recommended. 2. Individuals with functional limitations that may interfere with inspiratory muscle training (IMT) and/or maximal inspiratory pressure (MIP) measurement-for example, unstable angina, complex arrhythmias, rheumatologic disease, active infectious disease, or cognitive impairment.