Question
What precautions and contraindications should be considered when using Inspiratory Muscle Training?
Answer
When considering IMT, it is crucial to be mindful of potential precautions and contraindications, many of which are rooted in the theoretical possibility of generating significant negative pressure swings during training. As individuals draw in a breath, the pressure changes can pose certain risks.
For instance, caution should be exercised if a person has a history of spontaneous pneumothorax or presents with large bullae on a chest x-ray. In such cases, creating intense pressure within the lungs may not be advisable. Similarly, individuals with severe osteoporosis and a history of rib fractures should approach IMT cautiously. The aggressive inhalation involved in the training process may pose risks, especially if individuals experience desaturation during its application. These considerations underscore the importance of tailoring IMT interventions based on an individual's specific medical history and condition.
In the realm of precautions, it is noteworthy to exercise caution with asthma patients who have very low symptom perception and experience frequent severe exacerbations. Additionally, individuals with an active cold, sinus or respiratory infection, or an eardrum issue should approach IMT with care, as the negative pressure generated during training may not be beneficial in these conditions.
When it comes to osteoporosis, it is not necessarily a contraindication but a precaution. In such cases, the approach to IMT may involve adjusting the load and repetitions. Opting for lower loads and longer repetitions could be a more prudent strategy, akin to modifying strength training in any other context. The key takeaway is the importance of tailoring the IMT approach based on individual characteristics and conditions, emphasizing a personalized and cautious prescription. This ensures that the potential benefits of IMT are realized while minimizing any associated risks.
This Ask the Expert is an edited excerpt from the course, Inspiratory Muscle Training: A Review of the Evidence, presented by Jessica DeMars, BSc.P.T.
