Why Breathing Matters: The Role of Inspiratory Muscle Training in Physiotherapy

Every day we take nearly 20,000 breaths, yet we seldom give a thought to the strength behind each one until those breathing muscles are challenged. For patients preparing for surgery, navigating chronic conditions, or recovering from injury, strong respiratory muscles can be a pivotal factor in a smoother recovery. The role of Inspiratory Muscle Training (IMT) in Physiotherapy, especially with tools like the POWERbreathe breathing trainer, has emerged as a simple, evidence-based method to bolster these muscles.

At the same time, mobility is critical to rehabilitation. Technologies like h/p/cosmos treadmill ergometers have revolutionised gait training, offering safe and tailored solutions that enable patients to regain mobility effectively. When combined, these tools (IMT for the lungs and treadmill therapy for movement) can form a powerful, integrated approach to rehabilitation.

The Unseen Power of Breathing Muscles

Breathing is driven by skeletal muscles such as the diaphragm and intercostals, all of which can be trained and strengthened. The POWERbreathe device acts like a “dumbbell for your diaphragm”: patients inhale against calibrated resistance, gradually increasing respiratory muscle strength.

IMT has broad applications. In chronic lung diseases like COPD, it helps reduce dyspnoea and improves exercise tolerance. For athletes, stronger inspiratory muscles can aid performance by delaying respiratory fatigue and enabling them to sustain higher intensities closer to VO₂ max.

Prehabilitation: Building Resilience Before Surgery

Surgical procedures, especially major cardiac or abdominal operations, can significantly weaken respiratory muscles, increasing risks of postoperative pulmonary complications (PPCs) such as pneumonia. Research shows a notable percentage of patients already have weakened inspiratory muscles even before surgery, making them more vulnerable afterwards.

Implementing IMT in the preoperative phase can dramatically change the outcome:

• A randomised controlled pilot study showed that just five days of intensive pre-op IMT reduced PPCs from 27.3% to 10.2% and shortened hospital stays by nearly two days (9.38 vs. 7.51 days) in cardiac surgery patients.
• A systematic review found that preoperative threshold IMT significantly reduced both postoperative hospital stay and complications in cardiac surgery cases. Source: https://www.powerbreathe.com/wp-content/uploads/2023/04/The-effect-of-Preoperative-threshold-inspiratory-muscle-training-in-adults-undergoing-cardiac-surgery-on-postoperative-hospital-stay-a-systematic.pdf 
• Additional studies support increases in maximal inspiratory pressure and better postoperative outcomes through respiratory muscle training. Source: https://pmc.ncbi.nlm.nih.gov/articles/PMC10251281/ https://www.powerbreathe.com/us/whos-it-for/health/pre-and-post-op/ 

These findings highlight a straightforward, low-cost intervention that empowers patients to enter surgery stronger and recover faster.

Walking Again: The Therapeutic Value of Treadmill Ergometers

Regaining mobility is a cornerstone of physiotherapeutic recovery. Standard treadmills often fall short for patients with limited mobility, which is where h/p/cosmos treadmill ergometers stand apart:

• These systems boast low step-on heights, full-length handrails, and optional wheelchair ramps, making them accessible and safe – even for severely impaired patients. https://www.hpcosmos.com/en/products/medicine-therapy/neurological-gait-therapy-gait-training 
• Advanced models like the Locomotion treadmill can integrate with assistive systems such as the Robowalk expander, providing motion support or resistance to help patients regain natural gait patterns. https://www.youtube.com/watch?v=5QWQyk_iI5U 
• Adding VR-based systems to treadmill therapy has been shown to enhance neuroplasticity, motor re-learning, balance, and gait performance. https://www.hpcosmos.com/en/vr-gait-training-biomechanics-science-update 

Moreover, body-weight-supported treadmill training is backed by evidence showing improvements in walking speed, stride length, and functional independence, particularly in hemiparetic stroke patients. Read our Case Study about h/p/cosmos Locomotion Rehabilitation Treadmill at Great Western Hospital.

The Synergistic Advantage of Breathing and Movement Training

On World Physiotherapy Day, it’s inspiring to spotlight how two specialised interventions can merge into a cohesive rehabilitation strategy as well as the role Inspiratory Muscle Training takes in Physiotherapy.

Picture a patient awaiting heart surgery: before the procedure, they engage in POWERbreathe IMT, building resilience in their respiratory muscles and reducing surgical risks. Postoperatively, once stable, they transition into treadmill-based rehabilitation with h/p/cosmos systems: safe, progressive, and tuned to their mobility level. The stronger breathing muscles support physical recovery, while gait training accelerates functional gains.

This integrated model not only expedites recovery and reduces complications but also strengthens resilience and independence. Whether for surgical patients, athletes, those with chronic pulmonary conditions, or neurologically impaired individuals, the combined application of IMT and treadmill ergometers offers a versatile, high-impact therapeutic pathway.

Conclusion: Equipping the Future of Physiotherapy with Proven Tools

As physiotherapy continues to innovate, devices like POWERbreathe inspiratory muscle trainers and h/p/cosmos treadmill ergometers are more than equipment, they’re enablers of faster, safer, and more effective rehabilitation.

On World Physiotherapy Day, celebrating how breathing and movement converge to transform recovery underscores the essence of physiotherapy: empowering people to move, breathe, and live better.

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