OBJECTIVES: Identify the effects of inspiratory muscle training (IMT) on walking capacity, strength and inspiratory muscle endurance, activities of daily living, and quality of life poststroke. DESIGN: Double-blind randomized trial. SETTING: The Sarah Network of Rehabilitation Hospitals. SUBJECTS: Adult poststroke inpatients with inspiratory muscle weakness. INTERVENTIONS: The experimental group (EG) (n = 23) underwent IMT for 30 minutes/day, five times/week over six weeks. The control group (CG) (n = 27) performed sham IMT. Both groups underwent standard rehabilitation. MAIN MEASURES: Primary outcome was post-intervention six-minute walking test (6MWT) distance. We also measured maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), inspiratory muscle endurance, activities of daily living (functional independence measure -- FIM), and quality of life at baseline and post-intervention. Three months after intervention, we measured MIP, walking capacity and quality of life. RESULTS: Baseline characteristics were similar, with mean age 53 +/- 11 years and FIM 74 +/- 10 p. Both groups similarly increased the walking capacity at six weeks (63 versus 67 m, p = 0.803). Compared to the CG, the EG increased the inspiratory endurance (22 versus 7 cmH2O, p = 0.034) but there was no variation in MEP (14 versus 5 cmH2O, p = 0.102), MIP (27 versus 19 cmH2O, p = 0.164), FIM (6 versus 6, p = 0.966) or quality of life (0 versus 0.19, p = 0.493). Gains in both groups were sustained at three months. CONCLUSION: Adding IMT to a rehabilitation program improves inspiratory muscle endurance, but does not further improve MIP, 6-MWT distance, activities of daily living or quality of life of individuals after stroke beyond rehabilitation alone. Registered in ClinicalTrials.gov, NCT03171272.

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