BACKGROUND: To determine the effect of threshold inspiratory muscle training (IMT) on functional fitness and respiratory muscle strength (RMS) compared to incentive spirometry (IS) in children/adolescents with obesity. METHODS: A total of 60 obese children/adolescents aged 8 to 15 years were randomized into the threshold IMT group (n = 20), the IS group (n = 20), or the control group (n = 20). The IMT group performed 30 inspiratory breaths with the intensity set at 40% of baseline maximal inspiratory pressure (MIP) twice daily for 8 weeks; the IS group performed 30 breaths with sustained maximum inspiration twice daily for 8 weeks; and, the control group was assigned no training device for 8 weeks. Six-Min Walk Test (6-MWT), RMS, and spirometry were compared between baseline and 8 weeks. RESULTS: Six-MWT distance (528.5 +/- 36.2 versus 561.5 +/- 35.2 m, p = 0.002) and MIP (121.2 +/- 26.8 versus 135.3 +/- 32.1%Predicted, p = 0.03) were significantly improved after 8 weeks of IMT training. There was no significant difference in any evaluated pulmonary function parameters between baseline and 8 weeks in the IS or control groups; however, 6-MWT distance demonstrated a trend toward significant improvement in the IS group (526.9 +/- 59.1 versus 549.0 +/- 50.6 m, p = 0.10). No significant difference among groups was found for any variable relative to change from baseline to post-training. CONCLUSIONS: Eight weeks of threshold IMT training significantly improved both inspiratory muscle strength (MIP) and functional fitness (6-MWT) in children/adolescents with obesity. Eight weeks of IS training yielded a trend toward significantly improved functional fitness.

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