Inspiratory muscle training (IMT) has been shown to improve exercise capacity in diseased populations. We chose to examine the effects of eight weeks of IMT on exercise capacity and spontaneous physical activity in elderly individuals. Eighteen moderately active elderly subjects (68.1 +/- 6.8 years (mean +/- SD); range 58 to 78 years) were randomly assigned to either an experimental group (n = 9) or a control group (n = 9) in a double-blind manner. All subjects underwent inspiratory muscle testing, treadmill exercise testing and a four-day measurement period of spontaneous physical activity (using accelerometry) both pre- and post-intervention. The experimental group underwent eight weeks of incremental IMT using a pressure threshold device, while the control group underwent sham training using identical devices. After IMT training, inspiratory muscle strength (mean +21.5 cmH2O; 95%CI 9.3 to 33.7; p = 0.002), VO2peak (+2.8 ml/min/kg; 95%CI 0.5 to 5.2; p = 0.022), time to exhaustion during a fixed workload treadmill test (+7.1 min; 95%CI 1.8 to 2.4; p = 0.013) and time engaged in moderate-to-vigorous physical activity (+59 min; 95%CI 15 to 78; p = 0.008) improved. Except for a decline in moderate-to-vigorous physical activity, no significant changes were seen in the control group. Therefore, IMT may be a useful technique for positively influencing exercise capacity and physical activity in elderly individuals.

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