BACKGROUND: Most inspiratory muscle training (IMT) interventions in patients with COPD have been implemented as fully supervised daily training for 30 minutes with controlled training loads using mechanical threshold loading (MTL) devices. Recently, an electronic tapered flow resistive loading (TFRL) device was introduced that has a different loading profile and stores training data during IMT sessions. OBJECTIVE: We aimed to compare the efficacy of a brief, largely unsupervised IMT protocol, conducted using either traditional MTL or TFRL on inspiratory muscle function in patients with COPD. DESIGN: Twenty clinically stable patients with inspiratory muscle weakness, participating in a pulmonary rehabilitation program, were randomly allocated to perform eight weeks of either MTL- or TFRL-IMT. METHODS: Patients performed two daily home-based IMT sessions of 30 breaths (3 to 5 minutes per session) at the highest tolerable intensity, supported by twice weekly supervised sessions. Compliance, progression of training intensity, increases in maximal inspiratory mouth pressure (Pimax) and endurance capacity of inspiratory muscles (Tlim) were evaluated. RESULTS: More than 90% of IMT sessions were completed in both groups. The TFRL group tolerated higher loads during the final three weeks of the IMT program (all p < 0.05) with similar effort scores on a Borg CR-10 scale, and achieved larger improvements in Pimax (p = 0.02), and Tlim (p = 0.02) than the MTL-group. LIMITATION: Absence of a study arm involving a sham-IMT intervention. CONCLUSION: The short and largely home-based IMT protocol significantly improved inspiratory muscle function in both groups and is an alternative to traditional IMT protocols in this population. Patients in the TFRL-group tolerated higher training loads and achieved larger improvements in inspiratory muscle function than patients in the MTL group.

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