OBJECTIVE: To evaluate the effect of inspiratory muscle training (IMT) on functional sitting balance (FSB) in individuals with spinal cord injury (SCI). DESIGN: Rater-masked, parallel, two-group randomized clinical trial. SETTING: Tertiary care SCI rehabilitation hospital in Delhi, India. PARTICIPANTS: Forty-four participants (aged 18 to 60) with C4-T6 injuries (AIS A-C) (cervical-SCI = 25, thoracic-SCI = 19, AIS A = 33, B = 11, C = 0) in their first SCI-specific inpatient rehabilitation were randomized into experimental and control groups. INTERVENTIONS: Both groups received standard respiratory care and physiotherapy. The experimental group received additional flow-resistive IMT sessions over six weeks. MAIN OUTCOME MEASURES: FSB was measured using the Function in Sitting Test-SCI (FIST-SCI), and respiratory function was assessed via maximal inspiratory pressure (MIP), sustained maximal inspiratory pressure (SMIP), and Fatigue Index Test (FIT) score at baseline, four weeks and six weeks. Data was analyzed using repeated measures general linear model framework in IBM SPSS version 21. RESULTS: Analysis showed significant improvements in FSB for both groups (p < 0.001). SMIP, MIP, and FIT scores improved only for the experimental group (p < 0.05). Post-hoc analyses of interaction effects showed significantly greater improvements in all variables in the experimental group. CONCLUSION: This study is the first to show that FSB improves more with addition of IMT to standard care in individuals with SCI.

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