BACKGROUND: Age-related declines in respiratory muscle strength and ventilatory efficiency can impair functional capacity and metabolic health in older adults. Inspiratory muscle training (IMT) has been proposed as a practical intervention to counteract these changes, yet its systemic effects remain unclear. This study aimed to examine the effects of short-term IMT on functional capacity, diaphragm thickness, and liver tissue characteristics in healthy elderly men. METHODS: Thirty community-dwelling men aged 60 to 80 years were randomly assigned to an IMT or control group. The IMT group performed four weeks of breathing exercises using a POWERbreathe R device at 40% of maximal inspiratory pressure, with a weekly 10% increase in pressure. Pre- and post-intervention assessments included the six-minute walk test (6MWT), diaphragm thickness and liver density via computed tomography, and quality of life (QoL; SF-12). RESULTS: Four weeks of inspiratory muscle training significantly improved diaphragm thickness (11.7%), fatty liver density (FLD) (+16.7%), and six-minute walk performance (+5.3%), with large time x group effects favoring the IMT group. While the physical quality of life showed modest, comparable improvements, mental health outcomes demonstrated a moderate, time-dependent improvement without a significant group-by-time interaction. CONCLUSIONS: Short-term IMT improved diaphragmatic function and functional capacity in older men and was associated with favorable changes in a liver-related biomarker; however, given that only a single liver-related metric was assessed, these findings should not be interpreted as evidence of overall improvements in liver health.

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