INSPIRATORY MUSCLE TRAINING IN CARDIAC POPULATIONS

Abstract

Background: About 50% of patients with chronic heart failure (HF) have inspiratory muscle weakness, which exacerbates dyspnoea, exercise intolerance, and a poor prognosis. Although inspiratory muscle training (IMT) is a low-risk, low-cost technique, its evidence has not been mapped for physiotherapists across cardiac populations, including HF, post-cardiac surgery, and related cardiovascular illnesses. The aim was to map the nature, extent, and quality of evidence for IMT in adult cardiac populations, charting protocols, outcomes, effect directions, and gaps, with critical appraisal of the principal sources.

Methodology: Indexed literature (January 2018 - March 2026) was searched and screened; a scoping review was carried out in accordance with JBI and reported in accordance with PRISMA-ScR. Nine sources were retrieved.

Results: IMT improves maximal inspiratory pressure, peak oxygen uptake, six-minute walk distance, ventilatory efficiency, and quality of life in HF, with synergistic gains when combined with aerobic or resistance training, according to convergent meta-analytic evidence; recent trials also show benefits for arterial stiffness and cardiac autonomic function. There is limited data on valvular disease in the peri-PCI period, and there is positive but weaker evidence in post-CABG and related cardiovascular disorders. Certainty is limited by protocol heterogeneity, brief follow-up, small sample sizes, and the lack of hard-outcome data.

Conclusion: IMT is a promising post-cardiac surgery and well-supported adjunct for functional and symptomatic outcomes in HF, but more high-quality, longer, appropriately powered trials, as well as any evidence for valvular and periprocedural PCI populations are required