Review Article

Inspiratory Muscle Rehabilitation Training in Pediatrics: What Is the Evidence?

Table 2

Types of inspiratory muscle rehabilitation training.

Device typeSubtypesCommercial productsStrengthsLimitations

Voluntary isocapnic hyperpneaN/ASpiroTigerReal-time biofeedbackRelatively expensive and complex equipment
Limited portability
Training is strenuous and time-consuming

Flow-resistive loadingAnalogBreather, P-FlexInexpensive
Highly portable
Load varies with flow rate
Limited biofeedback capability
DigitalPOWERbreathe K-seriesHighly programmable

Automated data collection
Real-time biofeedback with Breathe-Link software for K4/K5
KH1 allows measurement of MIP
Wide range of resistance (5–200 cm H2O)
Relatively expensive
Full functionality for K4/K5 devices requires a computer, which increases cost and decreases portability
PrO2Highly portable
Highly programmable

Automated data collection
Real-time biofeedback provided via smartphone app
Measurement of MIP
Relatively expensive
Full functionality requires a smartphone/tablet and an app

Pressure-threshold loadingN/AThreshold IMTInexpensive
Highly portable
Load is relatively independent of flow rate
Calibration markings are easy to interpret and set
Limited biofeedback capability
Available load is low range and narrow (9–41 cm H2O)
Analog devices from POWERbreathe (e.g., Medic, Classic, Plus)Inexpensive
Highly portable
Load is relatively independent of flow rate
Relatively wide range of loads available
Limited biofeedback capability
Can be difficult to determine range of load for various models
Ordinal calibration markings do not quantify load
EMST75/150 with IA150Relatively inexpensive
Highly portable
Load is relatively independent of flow rate (mm)
Relatively wide range of loads available (5–75 cm H2O with EMST75; 30–150 cm H2O with EMST150)
Limited biofeedback capability
For inspiratory training, both expiratory device (EMST75 or EMST150) and inspiratory adapter (IA150) are required
Calibration markings to quantify load may be difficult to interpret

Note. MIP – maximal inspiratory pressure and EMST – expiratory muscle strength training.