Step 1

Determine the patient’s optimal training load


Use a pressure manometer to determine the patient’s maximal inspiratory pressure. The prescribed initial training load should be 30% of the PImax. You can adjust as needed based on age and quality of airflow.

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Step 2

Teach the patient to correctly use the device


Because most training will be done in the home, it is critical that the patient understands their device and proper training technique. The first training should be supervised and respiratory rate and oxygen saturation monitored. Patients should train using a large tidal volume and should be able to take a near maximal breath with every inhalation, maintaining a slow breathing rate.

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Step 3

Establish a training schedule


Most programs consist of training three days a week for a duration of eight weeks. Each session should be 15 to 30 minutes in length. Following the initial eight-week training period, a maintenance plan can be introduced to retain progress.

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Step 4



Following the initial training period, check in with your patient to measure the efficacy of IMT. Determine the program’s effectiveness by evaluating criteria such as dyspnea, exercise capacity, quality of life, and readmissions. If the patient should continue with training, you can increase pressure as muscle strength improves.

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