Inspiratory muscle training in addition to conventional physical rehabilitation in hospitalized patients undergoing hematopoietic stem cell transplantation: a randomized controlled trial

Purpose To investigate the effect of inspiratory muscle training (IMT) in addition to conventional physical rehabilitation on muscle strength, functional capacity, mobility, hemodynamics, fatigue, and quality of life in hospitalized patients undergoing hematopoietic stem cell transplantation (HSCT). Methods We conducted a randomized controlled trial in 57 inpatients with hematological diseases undergoing HSCT. Conventional inpatient physical rehabilitation was delivered to the IMT ( n = 27) and control (CON; n = 30) groups according to usual care, and the first group additionally performed IMT. The IMT was prescribed according to clinical and laboratory parameters at 40% of maximal inspiratory pressure (MIP), 5 days/week throughout the hospitalization, in sessions of 10–20 min. The primary outcome was MIP and the secondary outcomes were maximal expiratory pressure (MEP), peripheral muscle strength (handgrip and sit-to-stand tests), functional capacity (6-min step test), mobility (timed up and go test), blood pressure, quality of life (EORTC-QLQ-C30), and fatigue (FACT-F) at admission and hospital discharge. Results The population was predominately autologous HSCT. The IMT group significantly increased the MIP ( P < 0.01) and decreased both fatigue ( P = 0.01) and blood pressure ( P < 0.01) compared with control. No differences were found between admission and hospital discharge in peripheral and expiratory muscle strength, functional capacity, mobility, and quality of life in both groups ( P > 0.05). Conclusions Our results support the effectiveness of IMT as part of rehabilitation for HSCT inpatients, improving inspiratory muscle strength, and reducing fatigue and blood pressure. Trial registration NCT03373526 (clinicaltrials.gov).