Comparative effectiveness of progressive moderate- to high-intensity peripheral and inspiratory muscle training combined with aerobic exercise in community-dwelling older adults: A randomized clinical trial.

Between-group comparison revealed a significant difference only in the WHOQOL-OLD death and dying subscale, with greater improvement in the IMT group.

• P = .019, d = 0.185 for the between-group difference in the death and dying subscale
• 34 community-dwelling older adults were randomized: PMT group (n = 17) and IMT group (n = 17)
• All other outcome measures did not show significant between-group differences
• Assessments were conducted at baseline and after 10 weeks of training

Peripheral muscle training combined with aerobic exercise produced significant within-group improvements in expiratory muscle strength and functional capacity.

• MEP improved significantly: P = .003, d = 0.876
• MEP% improved significantly: P = .002, d = 0.932
• 6-minute walk test (6-MWT) improved significantly: P = .001, d = 0.974
• WHOQOL-OLD sensory abilities subscale also improved significantly: P = .035, d = 0.528
• PMT was performed at 60 to 80% of one-repetition maximum (1RM), targeting upper and lower extremities

Inspiratory muscle training combined with aerobic exercise produced significant within-group improvements in inspiratory muscle strength, functional capacity, and quality of life related to death and dying.

• MIP improved significantly: P = .002, d = 0.788
• MIP% improved significantly: P = .001, d = 1.032
• 6-MWT improved significantly: P = .003, d = 0.889
• WHOQOL-OLD death and dying subscale improved significantly: P = .040, d = 0.564
• IMT was performed at 60 to 80% of baseline maximum inspiratory pressure using a threshold IMT device

Both groups participated in supervised step-aerobic sessions as a common intervention component across the 10-week program.

• Step-aerobic sessions were conducted twice weekly for 10 weeks
• Target intensity was 50 to 70% of individual maximum heart rate
• Outcome measures included hand grip strength, MIP, MEP, 6-MWT, SPPB, SARC-F questionnaire, and WHOQOL-OLD
• Participants were community-dwelling older adults

Peripheral muscle training combined with aerobic exercise improved expiratory muscle strength despite not targeting respiratory muscles directly.

• MEP and MEP% showed significant improvements in the PMT group (P = .003 and P = .002, respectively)
• Effect sizes for MEP (d = 0.876) and MEP% (d = 0.932) were large
• The PMT group did not perform dedicated respiratory muscle training
• This finding suggests peripheral resistance training may have secondary effects on expiratory muscle strength

Both groups demonstrated significant improvements in functional capacity as measured by the 6-minute walk test.

• PMT group 6-MWT improvement: P = .001, d = 0.974
• IMT group 6-MWT improvement: P = .003, d = 0.889
• Both effect sizes were large (approaching d = 1.0)
• No significant between-group difference in 6-MWT was reported, suggesting comparable functional capacity gains