A rationale for training respiratory muscles.

In planning a training programme for respiratory muscles several factors should be considered: establish the objective according to the patient's pathology, provide an adequate stimulus (both in intensity and quality), define if the goal is to increase coordination, strength, endurance, or all three. Several respiratory muscle conditioning plans have been used, mostly derived from three major protocols: sustained hyperventilation, resistive breathing, and manipulations of the breathing pattern. They have proved to be effective in quadriplegia, cystic fibrosis and to some extent in COPD patients. Respiratory muscle recovery and training in patients with respiratory failure is discussed.