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CompletedNCT06958744Updated Sep 25, 2026

Effects of Functional Inspiratory Muscle Training in Patients With Chronic Non-Specific Low Back Pain

An interventional study of Functional Inspiratory Muscle Training (FIMT) group and Control group in Low Back Pain, sponsored by Uskudar University. Completed at 1 site in Turkey (Türkiye). Open to participants aged 18 Years to 55 Years. Per ClinicalTrials.gov, last updated 2026-09-25.

Sponsored by Uskudar University · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
40
Allocation
Randomized
Ages
18 Years to 55 Years
Sex
All
01

Study summary

The aim of the study was to investigate the effects of functional respiratory muscle training on diaphragm function, core stabilization, respiratory muscle strength, pain and functional status in patients with chronic non-specific low back pain.

Read the detailed description

Patients with chronic non-specific low back pain (CNSBP) have imbalances in postural control and kinetic chain. Postural control and respiratory function are mechanically and neuromuscularly interdependent. The diaphragm is the primary muscle in active inspiration with a vital role in contributing to spinal stability by modulating intra-abdominal pressure. The attachment of the diaphragm to the lumbar spine creates a synergistic working pattern with the transversus abdominis muscle. Altered activation patterns of the diaphragm and transversus abdominis have been observed in patients with chronic low back pain. Therefore, diaphragm function and respiratory pattern play a critical role in achieving and maintaining core stabilization. Studies have supported that different respiratory exercise programs are effective in reducing pain intensity, improving respiratory function and quality of life in CNSBP. These studies suggest a possible link between respiratory function, respiratory pattern, core stability and low back pain.

Inspiratory muscle training (IMT) is a technique used to increase the strength or endurance of the diaphragm and auxiliary respiratory muscles with a pressure threshold device. IMT consists of exercises involving breathing against resistance to improve respiratory muscle strength and aerobic capacity in healthy and sick populations. Respiratory muscles are also trunk muscles and their performance cannot be sufficiently optimized when respiratory muscle training is performed in isolation. Furthermore, if the load on the diaphragm, which has inspiratory, postural control and trunk stabilization tasks, increases, the muscle prefers breathing over these tasks. Functional training of the respiratory muscles is therefore recommended for optimal performance of the respiratory muscles. Functional inspiratory muscle training (FIMT) is defined as inspiratory respiratory muscle training during exercises in specific body positions. FIMT stimulates both the respiratory system and the core stabilization muscles as it consists of trunk and lumbopelvic exercises with stabilization of the spinal region during inspiratory load. Compared to traditional inspiratory muscle training, FIMT has a greater effect because it improves two roles of respiratory muscles (ventilation and spinal stabilization).

This study will investigate the effects of functional inspiratory muscle training (FIMT) on diaphragm thickness and mobility, respiratory muscle strength, core stabilization, pain and functional status in patients with CNSLBP.

02

Conditions studied

  • Low Back Pain

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03

In context

Low Back Pain

2,818 studies on the registry are indexed under Low Back Pain; 482 are open to participants now.

This study's enrollment of 40 is below the median of 60 across 2,268 interventional studies indexed under Low Back Pain.

Browse Low Back Pain studies →

Lead sponsor

Uskudar University is the lead sponsor of 164 studies on the registry; 35 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 55 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Low back pain lasting at least 3 months
  • Being between the ages of 18 and 55
  • Scoring 4 or more on the Numeric Pain Scale for the severity of low back pain
  • Having a non-specific origin (not caused by a specific pathology such as -Infection, osteoporosis, fracture, structural deformity, inflammatory disorder, radicular syndrome)
  • Individuals with inspiratory muscle strength ≥80 mmHg
  • Individuals with a forced expiratory volume (FEV1) of 80% or more

Exclusion criteria

Exclusion Criteria:

  • Tumor history
  • Spine surgery in the last 12 months
  • Spinal pathology (spondylolysis or spondylolisthesis) or concomitant neurological disease or neurological findings in the leg
  • Having a chronic systemic disease
  • Pregnancy
  • Having a disease that affects the lungs and causes breathing problems
  • Participation in a physiotherapy program in the last 6 months
05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Outcomes assessor)
Enrollment
40 participants (actual)

Study arms

  • Experimental
    Functional Inspiratory Muscle Training (FIMT) group

    Training will be given with the Powerbreath inspiratory muscle training device. Unlike traditional inspiratory muscle training, the exercises given in FIMT aim to integrate the functional capacity of respiratory muscles into daily life activities and include dynamic exercises in different positions with variable resistances. In this respect, it is defined as functional. Preparatory training will be given 4 weeks before starting FIMT: participants will be taught basic respiratory muscle training, respiratory control and exercises, and will be taught to perform the exercises while maintaining the spine in a neutral position. Patients will then be taken to FIMT for 3 days/6 weeks with a physiotherapist. On the other 3 days of the week, only inspiratory muscle training will be performed. The intensity of inspiratory muscle training will be increased from mild to moderate (Mild: Effort level between 20-40% of MIP or between Borg 2-3, Moderate: 50-60% of MIP or Borg 4-6).

    Other: Functional Inspiratory Muscle Training (FIMT) group

  • Active comparator
    Control group

    Thoracic expansion exercise will be performed for 10 weeks. The participant will be asked to practice 4 times a day as a home program.

    Other: Control group

Interventions

  • OtherFunctional Inspiratory Muscle Training (FIMT) group

    Training will be given with the Powerbreath inspiratory muscle training device. Unlike traditional inspiratory muscle training, the exercises given in FIMT aim to integrate the functional capacity of respiratory muscles into daily life activities and include dynamic exercises in different positions with variable resistances. In this respect, it is defined as functional. Preparatory training will be given 4 weeks before starting FIMT: participants will be taught basic respiratory muscle training, respiratory control and exercises, and will be taught to perform the exercises while maintaining the spine in a neutral position. Patients will then be taken to FIMT for 3 days/6 weeks with a physiotherapist. On the other 3 days of the week, only inspiratory muscle training will be performed. The intensity of inspiratory muscle training will be increased from mild to moderate (Mild: Effort level between 20-40% of MIP or between Borg 2-3, Moderate: 50-60% of MIP or Borg 4-6).

  • OtherControl group

    Thoracic expansion exercise will be performed for 10 weeks. The participant will be asked to practice 4 times a day as a home program.

06

What researchers measure

Primary outcomes

  1. Diaphragm Thickness

    Diaphragm thickness (millimeter-mm) will be measured in the supine position with ultrasonography.

    Time frame: 10 weeks

Secondary outcomes

  1. The Numeric Rating Scale

    NRS is a pain screening tool, used to assess pain severity at that moment in time using a 0-10 scale, with zero meaning "no pain" and 10 meaning "the worst pain imaginable".

    Time frame: 10 weeks

  2. Respiratory muscle strength

    Maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) measurements will be used to assess respiratory muscle strength.

    Time frame: 10 weeks

  3. McGill Core Endurance Test

    Trunk muscle endurance tests developed by McGill include Sorensen test, trunk flexion, trunk extension, right-left lateral bridge test.

    Time frame: 10 weeks

  4. The Oswestry Disability Index

    The Oswestry Disability Index (ODI) a patient-completed questionnaire which gives a subjective percentage score of level of function (disability) in activities of daily living in those rehabilitating from low back pain. The questionnaire examines the level of disability in 10 everyday activities of daily living. Each item consist of 6 statements which are scored from 0 to 5. With 0 indicating the least disability and 5 the greatest then the total score is calculated as a percentage, with 0% indicating no disability and 100% indicating the highest level of disability.

    Time frame: 10 weeks

  5. Diaphragm Mobility

    Diaphragm Mobility (millimeter-mm) will be measured in the supine position with ultrasonography.

    Time frame: 10 weeks

07

Study locations

1 site
  • Faculity of Health Sciences, Uskudar University
    Istanbul, Ümraniye 34764, Turkey (Türkiye)
08

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

09

Updates

1 registry update since Sep 25, 2026
Minor edits
Nothing that changes what the study is or who can join. Edited: description and secondary outcomes
1 update, last Sep 25, 2026
Show all 1 update
  1. Sep 25, 2026
    Minor edits only
    + 2 other changes: description and secondary outcomes

From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗

10

Registry details

Key details

Study ID
NCT06958744
Lead sponsor
Uskudar University
Responsible party
HATİCE HÜMEYRA AKIL (lecturer, Uskudar University) — Principal investigator
First posted
May 6, 2025
Start date
Apr 30, 2025
Primary completion
Sep 17, 2025
Completion
Sep 17, 2025
Last update
Sep 25, 2026

Study contacts

Filiz Eyüboğlu
principal investigator · Uskudar University

Oversight

FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Dec 2025. You cannot join it, but the record below documents what was studied.

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