IMT in Asthma: Activity, Coping, Self-Management

Reflections of Inspiratory Muscle Training on Patient Experiences in Asthma Rehabilitation

The aim of this study is to investigate asthma patients' experiences with an 8 week IMT and the perceived effects of this intervention on physical activity, coping strategies, and asthma self-management. A qualitative methodological design will be applied to understand the experiences of patients participating in the IMT program, how the program affected their daily activities, how they coped with symptoms and difficulties, and how they managed their condition.

The study will include patients diagnosed with asthma by a chest disease specialist and referred for pulmonary rehabilitation. Cases meeting the inclusion criteria will be questioned about the effects of their previous experience with COPD on their daily lives, their coping strategies, and their self-management processes. Therefore, it is determined as a basic criterion that participants have received IMT training for 8 weeks, 2 days a week via video conference and 1 day within the home program, for a total of 3 days a week. IMT should be performed in 7 sets, consisting of 2 minutes of work and 1 minute of rest, for a total of 21 minutes. Five main themes were identified as a result of data analysis. (a) Inspiratory Muscle Training and Participant Experiences (b) Experience of Exercising with Telerehabilitation (c) Changes in Physical Activity Levels (d) Self-Management Skills and (e) Coping Strategies.

Inclusion Criteria:

• Being between the ages of 18-65
• Having been diagnosed with severe persistent, non-allergic asthma by a pulmonologist in accordance with the Global Initiative for Asthma (GINA) guideline criteria,
• Patients with type 2 inflammation markers. According to accepted standards; peripheral eosinophils <150/µL and/or negative skin prick test and/or total IgE <30 kU/L
• Bronchodilator response (>12% or 200 mL improvement in FEV1% predicted following inhalation of 400 mg salbutamol)
• Diagnosis-follow-up period: Patients diagnosed at least 6 months prior, under follow-up and treatment, and/or with controlled asthma
• Having completed the pulmonary rehabilitation program
• Completion of 8 weeks of inspiratory muscle training (IMT)
• Patients who have read, understood, and signed the informed consent form

Exclusion Criteria:

• Having recently had a respiratory tract infection recently (within the last month),
• Having a smoking history of more than 10 pack-years or having a history of smoking within 6 months after quitting smoking
• Having received oral corticosteroid treatment in the last 4 weeks,
• Having a Body Mass Index >35,
• Eosinophilic Granulomatosis Polyangiitis (EGPA) and Allergic Bronchopulmonary Aspergillosis (ABPA),
• Vasculitis,
• History of malignancy,
• Pregnancy,
• Previous lung surgery, use of long-term oxygen therapy
• Having accompanying restrictive lung diseases (advanced kyphoscoliosis, ankylosing spondylitis) and neuromuscular diseases (myastania gravis, muscular dystrophies, myopathies) that will prevent healthy respiratory function testing and rehabilitation.
• Cognitive dysfunction, mental retardation, dementia, or other conditions that make it difficult to follow the protocol,
• Unwillingness to continue participating in the study,
• Communication difficulties or intellectual deficiencies