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Training of muscles requires that the muscle be overloaded during the training program. In many of the previous studies using resistive devices, changes in breathing strategy occurred because of lack of monitoring, even through in some cases patients were instructed to take long, slow, deep breathes [7]. In these cases, a decrease in inspiratory flow rate resulted and caused a drop in inspiratory pressures, even in situations where a smaller orifice than the original was used. This creates a paradoxical situation where reducing the orifice size may cause a decrease rather than an increase in inspiratory load.
More recently, a study evaluated the use of ventilatory muscle training as an aid to weaning chronic patients [12]. Thus, potentially there are many patients whose respiratory performance may be improved by ventilatory muscle training. The ability to regulate the training load provides an opportunity to evaluate this therapeutic technique more effectively.
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