Functional Inspiratory Training in Bronchiectasis

Participants will begin with Inspiratory Muscle Training (IMT) at 50% of maximal inspiratory pressure (MIP) for 4 weeks. Training will be performed once a week face-to-face, while adherence will be monitored on other days via WhatsApp. During each face-to-face session, MIP will be reassessed and training loads adjusted. Participants will perform 30 dynamic inspiratory efforts twice daily. In the following 4 weeks, Functional Inspiratory Muscle Training (FIMT) will be applied: once face-to-face, twice online under physiotherapist supervision, and twice unsupervised IMT. FIMT exercises will be performed with the POWERbreathe Classic Light Resistance device, consisting of 10 breaths lasting 15-30 seconds in 2 sets. Each session will include warm-up (diaphragmatic breathing and trunk stretches), loading (core stabilization exercises), and cool-down (trunk stretches). IMT intensity will be adjusted weekly using MIP measurement

Participants will perform IMT daily for 8 weeks. Training will be conducted once a week face-to-face, while on other days adherence will be monitored via WhatsApp. The group will complete 30 dynamic inspiratory efforts twice daily. The POWERbreathe Classic Light Resistance device (PowerBreathe, IMT Technologies Ltd, Birmingham, UK) will be used to strengthen the diaphragm and chest wall muscles by breathing against a set pressure load. Training intensity will be set at 50% of maximal inspiratory pressure (MIP). After 10-15 consecutive breaths, participants will perform 3-4 recovery breaths before continuing. IMT intensity will be re-adjusted weekly during face-to-face sessions using MIP measurements to maintain 50% loading.