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Chronic Kidney Disease (Stages 4 and 5)RespDialysisNCT07811947

Inspiratory Muscle Training During Hemodialysis

A study testing Inspiratory Muscle Training in people with Chronic Kidney Disease (Stages 4 and 5) and Hemodialysis, run by Tecsam - Tecnologia e Servicos Medicos at 1 site in Portugal.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
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Trial summary

This study will evaluate whether inspiratory muscle training performed during hemodialysis improves inspiratory muscle strength in adults receiving regular hemodialysis. After an initial 12-week period without study-protocolized inspiratory muscle training, participants will be randomly assigned to inspiratory muscle… Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Inspiratory Muscle Training
Could I receive a placebo?
No, everyone receives an active treatment
How many people
53 participants
Where
1 sitePortugal
Study dates
20 Sep 2026to Sep 2027
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Age 18 years or older
  • Enrolled in a regular hemodialysis program for at least 3 months
  • Receiving hemodialysis three times per week
  • Able to understand study information
  • Able to provide written informed consent

Who cannot join

  • Recent history of clinically significant cardiac arrhythmia, acute myocardial infarction, unstable angina, severe valvular disease, or uncontrolled hypertension
  • Medical condition that contraindicates an increase in intrathoracic negative pressure or performance of inspiratory muscle training
  • Uncontrolled acute or decompensated medical condition that compromises participant safety or the validity of the assessments
  • Severe cognitive impairment that prevents provision of informed consent or completion of study procedures

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Sónia Alexandra Claro Casado contact

+351965364163

soniaaccasado@gmail.com

André Filipe Morais Pinto Novo contact

+351917972163

andre@ipb.pt

Portugal1 site
  • Tecsam - Tecnologia e Serviços Médicos

    Mirandela, Braganza District, 5370-530

    Sónia Casado, +351965364163, soniaaccasado@gmail.com

    soniaaccasado@gmail.com

Other trials in Portugal

About this study

Official title: Impact of Inspiratory Muscle Training on Functional Capacity, Lung Volumes, Electrical Activity and Inspiratory Muscle Strength in Hemodialysed Patients

This study will evaluate whether inspiratory muscle training performed during hemodialysis improves inspiratory muscle strength in adults receiving regular hemodialysis. After an initial 12-week period without study-protocolized inspiratory muscle training, participants will be randomly assigned to inspiratory muscle training plus usual care or usual care alone for 12 weeks. The primary outcome is the change in maximum inspiratory pressure from baseline to Week 12. The study will also assess lung function, walking capacity, handgrip strength, electrical activity of inspiratory muscles, dyspnea, body composition, health-related quality of life, and daily physical activity.

Read the detailed description

Individuals receiving regular hemodialysis may experience reduced inspiratory muscle strength, impaired lung function, dyspnea, reduced functional capacity, decreased daily physical activity, and changes in body composition. This single-center, open-label, randomized controlled study will evaluate the effect of intradialytic inspiratory muscle training on inspiratory muscle strength and related clinical and functional outcomes.

All participants will first complete a 12-week observational period without study-protocolized inspiratory muscle training. Following the T0 assessment, participants will be randomly assigned in a 1:1 ratio to inspiratory muscle training plus usual care or usual care alone for 12 weeks. Participants assigned to inspiratory muscle training will perform training during hemodialysis using the POWERbreathe KH2 device.

After the Week 12 assessment, participants initially assigned to inspiratory muscle training will undergo a second independent 1:1 randomization to either weekly maintenance inspiratory muscle training or discontinuation of study-protocolized training for 12 weeks. Participants initially assigned to usual care will continue usual care. Following the Week 24 assessment, no participant will receive study-protocolized inspiratory muscle training for 12 weeks. Follow-up assessments will be conducted through Week 52 after the initial randomization.

The primary comparison is between inspiratory muscle training plus usual care and usual care alone at Week 12. Analyses of the second randomization and later follow-up assessments are exploratory.

Being tested
Inspiratory Muscle Training, Usual Care
Keywords
hemodialysis, respiratory muscles, muscle strength, rehabilitation, functional capacity
Medical subject headings
Renal Insufficiency, Chronic

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Inspiratory Muscle TrainingBehavioural

    Intradialytic inspiratory muscle training will be performed using the POWERbreathe KH2 electronic device. Training will begin approximately 30 minutes after the start of the hemodialysis session after confirmation of clinical and hemodynamic stability. Participants will be seated in the hemodialysis chair with the backrest raised to at least 45 degrees.

    The initial program will be performed three times weekly for 12 weeks, for a total of 36 planned sessions. Each session will include three sets of 30 inhalations against a resistance corresponding to 50 percent of maximum inspiratory pressure, with a two-minute rest between sets. Maximum inspiratory pressure will be reassessed after every six completed sessions, and resistance will be adjusted to 50 percent of the newly measured value.

    Training will be interrupted for chest pain, intolerable dyspnea, desaturation, hypotension, arrhythmia, intolerable fatigue, participant request, or any sign or symptom raising clinical concern.

  • Usual CareOther

    Usual care consists of the regular hemodialysis schedule and the clinical and nursing care routinely provided by the hemodialysis unit. No study-protocolized inspiratory muscle training will be administered.

Study groups in NCT07811947
Study groupRoleWhat they receive
Group A: Inspiratory Muscle Training Plus Usual CareExperimentalFrom T0 to Week 12, participants will receive intradialytic inspiratory muscle training in addition to usual hemodialysis care. After the Week 12 assessment, participants initially assigned to Group A will undergo a second randomization to either weekly maintenance inspiratory muscle training or discontinuation of study-protocolized inspiratory muscle training.
Receives: Behavioral: Inspiratory Muscle Training; Other: Usual Care
Group B: Usual CareActive comparatorParticipants will continue regular hemodialysis and routine clinical and nursing care provided by the hemodialysis unit. They will not receive study-protocolized inspiratory muscle training during the study participation period.
Receives: Other: Usual Care

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change in Maximum Inspiratory Pressure From Baseline to Week 12

    Maximum inspiratory pressure will be measured using the POWERbreathe KH2 device with the participant seated with back support before the second or third weekly hemodialysis session. The outcome is the change in maximum inspiratory pressure, expressed in cmH2O.

    Measured: Baseline at T0 and post-intervention at Week 12

Secondary outcomes (9)
  1. Change in Modified Borg Dyspnea Scale Score From Baseline to Week 12

    Dyspnea will be assessed using the Modified Borg Dyspnea Scale, with scores ranging from 0 to 10, at rest and after the 6-Minute Walk Test. Higher scores indicate greater perceived dyspnea. The outcome is the change in Modified Borg Dyspnea Scale score.

    Measured: Baseline at T0 and post-intervention at Week 12

  2. Change in Dominant-Hand Handgrip Strength From Baseline to Week 12

    Handgrip strength will be assessed using the GripWise dynamometer with the participant seated with back support. Three attempts will be performed for each hand. The highest value obtained for the dominant hand, expressed in kilograms, will be used as the primary handgrip variable.

    Measured: Baseline at T0 and post-intervention at Week 12

  3. Change in Body Composition From Baseline to Week 12

    Body composition will be assessed by bioimpedance using the InBody BWA 2.0 device at the end of the second or third weekly hemodialysis session. Outcomes are changes in fat-free mass, expressed in kilograms; skeletal muscle mass, expressed in kilograms; and fat mass, expressed as a percentage.

    Measured: Baseline at T0 and post-intervention at Week 12

  4. Change in KDQOL-SF 1.3 Health-Related Quality-of-Life Scores From Baseline to Week 12

    Health-related quality of life will be assessed using the Kidney Disease Quality of Life Short Form, version 1.3 (KDQOL-SF 1.3). Scores will be calculated according to the instrument scoring instructions and converted to a 0 to 100 scale. Physical and mental summary measures derived from the SF-36 will be prioritized. Higher scores indicate better health-related quality of life in the respective domain.

    Measured: Baseline at T0 and post-intervention at Week 12

  5. Change in Forced Vital Capacity From Baseline to Week 12

    Forced vital capacity will be measured by spirometry using the MIR Spirolab device with the participant seated with back support. The outcome is the change in forced vital capacity, expressed in liters and, when available, as a percentage of the predicted value.

    Measured: Baseline at T0 and post-intervention at Week 12

  6. Change in Surface Electromyography Root Mean Square Amplitude of Inspiratory Muscles From Baseline to Week 12

    Surface electromyography will assess electrical activity of the scalene, sternocleidomastoid, intercostal, and diaphragm muscles using the Sessantaquattro+ system. Electromyographic signal amplitude will be quantified as root mean square amplitude and analyzed separately for each assessed muscle.

    Measured: Baseline at T0 and post-intervention at Week 12

  7. Change in Average Daily Steps From Baseline to Week 12

    Daily physical activity will be assessed using a Garmin Forerunner 55 watch worn for seven consecutive days during each assessment period. The primary variable is the average number of steps per day, calculated from valid monitoring days. An assessment period requires at least four valid monitoring days.

    Measured: Baseline at T0 and post-intervention at Week 12

  8. Change in Forced Expiratory Volume in 1 Second From Baseline to Week 12

    Forced expiratory volume in 1 second will be measured by spirometry using the MIR Spirolab device with the participant seated with back support. The outcome is the change in forced expiratory volume in 1 second, expressed in liters and, when available, as a percentage of the predicted value.

    Measured: Baseline at T0 and post-intervention at Week 12

  9. Change in 6-Minute Walk Test Distance From Baseline to Week 12

    Functional capacity will be assessed by the distance covered during the 6-Minute Walk Test on a flat, straight 30-meter corridor. The outcome is the change in total walking distance, expressed in meters. Higher values indicate greater functional capacity. Participants may use their usual walking aid when routinely used in daily activities.

    Measured: Baseline at T0 and post-intervention at Week 12

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted10 Sep 2026
  2. Study start20 Sep 2026 (estimated)
  3. Primary completion21 Dec 2026 (estimated)
  4. Study completionSep 2027 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Supportive care
Allocation
Randomised
Intervention model
Parallel groups
Model description
Following a 12-week observational period without study-protocolized inspiratory muscle training, participants will be randomized in a 1:1 ratio to inspiratory muscle training plus usual care or usual care alone for 12 weeks. After the Week 12 assessment, participants initially assigned to inspiratory muscle training will undergo a second independent 1:1 randomization to weekly maintenance inspiratory muscle training or discontinuation of study-protocolized training for 12 weeks. Participants initially assigned to usual care will continue usual care. All participants will subsequently undergo 12 weeks without study-protocolized inspiratory muscle training and follow-up through Week 52 after initial randomization
Masking
None (open label)
Enrolment
53 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07811947
Sponsor's protocol ID
10.54499/2024.17137.PEX
Other IDs
P522771-R636876-D1882423
Acronym
RespDialysis
Status last verified
Sep 2026
First submitted
16 Aug 2026
Last updated
10 Sep 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: Individual participant data will not be shared, as the dataset contains sensitive health information and potentially identifiable data. Data will be used solely for the purposes of the present study, stored securely, and reported only in aggregated and anonymized form to ensure participant confidentiality and privacy.

Publications

  • Casado SAC, Mendes MER, Preto LSR, Vila-Cha CJF, Novo AFMP. Effect of inspiratory muscle training in hemodialysis patients: a systematic review of randomized controlled trials. Disabil Rehabil. 2026 Mar;48(5):1205-1215. doi: 10.1080/09638288.2025.2554947. Epub 2025 Sep 3.

    PubMed 40901738

Questions about this trial

What is this clinical trial studying?

A study testing Inspiratory Muscle Training in people with Chronic Kidney Disease (Stages 4 and 5) and Hemodialysis, run by Tecsam - Tecnologia e Servicos Medicos at 1 site in Portugal.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: opening soon, as of the sponsor's last update on 10 Sep 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Portugal. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Sónia Alexandra Claro Casado (+351965364163, soniaaccasado@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in Maximum Inspiratory Pressure From Baseline to Week 12 (time frame: Baseline at T0 and post-intervention at Week 12). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07811947, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 10 Sep 2026.

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