The Effect of Inspiratory Muscle Training on Respiratory Parameters, Balance, Trunk Endurance and Trunk Isokinetic Muscle Strength in Wrestling Athletes

November 13, 2025 updated by: MİNE PEKESEN KURTÇA, Ondokuz Mayıs University

The Effect of Inspiratory Muscle Training on Respiratory Parameters, Balance, Trunk Endurance and Trunk Isokinetic Muscle Strength in Elite Freestyle Female Wrestling Athletes

Title:

The Effects of Inspiratory Muscle Training on Respiratory Parameters, Balance, Trunk Endurance, and Trunk Isokinetic Muscle Strength in Elite Female Freestyle Wrestlers

Objective:

This experimental study aims to investigate the effects of inspiratory muscle training on respiratory functions, trunk muscle strength, endurance, and balance in elite female freestyle wrestlers.

Methods:

This randomized controlled trial will include 30 elite female freestyle wrestlers aged between 16 and 22. Participants will be randomly assigned to either an intervention group or a placebo control group using a simple randomization method. The intervention group will receive progressive inspiratory muscle training with the POWERbreathe Plus device, 5 days per week for 4 weeks. The training load will increase weekly. The control group will undergo low-resistance inspiratory training set at 15% of their baseline maximal inspiratory pressure (MIP), serving as a placebo. Pre- and post-intervention assessments will be conducted by a blinded evaluator.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Not yet recruiting

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

This study aims to investigate the multifaceted effects of inspiratory muscle training (IMT) on performance parameters in elite female freestyle wrestlers within the field of cardiopulmonary physiotherapy and rehabilitation. Unlike most studies in the sports physiotherapy literature, this research goes beyond respiratory parameters to include key functional outcomes such as balance, trunk endurance, and isokinetic trunk muscle strength.

Scientific Background and Rationale Freestyle wrestling is a physically demanding sport that requires simultaneous, dynamic use of both upper and lower extremities, along with high levels of strength, balance, and coordination. Success in competition is closely linked to factors such as postural stability, core muscle activation, and the ability to generate isometric and dynamic force. However, the contribution of respiratory muscles to athletic performance has often been overlooked or assessed only indirectly in previous studies.

Given the high-intensity and short-duration nature of wrestling matches, increased ventilatory demand places a significant burden on the diaphragm and accessory respiratory muscles. Recent evidence suggests that IMT not only improves pulmonary function but also enhances core stabilization and postural control. Therefore, directly assessing the effects of IMT on respiratory and trunk muscle performance in elite female wrestlers addresses a notable gap in the literature.

Study Design This is a randomized controlled experimental study involving 30 elite female freestyle wrestlers affiliated with the Turkish Olympic Preparation Center (TOHM-Trabzon). Participants will be randomly assigned into two groups (n=15 each) via simple randomization.

The intervention group will undergo IMT using the POWERbreathe Plus device, 5 days per week for 4 weeks. Training will begin at 50% of the participants' MIP and increase by 10% each week, reaching 80% by the final week.

The control group will receive placebo IMT at a constant load equivalent to 15% of baseline MIP, following the same training schedule.

All interventions will be delivered in addition to the athletes' regular training programs. Pre- and post-intervention assessments will be conducted by a blinded physiotherapist who is not involved in the implementation of the training.

Assessment Parameters and Instruments To comprehensively evaluate the impact of IMT, objective and validated tools will be employed. Pulmonary function will be assessed using the Cosmed Pony FX device, measuring MIP, MEP, FEV1, FVC, and the FEV1/FVC ratio. Trunk endurance will be evaluated using the McGill Core Endurance protocol, which includes tests for trunk flexion, extension, and lateral plank. Muscle strength will be measured using the Isomed 2000 isokinetic dynamometer at a velocity of 60°/s to determine peak torque during trunk flexion and extension. Balance performance will be assessed with both the Y Balance Test (in anterior, posterolateral, and posteromedial directions) and the Flamingo Balance Test, which measures the ability to maintain single-leg stance. In addition, a participant tracking form will be used to record demographic information, training history, and attendance. All assessments will be performed under standardized conditions by a blinded evaluator.

Statistical Methods Appropriate statistical methods will be employed to analyze the data. Distribution characteristics and group comparisons will be assessed accordingly. Intra-group and inter-group differences, as well as time-by-group interactions, will be analyzed. Effect sizes will be calculated using standard procedures, and statistical significance will be set at p < 0.05.

Original Contribution of the Study This study is unique in its comprehensive evaluation of the effects of IMT not only on performance-related physical parameters but also on cardiopulmonary capacity in elite athletes. By focusing specifically on female wrestlers, the study contributes to sex-specific physiological research and is expected to provide evidence for the development of clinically applicable IMT protocols aimed at enhancing athletic performance and health.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Estimated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
30

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.

Study Locations

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Child
  • Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  1. To be an athlete in the Freestyle Women's Wrestling branch.
  2. Participating in regular training at least 4 days a week.
  3. To volunteer to participate in the study.
  4. Being an athlete within TOHM for at least one year.
  5. To be between the ages of 16-22.

Exclusion Criteria:

  1. Have a cardiopulmonary disease that precludes the use of Pulmonary Function Testing.
  2. Have specific balance problems (e.g., vestibular or neurological impairment).

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Supportive Care
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Double

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: Inspiratory Muscle Training Program
Participants in this group will receive a progressive inspiratory muscle training (IMT) program using the POWERbreathe Plus device. Training will be conducted 5 days per week for 4 weeks. The intensity will start at 50% of the participant's measured maximal inspiratory pressure (MIP) and will be increased by 10% each week, reaching 80% in the final week. All training will be performed in addition to the athletes' regular wrestling sessions. Participants in this group will be assessed for respiratory parameters, trunk endurance, balance, and trunk isokinetic muscle strength before and after the intervention.
Device: Progressive Inspiratory Muscle Training (IMT)
The intervention involves the application of inspiratory muscle training using the POWERbreathe Plus device. Training will be conducted at an initial intensity of 50% of the individual's MIP and will be increased weekly by 10%, reaching 80% by week four. Sessions will take place 5 days per week and consist of 2 sets of 30 repetitions per day, with 2-minute rest intervals between sets. This training aims to improve inspiratory muscle strength and endurance, as well as core stability, respiratory function, dynamic balance, and trunk isokinetic strength.
Placebo Comparator: Control Group
Participants in the control group will receive a sham inspiratory muscle training program using the same device. The training intensity will be fixed at 15% of the initial MIP throughout the 4-week period to produce a placebo effect. The frequency and duration of training will mirror that of the experimental group. Participants will undergo identical pre- and post-intervention evaluations.
Other: Placebo Training
The placebo group will perform identical training sessions using the same device but with a constant minimal resistance set at 15% of the initial MIP, insufficient to induce a physiological training effect. This intervention is designed to control for placebo response. Assessment protocols will be identical to those in the experimental group.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Change in Maximal Inspiratory Pressure (MIP) [cmH₂O]
Time Frame: Baseline (Week 0) and Post-intervention (Week 4)
Maximal inspiratory pressure (MIP) will be measured using the Cosmed Pony FX device. This value reflects the strength of inspiratory muscles before and after the intervention.
Baseline (Week 0) and Post-intervention (Week 4)
Change in Maximal Expiratory Pressure (MEP) [cmH₂O]
Time Frame: Baseline (Week 0) and Post-intervention (Week 4)
Maximal expiratory pressure (MEP) will be assessed using the Cosmed Pony FX spirometer. It indicates the force generated by expiratory muscles and will be compared pre- and post-training.
Baseline (Week 0) and Post-intervention (Week 4)
Change in Forced Expiratory Volume in 1 Second (FEV1) [liters]
Time Frame: Baseline (Week 0) and Post-intervention (Week 4)
FEV1 will be measured using the Cosmed Pony FX to evaluate pulmonary function. The value reflects the volume of air expelled in the first second of a forced exhalation.
Baseline (Week 0) and Post-intervention (Week 4)
Change in Forced Vital Capacity (FVC) [liters]
Time Frame: Baseline (Week 0) and Post-intervention (Week 4)
FVC will be assessed with the Cosmed Pony FX device. It measures the total volume of air forcibly exhaled after a full inspiration, used to evaluate lung capacity changes due to training.
Baseline (Week 0) and Post-intervention (Week 4)
Change in FEV1/FVC Ratio [%]
Time Frame: Baseline (Week 0) and Post-intervention (Week 4)
The FEV1/FVC ratio will be calculated from pulmonary function testing to assess airway function and efficiency. The ratio will be compared between baseline and after the 4-week intervention.
Baseline (Week 0) and Post-intervention (Week 4)

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Time Held in Trunk Flexion Test [seconds]
Time Frame: Baseline (Week 0) and Post-intervention (Week 4)
Trunk flexion endurance will be assessed using the McGill Core Endurance Test Battery. The participant will maintain a trunk flexion position at a standardized angle. Duration will be recorded in seconds.
Baseline (Week 0) and Post-intervention (Week 4)
Time Held in Side Plank Test [seconds]
Time Frame: Baseline (Week 0) and post-intervention (Week 4)
Lateral trunk endurance will be evaluated via the McGill side bridge (side plank) test. The time the participant can hold the position on each side will be recorded in seconds.
Baseline (Week 0) and post-intervention (Week 4)
Time Held in Trunk Extension Test [seconds]
Time Frame: Baseline (Week 0) and Post-intervention (Week 4)
Trunk extension endurance will be measured with the McGill Core Endurance Test Battery. The participant will hold the trunk in an extended position; the time maintained will be recorded in seconds.
Baseline (Week 0) and Post-intervention (Week 4)
Peak Torque of Trunk Flexors [Nm]
Time Frame: Baseline (Week 0) and Post-intervention (Week 4)
Measured using the Isomed 2000 isokinetic dynamometer at 60°/s. Participants perform three trunk flexion repetitions; the highest peak torque value in Nm is recorded.
Baseline (Week 0) and Post-intervention (Week 4)
Peak Torque of Trunk Extensors [Nm]
Time Frame: Baseline (Week 0) and Post-intervention (Week 4)
Measured using the Isomed 2000 isokinetic dynamometer at 60°/s. Participants perform three trunk extension repetitions; the highest peak torque in Nm is recorded.
Baseline (Week 0) and Post-intervention (Week 4)
Reach Distance in Y Balance Test - Anterior Direction [cm]
Time Frame: Baseline (Week 0) and Post-intervention (Week 4)
The Y Balance Test will be used to assess dynamic balance. The maximum reach distance in the anterior direction will be measured in centimeters.
Baseline (Week 0) and Post-intervention (Week 4)
Reach Distance in Y Balance Test - Posteromedial Direction [cm]
Time Frame: Baseline (Week 0) and Post-intervention (Week 4)
The Y Balance Test will be used to assess dynamic balance. The maximum reach distance in the posteromedial direction will be measured in centimeters.
Baseline (Week 0) and Post-intervention (Week 4)
Reach Distance in Y Balance Test - Posterolateral Direction [cm]
Time Frame: Baseline (Week 0) and Post-intervention (Week 4)
The Y Balance Test will be used to assess dynamic balance. The maximum reach distance in the posterolateral direction will be measured in centimeters.
Baseline (Week 0) and Post-intervention (Week 4)
Time Maintained in Flamingo Balance Test [seconds]
Time Frame: Baseline (Week 0) and Post-intervention (Week 4)
Static balance will be assessed using the Flamingo Balance Test. The time (in seconds) the participant can maintain a single-leg stance on a beam without losing balance will be recorded.
Baseline (Week 0) and Post-intervention (Week 4)

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Ondokuz Mayıs University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
December 15, 2025

Primary Completion (Estimated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
June 30, 2026

Study Completion (Estimated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
December 30, 2026

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
July 2, 2025

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
July 16, 2025

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
July 24, 2025

Study Record Updates

Last Update Posted (Estimated)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
November 14, 2025

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
November 13, 2025

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
November 1, 2025

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • OMÜ2025/257

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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