Therapy using TIRE
TIRE can be used not only to measure and evaluate the performance of the inspiratory and expiratory muscles, but also as a highly effective therapeutic tool for training the inspiratory and expiratory muscles, which can also be monitored remotely thanks to the PrO2 device (Design Net, Smithfield USA — see the Devices section). It is therefore a very useful tool for performing respiratory telerehabilitation.
Practical procedure and nature of training
The PrO2 device must first be connected via Bluetooth to a tablet or mobile phone, which also serves as a monitor for the PrO2 device. The application is an environment for pre-training TIRE measurements, which are always performed three times. The actual IMT target is always considered to be the curve with the highest achieved result. The device then automatically generates a training lesson, which can be individually set directly in the application as a percentage of the SMIP of the initial curve (e.g., a curve consisting of 50% MIP/SMIP). The patient's goal is then to fill at least 90% of the area under the curve with inhalation/exhalation, otherwise the attempt will be considered unsuccessful by the software. Three unsuccessful breaths/exhalations are considered grounds for terminating the entire training cycle.
This procedure is repeated before each training lesson, with each lesson based on the current SMIP and MIP values. The training load is thus always adapted to the patient's current condition on a given day, ensuring a high degree of training progression, which is not possible with other respiratory trainers. Graphically and numerically evaluated, the SMIP template provides appropriate motivational feedback for the individual so that they can continue to improve their inspiratory/expiratory effort. The result of the overall inspiratory/expiratory TIRE training is the sum of the total area under the curve of all 36 endurance breaths/exhalations. After each breathing cycle, the results are automatically transferred via the internet from a mobile phone or tablet to the relevant account, where they are individually assessed by a physiotherapist, who then provides the patient with feedback (telemonitoring). The patient can also be motivated by telephone or any problems accompanying the training can be discussed with them (telecoaching).
The training lesson consists of 6 levels (A–F), each level consisting of 6 endurance breaths/exhalations (a total of 36 endurance breaths/exhalations). Between breaths/exhalations, there is a fixed rest period at each level, which gradually shortens from 40 seconds (level A) to 5 seconds (level F). This is a clinically proven training protocol that is preset in the PrO2 device.