Background: Electronic devices for inspiratory muscle training (IMT) already exist, offering benefits as biofeedback and adherence control. However, patients typically need to regularly visit physiotherapist to adjust the training, which can be a barrier to access due to associated costs and travel. The fully remote IMT device described in this study represents an innovative approach to IMT.

Aims: To report the proof of concept of a fully remote IMT device.

Methods: Ten lung transplant recipients (8 males, age: 50.2±4.3 yrs) with previous experience of standard IMT participated in a six-week IMT program using the Airofit training device and smartphone application. The device measures inspiratory muscle strength, which is necessary for setting up the progressive loading of therapy. The smartphone application processes the data and sends it to the expert module, where physiotherapists remotely set the target pressure for IMT. The application provides patient's biofeedback to facilitate the effect of therapy and analyses every patient's breath during training, enabling evaluation of compliance and overall adherence to the IMT.

Results: All patients found the device and application easy to use, and 80% preferred remote IMT over standard face-to-face IMT. All patients preferred Airofit device over the mechanical device (Threshold IMT) used in standard IMT programs. Finally, 80% of patients expressed interest in participating in similar program in the future, and all patients would recommend fully remote IMT to others.

Conclusions: Airofit training device connected to a smartphone app is user-friendly and can facilitate fully remote IMT. It may be the optimal choice for patients who face barriers to accessing programs.