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A total of 196 participants were randomly assigned (1:1) into two groups: a control group (routine care) and an intervention group (routine care\u2009+\u2009IMT training using a pressure threshold device). The intervention duration was 12\u00a0weeks with 30\u00a0min\/day, 5\u00a0days\/week. The primary outcome was breathlessness severity, assessed by the modified Borg scale (mBorg). Secondary outcomes were worst and average breathlessness over the past 24\u00a0h (assessed by the 11-point Numerical Rating Scale), breathlessness severity (assessed by the Dyspnoea-12, D-12), the 6-min walk distance (assessed by the 6-min walk test, 6MWT), quality of life (assessed by the St George\u2019s Respiratory Questionnaire, SGRQ), and emotional status (assessed by the Hospital Anxiety and Depression Scale). Assessments were conducted at baseline (T1), week 8 (T2), and week 12 (T3). Adjusted generalized estimating equations (GEE) models for repeated measures over time were performed using the Statistical Package for Social Science (SPSS) software. The modified intention-to-treat principle was used for data analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of the 196 participants, 190 completed the trial, and six dropped out. 31.63% of participants completely adhered to the required sessions of IMT. In the adjusted GEE model, statistical and minimal clinically important differences were observed on the m-Borg score at week 8 (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.002), while no significant group-by-time effect was observed in the mBorg. Compared with the control group and baseline, participants in the intervention group showed a significant reduction in D-12 total scores at week 8 (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.005) and week 12 (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.004). No significant group-by-time interaction effects were observed for worst and average breathlessness over the past 24\u00a0h, anxiety, depression, 6MWT, and SGRQ scores.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study highlights the short-term benefits of IMT for reducing breathlessness among patients with thoracic malignancies. However, the long-term effects should be explained with caution due to the participants\u2019 suboptimal adherence. Future studies should explore different strategies to improve adherence and further evaluate the sustained effects of IMT over time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration.<\/jats:title>\n                    <jats:p>ClinicalTrials.gov NCT03834116.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Date of registration.<\/jats:title>\n                    <jats:p>2019\u201302-06.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00520-025-09511-9","type":"journal-article","created":{"date-parts":[[2025,5,22]],"date-time":"2025-05-22T04:38:35Z","timestamp":1747888715000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The effect of resistance inspiratory muscle training in the management of breathlessness in patients with thoracic malignancies: a randomised controlled trial"],"prefix":"10.1007","volume":"33","author":[{"given":"Meng-Yuan","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xian-Liang","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"Peng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tao","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li-Qun","family":"Yao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hou-Qiang","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wai Hang","family":"Kwok","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing-Yu Benjamin","family":"Tan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Molassiotis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,5,22]]},"reference":[{"issue":"9","key":"9511_CR1","doi-asserted-by":"publisher","first-page":"624","DOI":"10.1038\/s41571-023-00798-3","volume":"20","author":"A Leiter","year":"2023","unstructured":"Leiter A, Veluswamy RR, Wisnivesky JP (2023) The global burden of lung cancer: current status and future trends. 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This study was approved by the Human Subjects Ethics Sub-Committee at The Hong Kong Polytechnic University (HSEARS20180509003), the Clinical Trials Ethics Committees at the Affiliated Hospital of Southwest Medical University (Ky2018002), and the Human Research Ethics Committee at Charles Darwin University (H19013).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"All participants provided informed consent prior to enrolling onto the study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"All authors consent to the publication of this manuscript in Supportive Care in Cancer.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"492"}}