Inspiratory muscle training
IMT was performed using Threshold IMT™ devices (Philips Healthcare), with instructions provided via video-visits to allow observation, feedback, and ensure IMT proficiency. Participants were instructed to adjust IMT resistance to a perceived rating of exertion of “somewhat-hard to hard” (4–6 on the 0–10 modified Borg scale), perform unsupervised IMT 10–15 min twice/day (or ≥ 20 min/daily) for ≥ 5 days/week (i.e., IMT ≥ 100 min/week), with progression to higher resistance as tolerated. Once participants have demonstrated proficiency with IMT in video-visit/s, telephone visits were allowed if participants encountered significant technical difficulties (e.g., loss of internet signal).