# PWR-019 — Respiratory-muscle endurance: learner worksheet Release: Revision 7T · Full Tutorial Edition Estimated time: Estimated 11 min reading; practical time is provider-set Difficulty: Intermediate Equipment: Common household or practice equipment — Calibrated provider-approved threshold inspiratory device; Clean personal mouthpiece and manufacturer cleaning materials; Supported chair and optional nose clip if prescribed; Breath counter, pace cue and symptom scale; A respiratory-device log for device and threshold, mouthpiece fit, breath count, rhythm, seal validity, rest, symptoms, cleaning and separate functional outcome. Space: Room-scale practice space Automated structural checklist: 10 of 10 structural checks present Evidence quality/context: G4; Focused research depth Automated method-quality band: Comprehensive Method-rating basis: Structure coverage, instruction/check specificity, alternative distinctness, source troubleshooting, comparison depth and whether purpose/check fields are authored rather than derived. Editorial review: Pending manual editorial sign off ## Before you begin - [ ] I read the tutorial authority and stop conditions. - [ ] I have the required equipment/space or a declared accessible alternative. ## Canonical source context Respiratory-muscle endurance is sustained work by the breathing muscles under a declared test or training load. This lesson teaches a supervised threshold-inspiratory sequence: sit supported, seal the lips around the mouthpiece, exhale normally, inhale briskly enough to open the valve, complete the breath without gulping, remove or relax from the device for a normal exhale and keep the provider-set rhythm. The provider controls clearance, pressure, breaths, sets, rest, monitoring and hygiene. Target outcome: The learner completes one supervised set at the provider-prescribed inspiratory threshold with a sealed mouthpiece, full valve-opening breaths and no breath-holding, dizziness or technique loss. ### Authority and setup conditions - Tell the provider about acute respiratory illness, chest pain, fainting, uncontrolled asthma symptoms, pneumothorax history or recent surgery. - Confirm device model, pressure setting, breath count, pace, rest and cleaning procedure. - Practise removing the mouthpiece and returning to ordinary breathing immediately. - Seat the learner upright, check the threshold-device setting and fit the mouthpiece. Start only when ordinary breathing is comfortable and the learner can make a full seal without strain. - Practise a complete lip seal, brisk valve-opening inhale and ordinary unforced exhale at the provider's easiest familiarisation setting. ### Required or supplied materials - Calibrated provider-approved threshold inspiratory device - Clean personal mouthpiece and manufacturer cleaning materials - Supported chair and optional nose clip if prescribed - Breath counter, pace cue and symptom scale - A respiratory-device log for device and threshold, mouthpiece fit, breath count, rhythm, seal validity, rest, symptoms, cleaning and separate functional outcome. ## 1. Sit and set the airway Sit supported with head and neck comfortable, device upright as instructed and the nose clip only if prescribed. Why: Posture and device angle affect the seal and valve action. Success check: The learner can breathe normally without strain before starting. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “The learner can breathe normally without strain before starting.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## 2. Make a complete lip seal Place lips around the mouthpiece so air does not leak at the corners; keep teeth and jaw relaxed. Why: A leak lowers the actual threshold work. Success check: No air hiss or cheek leak is heard during an easy test breath. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “No air hiss or cheek leak is heard during an easy test breath.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## 3. Exhale normally Breathe out to a comfortable level; do not force to empty the lungs or pause in a breath-hold. Why: Forced exhalation and holds change the task and can cause symptoms. Success check: The next inhale begins without gasping. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “The next inhale begins without gasping.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## 4. Open the threshold with the inhale Inhale briskly through the device until the valve opens, then continue a smooth full comfortable breath. Why: The threshold must be crossed for the breath to count. Success check: The device indicator and sound confirm a complete valve-opening breath. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “The device indicator and sound confirm a complete valve-opening breath.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## 5. Use a relaxed exhale Exhale normally through the prescribed route and return promptly to the next paced breath; do not hyperventilate. Why: A consistent cycle controls duty and recovery time. Success check: Breathing follows the pace without rushed extra breaths. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “Breathing follows the pace without rushed extra breaths.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## 6. Count only valid breaths Count a breath only when the seal holds and the valve opens fully. Stop the set on the first repeated leak, incomplete breath or symptom threshold. Why: Invalid breaths should not inflate endurance. Success check: The valid count and first error are recorded separately. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “The valid count and first error are recorded separately.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## 7. Recover and clean Remove the mouthpiece, breathe normally while supported and report symptoms. Clean and dry the personal device exactly as the manufacturer and provider direct. Why: Recovery and hygiene are part of safe repeated use. Success check: Ordinary breathing returns and the device is stored clean and dry. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “Ordinary breathing returns and the device is stored clean and dry.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## Reflection What changed? ________________________________________________________________________________ What remains difficult? ________________________________________________________________________________ What will I repeat, adapt, ask for help with, or stop? ________________________________________________________________________________ --- Completion of this worksheet demonstrates tutorial participation only. It does not establish capability, qualification, safety clearance, diagnosis, treatment or independent validation.