Effect of Inspiratory Muscle Training on Cardiovascular Fitness and Falls Prevention in Elderly Smokers: A Narrative Review

Smoking and aging both increase the risk of falls in older adults by causing deterioration in cardiovascular and respiratory function. Strengthening and enhancing the function of respiratory muscles through Inspiratory Muscle Training (IMT) has been demonstrated as a viable intervention. The present review examines the potential advantages of IMT for cardiovascular fitness and fall prevention, particularly focusing on the vulnerable group of senior smokers. Evidence from Randomised Controlled Trials (RCTs) investigating the effects of IMT on cardiovascular outcomes and fall prevention in older smokers is reviewed. The review aims to critically assess the methodological quality and clinical relevance of the existing research by following the Scale for the Assessment of Narrative Review (SANRA) guidelines. Literature from searches on Web of Science, PubMed, and Scopus was analysed. The study includes articles published between 2014 and 2025, in order to ascertain the role of physical therapists in sustainable global health initiatives. Keywords related to “Cardiovascular fitness,” ”Elderly,” “Falls Prevention,” “IMT,” and “Smoking” were optimised using Boolean operators. The included RCTs show that IMT results in statistically significant increases in inspiratory muscle strength. While improvements in core stability contributed to a reduced risk of falls, enhanced diaphragmatic function and oxygen uptake were associated with better cardiovascular performance. Although the findings are encouraging, they should be interpreted cautiously due to variations in participant characteristics, intervention duration, and outcome assessments. The current review concludes that cardiovascular fitness and IMT can reduce the incidence of falls in older smokers.