Compared with placebo , IMT increased maximal inspiratory pressure ( +@ % @ % , P = @ ) , diaphragm thickness at residual volume ( +@ % @ % , P = @ ) , and peak inspiratory flow ( +@ % @ % , P = @ ) but did not change other spirometry measures , plasma cytokine concentrations , DNA damage levels in peripheral blood mononuclear cells , dynamic inspiratory muscle function , inspiratory muscle endurance , exercise performance , PAL , or QoL .