People with spinal cord injury face respiratory compromise due to loss of innervation to the primary muscles of respiration. The weakness in respiratory muscles predisposes to a deterioration in pulmonary function in the spinal cord injury population due to weakened cough effort secondary to weakness of respiratory muscles and secretion stagnation. In the acute phase of injury, the flaccid muscles of the chest wall exhibit paradoxical in drawing with pressure changes in the thorax. This increases the risk of acute respiratory failure, atelectasis, pneumonia and other pulmonary infections. The degree of impairment depends on the neurological level of injury, the completeness of the injury and the time since the injury. Inspiratory muscle training has emerged as a promising tool in the respiratory rehabilitation of persons with SCI. A review article advocated the early incorporation of inspiratory muscle training (IMT) show significant improvements in the respiratory muscle strength and to an extent may be helpful for preventing respiratory complications. The literature mostly included hospital-based intervention for IMT. Literature has highlighted the fact that respiratory complications are a major contributor to re-admissions in chronic SCI. The assessment of respiratory muscle strength post injury is a major predictor of respiratory complications.

IMT being such a crucial part of the rehabilitation become a monotonous training without frequent reassessments. There is a need for a way of providing IMT training to individuals, including regular reassessment and alteration in level of training accordingly. A pilot study did examine the feasibility of a game-based approach for breathing exercises. The preliminary results have been promising with significant improvement in pulmonary functions. The lacunae of reassessment of the respiratory muscle strength in the app-based training persisted. Thus, the current study aims to provide a technology based IMT training and assessment for people with spinal cord injury.