Respiratory muscle training in neuromuscular disease: a systematic review and meta-analysis
Background Neuromuscular disease causes a progressive decline in ventilatory function which respiratory muscle training may address. Previous systematic reviews have focussed on single diseases, whereas this study systematically reviewed the collective evidence for respiratory muscle training in chi...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
European Respiratory Society
2022-11-01
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| Series: | European Respiratory Review |
| Online Access: | http://err.ersjournals.com/content/31/166/220065.full |
| _version_ | 1797961029794136064 |
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| author | Kathryn Watson Thorlene Egerton Nicole Sheers Sarah Retica Rebekah McGaw Talia Clohessy Penny Webster David J. Berlowitz |
| author_facet | Kathryn Watson Thorlene Egerton Nicole Sheers Sarah Retica Rebekah McGaw Talia Clohessy Penny Webster David J. Berlowitz |
| author_sort | Kathryn Watson |
| collection | DOAJ |
| description | Background
Neuromuscular disease causes a progressive decline in ventilatory function which respiratory muscle training may address. Previous systematic reviews have focussed on single diseases, whereas this study systematically reviewed the collective evidence for respiratory muscle training in children and adults with any neuromuscular disease.
Methods
Seven databases were searched for randomised controlled trials. Three reviewers independently reviewed eligibility, extracted characteristics, results, determined risk of bias and combined results using narrative synthesis and meta-analysis.
Results
37 studies (40 publications from 1986–2021, n=951 participants) were included. Respiratory muscle training improved forced vital capacity (standardised mean difference (SMD) 0.40 (95% confidence interval 0.12–0.69)), maximal inspiratory (SMD 0.53 (0.21–0.85)) and maximal expiratory pressure (SMD 0.70 (0.35–1.04)) compared to control (usual care, sham or alternative treatment). No impact on cough, dyspnoea, voice, physical capacity or quality of life was detected. There was high degree of variability between studies.
Discussion
Study heterogeneity (children and adults, different diseases, interventions, dosage and comparators) suggests that the results should be interpreted with caution. Including all neuromuscular diseases increased the evidence pool and tested the intervention overall.
Conclusions
Respiratory muscle training improves lung volumes and respiratory muscle strength in neuromuscular disease, but confidence is tempered by limitations in the underlying research. |
| first_indexed | 2024-04-11T00:52:59Z |
| format | Article |
| id | doaj.art-246e8686f8844182bb8c09802b61377b |
| institution | Directory Open Access Journal |
| issn | 0905-9180 1600-0617 |
| language | English |
| last_indexed | 2024-04-11T00:52:59Z |
| publishDate | 2022-11-01 |
| publisher | European Respiratory Society |
| record_format | Article |
| series | European Respiratory Review |
| spelling | doaj.art-246e8686f8844182bb8c09802b61377b2023-01-05T07:48:22ZengEuropean Respiratory SocietyEuropean Respiratory Review0905-91801600-06172022-11-013116610.1183/16000617.0065-20220065-2022Respiratory muscle training in neuromuscular disease: a systematic review and meta-analysisKathryn Watson0Thorlene Egerton1Nicole Sheers2Sarah Retica3Rebekah McGaw4Talia Clohessy5Penny Webster6David J. Berlowitz7 Department of Physiotherapy, Fiona Stanley Hospital, Perth, Australia Department of Physiotherapy, The University of Melbourne, Melbourne, Australia Department of Respiratory and Sleep Medicine, Austin Hospital, Heidelberg, Australia Department of Physiotherapy, Austin Hospital, Heidelberg, Australia Department of Physiotherapy, Austin Hospital, Heidelberg, Australia Department of Physiotherapy, Austin Hospital, Heidelberg, Australia Hunter New England Local Health District, Newcastle, Australia Department of Physiotherapy, The University of Melbourne, Melbourne, Australia Background Neuromuscular disease causes a progressive decline in ventilatory function which respiratory muscle training may address. Previous systematic reviews have focussed on single diseases, whereas this study systematically reviewed the collective evidence for respiratory muscle training in children and adults with any neuromuscular disease. Methods Seven databases were searched for randomised controlled trials. Three reviewers independently reviewed eligibility, extracted characteristics, results, determined risk of bias and combined results using narrative synthesis and meta-analysis. Results 37 studies (40 publications from 1986–2021, n=951 participants) were included. Respiratory muscle training improved forced vital capacity (standardised mean difference (SMD) 0.40 (95% confidence interval 0.12–0.69)), maximal inspiratory (SMD 0.53 (0.21–0.85)) and maximal expiratory pressure (SMD 0.70 (0.35–1.04)) compared to control (usual care, sham or alternative treatment). No impact on cough, dyspnoea, voice, physical capacity or quality of life was detected. There was high degree of variability between studies. Discussion Study heterogeneity (children and adults, different diseases, interventions, dosage and comparators) suggests that the results should be interpreted with caution. Including all neuromuscular diseases increased the evidence pool and tested the intervention overall. Conclusions Respiratory muscle training improves lung volumes and respiratory muscle strength in neuromuscular disease, but confidence is tempered by limitations in the underlying research.http://err.ersjournals.com/content/31/166/220065.full |
| spellingShingle | Kathryn Watson Thorlene Egerton Nicole Sheers Sarah Retica Rebekah McGaw Talia Clohessy Penny Webster David J. Berlowitz Respiratory muscle training in neuromuscular disease: a systematic review and meta-analysis European Respiratory Review |
| title | Respiratory muscle training in neuromuscular disease: a systematic review and meta-analysis |
| title_full | Respiratory muscle training in neuromuscular disease: a systematic review and meta-analysis |
| title_fullStr | Respiratory muscle training in neuromuscular disease: a systematic review and meta-analysis |
| title_full_unstemmed | Respiratory muscle training in neuromuscular disease: a systematic review and meta-analysis |
| title_short | Respiratory muscle training in neuromuscular disease: a systematic review and meta-analysis |
| title_sort | respiratory muscle training in neuromuscular disease a systematic review and meta analysis |
| url | http://err.ersjournals.com/content/31/166/220065.full |
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