Abstract
Study design:
Systematic review
Objectives:
To determine the effect of respiratory muscle training (RMT) on pulmonary function in tetraplegia.
Methods:
A comprehensive search of the research literature included MEDLINE, EMBASE, CINAHL, ISI Web of Science, PubMed, the relevant Cochrane and clinical trials registers and hand-searching the reference lists of appropriate papers. There was no language restriction. All randomised controlled trials that involved RMT vs control were considered for inclusion. Two reviewers independently selected articles for inclusion, evaluated the methodological quality and extracted data. Additional information was sought from the authors when necessary.
Results:
Eleven studies (212 participants) were included. A significant benefit of RMT was revealed for five outcomes: vital capacity (mean difference (95% confidence interval))=0.41(0.17–0.64) l, maximal inspiratory pressure=10.66(3.59, 17.72) cmH2O, maximal expiratory pressure=10.31(2.80–17.82) cmH2O, maximum voluntary ventilation=17.51(5.20, 29.81) l min−1 and inspiratory capacity=0.35(0.05, 0.65) l. No effect was found for total lung capacity, peak expiratory flow rate, functional residual capacity, residual volume, expiratory reserve volume or forced expiratory volume in 1 second.
Conclusion:
RMT increases respiratory strength, function and endurance during the period of training. Further research is needed to determine optimum dosages and duration of effect. This article is based in part on a Cochrane review published in the Cochrane Database of Systematic Reviews (CDSR) 2013, DOI:10.1002/14651858.CD008507.pub2. Cochrane reviews are regularly updated as new evidence emerges and in response to feedback, and the CDSR should be consulted for the most recent version of the review.
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Appendix
Appendix
1. exp spinal cord injuries/
2. exp spinal cord ischemia/
3. exp central cord syndrome/
4. (myelopathy adj3 (traumatic or post-traumatic)).ab,ti.
5. ((spine or spinal) adj3 (fracture$ or wound$ or trauma$ or injur$ or damag$)).ab,ti.
6. (spinal cord adj3 (contusion or laceration or transaction or trauma or ischemia)).ab,ti.
7. central cord injury syndrome.ab,ti.
8. central spinal cord syndrome.ab,ti.
9. exp Cervical Vertebrae/in (Injuries)
10. exp spinal cord/
11. SCI.ab,ti.
12. exp paraplegia/
13. exp quadriplegia/
14. (paraplegia* or quadriplegia* or tetraplegia*).ab,ti.
15. or/1–14
16. exp breathing exercises/
17. exp respiratory muscles/
18. exp exercise therapy/
19. (train* or exercis* or endurance or strength* or resistive).ab,ti.
20. 18 or 19
21. 17 and 20
22. normocapnic hyperpnoea training.ab,ti.
23. ((inspiratory or respiratory or breath*) adj5 (endurance or train* or exercis* or resist* or strength*)).ab,ti.
24. RMT.ab,ti.
25. 16 or 21 or 22 or 23 or 24
26. 15 and 25
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Tamplin, J., Berlowitz, D. A systematic review and meta-analysis of the effects of respiratory muscle training on pulmonary function in tetraplegia. Spinal Cord 52, 175–180 (2014). https://doi.org/10.1038/sc.2013.162
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DOI: https://doi.org/10.1038/sc.2013.162
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