Effects of Respiratory Muscle Training on Pulmonary Function in Individuals with Spinal Cord Injury: An Updated Meta-analysis.

Xiaojun Wang,Na Zhang,Yubin Xu

doi:10.1155/2020/7530498

Abstract

Objective To investigate the pulmonary function responses to respiratory muscle training (RMT) in individuals with tetraplegia and provide a systematic review of the included studies. Methods Computerized retrieval of randomized controlled trials (RCT) in PubMed, Embase, and the Cochrane Library on the improvement of respiratory function in patients with spinal cord injury by RMT was conducted until May 2019. Two researchers independently screened the literature, extracted the data, and evaluated the risk of bias in the included studies. Articles were scored for their methodological quality using the Cochrane Collaboration risk of bias assessment tool. Results Sixteen studies were identified. A significant benefit of RMT was revealed for five outcomes: force vital capacity (FVC, WMD: -0.43, 95% CI -0.84 to -0.03, P = 0.037), vital capacity (VC, WMD: -0.40, 95% CI -0.69 to -0.12, P = 0.037), vital capacity (VC, WMD: -0.40, 95% CI -0.69 to -0.12, P = 0.037), vital capacity (VC, WMD: -0.40, 95% CI -0.69 to -0.12, P = 0.037), vital capacity (VC, WMD: -0.40, 95% CI -0.69 to -0.12, P = 0.037), vital capacity (VC, WMD: -0.40, 95% CI -0.69 to -0.12, Conclusion Our findings demonstrate that RMT can effectively improve spinal cord injury pulmonary function of the patient, which is marked by increasing respiratory strength, function, and endurance. Limited by the quantity and quality of the included studies, the above conclusion needs to be verified by more high-quality studies.

Highlights

The injury of the cervical and upper thoracic spinal cord impairs the respiratory function involved in inspiratory and expiratory muscles [1], diaphragm, intercostal muscles, accessory respiratory muscles, and abdominal muscles, which are main sources of morbidity and mortality of SCI due to the pulmonary complications, such as atelectasis or pneumonia, both in the short and long terms after the injury [2, 3]
The inclusion criteria were as follows: (1) randomized controlled trials (RCTs); (2) adult patients (18 years or older) who have been diagnosed with spinal cord injury; (3) compared respiratory muscle training intervention with placebo, usual, or routine care; and (4) outcome measures including lung function (lung function for force vital capacity (FVC), vital capacity (VC), maximal voluntary ventilation (MVV), and forced expiratory volume in 1 second (FEV1)) or respiratory muscle strength (maximum static inspiratory pressure (MIP), maximum static expiratory pressure (MEP))
This systematic review and meta-analysis focused on the effect of Respiratory muscle training (RMT) on the full range of pulmonary function measured in tetraplegia

Summary

Introduction

The injury of the cervical and upper thoracic spinal cord impairs the respiratory function involved in inspiratory and expiratory muscles [1], diaphragm, intercostal muscles, accessory respiratory muscles, and abdominal muscles, which are main sources of morbidity and mortality of SCI due to the pulmonary complications, such as atelectasis or pneumonia, both in the short and long terms after the injury [2, 3]. Most individuals with tetraplegia have decreased capacity to get air into the lungs and reduced ability to cough to remove secretions. In the long term, reduced lung volumes and decreased chest wall compliance become the major manifestation [4]. Recent studies have focused on methods for improving respiratory function. Respiratory muscle training (RMT) is a therapeutic technique that involves the enhancement of respiratory muscle and becomes a clinical focus

Methods

Results

Conclusion