Respiratory training improved ventilatory function and respiratory muscle strength in patients with multiple sclerosis and lateral amyotrophic sclerosis: systematic review and meta-analysis

Physiotherapy ◽  
2016 ◽  
Vol 102 (3) ◽  
pp. 221-228 ◽  
Author(s):  
Gustavo D. Ferreira ◽  
Ana Cecília C. Costa ◽  
Rodrigo D.M. Plentz ◽  
Christian C. Coronel ◽  
Graciele Sbruzzi
2016 ◽  
Vol 67 (1) ◽  
Author(s):  
A. Chetta ◽  
M. Aiello ◽  
P. Tzani ◽  
D. Olivieri

Assessing and monitoring respiratory muscle function is crucial in patients with Amyotrophic Lateral Sclerosis, since impaired function can lead to either ventilatory failure or respiratory tract infection. Spirometry, diffusing capacity of the lung, breathing pattern, sleep study, blood gas analysis and respiratory muscle strength tests, as well as cough peak flow and cough expiratory volume measurements can provide relevant information on ventilatory function and cough efficacy. With regard to respiratory muscle strength testing, the rational approach consists in starting with volitional and non-invasive tests and later using invasive and non-volitional tests. This review focuses on both ventilatory and respiratory muscle strength testing, in order to undertake a timely treatment of respiratory failure and/or impaired cough efficacy. So far, the current literature has not highlighted any gold standard which stipulates when to commence ventilation and cough support in patients with Amyotrophic Lateral Sclerosis. A composite set of clinical and functional parameters is required for treatment scheduling to monitor lung involvement and follow-up in these patients.


2017 ◽  
Vol 63 (2) ◽  
pp. 76-83 ◽  
Author(s):  
Ana Irene Carlos de Medeiros ◽  
Helen Kerlen Bastos Fuzari ◽  
Catarina Rattesa ◽  
Daniella Cunha Brandão ◽  
Patrícia Érika de Melo Marinho

2020 ◽  
Vol 9 (1) ◽  
pp. 231
Author(s):  
Rocio Martín-Valero ◽  
Ana Maria Jimenez-Cebrian ◽  
Jose A Moral-Munoz ◽  
Maria de-la-Casa-Almeida ◽  
Manuel Rodriguez-Huguet ◽  
...  

Background: Respiratory muscle dysfunction is an important health problem with high morbidity and mortality and associated costs in patients with bronchiectasis (BC). The aim of this study was to analyse the effects of therapeutic respiratory muscle training (RMT) interventions on improving sputum clearance, ventilator function, muscle strength and functional capacity in BC. Methods: Systematic review and meta-analysis were conducted following PRISMA guidelines. Two independent investigators searched using several electronic databases. The methodological quality of nine studies was assessed using the PEDro scale. Study selection/eligibility criteria: The following were included: randomised controlled trials, randomised crossover trials and pilot studies of patients with BC that used the intervention as RMT (inspiratory/expiratory) and evaluations of respiratory muscle strength (maximal expiratory pressure/maximal inspiratory pressure). This systematic review was registered in PROSPERO (CRD42017075101). Nine studies were included, five of which obtained an A recommendation grade, three with B, and one with C. Study quality was poor to good (mean PEDro Score of 6.375 out of 10). Studies had small sample sizes (8–98). Results show improvements on PImax in favour of therapeutic respiratory muscle training intervention (MD = 6.08; 95% CI = 1.38, 10.77; p < 0.01; I2 = 92%). However, high heterogeneity was identified on meta-analysis.


2012 ◽  
Vol 8 (2) ◽  
pp. 124-130 ◽  
Author(s):  
Ross D. Pollock ◽  
Ged F. Rafferty ◽  
John Moxham ◽  
Lalit Kalra

2021 ◽  
Vol 45 (4) ◽  
pp. 264-273
Author(s):  
Fiona Verdine Dsouza ◽  
Sampath Kumar Amaravadi ◽  
Stephen Rajan Samuel ◽  
Harish Raghavan ◽  
Nagaraja Ravishankar

To determine the effect of inspiratory muscle training (IMT) on pulmonary function, respiratory muscle strength (RMS), and functional capacity in patients undergoing cardiac surgery. The PubMed, PEDro, CINAHL, Web of Science, CENTRAL, and EMBASE databases were searched from inception to June 2020. Randomized controlled trials (RCTs) that evaluated patients who underwent cardiac surgery were included in this review. Meta-analysis performed using a random-effects model showed that the mean difference in forced vital capacity, forced expiratory volume in 1 second, 6-minute walk distance, and RMS was 3.47% (95% confidence interval [CI], 0.57 to 6.36), 5.80% (95% CI, 2.03 to 9.56), 78.05 m (95% CI, 60.92 to 95.18), and 4.8 cmH2O (95% CI, -4.00 to 13.4), respectively. There is strong evidence that IMT improves inspiratory muscle strength, pulmonary function, and functional capacity, and reduces the length of hospital stay in patients undergoing cardiac surgery.


Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Ross Pollock ◽  
Ged Rafferty ◽  
John Moxham ◽  
Lalit Kalra

Background: Increased frequency of chest infections in acute stroke patients may be the result of respiratory muscle weakness contributing to a weak cough and poor airway clearance. We undertook a systematic review of studies comparing respiratory muscle strength in acute stroke patients with age-matched controls. Method: A systematic review of literature was performed using the electronic databases Medline, EMBASE, ISI web of knowledge and the Scopus. The key words searched were stroke or cerebrovascular accident in combination with cough, inspiratory, expiratory or respiratory and strength or weakness. Studies were included if they compared stroke patients with age matched controls and measured maximum inspiratory or expiratory mouth pressure (PImax and PEmax) for inspiratory and expiratory muscle strength respectively. Results: The initial search identified 136 articles, 14 of which remained after screening for pre-defined inclusion criteria and removal of duplicates. Eleven were excluded after reviewing abstracts (5 did not assess muscle strength, 5 did not include healthy control group, 1 absolute values could not be obtained). A further study was identified from the reference lists of screened articles. The 4 studies that met inclusion criteria included 121 subjects. Mean PImax ranged from 75-99 cmH 2 O in controls and 37-74 cmH 2 O in stroke patients. (mean difference 41 cmH 2 O, 95% CI 54 to 29 cm H 2 O; P<0.0001). Mean PEmax ranged from 52-89 cm H 2 O in stroke patients and was also reduced compared with age matched controls (mean difference 55 cmH 2 O, 95% CI 61 to 48 cmH 2 O; P<0.0001). ( Fig 1 ). Conclusion: Individual studies and pooled data suggest that respiratory muscle strength is impaired in acute stroke patients. However, these studies are limited by small samples and design heterogeneity. Larger studies are needed to assess the relationship of respiratory muscle weakness with chest infections and clinical outcomes in the acute phase.


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