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Inspiratory muscle training improves respiratory muscle strength, functional capacity and quality of life in patients with chronic kidney disease: a systematic review.
J Physiother 2017; 63(2):76-83JP

Abstract

QUESTION

Does inspiratory muscle training improve respiratory muscle strength, functional capacity, lung function and quality of life of patients with chronic kidney disease? Does inspiratory muscle training improve these outcomes more than breathing exercises?

DESIGN

Systematic review and meta-analysis of randomised trials.

PARTICIPANTS

People with chronic kidney disease undergoing dialysis treatment.

OUTCOME MEASURES

The primary outcomes were: maximal inspiratory pressure, maximal expiratory pressure, and distance covered on the 6-minute walk test. The secondary outcomes were: forced vital capacity, forced expiratory volume in the first second (FEV1), and quality of life.

RESULTS

The search identified four eligible studies. The sample consisted of 110 participants. The inspiratory muscle training used a Threshold® or PowerBreathe® device, with a load ranging from 30 to 60% of the maximal inspiratory pressure and lasting from 6 weeks to 6 months. The studies showed moderate to high risk of bias, and the quality of the evidence was rated low or very low, due to the studies' methodological limitations. The meta-analysis showed that inspiratory muscle training significantly improved maximal inspiratory pressure (MD 23 cmH2O, 95% CI 16 to 29) and the 6-minute walk test distance (MD 80m, 95% CI 41 to 119) when compared with controls. Significant benefits in lung function and quality of life were also identified. When compared to breathing exercises, significant benefits were identified in maximal expiratory pressure (MD 6 cmH2O, 95% CI 2 to 10) and FEV1 (MD 0.24litres 95% CI 0.14 to 0.34), but not maximal inspiratory pressure or forced vital capacity.

CONCLUSION

In patients with chronic renal failure on dialysis, inspiratory muscle training with a fixed load significantly improves respiratory muscle strength, functional capacity, lung function and quality of life. The evidence for these benefits may be influenced by some sources of bias.

REGISTRATION

PROSPERO (CRD 42015029986). [de Medeiros AIC, Fuzari HKB, Rattesa C, Brandão DC, de Melo Marinho PÉ (2017) Inspiratory muscle training improves respiratory muscle strength, functional capacity and quality of life in patients with chronic kidney disease: a systematic review. Journal of Physiotherapy 63: 76-83].

Authors+Show Affiliations

Physiotherapy Department, Universidade Federal de Pernambuco, Recife, Brazil.Physiotherapy Department, Universidade Federal de Pernambuco, Recife, Brazil.Physiotherapy Department, Universidade Federal de Pernambuco, Recife, Brazil.Physiotherapy Department, Universidade Federal de Pernambuco, Recife, Brazil.Physiotherapy Department, Universidade Federal de Pernambuco, Recife, Brazil.

Pub Type(s)

Journal Article
Systematic Review

Language

eng

PubMed ID

28433237

Citation

de Medeiros, Ana Irene Carlos, et al. "Inspiratory Muscle Training Improves Respiratory Muscle Strength, Functional Capacity and Quality of Life in Patients With Chronic Kidney Disease: a Systematic Review." Journal of Physiotherapy, vol. 63, no. 2, 2017, pp. 76-83.
de Medeiros AIC, Fuzari HKB, Rattesa C, et al. Inspiratory muscle training improves respiratory muscle strength, functional capacity and quality of life in patients with chronic kidney disease: a systematic review. J Physiother. 2017;63(2):76-83.
de Medeiros, A. I. C., Fuzari, H. K. B., Rattesa, C., Brandão, D. C., & de Melo Marinho, P. É. (2017). Inspiratory muscle training improves respiratory muscle strength, functional capacity and quality of life in patients with chronic kidney disease: a systematic review. Journal of Physiotherapy, 63(2), pp. 76-83. doi:10.1016/j.jphys.2017.02.016.
de Medeiros AIC, et al. Inspiratory Muscle Training Improves Respiratory Muscle Strength, Functional Capacity and Quality of Life in Patients With Chronic Kidney Disease: a Systematic Review. J Physiother. 2017;63(2):76-83. PubMed PMID: 28433237.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Inspiratory muscle training improves respiratory muscle strength, functional capacity and quality of life in patients with chronic kidney disease: a systematic review. AU - de Medeiros,Ana Irene Carlos, AU - Fuzari,Helen Kerlen Bastos, AU - Rattesa,Catarina, AU - Brandão,Daniella Cunha, AU - de Melo Marinho,Patrícia Érika, Y1 - 2017/03/14/ PY - 2016/03/11/received PY - 2016/07/07/revised PY - 2017/02/22/accepted PY - 2017/4/24/entrez PY - 2017/4/24/pubmed PY - 2019/8/15/medline KW - Breathing exercises KW - Chronic renal insufficiency KW - Haemodialysis KW - Physical therapy KW - Respiratory muscle training SP - 76 EP - 83 JF - Journal of physiotherapy JO - J Physiother VL - 63 IS - 2 N2 - QUESTION: Does inspiratory muscle training improve respiratory muscle strength, functional capacity, lung function and quality of life of patients with chronic kidney disease? Does inspiratory muscle training improve these outcomes more than breathing exercises? DESIGN: Systematic review and meta-analysis of randomised trials. PARTICIPANTS: People with chronic kidney disease undergoing dialysis treatment. OUTCOME MEASURES: The primary outcomes were: maximal inspiratory pressure, maximal expiratory pressure, and distance covered on the 6-minute walk test. The secondary outcomes were: forced vital capacity, forced expiratory volume in the first second (FEV1), and quality of life. RESULTS: The search identified four eligible studies. The sample consisted of 110 participants. The inspiratory muscle training used a Threshold® or PowerBreathe® device, with a load ranging from 30 to 60% of the maximal inspiratory pressure and lasting from 6 weeks to 6 months. The studies showed moderate to high risk of bias, and the quality of the evidence was rated low or very low, due to the studies' methodological limitations. The meta-analysis showed that inspiratory muscle training significantly improved maximal inspiratory pressure (MD 23 cmH2O, 95% CI 16 to 29) and the 6-minute walk test distance (MD 80m, 95% CI 41 to 119) when compared with controls. Significant benefits in lung function and quality of life were also identified. When compared to breathing exercises, significant benefits were identified in maximal expiratory pressure (MD 6 cmH2O, 95% CI 2 to 10) and FEV1 (MD 0.24litres 95% CI 0.14 to 0.34), but not maximal inspiratory pressure or forced vital capacity. CONCLUSION: In patients with chronic renal failure on dialysis, inspiratory muscle training with a fixed load significantly improves respiratory muscle strength, functional capacity, lung function and quality of life. The evidence for these benefits may be influenced by some sources of bias. REGISTRATION: PROSPERO (CRD 42015029986). [de Medeiros AIC, Fuzari HKB, Rattesa C, Brandão DC, de Melo Marinho PÉ (2017) Inspiratory muscle training improves respiratory muscle strength, functional capacity and quality of life in patients with chronic kidney disease: a systematic review. Journal of Physiotherapy 63: 76-83]. SN - 1836-9561 UR - https://www.unboundmedicine.com/medline/citation/28433237/Inspiratory_muscle_training_improves_respiratory_muscle_strength_functional_capacity_and_quality_of_life_in_patients_with_chronic_kidney_disease:_a_systematic_review_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1836-9553(17)30030-9 DB - PRIME DP - Unbound Medicine ER -